Cargando…

Malnutrition in Chakradharpur, Jharkhand: an anthropological study of perceptions and care practices from India

BACKGROUND: This study aims to investigate the knowledge, perception and practices related to health, nutrition, care practices, and their effect on nutrition health-seeking behaviour. METHODS: In order to have maximum representation, we divided Chakradharpur block in Jharkhand state into three zone...

Descripción completa

Detalles Bibliográficos
Autores principales: Chaand, Ipsha, Horo, Minashree, Nair, Mohit, Harshana, Amit, Mahajan, Raman, Kashyap, Vivek, Falero, Fernanda, Escruela, Montse, Burza, Sakib, Dasgupta, Rajib
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7050873/
https://www.ncbi.nlm.nih.gov/pubmed/32153948
http://dx.doi.org/10.1186/s40795-019-0299-2
_version_ 1783502676660584448
author Chaand, Ipsha
Horo, Minashree
Nair, Mohit
Harshana, Amit
Mahajan, Raman
Kashyap, Vivek
Falero, Fernanda
Escruela, Montse
Burza, Sakib
Dasgupta, Rajib
author_facet Chaand, Ipsha
Horo, Minashree
Nair, Mohit
Harshana, Amit
Mahajan, Raman
Kashyap, Vivek
Falero, Fernanda
Escruela, Montse
Burza, Sakib
Dasgupta, Rajib
author_sort Chaand, Ipsha
collection PubMed
description BACKGROUND: This study aims to investigate the knowledge, perception and practices related to health, nutrition, care practices, and their effect on nutrition health-seeking behaviour. METHODS: In order to have maximum representation, we divided Chakradharpur block in Jharkhand state into three zones (north, south and centre regions) and purposively selected 2 Ambulatory Therapeutic Feeding Centre (ATFC) clusters from each zone, along with 2 villages per ATFC (12 villages from 6 ATFCs in total). In-depth interviews and natural group discussions were conducted with mothers/caregivers, frontline health workers (FHWs), Medicins Sans Frontieres (MSF) staff, community representatives, and social leaders from selected villages. RESULTS: We found that the community demonstrates a strong dependence on traditional and cultural practices for health care and nutrition for newborns, infants and young children. Furthermore, the community relies on alternative systems of medicine for treatment of childhood illnesses such as malnutrition. The study indicated that there was limited access to and utilization of local health services by the community. Lack of adequate social safety nets, limited livelihood opportunities, inadequate child care support and care, and seasonal male migration leave mothers and caregivers vulnerable and limit proper child care and feeding practices. With respect to continuum of care, services linking care across households to facilities are fragmented. Limited knowledge of child nutrition amongst mothers and caregivers as well as fragmented service provision contribute to the limited utilization of local health services. Government FHWs and MSF field staff do not have a robust understanding of screening methods, referral pathways, and counselling. Additionally, collaboration between MSF and FHWs regarding cases treated at the ATFC is lacking, disrupting the follow up process with discharged cases in the community. CONCLUSIONS: For caregivers, there is a need to focus on capacity building in the area of child nutrition and health care provision post-discharge. It is also recommended that children identified as having moderate acute malnutrition be supported to prevent them from slipping into severe acute malnutrition, even if they do not qualify for admission at ATFCs. Community education and engagement are critical components of a successful CMAM program.
format Online
Article
Text
id pubmed-7050873
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-70508732020-03-09 Malnutrition in Chakradharpur, Jharkhand: an anthropological study of perceptions and care practices from India Chaand, Ipsha Horo, Minashree Nair, Mohit Harshana, Amit Mahajan, Raman Kashyap, Vivek Falero, Fernanda Escruela, Montse Burza, Sakib Dasgupta, Rajib BMC Nutr Research Article BACKGROUND: This study aims to investigate the knowledge, perception and practices related to health, nutrition, care practices, and their effect on nutrition health-seeking behaviour. METHODS: In order to have maximum representation, we divided Chakradharpur block in Jharkhand state into three zones (north, south and centre regions) and purposively selected 2 Ambulatory Therapeutic Feeding Centre (ATFC) clusters from each zone, along with 2 villages per ATFC (12 villages from 6 ATFCs in total). In-depth interviews and natural group discussions were conducted with mothers/caregivers, frontline health workers (FHWs), Medicins Sans Frontieres (MSF) staff, community representatives, and social leaders from selected villages. RESULTS: We found that the community demonstrates a strong dependence on traditional and cultural practices for health care and nutrition for newborns, infants and young children. Furthermore, the community relies on alternative systems of medicine for treatment of childhood illnesses such as malnutrition. The study indicated that there was limited access to and utilization of local health services by the community. Lack of adequate social safety nets, limited livelihood opportunities, inadequate child care support and care, and seasonal male migration leave mothers and caregivers vulnerable and limit proper child care and feeding practices. With respect to continuum of care, services linking care across households to facilities are fragmented. Limited knowledge of child nutrition amongst mothers and caregivers as well as fragmented service provision contribute to the limited utilization of local health services. Government FHWs and MSF field staff do not have a robust understanding of screening methods, referral pathways, and counselling. Additionally, collaboration between MSF and FHWs regarding cases treated at the ATFC is lacking, disrupting the follow up process with discharged cases in the community. CONCLUSIONS: For caregivers, there is a need to focus on capacity building in the area of child nutrition and health care provision post-discharge. It is also recommended that children identified as having moderate acute malnutrition be supported to prevent them from slipping into severe acute malnutrition, even if they do not qualify for admission at ATFCs. Community education and engagement are critical components of a successful CMAM program. BioMed Central 2019-07-02 /pmc/articles/PMC7050873/ /pubmed/32153948 http://dx.doi.org/10.1186/s40795-019-0299-2 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Chaand, Ipsha
Horo, Minashree
Nair, Mohit
Harshana, Amit
Mahajan, Raman
Kashyap, Vivek
Falero, Fernanda
Escruela, Montse
Burza, Sakib
Dasgupta, Rajib
Malnutrition in Chakradharpur, Jharkhand: an anthropological study of perceptions and care practices from India
title Malnutrition in Chakradharpur, Jharkhand: an anthropological study of perceptions and care practices from India
title_full Malnutrition in Chakradharpur, Jharkhand: an anthropological study of perceptions and care practices from India
title_fullStr Malnutrition in Chakradharpur, Jharkhand: an anthropological study of perceptions and care practices from India
title_full_unstemmed Malnutrition in Chakradharpur, Jharkhand: an anthropological study of perceptions and care practices from India
title_short Malnutrition in Chakradharpur, Jharkhand: an anthropological study of perceptions and care practices from India
title_sort malnutrition in chakradharpur, jharkhand: an anthropological study of perceptions and care practices from india
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7050873/
https://www.ncbi.nlm.nih.gov/pubmed/32153948
http://dx.doi.org/10.1186/s40795-019-0299-2
work_keys_str_mv AT chaandipsha malnutritioninchakradharpurjharkhandananthropologicalstudyofperceptionsandcarepracticesfromindia
AT horominashree malnutritioninchakradharpurjharkhandananthropologicalstudyofperceptionsandcarepracticesfromindia
AT nairmohit malnutritioninchakradharpurjharkhandananthropologicalstudyofperceptionsandcarepracticesfromindia
AT harshanaamit malnutritioninchakradharpurjharkhandananthropologicalstudyofperceptionsandcarepracticesfromindia
AT mahajanraman malnutritioninchakradharpurjharkhandananthropologicalstudyofperceptionsandcarepracticesfromindia
AT kashyapvivek malnutritioninchakradharpurjharkhandananthropologicalstudyofperceptionsandcarepracticesfromindia
AT falerofernanda malnutritioninchakradharpurjharkhandananthropologicalstudyofperceptionsandcarepracticesfromindia
AT escruelamontse malnutritioninchakradharpurjharkhandananthropologicalstudyofperceptionsandcarepracticesfromindia
AT burzasakib malnutritioninchakradharpurjharkhandananthropologicalstudyofperceptionsandcarepracticesfromindia
AT dasguptarajib malnutritioninchakradharpurjharkhandananthropologicalstudyofperceptionsandcarepracticesfromindia