6.4.2 Underlying causes of malnutrition
Poor diet and disease are the immediate causes of malnutrition for children but it is always important to try to find out why that child has a poor diet or why they have developed the disease. The underlying causes differ within different communities and from family to family but it is useful to group them into: family food shortages; inadequate care of children and women; unhealthy environment and poor health services; and too many children in a family to feed.
For each underlying cause you identify, there is probably another, ‘deeper’ cause. For example, a child may have a poor diet because the family has little food. But why is the family short of food? Perhaps they have too little land or a low income. But why have they too little land? Keep probing and asking ‘But why?’ Eventually you should be able to determine the basic causes.
Let us now further examine the underlying causes under three of the main groups given above.
Family food shortages: Many families do not have enough food to feed everyone properly throughout the year. But why are these families short of food?
The possible reasons for family food shortages may be that there is a large number of families in the locality, leading to over-cultivation of their lands. Another might be the effects of low income or poor budgeting. Some people may spend so much on ‘non-essential’ things such as ‘khat’, cigarettes and beer, so there is not enough money left for the family’s food needs. There may also be poor distribution of food among families.
Activity 6.2 Identifying local causes of family food shortages
Think of a family in your community who has food shortages and discuss with a work colleague what the reasons for the food shortages could be. Make a note of these in your Study Diary and discuss your findings with your Tutor.
There will be different causes for food shortages, some depending on the region in which you live. You might have identified large family size, small size of farming land, low income, or extravagance by the husbands on unnecessary items, such as cigarettes and beer.
Inadequate care of children and women: Nutrition and health care are often determined by the amount of care given to women and children, and this is strongly affected by a woman’s workload, access to resources and her education.
If the mother is busy, she might not have enough time to breastfeed and care for her child. Many women are uneducated and have little knowledge about feeding, childcare and hygiene. Thus they lack awareness of the correct things to do. These same women often cannot or do not attend clinics or women’s groups where they could learn skills to improve their lives and that of their families.
Activity 6.3 Effects of women’s activity on nutritional status of children
Discuss with some of your colleagues how the mothers in your community spend their time. Discuss how their activities affect the nutritional status of their children. Write down your discussion points in your Study Diary and discuss these with your Tutor.
Mothers may spend much of their time fetching water, farming or doing labour work; a minority of mothers may be government employees. If a mother is busy with these and other activities, she may not get time to breastfeed, prepare foods for her children and or ensure her children’s hygiene. Children of these mothers may be at higher risk of undernutrition either due to lack of appropriate and adequate feeding, or due to repeated infections as a result of poor sanitary conditions.
Unhealthy environment and poor health services: Disease is more likely to occur, especially among young children, when there are poor living conditions such as overcrowding, low immunization coverage and poor health services.