Why India is struggling to feed their young children? A qualitative analysis for tribal communities

OBJECTIVE: This interdisciplinary qualitative study aims to explore the health, education, engineering and environment factors impacting on feeding practices in rural India. The ultimate goal of the Participatory Approach for Nutrition in Children: Strengthening Health Education Engineering and Environment Linkages project is to identify challenges and opportunities for improvement to subsequently develop socioculturally appropriate, tailored, innovative interventions for the successful implementation of appropriate infant and young child feeding (IYCF) practices locally. DESIGN: Qualitative research method, involving five phases: (1) identification of local feeding practices; (2) identification of the local needs and opportunities for children aged 6–24 months; and (3–5) analysis of the gathered qualitative data, intervention design, review and distribution. SETTING: Nine villages in two community development blocks, that is, Ghatol and Kushalgarh, located in the Banswara district in Rajasthan, India. PARTICIPANTS: 68 participants completed semistructured interviews or focus group discussions including: mothers, grandmothers, auxiliary nurse midwife, Anganwadi worker, ASHA Sahyogini, school teachers and local elected representative. PHENOMENON OF INTEREST: IYCF practices and the factors associated with it. ANALYSIS: Thematic analysis. RESULTS: Our results could be broadly categorised into two domains: (1) the current practices of IYCF and (2) the key drivers and challenges of IYCF. We explicate the complex phenomena and emergent model focusing on: mother’s role and autonomy, knowledge and attitude towards feeding of young children, availability of services and resources that shape these practices set against the context of agriculture and livelihood patterns and its contribution to availability of food as well as on migration cycles thereby affecting the lives of ‘left behind’, and access to basic health, education and infrastructure services. CONCLUSIONS: This interdisciplinary and participatory study explored determinants impacting feeding practices across political, village and household environments. These results shaped the process for cocreation of our context-specific intervention package.