title: Maternal perceptions of factors contributing to severe under-nutrition among children in a rural African setting.
abstract: BACKGROUND
  In developing countries, severe undernutrition in early childhood is associated with increased mortality and morbidity, and 10-40% of hospital admissions. The current study aimed to elicit maternal perceptions of factors that contribute to severe undernutrition among children in a rural Kenyan community in order to identify appropriate and acceptable targeted interventions.
  
  
  METHODS
  The study consisted of 10 focus group discussions (FGDs) of between eight and ten mothers each, in a rural coastal community in Kenya. A grounded theory approach was used to analyse the FGD data.
  
  
  RESULTS
  In all FGDs 'financial constraints' was the main reason given for severe undernutrition of children. The mothers reported the additional factors of inadequate food intake, ill health, inadequate care of children, heavy workload for mothers, inadequate control of family resources by women and a lack of resources for generating income for the family. The mothers also reported their local cultural belief that severe malnutrition was due to witchcraft and the violation of sexual taboos.
  
  
  CONCLUSIONS
  The mothers in the study community recognised multiple aetiologies for severe undernutrition. A multidisciplinary approach is needed address the range of issues raised and so combat severe undernutrition. Suggested interventions include poverty alleviation, medical education and psychosocial strategies. The content and approach of any program must address the need for variability, determined by individual and local needs, concerns, attitudes and beliefs.
authors.affiliation: KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya.
authors.forename: A
authors.initials: A
authors.lastname: Abubakar
authors.forename: P
authors.initials: P
authors.lastname: Holding
authors.forename: M
authors.initials: M
authors.lastname: Mwangome
authors.forename: K
authors.initials: K
authors.lastname: Maitland
mesh_terms: D000328:Adult; D002648:Child; D015362:Child Nutrition Disorders / Q000523:psychology*; D002664:Child Nutritional Physiological Phenomena; D002669:Child Welfare / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007630:Kenya; D008425:Maternal Behavior / Q000523:psychology; D008875:Middle Aged; D009035:Mothers / Q000193:education / Q000523:psychology*; D009752:Nutritional Status; D011203:Poverty; D012931:Social Environment; D014505:Urban Population; D055815:Young Adult