title: A longitudinal assessment of the diet and growth of malnourished children participating in nutrition rehabilitation centres in Accra, Ghana.
abstract: OBJECTIVE
  To examine the adoption of feeding recommendations among caregivers of children recuperating from malnutrition and assess the determinants of growth of children attending a nutrition rehabilitation centre (NRC) in Accra, Ghana.
  
  
  METHODS
  Longitudinal study in which attendance and maternal programme participation were recorded daily and children's anthropometry and dietary intake were measured at four time points (admission, interim, exit, post-exit) at the NRC and participants' homes.
  
  
  METHODS
  NRCs at four polyclinics and participants' homes in Accra, Ghana.
  
  
  METHODS
  One hundred and eight caregivers and their 116 children referred to an NRC between November 1999 and July 2000.
  
  
  RESULTS
  Most caregivers attended the NRC sporadically (effective length of stay was 1.4+/-0.1 months). Use of NRC-promoted foods in the home after discharge was low due to inaccessibility of the food items, lack of preparation knowledge or money, child preferences and the common practice of purchasing ready-to-eat foods. Although there were significant increases in children's weight-for-age (P=0.048) and weight-for-height (P=0.002) Z-scores between enrollment and discharge, most children discontinued programme participation before adequate recuperation.
  
  
  CONCLUSIONS
  The NRC education did not address the use of street foods for child feeding and was unsuccessful in changing in-home feeding behaviour. The prominence of street foods in children's diets warrants re-evaluation of the NRC's educational approaches to enhance their responsiveness to caregivers' needs and effectiveness for the continued recuperation of malnourished children at home. NRC feeding strategies need improvement to ensure adequate provision of energy and nutrients to support catch-up growth in children.
authors.affiliation: Department of Food Science and Human Nutrition, 1127 HNSB, Iowa State University, Ames, IA 50014, USA.
authors.forename: Esi K
authors.initials: EK
authors.lastname: Colecraft
authors.forename: Grace S
authors.initials: GS
authors.lastname: Marquis
authors.forename: Alfred A
authors.initials: AA
authors.lastname: Bartolucci
authors.forename: LeaVonne
authors.initials: L
authors.lastname: Pulley
authors.forename: W Bruce
authors.initials: WB
authors.lastname: Owusu
authors.forename: H Michael
authors.initials: HM
authors.lastname: Maetz
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000886:Anthropometry; D001942:Breast Feeding; D017028:Caregivers; D002648:Child; D053198:Child Nutrition Sciences / Q000193:education / Q000502:physiology*; D002669:Child Welfare; D002675:Child, Preschool; D003153:Community Health Services / Q000379:methods*; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005869:Ghana; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D044342:Malnutrition / Q000178:diet therapy* / Q000534:rehabilitation; D015596:Nutrition Assessment