Mainstreaming nutrition in maternal, newborn and child health: barriers to seeking services from existing maternal, newborn, child health programmes

Abstract

Table of Contents Summary237Introduction238Objectives238Approach and methodology for the study238Background to barriers to use of health services239 Models of health service utilization239 Mosley and Chen Child Survival framework239 Explanatory models239 Hierarchy of resort240 Dimensions of access240 Framework for categorization of barriers241 Summary242Barriers to use of health services242 Geographic access243 Temporal access244 Socio‐cultural access245 Financial access248 Quality of care249Discussion250References252 Summary In the light of mainstreaming nutrition programs into health services, this review article approaches the issue of barriers to existing maternal child health programs from both theoretical and applied perspectives. It begins with a discussion of salient literature on models of health service utilization. The mid‐section of the paper presents the results of a review of research studies that illuminate the barriers to care. Categorical themes emerged from the review of studies in the form of barriers based on geographic factors, temporal factors, a myriad of socio‐cultural factors, financial factors and quality of care. The discussion focuses on the need to overcome existing restrictions to health services in order to facilitate initiatives to mainstream nutrition and achieve Millennium Development Goal #1.

Stigma as a barrier to treatment for child acute malnutrition in Marsabit County, Kenya

“…Access barriers were categorized using an adapted version of a framework proposed by Barton (Streatfield et al . ; Barton ).…”

Exploring and optimising maternal and infant nutrition in North West Pakistan

“…In targeting maternal and child under-nutrition the social, political and economic constraints upon women and families in securing the optimum nutritional standards must be understood and taken into account. There is a growing body of research that illuminates the ways in which maternal dietary and infant feeding practices relate substantially to local cultural norms and constraints (Morisky et al, 2002;Fikree et al, 2005;Bhutta et al, 2008;Streatfield et al, 2008;Dykes and Hall Moran, 2009;Blystad et al, 2010). Therefore, we cannot simply recommend interventions without thoroughly exploring the socio-cultural context and constraints that operate within a given community to be studied and supported.…”

Eating soup with nails of pig: thematic synthesis of the qualitative literature on cultural practices and beliefs influencing perinatal nutrition in low and middle income countries

“…In the post millennium development goal (MDG) era, maternal and child undernutrition continue to be problematic contributing to 800 000 neonatal deaths, stunting, wasting, micronutrient deficiencies, and nearly three million child deaths annually [ 9 ]. There are significant barriers at the household level in accessing appropriate nutrition for women and children [ 10 ]. The period from in-utero to 24 months of age, i.e.…”

“…There is an emerging body of research that illuminates the ways in which maternal dietary and infant feeding practices relate substantially to local cultural norms and constraints [ 10 , 16 , 17 ]. We therefore aimed to explore qualitative research conducted in low resource settings around the perinatal continuum, with a particular focus on the ‘cultural’ realm of shared beliefs, values, and practice; and to identify common themes in the research-base.…”