The status of nutritional knowledge, attitude and practices associated with complementary feeding in a post-conflict development phase setting: The case of Acholi sub-region of Uganda.

Inappropriate complementary feeding is an important challenge to proper child nutrition in post-conflict rural areas in many sub-Saharan African countries. While in protected areas during conflict situation and soon after during recovery, communities normally receive nutrition education as part of capacity building to improve knowledge, attitude, and practices to enable them manage maternal and child nutrition issues during the post-conflict development phase. It is largely unknown whether capacity in nutrition provided is maintained and adequately applied in the post-conflict development situation. Using Acholi sub-region of Uganda, an area that experienced violent armed conflict for 20 years (mid-80s-early 2000), as a case study, we examined the status of nutritional knowledge, attitude, and practices associated with complementary feeding among caregivers of 6- to 23-month-old children in a post-conflict development phase following return to normalcy nearly 10 years post-conflict emergency situation. The results showed that a high proportion of caregivers had good knowledge (88%) and attitude (90.1%) toward complementary feeding. However, only a half (50%) of them practiced correct nutrition behavior. Education status of the household head and sex of the child significantly predicted caregiver knowledge on complementary feeding (≤0.05). Education status of the household head also predicted caregiver attitude toward complementary feeding (≤0.05). Poverty, food insecurity, and maternal ill health were the major factors that hindered caregivers from practicing good complementary feeding behavior. These results demonstrate that nutrition education on complementary feeding provided to the community during conflict emergency and recovery situation is largely retained in terms of knowledge and attitude but poorly translated into good child feeding practices due to poverty, food insecurity, and maternal ill health. Maternal health, food security, and poverty reduction should be prioritized if adequate complementary feeding is to be achieved among conflict-affected communities in the post-conflict development phase.