Care and Nutrition
Outline:
• caring practice: definition, concept, and importance of caring practices;
• situation of caring practice in Bangladesh,
• caring practice of different population groups and physiological outcomes.
• Constrains to caring practices,
• measure to improve caring practices
Care
• Care is the provision in the household and the community of time,
attention and support to meet the physical, mental, and social needs of
the growing child and other household members (ICN 1992,
International Council of Nurses).
• Resources for care are defined as caregiver education, knowledge and
beliefs, caregiver physical health and nutritional status, caregiver
mental health and self-confidence, autonomy and control of resources,
workload and time availability, and family and community social
support.
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• This provision of time, attention, and support is manifest in certain types of behaviors
exhibited by caregivers (typically women):
1. Care for pregnant and lactating women, such as providing appropriate rest time or increased
food intake;
2. Breast-feeding and feeding of very young children;
3. Psychosocial stimulation of children and support for their development;
4. Food preparation and food storage behaviors;
5. Hygiene behaviors; and
6. Care for children during illness, including diagnosis of illness and health-seeking behaviors
(Engle 1992).
Provision of these behaviors depends on the availability of the resources for care at the
household level: education and knowledge, health of the caregiver, time, autonomy, and social
support.
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CONCEPTUAL MODEL OF CHILD
DEVELOPMENT
The Figure presents the original conceptual model of
child development, which identifies the role of care
(UNICEF 1990).
• Care, household food security, and a healthy
environment are the three underlying factors
determining child nutrient intake and health, child
survival, growth, and development.
• "Care" refers to behaviors performed by
caregivers that affect nutrient intake, health, and
the cognitive and psychosocial development of
the child.
• This model of care can be expanded in two areas.
First, it needs to emphasize that effective care
provision requires time and other resources,
• And second, it should underscore the role of the
child in determining care provision.
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THE EXTENDED UNICEF MODEL OF
CARE
• The extended UNICEF model of child care is
a useful framework for assessing the capacity
and ability of the caregiver to provide care
behaviors.
• However, a model of child care should
include not only an assessment of the
caregiver's behavior, but also the behavior of
the child, and the characteristics of the
environmental context.
All three of these factors play a significant role
in the eventual nutritional status of the child
(Black et al. 1994).
• The extended UNICEF model can be adapted
to include the relationship between child and
caregiver(s). This figure expands the central
part of the UNICEF model relating care,
nutrient intake, health, and child growth and
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• In order for care behaviors to be exhibited, the caregiver needs sufficient education, time,
and support. The provision of these resources can be considered care for the caregiver.
Six major categories of resources for care can be identified from the literature. These
include:
1. Education, knowledge, and beliefs;
2. health and nutritional status of the caregiver;
3. mental health, lack of stress, and self-confidence of the caregiver;
4. autonomy, control of resources, and intra household allocation;
5. workload and time constraints; and
6. social support from family members and community.
These aspects are the human and organizational resources identified in the UNICEF model
(Jonsson 1995)
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• Education, knowledge, and beliefs represent the capacity of the
caregiver to provide appropriate care. The physical and mental health
(self-confidence, and lack of stress and depression) of the caregiver
represent individual-level factors that facilitate the translation of
capacity to behavior. Finally, autonomy, workload, and social support
are facilitating conditions in the family and community. Some of these
resource categories have been investigated extensively, whereas others
have been investigated primarily in developed countries, or await
further investigation.
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THE TRANSACTIONAL MODEL OF
CARE
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