Perceived determinants of food choices among pregnant women and lactating mothers with their under two years children in three districts of rwanda: a qualitative study

Abstract

Background: Maternal and child nutrition during pregnancy and lactation has been associated with healthy outcomes for both mother and child. This study explored the factors influencing food choices and nutritional practices of pregnant women and lactating mothers with their children below two years in rural areas of Rwanda. Methods: A qualitative approach was used in the six sectors from three districts of Rwanda, where, 24 focus group discussions (FGDs), with and 12 Key Informant interviews (KIIs) were conducted in August 2019. FGDs included pregnant women, lactating mothers, grandmothers, community health workers (CHWs), and role model parents, men, and KKIs with nutrition officers in health centers and hospitals, local leaders and CRS-Gikuriro program implementing partners. A thematic analysis of content was performed using Atlas ti, version 7.5.18 to analyze all qualitative data, and all data were gathered around key themes of the study. Results: The theme “Perceived reasons of food choices among pregnant women, lactating mothers with their under two years’ children”; included mothers’ experiences in the battle of eating a balanced diet, existing support and barriers met day by day, trying to make good food choices for them, their children and the whole family in general. Positive perceptions on benefits from eating balanced diet have been identified, but many barriers are limiting the ability to put in practice the what they have learnt from various interventions; such as poverty and lack of husband’s support, time pressure and nature of daily jobs, husband and wife conflicts, climate change and food insecurity, lack of clean drinking water, societal and religious beliefs in making food taboos, … Conclusion: Intensified nutritional education was identified as a key measure for improving nutritional practices of women during pregnancy, lactation and for their under two years’ children. Special programs which stimulate husband support should be organized in order to increase men’s knowledge of adequate maternal and child nutrition intake during that particular period also improve both parent’s collaboration with supportive care which would positively affect the productivity and development of the family as well as mother and child nutritional health.