{"title":"马拉维养育照料行为的决定因素:一项民族志研究。","authors":"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","doi":"10.1111/mcn.70076","DOIUrl":null,"url":null,"abstract":"<p>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.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"21 4","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70076","citationCount":"0","resultStr":"{\"title\":\"Determinants of Nurturing Care Behaviours in Malawi: An Ethnographic Study\",\"authors\":\"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\",\"doi\":\"10.1111/mcn.70076\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>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.</p>\",\"PeriodicalId\":51112,\"journal\":{\"name\":\"Maternal and Child Nutrition\",\"volume\":\"21 4\",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-07-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70076\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Maternal and Child Nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/mcn.70076\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Maternal and Child Nutrition","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/mcn.70076","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
Determinants of Nurturing Care Behaviours in Malawi: An Ethnographic Study
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.
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.