Determinants of Nurturing Care Behaviours in Malawi: An Ethnographic Study

IF 2.6 2区 医学 Q3 NUTRITION & DIETETICS
Roschnik Natalie, Jupp Dee, Stein Danielle, Abisaputra Iqbal, Adhima Rizqan, Chasowa Sarah Kudeko, Ellis Steven, Gunda Rita, Indra Yeni, Kadawati Prisca, Kandulu Blessings, Koirala Neha, Kulemba Anthony, Lundu Chisoni, Lupafya Phindile, Mnyawa Judith, Mshanga Steven, Nowa Mphatso, Nkhonjera Jean, Phiri Brenda, Sambani Sungeni, Tobing Deborah, Zintambira Fatsani, Keiser Olivia, Gladstone Melissa
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Abstract

In Malawi, 38% of children under five are stunted, and only 36% are developmentally on track. An ethnographic study using the Reality Check Approach was conducted in four villages in Ntcheu and Balaka districts in Malawi to understand caregiving-related drivers of malnutrition and poor child development. Researchers immersed themselves in 12 rural households with a pregnant woman or a child under 2 years for 4 days and nights, and gathered information through informal conversations, participation in daily activities, observations, and group sessions. They assessed current behaviours and the factors driving these behaviours in five recommended nurturing care domains essential for a child to both survive and thrive. The study revealed that children were not receiving the nurturing care they needed. Caregiving-related issues identified included poor maternal, child, and family diets; inadequate infant and young child feeding; poor hygiene environment and practices; low use of health and nutrition services; limited responsive care, stimulation and learning opportunities, and early pregnancies. Caregiving determinants included chronic poverty and food insecurity, climate and economic shocks, low access to quality health, nutrition and early childhood development services, poor maternal wellbeing, gender inequality and harmful social norms. The research underscores the need for a multi-sector approach to improve maternal and child nutrition and development. It also stresses the importance of understanding the contextual determinants of caregiving behaviours to inform multi-sector programmes and policies and meet Malawi's Sustainable Development Goals and World Health Assembly targets for maternal and child health, nutrition, and development.

Abstract Image

马拉维养育照料行为的决定因素:一项民族志研究。
在马拉维,38%的五岁以下儿童发育迟缓,只有36%的儿童发育正常。在马拉维恩丘和巴拉卡地区的四个村庄开展了一项使用现实核查方法的人种学研究,以了解与护理有关的营养不良和儿童发育不良的驱动因素。研究人员在12个有孕妇或2岁以下儿童的农村家庭中度过了4个昼夜,并通过非正式交谈、参与日常活动、观察和小组会议收集信息。他们评估了目前的行为和驱动这些行为的因素,这些行为在五个推荐的养育护理领域对儿童的生存和发展至关重要。研究表明,孩子们没有得到他们需要的养育照顾。确定的与护理相关的问题包括母亲、儿童和家庭饮食不良;婴幼儿喂养不足;卫生环境和做法差;保健和营养服务使用率低;反应性护理、刺激和学习机会有限,早孕。照料决定因素包括长期贫困和粮食不安全、气候和经济冲击、获得优质保健、营养和幼儿发展服务的机会少、孕产妇福利差、性别不平等和有害的社会规范。这项研究强调需要采取多部门方法来改善孕产妇和儿童的营养和发育。它还强调了解照料行为的背景决定因素的重要性,以便为多部门方案和政策提供信息,并实现马拉维的可持续发展目标和世界卫生大会关于妇幼保健、营养和发展的具体目标。
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来源期刊
Maternal and Child Nutrition
Maternal and Child Nutrition 医学-小儿科
CiteScore
7.70
自引率
8.80%
发文量
144
审稿时长
6-12 weeks
期刊介绍: Maternal & Child Nutrition addresses fundamental aspects of nutrition and its outcomes in women and their children, both in early and later life, and keeps its audience fully informed about new initiatives, the latest research findings and innovative ways of responding to changes in public attitudes and policy. Drawing from global sources, the Journal provides an invaluable source of up to date information for health professionals, academics and service users with interests in maternal and child nutrition. Its scope includes pre-conception, antenatal and postnatal maternal nutrition, women''s nutrition throughout their reproductive years, and fetal, neonatal, infant, child and adolescent nutrition and their effects throughout life.
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