Barriers to practicing healthy behaviors for malaria prevention and child nutrition in Zambia: A qualitative study

Background: Despite improvements in coverage of malaria prevention and treatment interventions, malaria continues to be a major cause of morbidity and mortality among children and pregnant women in Zambia. This is exacerbated by Zambia's high prevalence of malnutrition. In 2010, the World Health Organization estimated that 14.9 percent of children under age five in Zambia were underweight. Methodology: The USAID-funded Communications Support for Health project in Zambia conducted a qualitative study in three provinces to identify barriers to malaria prevention and control and healthy infant-feeding practices. Focus group discussions and interviews were used to assess health-seeking behaviors of mothers of children under five years and pregnant women.

Results: Knowledge of malaria risks, signs and symptoms, and prevention methods was high; however, participants complained of difficulty breathing and itching when using insecticide-treated bed nets (ITNs). An inadequate number of ITNs in the household to cover all women and children under five years was reported as a barrier to ITN use.

Mothers said that the main barrier to exclusive breastfeeding was the belief that it does not provide sufficient food during the first six months. In addition, commitments such as employment or income-generating activities did not allow time for breastfeeding.

Study findings were used to develop the communication strategy and messages for an integrated malaria and nutrition campaign in Zambia. Future behavior change communication efforts should focus on helping families prioritize the use of ITNs by pregnant women and children under five years. Materials should also address concerns related to exclusive breastfeeding.