SOCIOCULTURAL FACTORS CONTRIBUTING TO MALNUTRITION

Abstract

Malnutrition in infants, young children, and pregnant and lactating mothers is a serious problem and an important cause of ill health and mortality in Sri Lanka. The problem .of protein energy malnutrition that affects millions of children in the world is firmly rooted in the cultural pattern, dietary habits and the general socioeconomic condition of the people. These are important factors to be considered in raising the nutritional status of the vulnerable groups in the community. The paucity of information on some aspects of these factors prompted me to under take this study. In this project the epidemiology of protein energy malnutrition was studied, with emphasis on sociocultural factors contributing to the nutritional problems among pre-school children in. four estates in the Kandy Superintendent of Health Services (SHS) area. Estates in the Kandy SHS area were selected for study because the prevalence of protein energy malnutrition (PEM) is highest'in the Kandy SHS area, and also because, out of the three islandwide population sectors (viz. urban, rural and estate) the highest prevalence of PEM is in the estate sector. Assessments were made of the nutritional status of the pre-school children anthropometrically and biochemically. In addition the educational and work status of parents, weaning and infant feeding practices, dietary patterns of the children, food taboos, beliefs, prejudices, customs and avoidances during infancy, pregnancy and lactation, food purchasing and consumption pattern of the family, maternal nutritional status, the level of their basic nutritional knowledge, and demographic data (e.g. family size, number of pre-school children, birth rank) which were thought to be relevant to malnutrition were also studied. A questionnaire was used for the socioeconomic survey, and the 24 hour recall method was adopted for the dietary survey. Data thus obtained revealed the widespread prevalence of malnutrition among children in the target population and allowed examination of the relationships between the various factors affecting the nutritional status of the children. The field work reported in this thesis was performed in 1980/8i and: the blood samples collected during this period were analysed in 1981.