Stigma as a barrier to treatment for child acute malnutrition in <scp>M</scp>arsabit <scp>C</scp>ounty, <scp>K</scp>enya

Bliss, Jessica; Njenga, Martin; Stoltzfus, Rebecca J.; Pelletier, David

doi:10.1111/mcn.12198

Cited by 25 publications

(25 citation statements)

References 34 publications

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“…There are also additional barriers to access of other child health care services including limited time available and workload constraints of caregivers. Feelings of shame and discomfort at health clinics have also been reported by mothers of malnourished children in Marsabit County [9]. Pregnant women consume restricted diets with the belief that they will have easier delivery.…”

Section: Food Insecuritymentioning

confidence: 99%

Nutritional and health challenges of pastoralist populations in Kenya

Wayua¹

2017

AJFAND

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This paper examines nutritional and health challenges facing pastoralists who inhabit fragile rangelands and are one of the most nutritionally vulnerable population groups in Kenya. The review is based on a synthesis of literature on pastoralist food security, nutrition and health status and livelihoods in Kenya's rangelands. Documents reviewed included health and nutrition surveys, journal articles, case studies, reports from NonGovernmental Organisations and 'grey' literature. The main nutritional challenge is food insecurity leading to high malnutrition rates. Global acute malnutrition rates for the last five years ranged from 10 to 28%. Nutritional status of pastoralists varies with seasons, with high malnutrition experienced during droughts, which have been worsened by increasing climate change. Micronutrient deficiencies include iron, folic acid and niacin. Pregnant women consume restricted diets in the belief that they will have easier delivery. This leads to low birth weight, estimated at 13% among some pastoral groups. Knowledge of breastfeeding and complementary feeding is poor. Infants are introduced to animal milk from a few days old, which is a risk factor for malnutrition and morbidity. Besides experiencing chronic under-nutrition, pastoralists carry a substantial disease burden and are poorly covered by health services. The main diseases are malaria, respiratory tract infections and diarrhoea. Availability of safe drinking water is a challenge, and pastoralists are frequently affected by water-borne diseases. Sedentarisation also presents negative nutritional consequences to pastoralists including inadequate housing and lack of clean drinking water. Efforts to address the challenges should focus on nutrition education around the importance of appropriate weight gain during pregnancy, benefits of exclusive breastfeeding, and sanitation concerning safe drinking water. At the community level, there should be an integrated approach by all stakeholders implementing health and nutrition interventions in pastoralist areas. At the national level, interventions should focus both on relief and resilience building, and be tailor-made specifically for the pastoralist communities. The nutritional impact of such interventions needs to be established.

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Section: Food Insecuritymentioning

confidence: 99%

Nutritional and health challenges of pastoralist populations in Kenya

Wayua¹

2017

AJFAND

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“…including their rights to receive respectful, dignified and humane care during growth monitoring (United Nations General Assembly, 1948, 1993. An association between the stigma of malnutrition and children's access to health care has also been reported in different contexts (Bliss, Njenga, Stoltzfus, & Pelletier, 2016;Howard & Millard, 1997;Mull, 1991;Nayar, Stangl, De Zalduondo, & Brady, 2014). The attitudes of health workers that were reported in the current study highlight the need to insist that health care providers separate their preconceived schemas from their professional duties.…”

Section: Naming and Shaming Of Mothers And Their Poorly Growing Babiesmentioning

confidence: 99%

Postpartum sex taboos and child growth in Tanzania: Implications for child care

Mchome

Bailey

Kessy³

et al. 2020

Maternal & Child Nutrition

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The social context and cultural meaning systems shape caregivers' perceptions about child growth and inform their attention to episodes of poor growth. Thus, understanding community members' beliefs about the aetiology of poor child growth is important for effective responses to child malnutrition. We present an analysis of caregivers' narratives on the risks surrounding child growth during postpartum period and highlight how the meanings attached to these risks shape child care practices. We collected data using 19 focus group discussions, 30 in‐depth interviews and five key informant interviews with caregivers of under‐five children in south‐eastern Tanzania. Parental non‐adherence to postpartum sexual abstinence norms was a dominant cultural explanation for poor growth and development in a child, including different forms of malnutrition. In case sexual abstinence is not maintained or when a mother conceives while still lactating, caregivers would wean their infants abruptly and completely to prevent poor growth. Mothers whose babies were growing poorly were often stigmatized for breaking sex taboos by the community and by health care workers. The stigma that mothers face reduced their self‐esteem and deterred them from taking their children to the child health clinics. Traditional rather than biomedical care was often sought to remedy growth problems in children, particularly when violation of sexual abstinence was suspected. When designing culturally sensitive interventions aimed at promoting healthy child growth and effective breastfeeding in the community, it is important to recognize and address people's existing misconceptions about early resumption of sexual intercourse and a new pregnancy during lactation period.

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“…Earlier studies of malnutrition in Marsabit County has concluded that social stigma connected with malnourished children is an important reason why mothers do not seek help for malnutrition. 13 We did not investigate this in our study, but we may suggest that increased general awareness on nutrition initiated by the establishment of mother support groups might contribute to reduce the stigma, and as such lower the threshold for mothers to seek help at health care facilities.…”

Section: Discussionmentioning

confidence: 87%

Effect of mother support groups on nutritional status in children under two years of age in Laisamis village, Kenya

2017

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Background: In tackling the ongoing malnutrition problem in many parts of Kenya, the government has initialized preventive actions such as mother support groups in order to improve health and nutrition among children. Few studies have evaluated the effectiveness of such intervention. Objective: This study aimed at determining how mother support groups affect the nutrition status of children under 2 years of age. Methods: 41 children participated. Anthropometric measurements were taken of the children once a month during 12 months. Medical history, nutrition status and socioeconomic factors were collected by interviews with the mothers. The children were divided into two groups depending on their mother's assigned group; mother support group or not. Results: Nutritional status was significantly better among children in the mother support group (P=0.001). There were significantly more children with severe acute malnutrition among the children not in support group (P=0.040). The mean height (P=0.001) and mean weight (P=0.0281) were significantly higher among children in the non-support group. Conclusion: Mother support groups may have a beneficial effect on the nutritional status of children under 2 years of age. Cases of severe acute malnutrition seemed to be less prevalent in children whose mothers attend mother support groups.

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Stigma as a barrier to treatment for child acute malnutrition in Marsabit County, Kenya

Cited by 25 publications

References 34 publications

Nutritional and health challenges of pastoralist populations in Kenya

Nutritional and health challenges of pastoralist populations in Kenya

Postpartum sex taboos and child growth in Tanzania: Implications for child care

Effect of mother support groups on nutritional status in children under two years of age in Laisamis village, Kenya

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