Abstract
BackgroundDespite different interventions to improve child nutrition conditions, chronic malnutrition is still a public health concern in Rwanda, with a high stunting prevalence of 38% among under 5-year-olds children. In Rwanda, only 18% of children aged 6–23 months are fed in accordance with the recommendations for infant and young child feeding practices. The aim of this study was to explore challenges to infant and young child feeding practices and the responses applied to overcome these challenges in Muhanga District, Southern province of Rwanda.MethodsSixteen (16) focus group discussions were held with mothers, fathers, grandmothers, and community health workers from 4 rural sectors of Muhanga District. The discussions were recorded, transcribed verbatim, and thematically analyzed using qualitative data analysis software, Atlas.ti.ResultsTwo main themes emerged from the data. Firstly, there was a discourse on optimal infant and young child feeding (IYCF) practices that reflects the knowledge and efforts to align with early initiation of breastfeeding, exclusive breastfeeding for the first 6 months, as well as initiation of complementary foods at 6 months recommendations. Secondly, challenging situations against optimal practices and coping responses applied were presented in a discourse on struggling with everyday reality. The challenging situations that emerged as impeding appropriate IYCF practices included perceived lack of breast milk, infant cues, women’s heavy workload, partner relations and living in poverty. Family and social support from community health workers and health facility staff, financial support through casual labor, and mothers saving and lending groups, as well as kitchen gardens, were used to cope with challenges.ConclusionFactors influencing IYCF practices are multifaceted. Hence, intervention strategies to improve child nutrition should acknowledge the socially embedded nature of IYCF and address economic and social environmental constraints and opportunities, in addition and above knowledge only.
Highlights
Despite different interventions to improve child nutrition conditions, chronic malnutrition is still a public health concern in Rwanda, with a high stunting prevalence of 38% among under 5-year-olds children
Overview of the results Two themes emerged from the data: Firstly, a discourse on optimal practices that reflects the knowledge about, and efforts to align with recommendations on proper infant and young child feeding (IYCF) practices
All aspects were reported by all groups with the exception of affective and responsive breastfeeding, which was not reported by fathers
Summary
Despite different interventions to improve child nutrition conditions, chronic malnutrition is still a public health concern in Rwanda, with a high stunting prevalence of 38% among under 5-year-olds children. In Rwanda, only 18% of children aged 6–23 months are fed in accordance with the recommendations for infant and young child feeding practices. Children’s rights to adequate nutrition, good health, and proper development are often violated, especially in developing countries, where undernutrition is one of the leading causes of mortality in children under the age of 5 [1]. Adoption of recommended feeding practices is one of the most effective strategies for optimal nutrition and preventing deaths among children under 5 years of age [6]. In Rwanda, despite the progress achieved in reducing under-5 mortality in the last decades, chronic malnutrition among children continues to be an important public health problem. 30% of breastfed children aged 6–23 months had been fed foods from the minimum number of food groups for their age, 47% were fed the minimum meal frequency, and 18% of Rwandan children aged 6–23 months met the minimum acceptable diet in 2015 [7]
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