P3.105: Parental Perception vs. Reality: The Caregiver’s Influence in Ecuador’s Stunting Crisis

Background: Children’s malnutrition remains a critical global health concern, with stunting being the most comprehensive measure of a child’s overall well-being. According to 2022 WHO data, approximately 148.1 million children under five suffer from stunted growth, impacting around 22.3% of this age group globally. In Ecuador, stunting is caused by inadequate feeding practices, food and water insecurity, and socioeconomic disparities. Despite multiple initiatives implemented to reduce stunting, it continues to be a public health problem with a prevalence of 23.2 % in preschoolers under 5 years old, with significantly higher rates among indigenous and low-income populations. Our study aims to investigate caregivers' perceptions about nutrition and its effect on their children’s growth outcomes.

Methods: This is a cross-sectional observational study conducted in January 2024 at a primary health care center in Puerto Lopez, Ecuador. A sample of 133 children, aged 0 to 36 months, participated in the study. Data was collected through anthropometric measurements and a researcher-developed questionnaire. The survey focused on three main questions: 1) How well do caregivers feed their children on a scale of 1 to 10? 2) What is the primary source of dietary advice for their children? 3) Are home dietary habits considered healthy? Analysis of Variance (ANOVA) was used to compare the height-for-age across different categories, with p < 0.05 considered statistically significant.

Results: Of the 133 participants, 63 (47%) were females. The age distribution included 72 children (54%) between 0-12 months, 40 children (30%) between 13-24 months, and 21 children (16%) from 25-36 months. Twenty-five percent of the sample had a height-for-age below the 25th percentile. When caregivers were asked to rate their children’s nutrition, 44% gave a score of 7-8, and 42% rated it 9-10. The majority of caregivers (46%) reported receiving nutrition advice from family members, while 25% cited healthcare providers. No statistically significant associations were found between low height-for-age and the source of dietary advice (p=0.537) or caregiver’s assessment of their child's diet (p=0.1). However, 59 (44%) mothers considered their home diet healthy, and this was significantly associated with low height-for-age (p=0.008).

Conclusion: Our study found that 1 in 4 children had low height-for-age. Mothers who relied on healthcare providers for dietary advice did not see better growth outcomes in their children. However, when caregivers believed they were providing a healthy diet at home, children generally had better growth measurements. This suggests that healthcare providers’ counseling may be insufficient, and caregivers’ ability to assess a healthy diet is limited. These findings highlight the need for clear, accessible nutrition information for parents and caregivers, which could improve children’s growth and overall health from an early age.