Skip to main content Accessibility help
×
Home
Hostname: page-component-564cf476b6-44467 Total loading time: 0.233 Render date: 2021-06-20T23:06:48.095Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true }

Community perspectives on maternal and child health during nutrition and economic transition in sub-Saharan Africa

Published online by Cambridge University Press:  15 September 2020

Daniella Watson
Affiliation:
Global Health Research Institute, School of Human Development and Health, Faculty of Medicine, University of Southampton, SouthamptonSO16 5YA, UK
Sarah H Kehoe
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
Agnes Erzse
Affiliation:
SAMRC Centre for Health Economics and Decision Science, PRICELESS, University of Witwatersrand School of Public Health, Faculty of Health Sciences, Johannesburg, South Africa
Adélaïde Compaoré
Affiliation:
Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso
Cornelius Debpuur
Affiliation:
Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
Engelbert A Nonterah
Affiliation:
Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
Hermann Sorgho
Affiliation:
Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso
Shane A Norris
Affiliation:
Global Health Research Institute, School of Human Development and Health, Faculty of Medicine, University of Southampton, SouthamptonSO16 5YA, UK SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
Karen J Hofman
Affiliation:
SAMRC Centre for Health Economics and Decision Science, PRICELESS, University of Witwatersrand School of Public Health, Faculty of Health Sciences, Johannesburg, South Africa
Wendy Lawrence
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
Marie-Louise Newell
Affiliation:
Global Health Research Institute, School of Human Development and Health, Faculty of Medicine, University of Southampton, SouthamptonSO16 5YA, UK School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Keith M Godfrey
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
Kate A Ward
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Mary Barker
Affiliation:
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Corresponding
E-mail address:

Abstract

Objective:

To explore community perceptions on maternal and child nutrition issues in Sub-Saharan Africa.

Design:

Thirty focus groups with men and women from three communities facilitated by local researchers.

Setting:

One urban (Soweto, South Africa) and two rural settings (Navrongo, Ghana and Nanoro, Burkina Faso) at different stages of economic transition.

Participants:

Two hundred thirty-seven men and women aged 18–55 years, mostly subsistence farmers in Navrongo and Nanoro and low income in Soweto.

Results:

Differences in community concerns about maternal and child health and nutrition reflected the transitional stage of the country. Community priorities revolved around poor nutrition and hunger caused by poverty, lack of economic opportunity and traditional gender roles. Men and women felt they had limited control over food and other resources. Women wanted men to take more responsibility for domestic chores, including food provision, while men wanted more involvement in their families but felt unable to provide for them. Solutions suggested focusing on ways of increasing control over economic production, family life and domestic food supplies. Rural communities sought agricultural support, while the urban community wanted regulation of the food environment.

Conclusions:

To be acceptable and effective, interventions to improve maternal and child nutrition need to take account of communities’ perceptions of their needs and address wider determinants of nutritional status and differences in access to food reflecting the stage of the country’s economic transition. Findings suggest that education and knowledge are necessary but not sufficient to support improvements in women’s and children’s nutritional status.

Type
Research paper
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The Nutrition Society

Access options

Get access to the full version of this content by using one of the access options below.

References

Bain, LE, Awah, PK, Geraldine, Net al. (2013) Malnutrition in Sub–Saharan Africa: burden, causes and prospects. Pan Afr Med J 15, 120.CrossRefGoogle ScholarPubMed
Lartey, A (2008) Maternal and child nutrition in Sub-Saharan Africa: challenges and interventions. Proc Nutr Soc 67, 105108.CrossRefGoogle ScholarPubMed
Steyn, NP & Mchiza, ZJ (2014) Obesity and the nutrition transition in Sub-Saharan Africa. Ann N Y Acad Sci 1311, 88101.CrossRefGoogle ScholarPubMed
World Health Organization (2017) The Double Burden of Malnutrition. Geneva: World Health Organization.Google Scholar
Popkin, BM, Corvalan, C & Grummer-Strawn, LM (2020) Dynamics of the double burden of malnutrition and the changing nutrition reality. Lancet 395, 6574.CrossRefGoogle ScholarPubMed
Hawkes, C, Ruel, MT, Salm, Let al. (2020) Double-duty actions: seizing programme and policy opportunities to address malnutrition in all its forms. Lancet 395, 142155.CrossRefGoogle ScholarPubMed
Black, RE, Victora, CG, Walker, SPet al. (2013) Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 382, 427451.CrossRefGoogle ScholarPubMed
Bhutta, ZA, Das, JK, Rizvi, Aet al. (2013) Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet 382, 452477.CrossRefGoogle ScholarPubMed
The World Bank (2019) Understanding Poverty. https://www.worldbank.org/en/topic/poverty/overview (accessed September 2019).Google Scholar
Food and Agriculture Organisation of the United Nations (2015) Regional Overview of Food Insecurity: African Food Security Prospects Brighter than Ever. Accra, Ghana: FAO.Google Scholar
Rayco-Solon, P, Fulford, AJ & Prentice, AM (2005) Differential effects of seasonality on preterm birth and intrauterine growth restriction in rural Africans. Am J Clin Nutr 81, 134139.CrossRefGoogle ScholarPubMed
Branca, F, Pastore, G, Demissie, Tet al. (1993) The nutritional impact of seasonality in children and adults of rural Ethiopia. Eur J Clin Nutr 47, 840850.Google ScholarPubMed
Abubakar, I, Aldridge, RW, Devakumar, Det al. (2018) The lancet commissions The UCL: lancet commission on migration and health: the health of a world on the move. Lancet 392, 26062654.CrossRefGoogle Scholar
Mendenhall, E & Singer, M (2019) The global syndemic of obesity, undernutrition, and climate change. Lancet 393, 741.CrossRefGoogle ScholarPubMed
Popkin, BM (2004) The nutrition transition: an overview of world patterns of change. Nutr Rev 62, 140S143.CrossRefGoogle ScholarPubMed
Imamura, F, Micha, R, Khatibzadeh, Set al. (2015) Dietary quality among men and women in 187 countries in 1990 and 2010: a systematic assessment. Lancet Glob Health 3, e132e142.CrossRefGoogle ScholarPubMed
High Level Panel of Experts on Food Security and Nutrition (2017) A Report by the High Level Panel of Experts on Food Security and Nutrition of the Committee on World Food Security. Rome, Italy: FAO.Google Scholar
Barrett, R, Kuzawa, CW, McDade, Tet al. (1998) Emerging and re-emerging infectious diseases: the third epidemiologic transition. Ann Rev Anthr 27, 247271.CrossRefGoogle Scholar
Agyepong, IA, Sewankambo, N, Binagwaho, Aet al. (2017) The path to longer and healthier lives for all Africans by 2030: the Lancet Commission on the future of health in sub-Saharan Africa. Lancet 390, 28032859.CrossRefGoogle ScholarPubMed
Coquery-Vidrovitch, C (2018) African Women: A Modern History. London, UK & New York, United States: Routledge, Taylor & Francis Group.CrossRefGoogle Scholar
Van den Bold, M, Quisumbing, AR & Gillespie, S (2013) Women’s Empowerment and Nutrition: An Evidence Review. Washington DC, USA: International Food Policy Research Institute, 1294.Google Scholar
Compaoré, A, Ouedraogo, K, Boua, Ret al. (2020) “Men are no more playing their roles”: Maternal and child nutrition in Nanoro, Burkina Faso. Public Health Nutr.Google Scholar
Erzse, A, Goldstein, S, Norris, SAet al. (2020) Double-duty solutions for optimising maternal and child nutrition in urban South Africa: a qualitative study. Public Health Nutr.CrossRefGoogle Scholar
Huang, TT, Cawley, JH, Ashe, Met al. (2015) Mobilisation of public support for policy actions to prevent obesity. Lancet 385, 24222431.CrossRefGoogle ScholarPubMed
Denzin, NK & Lincoln, YS (2008) Introduction: The Discipline and Practice of Qualitative Research. Strategies of Qualitative Inquiry 1–43. Califorina, United States: Sage Publications, Inc.Google Scholar
Sumankuuro, J, Crockett, J & Wang, S (2018) Sociocultural barriers to maternity services delivery: a qualitative meta-synthesis of the literature. Public Health 157, 7785.CrossRefGoogle ScholarPubMed
Raman, S, Nicholls, R, Ritchie, Jet al. (2016) Eating soup with nails of pig: thematic synthesis of the qualitative literature on cultural practices and beliefs influencing perinatal nutrition in low and middle income countries. BMC Pregnancy Childbirth 16, 192.CrossRefGoogle ScholarPubMed
Debpuur, C, Nonterah, EA, Chatio, STet al. (2020) Supporting maternal and child nutrition: views from community members in rural Northern Ghana. Public Health Nutr.Google Scholar
World Bank (2020) World Bank Country and Lending Groups. https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups (assessed July 2020).Google Scholar
World Health Organisation (2020) Nutrition Landscape Information System (NLiS) Country Profile: Burkina Faso. http://apps.who.int/nutrition/landscape/report.aspx?iso=BFA&rid=1620&goButton=Go (accessed January 2019).Google Scholar
Darteh, EKM, Acquah, E & Kumi-Kyereme, A (2014) Correlates of stunting among children in Ghana. BMC Public Health 14, 504.CrossRefGoogle ScholarPubMed
World Health Organisation (2020) Global Nutrition Monitoring Framework Country Profile: Ghana. http://apps.who.int/nutrition/landscape/global-monitoring-framework?ISO=GHA (accessed January 2019).Google Scholar
National Department of Health (2016) South Africa Demographic and Health Survey. https://dhsprogram.com/pubs/pdf/FR337/FR337.pdf (accessed September 2019).Google Scholar
Derra, K, Rouamba, E, Kazienga, Aet al. (2012) Profile: nanoro health and demographic surveillance system. Int J Epidemiol 41, 12931301.CrossRefGoogle ScholarPubMed
Oduro, AR, Wak, G, Azongo, Det al. (2012) Profile of the Navrongo health and demographic surveillance system. Int J Epidemiol 41, 968976.CrossRefGoogle ScholarPubMed
Mahajan, S (2014) Economics of South African townships: special focus on Diepsloot. In A World Bank Study [World Bank, editor]. Washington DC, USA: World Bank Group.Google Scholar
INPreP (2019) Improved Nutrition Pre-conception, Pregnancy and Post-Delivery. www.inprep.soton.ac.uk (accessed December 2019).Google Scholar
Stewart, DW & Shamdasani, PN (2014) Focus Groups: Theory and Practice. California, United States: Sage Publications.Google Scholar
Braun, V & Clarke, V (2006) Using thematic analysis in psychology. Qual Res Psychol 3, 77101.CrossRefGoogle Scholar
Tong, A, Sainsbury, P & Craig, J (2007) Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Intl J Quality Health Care 19, 349357.CrossRefGoogle ScholarPubMed
Becquey, E, Savy, M, Danel, Pet al. (2010) Dietary patterns of adults living in Ouagadougou and their association with overweight. Nutr J 9, 13.CrossRefGoogle ScholarPubMed
Ruel, MT, Alderman, H & Maternal Group, CNS (2013) Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet 382, 536551.CrossRefGoogle ScholarPubMed
Ruel, MT, Quisumbing, AR & Balagamwala, M (2018) Nutrition-sensitive agriculture: what have we learned so far? Glob Food Security 17, 128153.CrossRefGoogle Scholar
Heise, L, Greene, ME, Opper, Net al. (2019) Gender inequality and restrictive gender norms: framing the challenges to health. Lancet 393, 24402454.CrossRefGoogle Scholar
Weber, AM, Cislaghi, B, Meausoone, Vet al. (2019) Gender norms and health: insights from global survey data. Lancet 393, 24552468.CrossRefGoogle ScholarPubMed
Heymann, J, Levy, JK, Bose, Bet al. (2019) Improving health with programmatic, legal, and policy approaches to reduce gender inequality and change restrictive gender norms. Lancet 393, 25222534.CrossRefGoogle ScholarPubMed
Hay, K, McDougal, L, Percival, Vet al. (2019) Disrupting gender norms in health systems: making the case for change. Lancet 393, 25352549.CrossRefGoogle Scholar
Gupta, GR, Oomman, N, Grown, Cet al. (2019) Gender equality and gender norms: framing the opportunities for health. Lancet 393, 25502562.CrossRefGoogle ScholarPubMed
Tokhi, M, Comrie-Thomson, L, Davis, Jet al. (2018) Involving men to improve maternal and newborn health: a systematic review of the effectiveness of interventions. PLoS One 13, e0191620.CrossRefGoogle ScholarPubMed
Prost, A, Colbourn, T, Seward, Net al. (2013) Women’s groups practising participatory learning and action to improve maternal and newborn health in low-resource settings: a systematic review and meta-analysis. Lancet 381, 17361746.CrossRefGoogle ScholarPubMed
Cresswell, JA, Ganaba, R, Sarrassat, Set al. (2019) The effect of the Alive & Thrive initiative on exclusive breastfeeding in rural Burkina Faso: a repeated cross-sectional cluster randomised controlled trial. Lancet Glob Health 7, e357e365.CrossRefGoogle ScholarPubMed
Supplementary material: File

Watson et al. Supplementary Materials

Watson et al. Supplementary Materials

Download Watson et al. Supplementary Materials(File)
File 20 KB
3
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Community perspectives on maternal and child health during nutrition and economic transition in sub-Saharan Africa
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Community perspectives on maternal and child health during nutrition and economic transition in sub-Saharan Africa
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Community perspectives on maternal and child health during nutrition and economic transition in sub-Saharan Africa
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *