"I Should Not Be Giving My Child the Same Thing Over and Over:" A Qualitative Assessment of Barriers to and Opportunities for Child Dietary Diversification in Ntchisi, Malawi Open Access

Foley, Amelia (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/jm214p29x?locale=en
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Abstract

Introduction: Stunting affects approximately 47% of the population in Malawi. The Government of Malawi, with support from the World Food Programme (WFP) and cooperating partners, has launched a stunting prevention programme to support the Scale Up of Nutrition (SUN) initiative in the Ntchisi district of Malawi.

Objective: This study assesses the knowledge, attitudes, and practices of mother beneficiaries of the stunting prevention programme in rural Ntchisi District, Malawi regarding infant and young child feeding. It examines the real and perceived barriers to and opportunities for enhanced infant and young child feeding in this population and context.

Methods: The data for this qualitative study were collected from May to July 2015. Data collection included 5 focus group discussions and 14 in-depth interviews with mother beneficiaries of the stunting prevention program. Descriptive analysis was conducted using MAXQDA version 11, qualitative data analysis software.

Results: The data revealed that mother beneficiaries' depth of infant and young child feeding knowledge was limited. The attitudes of participants towards stunting also showed a lack of understanding of this serious condition. This study confirmed that current complementary feeding practices utilized by participants were not in accordance with program-promoted infant and young child feeding practices. Barrier analysis uncovered a number of obstacles that participants faced when trying to adopt promoted infant and young child feeding practices, including but not limited to: financial resources, availability and seasonality, birth spacing, education and skill, and inadequate external support.

Discussion: In order to increase the adoption of promoted infant and young child feeding practices, the stunting prevention program needs to adhere to the Social and Behavior Change Communication Strategy. In addition, there are contextual, underlying determinants that need to be addressed in order to increase adoption of promoted complementary feeding practices and ultimately prevent stunting in this population.

Table of Contents

Chapter 1: Introduction...............................................1

Background.................................................................1

Problem Statement......................................................3

Purpose.......................................................................4

Significance.................................................................5

Chapter 2: Literature Review.........................................6

Etiology of Linear Growth.............................................6

Lifecycle Vulnerability..................................................6

Determinants of Stunting.............................................7

Consequences of Stunting.............................................8

Stunting Prevention Interventions.................................9

Social and Behavioral Change Communication Strategy....10

Complementary Feeding Emphasis...............................11

Dietary Diversity.........................................................12

Lipid Nutrient Supplementation...................................13

Reinforcing Government Priorities................................14

Conclusion..................................................................15

Chapter 3: Methodology...............................................16

Introduction................................................................16

Study Setting...............................................................16

Study Procedures.........................................................17

Data Analysis...............................................................20

Chapter 4: Results........................................................22

Knowledge..................................................................23

Attitudes.....................................................................25

Practice.......................................................................30

Barriers.......................................................................32

Summary.....................................................................34

Chapter 5: Discussion...................................................37

Maternal Education......................................................38

Social & Behavior Change Communication Strategy........38

Social Desirability Bias..................................................39

Family planning............................................................40

Implications..................................................................42

Appendix A:..................................................................50

Appendix B: In-depth Interview Guide.............................51

Appendix C: Focus Group Discussion Guide.....................56

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