title: A framework to explore micronutrient deficiency in maternal and child health in Malawi, Southern Africa.
abstract: BACKGROUND
  Global food insecurity is associated with micronutrient deficiencies and it has been suggested that 4.5 billion people world-wide are affected by deficiencies in iron, vitamin A and iodine. Zinc has also been identified to be of increasing concern. The most vulnerable are young children and women of childbearing age. A pilot study has been carried out in Southern Malawi, to attempt to link the geochemical and agricultural basis of micronutrient supply through spatial variability to maternal health and associated cultural and social aspects of nutrition. The aim is to establish the opportunity for concerted action to deliver step change improvements in the nutrition of developing countries.
  
  
  RESULTS
  Field work undertaken in August 2007 and July/August 2008 involved the collection of blood, soil and crop samples, and questionnaires from ~100 pregnant women. Complex permissions and authorisation protocols were identified and found to be as much part of the cultural and social context of the work as the complexity of the interdisciplinary project. These issues are catalogued and discussed. A preliminary spatial evaluation is presented linking soil quality and food production to nutritional health. It also considers behavioural and cultural attitudes of women and children in two regions of southern Malawi, (the Shire Valley and Shire Highlands plateau). Differences in agricultural practice and widely varying soil quality (e.g. pH organic matter, C/N and metal content) were observed for both regions and full chemical analysis of soil and food is underway. Early assessment of blood data suggests major differences in health and nutritional status between the two regions. Differences in food availability and type and observations of life style are being evaluated through questionnaire analysis.
  
  
  CONCLUSIONS
  The particular emphasis of the study is on the interdisciplinary opportunities and the barriers to progress in development support in subsistence communities. Engaging at the community level and the balance of expectations from both study subjects and research team highlight the merit of careful and detailed planning and project delivery.
authors.affiliation: School of Health Nursing & Midwifery University of the West of Scotland, Paisley, UK. Natalie.dickinson@uws.ac.uk
authors.forename: Natalie
authors.initials: N
authors.lastname: Dickinson
authors.forename: John
authors.initials: J
authors.lastname: Gulliver
authors.forename: Gordon
authors.initials: G
authors.lastname: MacPherson
authors.forename: John
authors.initials: J
authors.lastname: Atkinson
authors.forename: Jean
authors.initials: J
authors.lastname: Rankin
authors.forename: Maria
authors.initials: M
authors.lastname: Cummings
authors.forename: Zoe
authors.initials: Z
authors.lastname: Nisbet
authors.forename: Andrew
authors.initials: A
authors.lastname: Hursthouse
authors.forename: Avril
authors.initials: A
authors.lastname: Taylor
authors.forename: Chris
authors.initials: C
authors.lastname: Robertson
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Burghardt
mesh_terms: D002648:Child; D002669:Child Welfare; D018556:Crops, Agricultural / Q000737:chemistry; D004784:Environmental Monitoring; D005260:Female; D006801:Humans; D007501:Iron / Q000032:analysis / Q000097:blood; D008295:Malawi; D044342:Malnutrition / Q000517:prevention & control*; D008429:Maternal Welfare; D018977:Micronutrients / Q000032:analysis / Q000097:blood / Q000172:deficiency*; D010865:Pilot Projects; D011247:Pregnancy; D016730:Program Development / Q000379:methods*; D012987:Soil / Q000032:analysis; D011795:Surveys and Questionnaires; D015032:Zinc / Q000032:analysis / Q000097:blood
chemical_list: D018977:Micronutrients; D012987:Soil; D007501:Iron; D015032:Zinc