Life course learning experiences and infant feeding practices in rural Rwanda

Most studies about infant and young child feeding (IYCF) practices are often perceived as an individual choice depending on mothers' or caregivers' knowledge or attitudes and are focused on mothers' failure rather than successes in adequately feeding their children. However, the role of life course experiences in IYCF is less investigated. Applying a Salutogenic Model of Health, this study on 14 mothers looks at women's life course learning experiences shaping appropriate IYCF practices during the first year of child's life in a rural district of Rwanda. Transcripts from in-depth interviews were analysed using thematic analysis. Results indicate that positive social interaction with parents or grandmothers during childhood such as sharing meals, parental role models for dietary choices and cooking skills gained by participating in household food preparation played a role in shaping appropriate IYCF practices. Negative experiences during childhood also had a positive influence on IYCF practices for some participants by converting life course constraints into learning opportunities. Motherhood increased mothers' sense of responsibility over their children's health and nutrition. Moreover, mothers' participation in community cooking classes and role modelling approach were strong avenues that enabled their learning through positive interactions and encouragement. Nutrition promotion interventions should consider tailoring nutrition advice to the complexity of mothers' life course experiences by creating opportunities for positive learning experiences of appropriate IYCF practices.</p

Qualitative, longitudinal exploration of coping strategies and factors facilitating infant and young child feeding practices among mothers in rural Rwanda

Background: Mothers in low-income countries face many challenges to appropriately feed their children in the first year such as poverty, food insecurity and high workloads. However, even in the lowest income families there are mothers who succeed to feed their children according to the recommendations. In this paper, we explored the coping strategies that facilitate appropriate breastfeeding and complementary feeding practices among rural Rwandan mothers from birth to one year of a child’s life. Methods: This qualitative longitudinal study recruited a purposive sample of 17 mothers who followed the infant and young child feeding recommendations (IYCF). They were selected from a larger study of 36 mothers. In-depth interviews were conducted with mothers of the total group (36 mothers) within the first week, at 4th, 6th, 9th and 12th months postpartum. Interviews were audio-recorded, transcribed verbatim and analyzed thematically. Results: Coping strategies included improving mothers’ own diet for adequate breastmilk production, prioritizing child feeding over livelihood chores, livelihood diversification and mothers’ anticipatory behaviors such as preparing child’s food in advance. Some of those coping strategies were shifting overtime depending on the development of the children. Personal factors such as breastfeeding self-efficacy, religious beliefs and perceived benefits of breastfeeding were among the facilitating factors. Additionally, social support that mothers received from family members, other mothers in the community, Community Health Workers (CHWs) and health professionals played an important role. Conclusion: In challenging contextual conditions, mothers manage to follow the recommended breastfeeding and complementary feeding practices through the interplay of active coping strategies, feeling to be in control and social support. Nutrition promotion interventions that aim to improve IYCF should consider strengthening mothers’ capability in gaining greater control of their IYCF practices and the factors facilitating their appropriate IYCF practices.</p

Valorisation des sous produits de conservie: cas des graines de tomates

Les graines de tomates sont les constituants majeurs des déchets de l’industrie de transformation des fruits de tomate, elles représentent 0,5%du poids du fruit et contiennent entre 18 et 30% de lipides sous forme d’huile. L’objet de ce travail est l’extraction et la caractérisation de l’huile de graine de tomate. Les graines de tomate proviennent d’un tas de déchet en stockage au niveau de la conserverie Ammour – Mouzaîa – Algérie. Après séparation, triage et séchage à l’air libre, les graines sont placées dans un dispositif Soxhelet contenant le n-hexane comme solvant d’extraction. Le rendement à l’extraction a été calculé, il est de 209,86 grammes d’huile pour 934,06grammes de graines de tomate, soit 22,47% ; après filtration le rendement est de 21,6%, soit 82%des lipides présent dans les graines de tomate. Les constantes physicochimiques caractéristiques de la qualité des huiles ont été mesurées avant et après raffinage de l’huile extraite ; il en ressort que le raffinage diminue l’acidité de 0,9 à 0,06%, la teneur en chlorophylle de 15,46 à 0,0092 ppm et entraine la disparition du phosphore. Les autres constantes mesurées n’ont pas subi de variation notable. Les résultats de l’analyse chromatographique de la fraction lipidique de l’huile de graines de tomate raffinée a révélé un profil chromatographique composé de 07 acides gras à 16 et 18 atomes de carbones. Les acides linoléiques et oléiques sont prédominants avec 52 et 22% respectivement. Les acides gras saturés sont représentés essentiellement par 13,18% d’acide palmitique et par de la résistance à l’oxydation de l’huile de graines de tomate extraite est de 4,70 heures à la température de 120°C, correspondant à une durabilité de 223 jours à 20°C

Challenges and responses to infant and young child feeding in rural Rwanda: A qualitative study

Background: Despite different interventions to improve child nutrition conditions, chronic malnutrition is still a public health concern in Rwanda, with a high stunting prevalence of 38% among under 5-year-olds children. In Rwanda, only 18% of children aged 6-23 months are fed in accordance with the recommendations for infant and young child feeding practices. The aim of this study was to explore challenges to infant and young child feeding practices and the responses applied to overcome these challenges in Muhanga District, Southern province of Rwanda. Methods: Sixteen (16) focus group discussions were held with mothers, fathers, grandmothers, and community health workers from 4 rural sectors of Muhanga District. The discussions were recorded, transcribed verbatim, and thematically analyzed using qualitative data analysis software, Atlas.ti. Results: Two main themes emerged from the data. Firstly, there was a discourse on optimal infant and young child feeding (IYCF) practices that reflects the knowledge and efforts to align with early initiation of breastfeeding, exclusive breastfeeding for the first 6 months, as well as initiation of complementary foods at 6 months recommendations. Secondly, challenging situations against optimal practices and coping responses applied were presented in a discourse on struggling with everyday reality. The challenging situations that emerged as impeding appropriate IYCF practices included perceived lack of breast milk, infant cues, women's heavy workload, partner relations and living in poverty. Family and social support from community health workers and health facility staff, financial support through casual labor, and mothers saving and lending groups, as well as kitchen gardens, were used to cope with challenges. Conclusion: Factors influencing IYCF practices are multifaceted. Hence, intervention strategies to improve child nutrition should acknowledge the socially embedded nature of IYCF and address economic and social environmental constraints and opportunities, in addition and above knowledge only.</p