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A qualitative analysis of infant and young child feeding practices in rural Rwanda

Published online by Cambridge University Press:  02 July 2020

Theogene Dusingizimana
Affiliation:
School of Food and Advanced Technology, Massey University, Palmerston North4442, New Zealand Department of Food Science and Technology, College of Agriculture, Animal Sciences and Veterinary Medicine, University of Rwanda, Musanze, Rwanda
Janet L Weber
Affiliation:
School of Food and Advanced Technology, Massey University, Palmerston North4442, New Zealand
Thiagarajah Ramilan
Affiliation:
School of Agriculture and Environment, Massey University, Palmerston North, New Zealand
Per O Iversen
Affiliation:
Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway Department of Hematology, Oslo University Hospital, Oslo, Norway Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellebosh University, Tygerberg, South Africa
Louise Brough
Affiliation:
School of Food and Advanced Technology, Massey University, Palmerston North4442, New Zealand
Corresponding
E-mail address:

Abstract

Objective:

To explore and gain an in-depth understanding of the factors influencing child feeding practices among rural caregivers in Rwanda.

Design:

In-depth semi-structured qualitative interviews were conducted. Purposive sampling was used to recruit participants. Interviews were audio-recorded, transcribed verbatim and coded. Data were analysed inductively using thematic analysis.

Setting:

Rutsiro District, Western Province, Rwanda.

Participants:

Participants included twenty-four mothers (median age 32 years) with children 6–23 months old.

Results:

We identified five key themes: (i) breast-feeding practices and role in food supply; (ii) family v. children’s food preparations; (iii) food classification systems and their influence on child feeding decisions; (iv) child feeding during diarrhoeal episodes and (v) influence of poverty on child feeding practices and child care.

Conclusions:

Mothers’ infant and young child feeding decisions are informed by information both from health workers and from traditional/own knowledge. Navigating through this information sometimes creates conflicts which results in less than optimal child feeding. A nutrition educational approach that is cognisant of maternal perceptions should be employed to improve child feeding practices. Efforts to improve child feeding practices must be complemented by programmes that enhance household economic opportunities and access to foods.

Type
Research paper
Copyright
© The Authors 2020

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References

Development Initiatives (2018) 2018 Global Nutrition Report: Shining a Light to Spur Action on Nutrition. Bristol: Development Initiatives.Google Scholar
Black, RE, Victora, CG, Walker, SPet al. (2013) Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 382, 427451.10.1016/S0140-6736(13)60937-XCrossRefGoogle ScholarPubMed
National Institute of Statistics of Rwanda (NISR) [Rwanda], Ministry of Health (MOH) [Rwanda] & ICF International (2015) Rwanda Demographic and Health Survey 2014–15. Rockville, MD, USA: NISR, MOH, ICF International.Google Scholar
National Institute of Statistics Rwanda (2018) Rwanda: Comprehensive Food Security and Vulnerability Analysis 2018. https://docs.wfp.org/api/documents/WFP-0000103863/download/ (accessed July 2019).Google Scholar
Institut National de la Statistique (NISR) & ORC Marco (2006) Rwanda Demographic and Health Survey 2005. Calverton, MD: INSR and ORC Macro.Google Scholar
Ministry of Health (MOH) (Rwanda) (2012) Third Health Sector Strategic Plan July 2012–June 2018. Kigali: Ministry of Health.Google Scholar
Lamichhane, DK, Leem, JH, Kim, HCet al. (2016) Association of infant and young child feeding practices with under-nutrition: evidence from the Nepal Demographic and Health Survey. Paediatr Int Child H 36, 260269.10.1080/20469047.2015.1109281CrossRefGoogle Scholar
Lutter, CK, Daelmans, BM, de Onis, Met al. (2011) Undernutrition, poor feeding practices, and low coverage of key nutrition interventions. Pediatrics 128, e1418e1427.10.1542/peds.2011-1392CrossRefGoogle ScholarPubMed
World Health Organization (2005) Guiding Principles for Feeding Non-breastfed Children 6–24 Months of Age. Geneva: WHO.Google Scholar
Dewey, KG & Adu-Afarwuah, S (2008) Systematic review of the efficacy and effectiveness of complementary feeding interventions in developing countries. Matern Child Nutr 4, 2485.10.1111/j.1740-8709.2007.00124.xCrossRefGoogle ScholarPubMed
Lung’aho, M, Birachi, E, Butare, Let al. (2015) Rwanda Nutrition, Markets and Gender Analysis 2015: an integrated approach towards alleviating malnutrition among vulnerable populations in Rwanda. Nairobi: Government of Rwanda/International Center for Tropical Agriculture (CIAT).Google Scholar
White, JM, Bégin, F, Kumapley, Ret al. (2017) Complementary feeding practices: current global and regional estimates. Matern Child Nutr 13, e12505.10.1111/mcn.12505CrossRefGoogle ScholarPubMed
Habyarimana, F, Zewotir, T, Ramroop, Set al. (2016) Spatial distribution of determinants of malnutrition of children under five years in Rwanda: simultaneous measurement of three anthropometric indices. J Hum Ecol 54, 138149.CrossRefGoogle Scholar
Mukabutera, A, Thomson, DR, Hedt-Gauthier, BLet al. (2016) Risk factors associated with underweight status in children under five: an analysis of the 2010 Rwanda Demographic Health Survey (RDHS). BMC Nutr 2, 40.CrossRefGoogle Scholar
Nkunzimana, T, Custodio, E, Pérez-Hoyos, Aet al. (2016) Assessing MDG achievements through under-5 child stunting in the east African community: some insights from urban versus rural areas in Burundi and Rwanda using DHS2010. In Poverty and Well-being in East Africa, pp. 6186 [Heshmati, A, editor]. Cham, Switzerland: Springer.10.1007/978-3-319-30981-1_4CrossRefGoogle Scholar
Nsereko, E, Mukabutera, A, Iyakaremye, Det al. (2018) Early feeding practices and stunting in Rwandan children: a cross-sectional study from the 2010 Rwanda demographic and health survey. Pan Afr Med J 29, 157157.10.11604/pamj.2018.29.157.10151CrossRefGoogle ScholarPubMed
Aoun, N, Matsuda, H & Sekiyama, M (2015) Geographical accessibility to healthcare and malnutrition in Rwanda. Soc Sci Med 130, 135145.10.1016/j.socscimed.2015.02.004CrossRefGoogle ScholarPubMed
Binagwaho, A, Condo, J, Wagner, Cet al. (2014) Impact of implementing performance-based financing on childhood malnutrition in Rwanda. BMC Public Health 14, 1132.10.1186/1471-2458-14-1132CrossRefGoogle ScholarPubMed
Chunling, L, Mejia-Guevara, I, Hill, Ket al. (2016) Community-based health financing and child stunting in rural Rwanda. Am J Public Health 106, 4955.Google Scholar
Roesler, A, Smithers, LG, Winichagoon, Pet al. (2018) Local perspectives and context in relation to feeding practices of children under 2 years in the mountain villages of northern Thailand. Public Health Nutr 21, 29892997.10.1017/S1368980018001957CrossRefGoogle ScholarPubMed
Arts, M, Geelhoed, D, De Schacht, Cet al. (2011) Knowledge, beliefs, and practices regarding exclusive breastfeeding of infants younger than 6 months in Mozambique: a qualitative study. J Hum Lact 27, 2532.10.1177/0890334410390039CrossRefGoogle ScholarPubMed
Lee, J, Dusingizimana, T & Umutoni, F (2016) Understanding Consumer Demand for Nutritious Food in Nyanza District, Rwanda. https://www.usaid.gov/sites/default/files/documents/1860/GAIN%20Summary%20Focused%20Ethnographic%20Survey%20Report.pdf (accessed June 2019).Google Scholar
National Institute of Statistics of Rwanda (NISR) [Rwanda], Ministry of Health (MOH) [Rwanda] & ICF International (2012) Rwanda Demographic and Health Survey 2010. Calverton, MD: NISR, MOH, and ICF International.Google Scholar
National Institute of Statistics of Rwanda (2015) Integrated Household Living Conditions Survey 4 (EICV 4). http://www.statistics.gov.rw/publication/rwanda-poverty-profile-report-results-eicv-4 (accessed January 2020).Google Scholar
Pelto, GH, Goodman, AH & Dufour, DL (2000) The biocultural perspective in nutritional anthropology. In Nutritional Anthropology: Biocultural Perspectives on Food and Nutrition, pp. 110 [Goodman, AH, Pelto, GH & Dufour, DL, editors]. Mountain View, CA: Mayfield Publishing.Google Scholar
Patton, MQ (2002) Qualitative Research and Evaluation Methods. Thousand Oaks, CA: Sage Publications.Google Scholar
Saunders, B, Sim, J, Kingstone, Tet al. (2018) Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant 52, 18931907.10.1007/s11135-017-0574-8CrossRefGoogle ScholarPubMed
Given, LM (2008) The SAGE Encyclopedia of Qualitative Research Methods. Thousand Oaks, CA: SAGE Publications.10.4135/9781412963909CrossRefGoogle Scholar
Fook, J & Gardner, F (2007) Practising Critical Reflection: A Resource Handbook. Maidenhead: Open University Press.Google Scholar
DiCicco-Bloom, B & Crabtree, BF (2006) The qualitative research interview. Med Educ 40, 314321.10.1111/j.1365-2929.2006.02418.xCrossRefGoogle ScholarPubMed
Braun, V & Clarke, V (2006) Using thematic analysis in psychology. Qual Res Psychol 3, 77101.10.1191/1478088706qp063oaCrossRefGoogle Scholar
Saldaña, J (2013) The Coding Manual for Qualitative Researchers, 2nd ed.London: SAGE Publications.Google Scholar
Tong, A, Sainsbury, P & Craig, J (2007) Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care 19, 349357.10.1093/intqhc/mzm042CrossRefGoogle ScholarPubMed
Ministry of Health (MOH) (Rwanda) (2013) National Food and Nutrition Strategic Plan (NFNSP 2013–2018). Kigali: Ministry of Health.Google Scholar
Pelto, GH, Levitt, E & Thairu, L (2003) Improving feeding practices: current patterns, common constraints, and the design of interventions. Food Nutr Bull 24, 4582.10.1177/156482650302400104CrossRefGoogle ScholarPubMed
Alderman, H & Headey, DD (2017) How important is parental education for child nutrition? World Dev 94, 448464.10.1016/j.worlddev.2017.02.007CrossRefGoogle ScholarPubMed
Engle, PL, Menon, P & Haddad, L (1999) Care and nutrition: concepts and measurement. World Dev 27, 13091337.10.1016/S0305-750X(99)00059-5CrossRefGoogle Scholar
Ip, S, Chung, M, Raman, Get al. (2007) Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (Full Rep) 153, 1186.Google Scholar
Kramer, MS & Kakuma, R (2012) Optimal duration of exclusive breastfeeding. Cochrane Database Syst Rev, Cd003517.10.1002/14651858.CD003517.pub2CrossRefGoogle ScholarPubMed
Ministry of Health (MOH) (Rwanda) (2014) 1000 Days to a Healthy Rwanda. https://rwanda.thecompassforsbc.org/first-1000-days-healthy-rwanda (accessed December 2019).Google Scholar
Sukkary-Stolba, S (1987) Food classifications and the diets of young children in rural Egypt. Soc Sci Med 25, 401404.10.1016/0277-9536(87)90278-4CrossRefGoogle ScholarPubMed
Laderman, C (1981) Symbolic and empirical reality: a new approach to the analysis of food avoidances. Am Ethnol 8, 468493.CrossRefGoogle Scholar
Zobrist, S, Kalra, N, Pelto, Get al. (2017) Results of applying cultural domain analysis techniques and implications for the design of complementary feeding interventions in northern Senegal. Food Nutr Bull 38, 512527.CrossRefGoogle ScholarPubMed
Alive & Thrive (2010) IYCF Practices, Beliefs and Influences in Tigray Region, Ethiopia. Addis Ababa: Alive & Thrive.Google Scholar
Paul, KH, Muti, M, Khalfan, SSet al. (2011) Beyond Food Insecurity: how context can improve complementary feeding interventions. Food Nutr Bull 32, 244253.10.1177/156482651103200308CrossRefGoogle ScholarPubMed
Zeitlyn, S, Rowshan, R, Mahalanabis, Det al. (1993) The ethnophysiology of digestion and diarrhoea in a Bangladeshi hospital population. J Diarrhoeal Dis Res 11, 243248.Google Scholar
Assis, AM, Barreto, ML, Santos, LMet al. (2005) Growth faltering in childhood related to diarrhea: a longitudinal community based study. Eur J Clin Nutr 59, 13171323.10.1038/sj.ejcn.1602245CrossRefGoogle ScholarPubMed
Shubh, KKR, Ruchira, N & Bhattarai, S (1997) Child Care Practices Associated with Positive and Negative Nutritional Outcomes for Children in Bangladesh: A Descriptive Analysis. Washington, DC: International Food Policy Research Institute.Google Scholar
Ali, NS, Azam, SI & Noor, R (2003) Women’s beliefs regarding food restrictions during common childhood illnesses: a hospital based study. J Ayub Med Coll Abbottabad 15, 2628.Google ScholarPubMed
Berggren, WL & Wray, JD (2002) Positive deviant behavior and nutrition education. Food Nutr Bull 23, 78.10.1177/15648265020234S102CrossRefGoogle ScholarPubMed
McLean, J, Northrup-Lyons, M, Reid, RJet al. (2019) From evidence to national scale: an implementation framework for micronutrient powders in Rwanda. Matern Child Nutr 15, e12752.10.1111/mcn.12752CrossRefGoogle ScholarPubMed
Feed the Future (2018) Postharvest Loss Assessment of Orange-Fleshed Sweet Potatoes in Rwanda. https://horticulture.ucdavis.edu/sites/g/files/dgvnsk1816/files/extension_material_files/Postharvest%20Loss%20Assessment%20of%20OFSP%20in%20Rwanda.pdf (accessed December 2019).Google Scholar
Bhutta, ZA, Ahmed, T, Black, REet al. (2008) What works? Interventions for maternal and child undernutrition and survival. Lancet 371, 417440.10.1016/S0140-6736(07)61693-6CrossRefGoogle ScholarPubMed
Jones, AD, Cruz Agudo, Y, Galway, Let al. (2012) Heavy agricultural workloads and low crop diversity are strong barriers to improving child feeding practices in the Bolivian Andes. Soc Sci Med 75, 16731684.10.1016/j.socscimed.2012.06.025CrossRefGoogle ScholarPubMed
Ministry of Local Government (2011) National Social Protection Strategy. https://www.minaloc.gov.rw/fileadmin/documents/Minaloc_Documents/National_Social_Protectiion_Strategy.pdf (accessed June 2019).Google Scholar
Roelen, K, Shelmerdine, H, Delap, Eet al. (2014) Researching the Linkages between Social Protection and Children’s Care in Rwanda: The VUP and Its Effects on Child Wellbeing, Care and Family Reunification. London: Family for Every Child.Google Scholar
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