Factors associated with complementary feeding practices among children aged 6-23 mo in Malawi: an analysis of the Demographic and Health Survey 2015-2016

Background: Optimal child complementary feeding practices are crucial for nutritional status, growth, development and health, and ultimately affect child survival. This is the first population-based study in Malawi that aimed to examine factors associated with complementary feeding practices among children aged 6-23 mo. Methods: Utilizing data from the 2015-16 Malawi Demographic and Health Survey (MDHS), 4732 children aged 6-23 mo and their mothers were analysed. The MDHS produced a nationally representative sample using a multistage cluster sampling design that included sampling weights. The impact of child, maternal, household, community and health service utilization factors on complementary feeding practices was examined using the generalized estimating equation logistic regression. Results: After controlling for a wide range of covariates, children from mothers with secondary or post-secondary education and from mothers working in agriculture and living in the central region were significantly more likely to have timely introduction to solid, semi-solid or soft food. Surprisingly, being >1 y of age was associated with reduced odds of achieving minimum meal frequency. In addition, children >1 y of age from mothers older than 24 y and from mothers with primary, secondary and post-secondary education were significantly more likely to achieve minimum dietary diversity. Children from rich households were more likely to achieve both minimum dietary diversity and minimum acceptable diet. Finally, exposure to mass media was significantly associated with increased odds of achieving minimum meal frequency, minimum dietary diversity and minimum acceptable diet. Conclusions: Public health strategies aimed at reducing childhood undernutrition should focus on children from poor households whose mothers have no formal education and are unemployed. In addition, exposure to mass media had a positive impact on the three complementary feeding indicators. Therefore behaviour change communication messages through mass media aimed at promoting child nutrition are necessary to achieve optimal child complementary feeding practices

An exploration of the concept of community and its impact on participatory governance policy and service delivery in poor areas of Cape Town, South Africa

The inclusion of citizen participation as a means to the equitable delivery of public services has distinguished South Africa’s democratic development trajectory over the last 20 years. While equitable resource allocation remains high on the agenda of more recently democratised states, most of which have highly diverse and unequally resourced populations. Influencing the design of more inclusive participation is the notion of a universal citizenship that applies the concept of the equality of individuals to the needs, identities and sense of agency of citizens both between and within states. The liberal democratic theoretical conceptualisation of the individual centres on the notion of universal citizen, who is the recipient and embodiment of democracy through the rights bestowed through the democratic model. This conceptualisation has been criticised for its inability to deal with the imprecision of individual and collective political identities, especially as these evolve in newly democratic contexts. The construction of a single identity citizen living in communities imbued with homogenous characteristics is carried forward into the policy construction of participatory governance. This article explores and challenges the notion of the single identity citizen that belongs to one homogenous community that can be identified and drawn into formally constructed government spaces. The paper explores the construction of political and socio-economic identities and how notions of community are constructed by citizens, on the one hand, and government policies, on the other.IS