Browsing by Author "Nousiainen (nyk. Varjonen), Silja"

Malnutrition in early life has long-lasting and irreversible consequences, and it is estimated to be the cause of nearly half of the deaths in children under the age of five. Most child undernutrition occurs in the period of complementary feeding, when breast milk is gradually being replaced by complementary foods. Undernutrition is caused by inadequate nutrient and energy intakes and diseases that result from poor feeding practices. Complementary feeding includes a complex set of behaviours and decisions, which are in turn influenced by a vast number of determinants, such as caregiver s knowledge and skills, time constraints, social support system and community context. The aim of this study is to qualitatively investigate mothers perceptions of complementary feeding and to evaluate the influence of household and community context on complementary food choices in rural area of Southern Benin. Child undernutrition is extremely prevalent in Benin, and 45 % of children under the age of five are chronically malnourished. Two remote rural villages in the Mono region of Benin were selected for the study. The sample consisted of mothers who had a child aged 6 to 24 months. Purposeful sampling was used. Data was collected through individual interviews with structured and open-ended questions (n=30) and six focus group discussions. Four groups were organised for caregivers (n=34) and two for healthcare and social workers in the region (n=13). Translated and transcribed data was systematically coded with the Atlas.ti program and analysed using qualitative content and thematic analysis. The analysis was inductive and data-driven. Data and methodological triangulation were used in order to evaluate the validity and credibility of data, which was collected using different research methods. Young children in the villages were not fed according to WHO recommendations. Complementary foods lacked variety and especially animal-source foods were limited. Children were usually fed maize gruel or porridge, which were seldom supplemented with more nutritious ingredients. Four themes were formed of the determinants of feeding practices: maternal knowledge framework, child characteristics, household context and community context. Mothers had several ways to rationalise why certain foods were better than others. Mothers considered macaroni, maize gruel and porridge to be the most suitable and healthy foods for young children. However, mothers also valued locally available, more nutritious products, such as eggs, beans and green leafy vegetables. No food taboos concerning feeding of young children existed in the villages. Children started eating family foods from a very early age, and separate foods were hardly ever prepared for them. Mothers made many feeding decisions based on children s behaviour, cues and development level. Mothers seemed to have quite a lot of power over infant feeding decisions on the household level, but also the older generation and fathers influenced feeding choices. Fathers decided how money was spent in the household and grandmothers tried to maintain the traditional ways of child care. The main reason for poor feeding practices was poverty, which limited the choice of foods and the time mothers had for child care. Rural migration led to fathers being absent from families, increasing mothers work burden. These results suggest that there are several possible barriers and also enablers of optimal complementary feeding in the study villages.