4 research outputs found
Filial factors of kwashiorkor survival in urban Ghana: Rediscovering the roles of the extended family
This paper discusses the findings of two field studies in urban Accra, Ghana that investigated the social and familial factors that were associated with survival of childhood kwashiorkor, a protein-caloric deficiency form of malnutrition that is endemic in that nation. Data was collected from qualitative interviews with family groups that included teenaged survivors of kwashiorkor, and the adults who were involved in the young person’s childhood rearing, including those who were responsible for compliance with the Ghana Ministry of Health malnutrition rehabilitation effort. Extensive interviews were documented in audio and video tape and field notes by a team that included the fields of social work, public health, nursing and sociology. All members of the participating families who were involved in the data collection were offered compensation for their time as well as full protection of privacy through the human subjects informed consent protocol and oversight of the University of Ghana, Eastern Michigan University and Wayne State University. The findings included reporting of a consistently critical role of the grandmothers and other senior women in the family units. The senior women either managed the economics and maintenance of the extended household, or took principal responsibility for sustaining the malnourished children’s participation in rehabilitation efforts. In some cases, the mothers were deceased and two or more senior women in the family carried out roles of parenting as well as familial economic support and coordination of care for the afflicted child. The findings suggest that full compliance with rehabilitation efforts for a single mother with multiple children and no extended familial support system would be very difficult and more likely to result in non-compliance and failure of the child to survive. Suggestions are offered for family oriented, community health education regarding the irony of this form of malnutrition being endemic in communities that do not lack appropriate food. Implications for increased recognition and support for the elderly and senior family members to enhance child survival are discussed within the context of changing social and epidemiological profiles of urban centers in Ghana and elsewhere among developing nations of sub- Saharan Africa.Keywords: Kwashiorkor, Malnutrition, Rehabilitation compliance, Grandmothers, Endemic malnutritio
Filial Factors Of Kwashiorkor Survival In Urban Ghana: Rediscovering The Roles Of The Extended Family
This paper discusses the findings of two field studies in urban Accra,
Ghana that investigated the social and familial factors that were
associated with survival of childhood kwashiorkor, a protein-caloric
deficiency form of malnutrition that is endemic in that nation. Data
was collected from qualitative interviews with family groups that
included teenaged survivors of kwashiorkor, and the adults who were
involved in the young person's childhood rearing, including those who
were responsible for compliance with the Ghana Ministry of Health
malnutrition rehabilitation effort. Extensive interviews were
documented in audio and video tape and field notes by a team that
included the fields of social work, public health, nursing and
sociology. All members of the participating families who were involved
in the data collection were offered compensation for their time as well
as full protection of privacy through the human subjects informed
consent protocol and oversight of the University of Ghana, Eastern
Michigan University and Wayne State University. The findings included
reporting of a consistently critical role of the grandmothers and other
senior women in the family units. The senior women either managed the
economics and maintenance of the extended household, or took principal
responsibility for sustaining the malnourished children's participation
in rehabilitation efforts. In some cases, the mothers were deceased and
two or more senior women in the family carried out roles of parenting
as well as familial economic support and coordination of care for the
afflicted child. The findings suggest that full compliance with
rehabilitation efforts for a single mother with multiple children and
no extended familial support system would be very difficult and more
likely to result in non-compliance and failure of the child to survive.
Suggestions are offered for family-oriented, community health education
regarding the irony of this form of malnutrition being endemic in
communities that do not lack appropriate food. Implications for
increased recognition and support for the elderly and senior family
members to enhance child survival are discussed within the context of
changing social and epidemiological profiles of urban centers in Ghana
and elsewhere among developing nations of sub-Saharan Africa.Ce document présente les résultats de deux études de
terrain effectuées dans des zones urbaines d'Accra au Ghana. Ces
études ont porté sur les facteurs sociaux et familiaux qui
ont été associés à la survie au kwashiorkor de
l'enfance, une forme de malnutrition causée par la carence en
protéines et en calories, et cette malnutrition est endémique
dans ce pays. Des données ont été collectionnées
à partir d'interviews qualitatives auprès de groupes
familiaux qui incluaient des adolescents survivants du kwashiorkor, et
des adultes qui ont été impliqués dans l'éducation
de jeunes enfants, tels que ceux qui étaient responsables de se
conformer aux initiatives de réhabilitation en matière de
nutrition entreprises par le ministère ghanéen de la
Santé. Des interviews extensives ont été publiées
sur cassettes audio et vidéo et au moyen des notes de terrain par
une équipe qui représentait des domaines tels que le travail
social, la santé publique, l'infirmerie et la sociologie. Tous les
membres des familles participantes qui étaient impliquées
dans la collecte des données ont reçu une indemnisation pour
leur temps ainsi que la protection des renseignements fournis, à
travers le protocole de consentement informé des sujets humains et
par la supervision de l'Université du Ghana, l'Université de
l'Est de Michigan et l'Université de l'Etat de Wayne. Les
résultats comprenaient un rapport sur le rôle de plus en plus
important des grand-mères et d'autres femmes âgées de la
famille. Les femmes âgées s'occupaient de la gestion de
l'économie et de l'entretien du ménage élargi, ou alors
elles prenaient la principale responsabilité d'appuyer la
participation des enfants mal nourris aux initiatives de
réhabilitation. Dans certains cas, les mères étaient
décédées et deux ou plusieurs femmes âgées da
la famille avaient pris la relève dans les rôles des parents
et de l'appui familial au niveau économique ainsi que la
coordination des soins des enfants affligés. Les résultats
suggèrent que pour une mère seule qui a plusieurs enfants il
serait très difficile de se conformer entièrement aux
initiatives de réhabilitation si elle n'a pas d'appui de la
famille au sens large, et la conséquence serait sans doute la
non-conformité à ces initiatives et la non survie de
l'enfant. Des suggestions sont offertes en vue d'une éducation
orientée vers la famille et la santé de la communauté en
ce qui concerne l'ironie de cette forme de malnutrition qui est
endémique dans des communautés qui n'ont pas d'alimentation
appropriée. Des implications visant la revalorisation du rôle
des personnes âgées et des membres de famille âgés
ainsi que l'appui à ces catégories de personnes pour qu'elles
contribuent davantage à la survie des enfants font l'objet de
discussions dans le cadre du changement des profils sociaux et
épidémiologiques des centres urbains du Ghana et d'ailleurs
dans des pays en développement de l'Afrique sub-saharienne