Stigma as a barrier to treatment for child acute malnutrition in M arsabit C ounty, K enya

Dados Bibliográficos

ID15536766
AutoresJessica Bliss (Cornell University, autor correspondente), Jessica Robin Bliss (Division of Nutritional Sciences Cornell University Ithaca New York USA), Martin Njenga (Concern Worldwide US), Rebecca J Stoltzfus (0000-0002-3191-5372, Cornell University), David Pelletier (0000-0003-0134-6460, Cornell University)
Ano2015
Volume12
Fascículo1
Páginas125-138
Data de publicação2015-05-18
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoMaternal and Child Nutrition (JOURNAL)
Identificadores do periódicoISSN: 1740-8695 • E-ISSN: 1740-8709
EditoraWiley (PUBLISHER • GB)
DOI10.1111/mcn.12198
PMID25989353
OpenAlexW1845410920
IdiomaEN
Citações recebidas14
Referências citadas36

Acute malnutrition affects millions of children each year, yet global coverage of life-saving treatment through the community-based management of acute malnutrition (CMAM) is estimated to be below 15%. We investigated the potential role of stigma as a barrier to accessing CMAM. We surveyed caregivers bringing children to rural health facilities in Marsabit County, Kenya, divided into three strata based on the mid-upper arm circumference of the child: normal status (n = 327), moderate acute malnutrition (MAM, n = 241) and severe acute malnutrition (SAM, n = 143). We used multilevel mixed effects logistic regression to estimate the odds of reporting shame as a barrier to accessing health care. We found that the most common barriers to accessing child health care were those known to be universally problematic: women's time and labour constraints. These constituted the top five most frequently reported barriers regardless of child acute malnutrition status. In contrast, the odds of reporting shame as a barrier were 3.64 (confidence interval: 1.66-8.03, P < 0.05) times higher in caregivers of MAM and SAM children relative to those of normal children. We conclude that stigma is an under-recognized barrier to accessing CMAM and may constrain programme coverage. In light of the large gap in coverage of CMAM, there is an urgent need to understand the sources of acute malnutrition-associated stigma and adopt effective means of de-stigmatization

Environmental health · Logistic regression · Malnutrition · Odds · Odds ratio · Psychiatry · Severe Acute Malnutrition · Shame · Stigma (botany · Child Nutrition and Water Access · Food Security and Health in Diverse Populations · Medicine · Poverty, Education, and Child Welfare · Psychology · Social Psychology · Internal Medicine · Pediatrics