The social context of childcare practices and child malnutrition in Niger’s recent food crisis
Katherine Hampshire, Rachel Casiday, Kate Kilpatrick and Catherine Panter-Brick
ABSTRACT
In 2004–05, Niger suffered a food crisis during which global attention focused on high levels of acute malnutrition among children. In response, decentralised emergency nutrition programmes were introduced into much of southern Niger.
Child malnutrition, however, is a chronic problem and its links with food production and household food security are complex. This qualitative, anthropological study investigates pathways by which children are rendered vulnerable in the context of a nutritional ‘emergency’. It focuses on household-level decisions that determine resource allocation and childcare practices in order to explain why practices apparently detrimental to children’s health persist.
Risk aversion, the need to maintain self-identity and status, and constrained decision making result in a failure to invest extra necessary resources in growthfaltering children. Understanding and responding to the social context of child malnutrition will help humanitarian workers to integrate their efforts more effectively with longer-term development programmes aimed at improving livelihood security.
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This is an important informative article for all of us who have started using the term G/SAM, global/severe acute malnutrition in the past called wasting, to contrast that with GCM or stunting. I am convinced that the ubiquitous use now of G/SAM and especially SAM is incorrect. As the above article cleardy demonstrates very few children develope suddenly and Acute Severe Malnutrition. It almost invariably is superimposed on chronic episodes food insecurity which have reseulted in wasting and stunting.
In our Southern African health systems burdened by a high prevalence of HIV and TB and thus also other chronic infections all inducing poor appetite and malabsorption we face "slim disease"and that is CHRONIC malnutrition. During my daily rounds in our large malnutrition ward, annually 1600-2000 admissions of only severely malnourished children, I see many young chronically malnourished infants and children invariably with a horizontal growth curve for about half of their life. 50-60% of the total admitted is HIV reactive and in need of HAART and RUTF started in our facility and soon transfeerd to VCT/HAART programmes.
I like to make a plea to reconsider the term SAM as it is in many situations a misnomer and mis informer. This needs to be done at policy level like in WHO and UNICEF since their policy documents are all using now these terms probaly since Steve Collins in his excellent Lancet review coined that term.
Comment by tom heikens — 2010-02-12 13:11 | # - re