Care and nutrition: Concepts and measurement

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. The significance of care has best been articulated in the framework developed by the United Nations Children's Fun d (UNICEF). This paper extends the UNICEF model of care and summarizes the literature on the relationship of care practices and resources to child nut rition. The paper also summarizes attempts to measure the various dimension s of care. The concept of care is extended in two directions: first, we def ine resources needed by the caregiver for care and, second, we show that th e child's own characteristics play a role in the kind of care that he or sh e receives. The literature summary and methodological recommendations are m ade for six types of resources for care and for two of the least studied ca re practices: complementary feeding and psychosocial care. The other care p ractices are care for women, breast-feeding, food preparation, hygiene, and home health practices. Feeding practices that affect a child's nutritional status include adaptation of feeding to the child's abilities (offering fi nger foods, for example); responsiveness of the caregiver to the child (per haps offering additional or different foods); and selection of an appropria te feeding context. Psychosocial care is the provision of affection and att ention to the child and responsiveness to the child's cues. It includes phy sical, visual, and verbal interactions. (C) 1999 Published by Elsevier Scie nce Ltd. All rights reserved.