Myths and Cultural Beliefs Regarding Maternal and Child Nutrition: A Cause For Worry?
By Milka Njeri , A research Assistant, APHRC
July 17, 2012
Recent statistics indicate poor maternal and child nutrition are the underlying causes of 3.5 million deaths every year and 35 percent of disease burden for children under five years globally (Bryce et al. 2008).
In Kenya, neonatal and infant mortality rates are relatively high at 31 and 52 in 1000 live births respectively (KDHS 2008/09).
The effect of maternal nutrition on the health of the infant has been a subject of concern as more and more research shows that poorly nourished mothers are at a higher risk of giving birth to low birth weight babies, while facing multiple threats to their own health.Their babies in turn face greater risk of dying in the few weeks after birth and, if they survive, they have to reckon with poor growth, ill health, and slow cognitive development in childhood http://www.who.int/pmnch/media/publications/africanewborns/en/index.html.
As a result, numerous programmes have been initiated to improve maternal and newborn health including the Baby-Friendly Hospital Initiative (BFHI), a global programme that aims at enhancing optimal levels of maternal and infant feeding and care in healthcare facilities. The envisaged results of these programmes, however, have not been satisfactorily achieved due to several challenges.
Some of these challenges include myths and cultural beliefs, which contribute to reluctance to adopt good practices in relation to maternal and child nutrition. With the high levels of literacy reported in Kenya, it may seem inconceivable that such beliefs still exist but in reality they are and are a major hurdle that must be addressed overcome if initiatives such as the BFHI are to succeed.
The Millennium Development Goals 4 and 5 of reducing child mortality and improving maternal health will be realized if there is great emphasis on: reduced mortality in children under five years, reduced malnutrition ,addressing concerns of HIV / AIDS affected children, preventive interventions like vaccinations, vitamin A supplementation, water and sanitation and nutrition interventions in Africa.
Maternal health Issues including increasing the rate of delivery with skilled attendance and improving maternal nutrition are most important as well as intervention programs like supplementation with iron to reduce the incidences of anaemia during pregnancy
A study done by the African Population and Health Research Center (APHRC) among residents of two informal settlements in Nairobi indicate that pregnant women avoid some foods as dictated by myths and their cultural beliefs. Eggs, for instance are regularly avoided in several communities during pregnancy and infancy for fear that they cause delayed or slurred speech in children.
Some fruits such as avocados and bananas are to be avoided at all costs during pregnancy because they are thought to “have a lot of energy” and so may cause the unborn baby to grow too big resulting in complications while giving birth and forcing the mother to undergo caesarean section during delivery (something she’d rather avoid).” For pregnant women in this community, “A fruit a day keeps the doctor away” is a statement in vain!
Others foods that are thought to have similar effects on the baby’s size include rich sources of animal protein like fish, chicken and beef.
Healthy foods that are essential for nourishing the mother and her unborn baby are regularly shunned for fear of Caesarean Sections!
Having heavy meals a few days before delivery is also not recommended in some communities as the mother may ‘poop’ during delivery which is deemed very embarrassing for the mother. A mother may therefore go in labour with low energy reserves for the gruelling process. This affects the progress of labour and may result at best in the need for a glucose infusion during labour and at worst a Caesarean Section (which she may have been avoiding throughout the pregnancy).
No scientific evidence has linked moderate intake of any of these foods to any birth complications and yet these foods are excellent and affordable sources of much needed nutrients during pregnancy. Avoiding them may mean missing out on essential nutrients and limited food diversity which eventually results in poor maternal nutrition and consequently, increased risks for the infant.
APHRC is in the process of implementing a community-based intervention in these two informal settlements in Nairobi where the study was conducted, dubbed Maternal Infant and Young Child Nutrition (MIYCN) project. The three- year intervention is funded by the Wellcome Trust and aims at actualising the BFH initiative at the community level.
The intervention will involve personalised home-based counselling of pregnant women and mothers of infants in both Korogocho and Viwandani, on optimal maternal, infant and young child nutrition by community health workers. It is envisaged that this study will be beneficial in, among other things, dispelling all these harmful cultural beliefs and myths existing in these communities, thus improving maternal and child nutrition and consequently preventing any complications that may arise in the critical first 1,000 days of a child’s life as a result of poor nutrition. This will ensure a healthy, productive and intellectual future generation.
It is hoped that if the project is proven to be effective and feasible on a wide scale, it will be adopted by the Kenyan government and other governments in the region for scaling up countrywide.