Formative study to examine community norms of infant care practices in Democratic Republic of Congo

Objective: The development of effective programs to reduce infant mortality necessitates the inclusion of community members most likely to be affected. This paper summarizes a formative study to identify community norms surrounding infant care and child feeding practices in an underserved village of South Kivu, DRC.

Methods: In-depth interviews with mothers of infants/young children, health care providers and community leaders of the Buhozi village were conducted in July 2008. Qualitative data analysis consisted of unstructured interviews with open-ended questions and field notes.

Results: Qualitative analyses indicate community norms are consistent with established guidelines but practice of desired norms was hindered by a lack of milk production, subsequent pregnancies, and separation from the infant due to mothers searching for food. Noted challenges to optimal child feeding include insufficient daily supply of potable water and food, inability to purchase foods and low food production within the community. Respondents noted that while they recognized signs of infant/child illness, they typically delayed seeking treatment from a qualified health professional due to the inability to pay for services, leading mothers to take a wait-and-see approach to attaining care.

Conclusions: Community norms surrounding infant care and child feeding practices were supportive of sustained breastfeeding and appropriate health care practices. Environmental factors outside maternal control such as decreased availability and access to potable water, food and services caused by financial constraints, environmental barriers and maternal nutrition/health provided formidable challenges to optimal care and should be the focus of sustained health promotion programs in South Kivu, DRC.