Barriers to Optimal Maternal and Child Feeding Practices in Pastoralist Areas of Somali Region, Eastern Ethiopia: A Qualitative Study

Abstract

Maternal and child nutrition is critical for child health and survival. Appropriate feeding practices are of fundamental importance for health, nutrition, survival and development of infants and children. In pastoral areas of Ethiopia, barriers related to culture, knowledge, social norms, beliefs, behaviors, decision making in the household and burden of other responsibilities contribute to nutritional status of women and children to deteriorate. Policies and strategies are recommending assessment of barriers for designing programs and interventions to improve maternal and child nutrition practices. This study is aimed to assess barriers of optimal maternal and child feeding practices in Pastoralist areas of Somali region, Eastern Ethiopia. A qualitative community based research method was used involving 17 focus group discussions and 20 in-depth interviews with mothers, grandmothers, health professionals and religious leaders from three districts. Data from FGDs and interviews were transcribed and coded. The agreed upon codes were synthesized and grouped into exhaustive categories. The categories were then merged into themes representing the most common barriers on maternal and child feeding practice that emerged from the FGDs and interviews. We found that traditional beliefs, myths, culture custodian influence, low accessibility and availability of nutritional foods, pattern and burden of other responsibilities, poor knowledge and health seeking behavior, perceived milk insufficiency as main barriers for optimal maternal and child feeding practices. Barriers on optimal maternal and child feeding are very common in the study areas. More work needs to be done to strengthen community-based nutrition with strong social behavioral change communication with emphasis on age-specific counselling on maternal and child nutrition at health facilities, during antenatal and early postnatal visits in the study areas through different media channels, particularly, Somali Region TV

Pre-lacteal feeding practice and its associated factors among mothers with children under the age of two years in Dubti town, Afar region, North East Ethiopia: a community based mixed study design

“…The main reasons to give pre-lacteal feedings to children were a cultural perspective and the expectation of insufficient breast milk. These findings corroborated the findings of previous studies ( 18 , 26 – 30 ). The causes of milk being the commonest pre-lacteal feeding in the Afar region can be attributed to the pastoralist nature of the Afar people, whose income depends on animal products.…”

“…Animal products are highly consumed in pastoral areas where cow or goat milk is a major part of the diet for pastoralist children in addition to breastfeeding (17). The main reasons for practicing pre-lacteal feeding are the assumption of cultural taboos and beliefs (26)(27)(28), and insufficient breast milk production (18,29,30). Mothers with a lower socioeconomic status commonly practice pre-lacteal feeding (31).…”

How do high ambient temperatures affect infant feeding practices? A prospective cohort study of postpartum women in Bobo-Dioulasso, Burkina Faso

“…Despite efforts to improve breastfeeding practices in sub-Saharan Africa,48 the belief that breast milk is insufficient to hydrate babies and that water is needed to quench their thirst still prevails in several societies 12 49–51. In the commune of Bobo-Dioulasso, provision of supplementary fluids (particularly water) was widespread.…”

Food consumption and dietary diversity associated with breastfeeding mod of children aged 6-23 months in Ouagadougou, Burkina Faso

“…This situation could be explained by socio-cultural constraints. Indeed, some authors had reported that in Sudan and Ethiopia, the non-consumption of some food groups such as eggs was linked to socio-cultural considerations [34,35]. Particularly for non-breastfed children, dairy products were heavily consumed.…”