Perceptions of Child Body Size and Health Care Seeking for Undernourished Children in Southern Malawi

Flax, Valerie L.; Thakwalakwa, Chrissie

doi:10.1177/1049732315610522

Cited by 9 publications

(13 citation statements)

References 41 publications

(46 reference statements)

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“…Strikingly, despite the high proportion of undernutrition among children in our study sample, an overwhelmingly large number of mothers did not consider their children to be malnourished. Research from various settings has shown that parents’ (especially mothers’) perceptions of child undernutrition are likely to influence provision of care, and children’s overall growth and development are associated with households time spent in caring for children [39, 40]. However, mothers from poor households often lack appropriate information on aspects such as optimal feeding practices or need for extensive care during illnesses which are critical for addressing undernutrition [41, 42].…”

Section: Discussionmentioning

confidence: 99%

Nutrition among children of migrant construction workers in Ahmedabad, India

Ravindranath

Trani

Iannotti

2019

Int J Equity Health

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Background Millions of poor households in India undertake short duration rural to urban migration along with their children to find work in the informal economy in the city. While literature has documented the precarity of such temporary jobs, typically characterized by low wages, insecure jobs, harsh recruitment regimes and economic vulnerability, little is known about its implications for children who migrate with their parents to the city. In this study, we draw attention to children of migrant construction workers and focus on their overall nutritional well-being, which remains under-studied. Our objectives were to categorize the current nutritional status of children under the age of five and determine the underlying causes of poor nutritional outcomes. Methods The field work for this study was undertaken between May 2017 and January 2018 at five construction sites in the city of Ahmedabad. We undertook anthropometric measurements of children under the age of five [N = 131; (male: 46%, female 53%); (mean age: 31.7 months)] and categorized their nutritional status. Using the UNICEF framework on undernutrition, we examined the underlying causes of poor nutritional outcomes among this group of children with the help of qualitative methods such as interviews, focused group discussions and participant observation at the field sites. Results Undernutrition was highly prevalent among the children (N = 131): stunted (40.5%); wasted (22.1%); and underweight (50.4%). We found common factors across parents interviewed such as similar misperceptions of malnutrition, long hours of work and lack of childcare provision at the worksite which resulted in disrupted quality of care. While socio-cultural beliefs and lack of information influenced breastfeeding, other factors such as inability to take breaks or lack of space further impaired infant feeding practices more broadly. Lack of dietary diversity at home, poor hygiene and sanitation, and economic inability to seek healthcare further affected child nutritional status. Conclusions Our study addresses a critical gap in migration literature in India by building a comprehensive narrative of migrant children’s experiences at construction sites. We find that parents’ informal work setting exposes children to a nutritionally challenging environment. Policies and programs seeking to address undernutrition, a critical challenge in India, must pay attention to the specific needs of migrant children.

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Section: Discussionmentioning

confidence: 99%

Nutrition among children of migrant construction workers in Ahmedabad, India

Ravindranath

Trani

Iannotti

2019

Int J Equity Health

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“…Mothers who preferred an overweight silhouette for their child said that a larger size shows that the child is healthy and strong. Mothers who wanted their child to have a smaller body size (N = 28) listed foods similar to those who wanted their child to maintain or gain weight, such as porridge (54%); fruit, nsima and fizzy drinks (36%); sweetened yogurt (29%); meat and green leafy vegetables (25%); groundnuts (18%); and milk and rice (14%; was higher than in studies in Nigeria, Kenya, the Seychelles, South Africa, Tanzania and Zambia, some of which included both men and women or only overweight/obese adults (Akindele, Phillips, Igumbor, & Useh, 2017;Devanathan et al, 2013;Ettarh, Van de Vijver, Oti, & Kyobutungi, 2013;Muhihi et al, 2012;Tateyama et al, 2018;Yepes et al, 2015). In the present study, the percentage of women who correctly estimated their current size did not differ significantly by measured weight status, in contrast to some other studies, which found that overweight participants were more likely than normal weight participants to underestimate their weight status (Muhihi et al, 2012;Tateyama et al, 2018).…”

Section: Child Body Size Perceptions and Preferencesmentioning

confidence: 91%

Body size preferences and food choice among mothers and children in Malawi

Flax

Thakwalakwa

Phuka

et al. 2020

Maternal & Child Nutrition

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Overweight in mothers and children in sub‐Saharan Africa is rapidly increasing and may be related to body size perceptions and preferences. We enrolled 268 mother–child (6–59 months) pairs in central Malawi; 71% of mothers and 56% of children were overweight/obese, and the remainder were normal weight. Interviewers used seven body silhouette drawings and a questionnaire with open‐ and closed‐ended questions to measure mothers' perceptions of current, preferred and healthy maternal and child body sizes and their relation to food choices. Overweight/obese and normal weight mothers' correct identification of their current weight status (72% vs. 64%), preference for overweight/obese body size (68% both) and selection of an overweight/obese silhouette as healthy (94% vs. 96%) did not differ by weight status. Fewer overweight/obese than normal weight mothers' preferred body silhouette was larger than their current silhouette (74% vs. 29%, p < .001). More mothers of overweight than normal weight children correctly identified the child's current weight status (55% vs. 42%, p < .05) and preferred an overweight/obese body size for the child (70% vs. 58%, p < .01), and both groups selected overweight/obese silhouettes as healthy for children. More than half of mothers in both groups wanted their child to be larger than the current size. Mothers said that increasing consumption of fruits, vegetables, meat, milk, grains, fizzy drinks and fatty foods could facilitate weight gain, but many cannot afford to purchase some of these foods. Their desired strategies for increasing weight indicate that body size preferences may drive food choice but could be limited by affordability.

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“…However, the severity of malnutrition and the presence of co-morbid conditions have been shown to confer additional mortality risk among malnourished children [47]. Also delay in seeking healthcare [48] 6%). Majority (79.7%) of the patients spent a maximum of fourteen days on admission.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Study on Child Malnutrition in the Tamale Teaching Hospital, Ghana

Walana

Acquah

Makinin

et al. 2016

JSRR

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Introduction: Malnutrition is an essential global public health challenge affecting millions of people. The burden of malnutrition is huge especially among children in developing countries and poverty stricken regions. Aims: This study investigated the distributions, co-morbidities, and admission outcomes among malnourished children in the paediatric ward of the Tamale Teaching Hospital, Ghana. Study Design: A retrospective health facility based study was employed. Place and Duration of Study: The study was conducted in the paediatric ward of the Tamale Original Research Article

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Perceptions of Child Body Size and Health Care Seeking for Undernourished Children in Southern Malawi

Cited by 9 publications

References 41 publications

Nutrition among children of migrant construction workers in Ahmedabad, India

Nutrition among children of migrant construction workers in Ahmedabad, India

Body size preferences and food choice among mothers and children in Malawi

A Retrospective Study on Child Malnutrition in the Tamale Teaching Hospital, Ghana

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