Assessment the Relationship Between Parents' Literacy Level with Children Growth in Mashhad: An Analytic Descriptive Study

Authors

1 Students Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Department of Pediatrics Endocrinology,Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Midwifery MSc; instructor, Midwifery department, Sabzevar University of Medical Sciences, Sabzevar, Iran.

4 Department of Pediatrics, North Khorasan University of Medical Sciences, Bojnurd, Iran.

5 Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Present children are the investments of community in the future. Preparing children health which leads to the stability of community health, provided to accurate implementation of educational and health programs in the community and especially in mothers. So it is necessary to determine the relationship between parents' literacy  with growth rate in children.
Materials and Methods: This cross-sectional descriptive-analytic study was conducted on 300 mothers referring to 10 selected Mashhad health-care centers for monitoring their 6-24-month year old infants. They completed questionnaire. Participants were selected by cluster and simple random sampling. Data were analyzed by descriptive- analytic statistics and using SPSS 16.
Results: Presentfindings showed a significant relationship between literacy  level of parents with child growth status, breast feeding rate, junk food consumption, referring to health care center for growth monitoring, the age of initiating supplementary nutrition, the use of oil and butter in baby food and rate of attending in educational classes. So that higher literacy  level of parents was associated with using more formula, less junk food, oil and butter in baby's food and more referring times to health care center for monitoring child growth, desirable growth, and  also initiating supplementary food more at the assigned time (p<0.05).
Conclusion: Parents' literacy  level influence on children growth status. However, with increasing parents' literacy  level, using formula for infants has been increased, but breast milk feeding is also high in this group.

Keywords


Introduction

Present children are the investments of community in the future. The present physical and psychotic health prepares them for managing future society. Accurate nutrition in the 2 first years of life will be the most important factor in preparing health, growth and development of children in the future. In the third world countries, mortality of children under 5 years includes significant rate of total mortality. The most important factor of mortality in these groups include: respiratory infections, diarrhea diseases and malnutrition (1,2).

Children who had improper nutrition, would be more ill and their disease would be longer. Growth rate in primary years of life and lack of necessary knowledge about proper nutrition of child are influencing factors in malnutrition incidence in children under 5 year. Children who had improper and insufficient diet in the first years of life, had lower IQ and were unable to do their homework in school (1,2).

Assessments showed that Iranian children have appropriate birth weight, but they lose their weight slowly between 4-6 months of life. This is probably due to child's need to supplementary food, inappropriate pattern of supplementary nutrition and inaccurate habits of nutrition. Weight loss continues till 18 months of life due to insufficient health care and lack of necessary knowledge, after that although increasing weight parallels to reference percentile, growth curve always passes in lower level than middle curve (3).

In this regard, physicians and health care givers and more importantly mothers should have deep and sufficient understanding and knowledge about different stages of children growth and development and their influencing factors. So this study aimed to assess the relationship between parents' literacy level with growth status of children.

 

Materials and Methods

This cross-sectional descriptive-analytic study was conducted on mothers referring to Mashhad health-care centers for monitoring their 6-24-month year old infants. Sample size calculated 300 mothers. Participants were selected by cluster and simple random among 10 selected health-care centers. 30 mothers entered the study randomly in each health care center. The researchers referred to the research settings and after coordination with the center’s manager, introduced the research for the participants and obtained informed consents. Then they obtained required data by completing research tools. Research tool was a reliable and valid questionnaire which was confirmed by content validity and internal consistency Cranbach's alpha (α=0.86) reliability. The questionnaire consists of 2 parts: personal characteristics and demographic information, and questions relating to knowledge assessment about influencing factors on child growth. After gathering data, they were coded and analyzed by descriptive and analytic (Analysis of variance (ANOVA), t-test, chi-square) statistics and confidence interval 95% by SPSS-16.P

 

Results

300 mothers who were qualified the inclusion criteria were assessed. 49% of mothers had boys and 51% had girls (Table1). Shows frequency of participants' demographic variables.

Mothers who had academic educations, referred more times to health care center to receive prenatal care, had more desirable weight gain in pregnancy and attended more in educational classes than the others (P=0.000).

Formula consumption was more in mothers with academic education and breast milk feeding was more in mothers with junior high school (P=0.000) (Table 2).

Findings showed that rate of junk food
consumption was more in mothers with primary education than the others (P=0.000).

 

 

Table 1: Frequency of Demographic Variables in participating mothers.

 

Variables

Frequency

Percent

Child growth status

Desirable

Growth retardation

Horizontal

 

260

31

9

 

86.7

10.3

3

 

 

 

Mother's literacy

Primary

Junior high school

High school

Academic

 

46

49

150

55

 

15.3

16.3

50

18.3

 

 

 

Father's literacy

Primary

Junior high school

High school

Academic

 

40

62

146

52

 

13.3

20.7

48.7

17.3

Family income

Low

Moderate

good

Very good

 

41

248

11

 

 

13.7

82.7

3.7

4

Baby's birth ranking

first

second

third

 3 <

 

157

121

19

3

 

52.3

40.3

6.3

1

 

 

 

 

Table 2: Frequency of children's nutrition types according to mothers' literacy  level.

Pattern of nutrition

                           Literacy 

Breast Milk (BM)

Formula

BM + Caw milk

BM + Formula

Total

Primary

33 (71.7)

4 (8.7)

4 (8.7)

4 (10.9)

46 (100)

Junior high school

43 (87.8)

0 (0)

6 (12.2)

0 (0)

49 (100)

Diploma

115 (76.7)

2 (1.3)

19 (12.7)

14 (9.3)

150 (100)

Academic

41 (74.5)

10 (18.2)

4 (7.3)

0 (0)

55 (100)

Total

232 (77.3)

16 (5.3)

33 (11)

19 (6.3)

300 (100)

 

 

 

 

 

 

 

Using iron and multi-vitamin drops for children was more in diploma mothers than the others, and less in mothers with primary education than the others (P=0.000).Rate of drug application during pregnancy was more in mothers with primary education than the others (P<0.05), and also in mothers whom their spouses had primary education  (P=0.002). Adding oil and butter to children food was more in mothers with primary education than the others (P<0.05), and also in mothers whom their spouses had academic education (P=0.000). Findings showed that rate of referring to health care centers for monitoring children growth was more in mothers whom their spouses had primary education, than the others (P<0.001) (Table 3).

 

Low birth weight (LBW)1 rate was more in children whom their fathers had primary education (P=0.004).

 

Table 3: Frequency of mothers referring to health care centers for child growth monitoring according to mothers' literacy  level.

Referring

Literacy 

Yes

No

Sometimes

Total

Primary

35 (76.1)

0

 (0.0)

11

(23.9)

46 (100)

Junior high school

37 (75.5)

5 (10.2)

7

(14.3)

49 (100)

Diploma

138 (92.0)

2

 (1.3)

10

(6.7)

150 (100)

Academic

51 (92.7)

4

(7.3)

0

(0.0)

55 (100)

Total

261 (87)

11 (3.7)

28

(9.3)

300 (100)

 

Discussion
  In the present study, 65% of mothers had knowledge about suitable age of initiating supplementary nutrition. Since brain growth after fetal period occurs most in the first year of life, the importance of appropriate and accurate nutrition in children's growth, mental and physical health, learning and their efficacy is undeniable. So it is necessary to consider more importance to nutrition and nutrient types which are available for children in order to preparing children security and health (1,2,4).

Our findings showed that 80.7 % of mothers had been used iron and multi-vitamin drops for their children, which is nearly consistent with Nik Niaz findings (5). Previous studies have shown that lack of supplementary drops esp. iron leads to reduction of IQ and learning ability, physical growth disorder and finally decreasing mental and physical abilities, in addition to iron deficiency anemia (1,2).

Imani's findings showed no significant relationship between age of initiating supplementary nutrition with child ranking and mother literacy (6), which is inconsistent with the present study's findings.

The present study's findings showed a significant relationship between parents' literacy  level and place of residence and births' interval with children growth status. This finding is in accordance with Halakouyi's findings (7).

The present study's findings are consistent with Soheili azad's findings (8) about births' interval and duration of breast milk feeding, and also in accordance with Alavi Naieni (9), Karimi, Teimouri, Kabiri findings (10-12).

Our study findings were consistence with Keighobadi findings (13) in relation to a significant relationship between mother's literacy  levels with education of nutrition to mothers.

Our findings showed no significant relationship between birth weight, age of initiating supplementary nutrition and child gender with children growth status, which is inconsistent with Alavi Naeini's findings about child gender and family income (9) and Keighobadi's findings about birth weight (13), and Teimouri's findings about adding oil to child's food (11), and Kabiri's study about child gender and economic status (12).

The present study showed that 34.3% of mothers attended in educational programs of health care centers regularly, which is inconsistent with Barzegar's findings who reported just 2.3% of families attended in these programs (14). These differences may be due to the presentation of new and various information by a modern educational method in health care centers of Mashhad, and more interest of mothers to these programs.

 

Conclusion

Parents' literacy level influence on children growth status. However, with increasing parents' literacy level, using formula for infants has been increased, but breast milk feeding is also high in this group. In addition, since educational classes in pregnancy, weight gain in this period, supplement drugs for children may be influencing factors on child growth, desirable growth of children in parents with academic education can be justified.

 

Acknowledgment

The researchers appreciate the cooperation of technical Vice Chancellery of province health care center, dear Dr. Gholam Hasan Khodayi, and all staff of 10 Mashhad health care centers (Shahid Ghodsi, Shahid Motahhari, Khaje rabi center, Danesh amouz, Abo Bargh, Shahid Saffari, Alteimour, Chahar dah Ma'soum, Emam Hasan Mojtaba, Shahid Hashrmi Nejad) and dear participating mothers.



1LBW:

1. Robert M Kliegman. Nelson Textbook of Pediatrics. 18th Edition & Atlas of Pediatric Physical Diagnosis. Philadelphia:W.B. Saunders Company;2007.

2. Vakili R. Child Development. Mashhad:Mashhad University of Medical Sciences; 2006.

3. Ministry of Health and Medical Education in collaboration with United Nations Children's Fund (UNICEF). Children feeding systems in the province.Tehran: Ministry of Health and Medical Education; 2000.

4. Khoshnevisasl P, Sadeghzadeh M, Koosha A, Mazloumzadeh S, Dariabari N.Maternal Knowledge about Nutritional Status of 6 to 12 Month old Infants in the Community Oriented Medical Education of Zanjan University of Medical Sciences. ZUMS Journal 2000; 5 (2) :45-52.

5. Nikniaz A, Shaghaghi A, Farah Bakhsh M, Alizadeh M. Care for children under 6 years in the North West of Tabriz. Medical Journal of Tabriz University of Medical Science & Health Service 2004;59(3): 120-128.

6. Imani M, Mohammadi M. Complementary feeding patterns and its influencing factors in urban and rural areas of Zabol city. ISMJ 1998; 4 (2) :150-156.

7. Holakouie Naieni K, Fotouhi A, Borhani M, Pooya B. Risk Factors for Malnutrition in 6- to 30-Months Old Children Seen at Health Centers in Hormozgan Province. irje 2006; 1 (3 and 4) :27-32.

8. Soheili Azad AA, Zamasnian M. Prevalence of malnutrition and factors affecting in children 36-0 month in Nahavand city. Pejouhesh 2000; 28 (1) :53-58.

9. Alavi Naeini M. Prevalence of malnutrition and factors affecting  in children under five in health house covers the city of Birjand. TUMJ  2000;59(1): 99-103.

10. Karimi M, Orduei M, Jamshidi K. Maternal knowledge of infant feeding in the first 2 years after birth in Azadshahr are in Yazd City. JSSU 2002; 9 (4) :16-22.

11. Teimuri P, Rashadmanesh N. The effect of nutrition knowledge of mothers of children 2-0 years of growth in women attending urban health centers in Kurdestan. SJKU 1999;2(7): 20-25.

12. Kabiri M, Parsinia M, Godarzi M, Babaei GR. Study of  relationship between physical growth of children 0 to 2 years old were referred to health centers in the city of Karaj with economic, social, cultural in parents with using a logistic regression model.  Iran J Pediatr 2004;13(1): 47-52.

13. Keighobadi K, Siasi F, Malekafzali H, Jarolahi N, Sadrzadeh H. The effect of maternal education on nutritional status of marginalized families in Kerman. Hakim 2000;5(1): 49-55.

14. Barzegar M, Amini A, Hanaei J, Yaghubi AR, Sadr K, Mohammadzadeh H. Knowledge, attitude and practice of mothers living in North West Iran about Care children under 6 years. MJTUOMS 2000;59(3): 23-28.