Participatory nutrition education and adoption of new feeding practices are associated with improved adequacy of complementary diets among rural Malawian children: a pilot study

Hotz, Christine; Gibson, Rosalind S.

doi:10.1038/sj.ejcn.1602063

Cited by 73 publications

(97 citation statements)

References 29 publications

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“…Nutrition education has been shown to improve nutritional behaviour and practices [37,38]. This is against the background that some of the taboos have persisted due to lack of an understanding of the nutritional benefits of prohibited foods.…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Cultural Norms and Food Security in the Karamoja Sub-Region of Uganda

Olum¹,

Okello-Uma²,

Tumuhimbise³

et al. 2017

JFNR

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Culture is a strong determinant of food security through its influence on what society considers acceptable for consumption. Karamoja sub-region is one of the most ethnically diverse parts of eastern Africa, and is associated with the highest levels of food insecurity in Uganda. However, there is a general lack of understanding on the extent to which ethnicity is a contributing factor to food insecurity. We examined the relationship between ethnicity and food security in relation to commonly practiced cultural norms among the Jie, Karamojong and Tepeth ethnic groups of Karamoja. Data from 273 randomly selected households across a range of cultural settings were obtained using structured questionnaires in the September-October (2015) period. Food security status was assessed using the Household Food Insecurity Access Scale (HFIAS), daily calorie intake and coping strategy index. The study also used focus group discussions to assess the implications for food security of common cultural practices. Results confirm the general observation that the sub-region is food insecure. There were also significant variations in food security across geographical location and ethnicity. Cultural restrictions, applied particularly to women and children, over the consumption of several nutritious foods from livestock were revealed. Consumption of raw milk and animal blood, potential sources of food-borne infections and thus of malnutrition, was found to be high in the sub-region and varied significantly across ethnicity. The findings provide a basis for interventions aimed at reducing food insecurity and averting cultural impediments to a more nutritious diet.

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Section: Discussionmentioning

confidence: 99%

The Relationship between Cultural Norms and Food Security in the Karamoja Sub-Region of Uganda

Olum¹,

Okello-Uma²,

Tumuhimbise³

et al. 2017

JFNR

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“…Gibson (2001, 2005) have carried out several nutrition interventions to improve complementary feeding practices in Malawi. The approach used involved pilot testing different recipes that would increase the nutritional value of complementary foods and promoting a series of 'messages' for mothers about ways to improve complementary feeding (Hotz & Gibson, 2005). While integrating local cooking practices into their messages, the nutrition educational approach appears to be primarily an information transfer model focused on the mother (Lee & Garvin, 2003).…”

Section: Child Nutrition and Health Education Modelsmentioning

confidence: 99%

“We Grandmothers Know Plenty”: Breastfeeding, complementary feeding and the multifaceted role of grandmothers in Malawi

Kerr

Dakishoni²,

Shumba³

et al. 2008

Social Science & Medicine

177

123

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This paper has two purposes: first of all, we examine grandmothers' role and views of child feeding practices in northern Malawi, and their influence on younger women's practices. Secondly, we consider the implications of these findings for health promotion activities and models of health education. Data were collected from semi-structured interviews, focus groups and a participatory workshop. Findings demonstrate that, to address child feeding practices which have an effect on nutrition, attention must be paid to the broader context that influences child nutrition, including extended family relations. Paternal grandmothers have a powerful and multifaceted role within the extended family in northern Malawi, both in terms of childcare and in other arenas such as agricultural practices and marital relations. Grandmothers often differ in their ideas about early child feeding from conventional Western medicine. Some practices have existed in the area at least since colonial times, and have strong cultural significance. Despite the important integrated role, older women have within households and communities in this part of Malawi, hospital personnel often have disparaging and paternalistic attitudes towards 'grannies' and their knowledge. Health education rarely involves grandmothers, and even if they are involved, their perspectives are not taken into consideration. Hospital staff often reject grandmother knowledge as part of a broader modernization paradigm which views 'traditional knowledge' as backward. Grandmothers view current child health conditions within a broader context of changing livelihood conditions and a high prevalence of HIV/ AIDS. The paper concludes by discussing the challenges of involving grandmothers in health education, and the difficulties of incorporating local knowledge into a medical system that largely rejects it.

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“…In addition, even when food resources are available in the home, caregivers might not make the best use of them due to lack of knowledge of the best foods for young children, cultural beliefs and practices, and inappropriate advice (14)(15)(16) . Studies on young children's feeding practices in other countries have demonstrated evidence that educational interventions have positive effects on knowledge of caregivers, complementary feeding practices and growth among children (17)(18)(19)(20)(21) .…”

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confidence: 99%

Community-based educational intervention improved the diversity of complementary diets in western Kenya: results from a randomized controlled trial

Waswa

Jordan

Herrmann

et al. 2015

Public Health Nutr.

126

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Objective: Lack of diversity is a major factor contributing to inadequate nutrient intakes among children during the complementary feeding period in many rural areas in developing countries. This has been attributed to inadequate feeding practices and nutrition knowledge among their caregivers. The aim of the present study was to assess the effect of an educational intervention on children's dietary diversity and nutrition knowledge of caregivers. Design: Cluster randomization was applied and twenty matched village pairs were randomly assigned to the intervention or control group. The nutrition education intervention consisted of four sessions comprising of group trainings and cooking demonstrations that were conducted over a period of 5 months. Setting: Households in rural communities in Bondo and Teso South sub-counties, western Kenya. Subjects: Caregivers with children aged 6-17 months receiving nutrition education. Results: The children's dietary diversity scores (CDDS) and nutrition knowledge scores of the caregivers improved significantly in the intervention group at endline. The treatment effect on CDDS was positive and significant (P = 0·001). The CDDS rate of the children in the intervention group was 27 % larger than it would have been without the treatment effect. The intervention also had a significant effect on the caregivers' nutrition knowledge scores (incidence rate ratio = 2·05; P < 0·001). However, the nutrition knowledge of the caregivers did not have a significant effect on CDDS (P = 0·731). Conclusions: The nutrition education intervention led to improvements in children's dietary diversity and nutrition knowledge of the caregivers. Keywords Nutrition education Complementary feeding Dietary diversity Caregivers InterventionMalnutrition among children under 5 years of age is still a widespread problem in many developing countries. Worldwide, approximately 162 million children under 5 years are stunted, while 99 million and 51 million are underweight and wasted, respectively (1) . An analysis of data from the Kenya Demographic and Health Surveys (KDHS) over the last three decades shows that there has been a slow decline in the prevalence of malnutrition among young children in Kenya (2,3) . Data from the 2008-2009 KDHS showed that in Kenya, 35 % of children aged <5 years were stunted, 16 % were underweight and 7 % were wasted. The prevalence of stunting was highest (46 %) among children aged 18-24 months and 42 % among those aged 6-12 months. Stunting rates were highest among children living in rural areas (37 %) compared with those living in urban areas (26 %) (4) .While the causes of malnutrition are complex, inappropriate feeding practices during the complementary feeding period have been identified as major factors contributing to inadequate nutrient intakes among infants and young children (5)(6)(7)(8)(9) . While consuming a variety of foods is important for meeting essential nutrient requirements needed to promote growth, traditional diets fed to children in developing countries ...

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Participatory nutrition education and adoption of new feeding practices are associated with improved adequacy of complementary diets among rural Malawian children: a pilot study

Cited by 73 publications

References 29 publications

The Relationship between Cultural Norms and Food Security in the Karamoja Sub-Region of Uganda

The Relationship between Cultural Norms and Food Security in the Karamoja Sub-Region of Uganda

“We Grandmothers Know Plenty”: Breastfeeding, complementary feeding and the multifaceted role of grandmothers in Malawi

Community-based educational intervention improved the diversity of complementary diets in western Kenya: results from a randomized controlled trial

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