Child welfare clinic attendance during the COVID-19 restriction era and the nutritional status of children

Background: The covid-19 pandemic undoubtedly affected child welfare clinic services. However, there is limited data on how attendance to child welfare clinics during the pandemic associates with the nutritional status of children. This cross-sectional study, therefore, sought to assess child welfare clinic attendance within the covid-19 restriction era and how it associates with the nutritional status of children. Methods: The study was conducted in four health facilities– one hospital, one health centre and two outreach centres. A total of 300 mother-child pairs participated in the study. Socio-demographic, dietary (multiple 24hr recalls), anthropometric (weight, height and mid-upper arm circumference) and biochemical (haemoglobin) characteristics were assessed for all children. Also, information on child welfare clinic attendance, vaccinations and supplementations were obtained from the maternal and child health record book. Results: The median age of the children was 15(14) months. The mean weight-for-age and height-for-age z scores were -0.630(1.66) and -0.770(1.99). Among study participants, the mean number of attendances to child welfare clinics from the index case through the restriction period and after the easing of restrictions were 6.0(3.0) vrs 7.0(4.0), p<0.001. Missing of child welfare clinic was associated with lower intakes for most nutrients below recommended levels – total calories (did not miss 1024.0(458.2) kcal vrs missed 869.4(471.3) kcal, p= 0.004) and lower anthropometric measurements but these were not significantly different­– height-for-age (did not miss -0.85(2.0) vrs missed -1.2(2.3). Anaemia prevalence was high among children (66.3%). Child welfare clinic attendance and caloric intake were the most important predictors of stunting. Conclusions: Findings from this study revealed that the covid-19 restriction period was associated with a decline in child welfare clinic attendance, vitamin A supplementation and vaccination. The study showed that children who missed CWC during the covid-19 restriction era were more likely to have nutrient consumption below recommended levels. High prevalence of stunting and anaemia exist among children. Frequent nutrition education, nutrition surveillances and provision of micronutrient powders can help mitigate malnutrition among children.