Infant and child health status ahead of implementation of an integrated intervention to improve nutrition and survival: a cross-sectional baseline assessment

BACKGROUND: Burundi has one of the poorest child health outcomes in the world. With an acute malnutrition rate of 5% and a chronic malnutrition rate of 56%, under five death is 78 per 1000 live births and 47 children for every 1000 children will live until their first birthday. In response to this grim statistics, Village Health Works, a Burundian-American organisation has invested in an integrated clinical and community intervention model to improve child health outcomes. The aim of this study is to measure and report on child health indicator ahead of implementing this model. METHODS: A cross sectional design was employed, adopting the Demographic Health Survey methodology. We reached out to a sample of 952 households comprising of 2675 birth, in our study area. Mortality data was analysed with R package for mortality computation and other outcomes using SPSS. Principal component analysis was used to classify households into wealth quintiles. Logistic regression was used to assess strength of associations and significance of association was considered at 95% confidence level. RESULTS: The incidence of low birth weight (LBW) was 6.4% at the study area compared to 10% at the national level with the strongest predictor being malnourished women (OR 1.4 95%CI 1.2–7.2 p = 0.043). Fever incidence was higher in the study area (50.5%) in comparison to 39.5% nationally. Consumption of minimum acceptable diet was showed a significant protection against fever (OR 0.64 95%CI 0.41–0.94 p = 0.042). Global Acute Malnutrition rate was 7.6% and this significantly reduced with increasing age of child. Under-five mortality rate was 32.1 per 1000 live births and infant mortality was 25.7 per 1000 in the catchment with most deaths happening within the first 28 days of life (57.3%). CONCLUSION: Improving child health status is complex, therefore, investing into an integrated intervention for both mother and child could yield best results. Given that most under-five deaths occurred in the neonatal period, implementing integrated clinical and community newborn care interventions are critical.