 | Kelly Muraya Miss & PhD Student - KEMRI-Wellcome Trust Research Programme |
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03.07.2014-27.09.2014
Gender relations and the implementation and use of child nutrition interventions within households in rural Kenya
Intra-household gender relations play an important role in the management of child health. However, little attention has been paid to gender dynamics in perceptions and handling of childhood malnutrition; or how these influence and are influenced by engagement with nutrition interventions. Understanding these dynamics is important to strengthening public health efforts to tailor nutrition interventions to household realities, and improve outcomes. This qualitative study aimed to address this gap through exploring the household level interactions between gender relations and the implementation and use of a child nutrition intervention in rural Kenya. The work was conducted in Kilifi County on the Kenyan Coast. It focused on household interactions with the Targeted Supplementary Feeding Programme (SFP) - a community-based strategy for managing moderate acute malnutrition in children aged 6-59 months. Fifteen households enrolled in the SFP were followed over 12 months. Repeat interviews were undertaken with respondents within the households; supplemented by discussions with community representatives and front-line implementers of the intervention. Engagement with the SFP was gendered with women being the primary decision-makers and engagers with the intervention. However, the intervention had little impact on gender relations or on child feeding practices. Possible explanations include: gendered local childcare norms; the socio-economic and nutritional context; and the nature and process of intervention implementation. Women were responsible for managing child feeding and minor child illnesses; and with a history of food shortages in the area, involvement in nutrition interventions and moderate malnutrition were normalized. Furthermore, there was confusion among providers in intervention recruitment criteria as well as delays in implementation. The interaction of socio-economic context and gender norms played a central role in shaping child nutrition perceptions and practices. To improve outcomes, community-based nutrition interventions need to understand and take into account these structural and social issues.
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