Community perceptions of the risk factors of maternal and child malnutrition in the district of Zè, Benin

Introduction: Fighting malnutrition inevitably requires good understanding of its causes. This study aims primarily to understand community perceptions of two major risk factors of maternal and child undernutrition in the district of Zè, Benin. Methodology: The study used a cross-sectional mixed design. It was conducted in the village of Domè-Sèko in Zè. Participants were 64 pairs of mothers and 6-59 months old children. Questionnaires were used to collect data on household food insecurity and mothers and children’s dietary diversity. Anthropometric variables were measured to assess their nutritional status. Eight focus groups were conducted separately with purposively selected active men, older men, women of childbearing age and older women. Simple linear regression was used to test the association of mothers or children’ nutritional status with dietary diversity and household food security. The qualitative data were classified per category of focus group participants, coded using NVIVO software, and used to corroborate the quantitative results. Results: The prevalence of wasting, underweight and stunting was respectively 6.3%, 18.8% and 57.8% among the children. Chronic energy deficiency affected 9% of mothers, 13% were overweight or obese. Only 21% of children aged 6-23 months had the minimum dietary diversity and 15% the minimum acceptable diet. Average dietary diversity score of 24-59 months old children and mothers was 5±1 in 14 food groups. Food insecurity affected 80% of households in total, 53% severely. Besides poor dietary diversification, focus groups identified low contribution of men in household food supply, poor sanitation, insufficient utilisation of health services, due to cultural beliefs and bad reception, as main risk factors of mothers and children’s undernutrition.  Conclusion: Zè remains highly disadvantaged despite numerous nutritional interventions. Beyond quantitative data, community perceptions gave good insight into context-specific risk factors of maternal and child malnutrition, in view of strategies refinement using a more participatory approach.