Child Growth in Karamoja, Uganda: Effects of Armed Conflict, Subsistence Change, and Maternal Behavior

Abstract

This chapter reviews recent studies of child growth among Karimojong agropastoralists in Moroto District (Karamoja sub-region), northeast Uganda. In recent decades, prevalence of stunting and wasting has increased among Karimojong children, compared with children from this population in the 1960s. Their growth is also poor by comparison with closely related Turkana pastoralists in Kenya. Slow growth and poor nutritional status of Karimojong children today is partly a consequence of heavy disease burdens in this population, but these have not changed since earlier decades. However, maternal capacity to mediate the impact of infection and other stressors on children’s physical well-being – a critical buffer against environmental insults resulting in growth faltering – has been undermined by subsistence changes associated with worsening environmental conditions and decades of armed conflict in Karamoja. As a result of the disabling of the agropastoral system, the nutritional quality of the diet has deteriorated while demands on maternal time of other subsistence activities interfere with maternal care. Specific effects of dietary change and altered maternal behaviors on breastfeeding and weaning and on the growth of children in their first few years are considered.