A Qualitative Research Study in Madagascar: One student's Experiences, Results, and Reflections

Introduction:Madagascar has one of the highest prevalence of stunting (low-height for-age) in the world. Stunting leads to negative consequences for the long-term: poor cognitive function, lower levels of income, and shorter stature in adulthood. In 2008 ADRA, CARE, CRS, and Land'O Lakes formed a partnership to implement a food security program. The 2009 baseline survey showed the highest rates of stunting (WHO Height-for-Age Z score <-2SD) in the Central Plateau region. This was unexpected. The Central Plateau has positive scores on risk factors commonly associated with stunting when compared to other geographic regions of Madagascar. Methods:With guidance from the partnership, we undertook a qualitative study to understand perceptions of malnutrition, infant and young child feeding practices, and taboos. We conducted focus group discussions (FGD). FGDs were conducted separately with mothers, fathers, and grandmothers of stunted children (HAZ ≤-2) and relatives of non-stunted children (HAZ≥-1) between the ages of 6-24 months. Results:We conducted 19 FGDs. Perceptions of malnutrition were similar for relatives of stunted and non-stunted children. All participants reported that a malnourished child has an impact on the household because their is less time for income generating activities. Some mothers of stunted children reported introducing liquids earlier and solids later than mothers of non-stunted children. Lack of dietary diversity was a problem despite access to various food groups. Hygiene was also a problem. Some participants reported that women drink alcohol, use chewing tobacco, and drink coffee when pregnant and while breastfeeding. Results will be used to improve program delivery.