Child stunting in Zambia: A look into maternal and child nutrition behaviors and the feasibility of change

Background: In Zambia, levels of malnutrition, measured through rates of child stunting are very high. According to the 2007 Zambia Demographic Health Survey, 45 percent of children are stunted, 5 percent are wasted, and 15 percent are underweight. The highest prevalence of stunting is in rural areas with 48 percent.

Methods: The USAID-funded Communications Support for Health project conducted a formative research study to inform the development of a behavior change communication campaign to improve the nutritional status of pregnant women, breastfeeding mothers, and children under the age of 2. Research methods used were Trials of Improved Practices (TIPs) and interviews. Participants included pregnant women, mothers, fathers, and grandmothers of children under the age of 2.

Results: While mothers practice ideal breastfeeding behaviors, they need to improve practices such as proper positioning and increased length of feeding sessions. Most mothers followed guidance in delaying solid foods until their child is 6 months old. However, mothers lack awareness of the importance of introducing a variety of solid calorie-dense foods into their children's diet. Some mothers are not aware of what foods can be given to a sick child. As a result, they overfeed or give non-nutritious fluids.

The TIPs methodology revealed that the behaviors most likely to change among mothers are associated with breastfeeding, including use and empty of both breasts. Those most difficult to change were increasing fruits, vegetables, and proteins and number of meals or snacks for mother and child. Water chlorination was also described as difficult to change.