Knowledge, Attitude and Practice of Health Care Providers at Primary Health Care Setting Regarding Stunting Among Egyptian Under Five Years

Abstract
Background: Children malnutrition constitutes one of the major public health problems in Egypt. Healthcare personnel lack adequate nutrition knowledge and they also lack the competence and skills to provide basic nutrition advice to their clients.
Aim: To assess the knowledge, attitude and practice (KAP) of health care providers about chronic malnutrition (stunting) in children under-five in primary health care (PHC) centers and to identify the main items in which health care provides are trained including Integrated Management of Childhood Illness (IMCI) supporting the problem of stunting.
Subjects and Methods: This is a cross-sectional descriptive study including all healthcare providers (N=51 doctors and 31 nurses), who were involved in the nutrition care of children under-five at PHC centers in Giza Governorate, at the time of the study. Data were collected using a structured question-naire for KAP of healthcare providers regarding chronic malnutrition (stunting) and training of healthcare providers, and using a checklist to record performance of healthcare providers providing nutrition related services to children under- five.
Results: Overall, the mean percent knowledge score of healthcare providers about 'main health problems', 'main nutritional problems' and 'nutritional assessment methods' in children under five was below 50. Healthcare providers had overall positive attitude towards characteristics and manage-ment of stunting in children under-five. The mean percent score for 'Reported Practice related to breast feeding' was higher in nurses, where as reported practice related to com-plementary feeding was higher in doctors. More than 64.5% of healthcare providers reported correct practice regarding recommendation of micronutrient supplementation to children and mothers. Overall healthcare providers' performance re-garding communication and nutrition related services to children under five was suboptimal, but the nurses performing better than doctors. More than 70% of healthcare providers were trained in IMCI but there was a deficiency in nutritional training.
Conclusion: The healthcare providers had optimal knowl-edge regarding some aspects of stunting. There was no signif-icant difference between doctors' and nurses' KAP in most of the items. Although they had overall positive attitude towards stunting and the majority were trained in IMCI, they showed suboptimal performance during care of children under five at PHC. The results of the study directed us to some of the recommendations as, preservice, on job and continuous prac-tical training of the health care providers on comprehensive management of malnutrition, improving the quality of health care services in PHCs and prioritizing key 1000 days window concepts in nutrition counseling for future trainings.