Perceptions of mothers and caregivers regarding the detection and treatment of severely malnourished children in Kanchele, Kalomo district, Zambia

Abstract

Each year, malnutrition accounts for about 50 percent of the deaths of under-fives in developing countries. In Zambia, about 45 percent of children under the age of five exhibit stunted growth, mainly due to malnutrition. Early detection of cases by health workers and prompt health-seeking practices at household and community levels can improve the identification and management of malnutrition, and prevent unnecessary deaths. The study provides insights into the perceptions of mothers, caregivers, community members and community health workers regarding the detection, referral and health-seeking practices of malnourished children in Kalomo district of Zambia. This qualitative study explored perceptions and challenges of detection and prompt treatment of malnutrition (kwashiorkor and marasmus) in children under five years of age in the community. Focus group discussions using pictographs were conducted with purposely selected mothers and caregivers of children attending immunisation clinics in rural health centres in Zambia. In-depth interviews were also conducted with purposely selected grandparents, community health workers and nutrition advisors to validate the findings obtained from focus group discussions. Data were analysed using thematic analysis. Malnutrition, particularly marasmus, was linked to HIV infection. Barriers to seeking health care for severely malnourished children included beliefs about causes of malnutrition, failure to link malnutrition to poor feeding practices, distance to health care facilities and the lack of free feeding schemes for malnourished children. Mothers’ decisions to seek care for malnourished children were influenced largely by grandparents. Increasing awareness about causes, signs and symptoms of malnutrition in this community is needed to improve detection and treatment of malnourished children.