Influence of Sociocultural Practices on Food and Nutrition Security in Karamoja Subregion of Uganda

Unravelling taboos and cultural beliefs associated with hidden hunger among pregnant and breast-feeding women in Buyende district Eastern Uganda

BACKGROUND

Food taboos and cultural beliefs among pregnant and breast-feeding women influence their food consumption patterns and hence the health of women and unborn children. Cognizant of their neglect in programs aimed to ameliorate hidden hunger among pregnant and breast-feeding women in Buyende and other resource-poor communities in sub-Saharan Africa, we opted for a study to unravel them to inform program design.

METHODS

We documented food taboos and beliefs amongst pregnant and breast-feeding women from six sub-counties of Buyende district in Eastern Uganda. A mixed-methods approach was used, which was comprised of questionnaire interviews with 462 women, eight focus group discussions with 6-10 participants in each and a total of 15 key informant interviews.

RESULTS

The present study revealed that 129 (27.9%) of the respondents practice food taboos and adhere to cultural beliefs related to their dietary habits during pregnancy and breast-feeding that are fuelling the prevalence of hidden hunger. The most tabooed foods during pregnancy were sugarcane (17.8%), fishes which included lung fish, catfish and the Lake Victoria sardine (Rastrineobola argentea) (15.2%), oranges (6.6%), pineapples (5.9%), eggs (3.3%), chicken (3.3%) and cassava, mangoes and Cleome gynandra (each at 3%). Most foods were avoided for reasons associated with pregnancy and labour complications and undesirable effects on the baby. Most women learnt of the taboos and beliefs from the elders, their own mother, grandparents or mother-in-law, but there was also knowledge transmission in social groups within the community.

CONCLUSIONS

The taboos and cultural beliefs in the study area render pregnant and breast-feeding women prone to micronutrient deficiency since they are denied consumption of a diversity of nutritious foods. There is a need to educate such women about consumption of nutrient-rich foods like fish, eggs, fruits and vegetables in order to improve their health, that of the unborn and children being breast fed. Additionally, culturally appropriate nutrition education may be a good strategy to eliminate inappropriate food taboos and beliefs with negative impact on the health of pregnant and breast-feeding women.

Myths About Breastfeeding as Voiced by Lactating Nurses and Midwives: A Qualitative Study at the Greater Accra Region of Ghana

Introduction

Breastfeeding has proven over the years to be one of the most effective means to ensure child survival. The advocators and myth busters of breastfeeding myths are supposed to be health professionals. However very little is known about myths surrounding breastfeeding as expressed by these health professionals (nurses and midwives). Hence this study.

Objective

The study aimed at exploring the myths about breastfeeding as voiced by lactating nurses and midwives.

Method

Qualitative exploratory descriptive design was used to investigate the subject matter. Twenty-five nurses and midwives were purposely selected to participate in the study after they had voluntarily opted to be part of the study. Data was audiotaped, transcribed verbatim and inductively analyzed.

Results

It was evident that participants believed in myths about breastfeeding. The main themes discovered were breastfeeding myth beliefs and sociocultural myth influences. Six sub-themes identified were green stools/diarrhoea, childhood disease, teeth discoloration, child becoming stupid, culture and close relatives.

Conclusion

Health professionals believe in unfounded myths about breastfeeding. Steps should be taken for them to get better lactation support. The outcomes of this study underscore the need for health professionals to address breastfeeding myths, understand the sociocultural context, and support evidence-based practice. Improving lactation support and education for nurses and midwives can lead to better clinical practice and, as a result, help to promote successful and healthy breastfeeding in Ghana.

Who Has Access to Livestock Vaccines? Using the Social-Ecological Model and Intersectionality Frameworks to Identify the Social Barriers to Peste des Petits Ruminants Vaccines in Karamoja, Uganda

Access to veterinary services is important in Karamoja, northeastern part of Uganda, as livestock is a primary source of livelihood. Gender is often overlooked in animal health programs, let alone intersectionality. However, given the socio-cultural intricacies of Karamoja, ignoring these factors may hinder animal vaccination practices, limiting the success of programs designed to control and prevent animal diseases, such as peste des petits ruminants (PPR). The study used qualitative research methods, including focus group discussions, individual interviews, and key informant interviews in a participatory research approach to investigate the constraints faced by livestock keepers when accessing vaccines. The study was carried out in Abim, Amudat, Kotido, and Moroto, four districts in the Karamoja Subregion of Uganda. A modified version of the socio-ecological model (SEM) blended with an intersectional approach were used as frameworks to analyze underlying individual, social and structural determinants of vaccine access with intersecting factors of social inequalities. The results show there are seven intersecting factors that influence access to vaccination the most. These are: gender, ethnicity, geographic location, age, physical ability, marital status, and access to education. The impact of these intersections across the different levels of the SEM highlight that there are vast inequalities within the current system. Access to vaccines and information about animal health was most limited among women, widows, the elderly, the disabled, geographically isolated, and those with unfavorable knowledge, attitudes, and practices about vaccination. Cultural norms of communities were also important factors determining access to PPR vaccines. Norms that burden women with household chores and beliefs that women cannot manage livestock, combined with gender-based violence, leaves them unable to participate in and benefit from the livestock vaccine value chain. Trainings and sensitization on gendered intersectional approaches for those involved in the distribution and delivery of vaccines are necessary to avoid exacerbating existing inequalities in Karamoja.

Elucidating the Macroeconomic Determinants of Undernourishment in South Asian Countries: Building the Framework for Action

Undernourishment is a big challenge for humanity across the world. Considering the significance of reducing undernourishment, the current study focuses on exploring the macroeconomic determinants of undernourishment in the South Asian panel. The study employed econometric models that are more robust to underpin cross-sectional dependency and heterogeneity in a panel data set. The overall findings reveal that an increase in food production increases undernourishment and infer that food availability at the national level is insufficient to reduce undernourishment unless poor people also had economic and physical access to food. In the case of economic growth and governance, the results are negatively significant in some countries. The results infer that GDP and quality of governance are nuanced in declining the rate of undernourishment in some countries, while in other countries where the results are found insignificant, the government should seek other interventions to curtail the prevalence of undernourishment. Unexpectedly, an increase in food prices lessens the undernourishment in developing countries that reflect that food prices might transform the dietary patterns of poor people from nutrient-rich foods to nutrient-poor staples, thus lead to undernourishment reduction but trigger overweight and obesity alongside. In conclusion, the results depict that policymakers should devise strategies keeping in view fundamental aspects of the country to reduce undernourishment.

Factors impacting on childhood nutrition: The experience of mothers in a rural Ghanaian community

Despite globally recommended infant and young child feeding (IYCF) practices, inadequate Child feeding remains a global challenge and the root cause of undernutrition. Most mothers who primarily feed children in most developing settings appear to have received information on the IYCF practices. We explored mothers' limitations to provide children optimally in a rural Ghanaian community. We interviewed 42 family members, including parents and grandparents of thirty-two children under five years, from fifteen households using an ethnographic fieldwork approach. We observed and participated in food preparation and child feeding and interviewed religious leader, diviners. Households' decision-making arrangements, mothers, emerging roles and inconsistency of fathers' roles, competing sources of knowledge poverty, food insecurity and the nature of the community's social interactions and policing of women's child feeding practices are issues mothers have to navigate to feed children in the study community. Cultural custodians should be given child nutrition and providing information. Mothers should be empowered to manage child feeding and emerging roles.

Examining the Effect of Geographic Region of Residence on Childhood Malnutrition in Uganda

OBJECTIVES

In our study, we examine how geographic region of residence may predict childhood malnutrition, expressed as stunting, wasting and underweight, among children under the age of 5 years in Uganda.

METHODS

Using data from the 2016 Uganda Demographic and Health Survey, we performed an incremental multivariate multilevel mixed-effect modelling to examine the effect of a child, parental and household factors on the association between region of residence and each indicator of childhood malnutrition.

RESULTS

Approximately 28%, 3% and 9% of children under age 5 suffered from stunting, wasting and underweight, respectively. The bivariate result shows that the proportion of children suffering from stunting and underweight was relatively lower in the Kampala region compared with the other regions. With the exception of the Northern region (6.44%), wasting was higher (4.12%) among children in the Kampala region. Children in the other regions were more likely to experience stunting and underweight. When controlling for child, parent and household factors, children in the other regions were less likely to suffer from underweight and stunting, compared with those in Kampala region. Children in the other regions, except the Northern region, were less likely to be wasted compared with those in Kampala region.

CONCLUSION

Our finding suggests that child, parental and household characteristics have effects on the association between region of residence and childhood malnutrition. Addressing individual and household socioeconomic disparities may be vital in tackling regional differences in childhood malnutrition.

An Ethnographic Study on Feeding Bugis Children Aged 0-23 Months in Palopo, South Sulawesi, Indonesia

This study aimed to explore Bugis culture related to feeding practice in children age 0-23 months. The study used a qualitative research method with an ethnographic study approach. Observations and focused group discussions were conducted on 22 caregivers, while in-depth interviews were conducted with a customary leader, two cadres, and a village mindwife. Data analysis applied a thematic analysis with an ethnonursing approach. This study resulted in three themes: giving sweet food, choosing a qualified person to give the first bribe, and delayed feeding of animal-sourced food (ASF) before the age of one year. These results affirm that culture is one of the most influential aspects of feeding children. The culture embraced by parents and society can affect the nutritional intake of children, especially during the first 1000 days of life.