Project report
Improving Nutrition Outcomes for Children in Sri Lanka’s Estate Sector : The Positive Deviance Approach
·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study looks at child undernutrition in Sri Lanka's estate sector, where 31.7 percent of children under five were stunted in 2016. It uses a positive deviance approach, which looks at what mothers and caregivers of well-nourished children do differently from others in the same setting. The work was carried out in two estates in Nuwara Eliya district with children aged 6 to 59 months. Researchers used focus groups, interviews, and home and child development centre visits, and compared children with better nutrition (PD) with those without (NPD). The abstract does not report the actual findings.
Key points
- Stunting among children under five in the estate sector was 31.7 percent in 2016, despite some improvement from 2006 to 2016.
- A earlier multisectoral assessment named low birth weight, sub-optimal child care practices and lack of dietary diversity as key contributors to undernutrition.
- Most nutrition studies focus on problems and barriers rather than on practices that lead to good nutrition.
- The study used a purposive sample of children aged 6 to 59 months in two estates in Nuwara Eliya district.
- Findings of the PD and NPD groups were compared using a modified UNICEF nutrition conceptual framework.
Limitations
The abstract gives no results about which practices distinguish the positive deviance group, so conclusions cannot be drawn from it. The purposive sample from two estates and the qualitative design limit how far findings apply to other settings.
Abstract
In recent decades, most health indicators for Sri Lankan children have improved, but the prevalence of undernutrition has stagnated and inequities among sub-populations, particularly those in Sri Lanka’s estate sector, persist. Despite some improvement in the nutritional status indicators for children in the estate sector from 2006 to 2016, the stunting prevalence for children under five years was 31.7 percent in 2016. Undernutrition among young children is the result of a complex interaction between social, behavioral, economic, health, and other related factors. A multisectoral nutrition assessment in Sri Lanka’s estate sector, for example, identified low birth weight, sub-optimal child care practices, and lack of dietary diversity as key factors contributing to undernutrition. Many nutrition studies, including the multisectoral nutrition assessment, focus mainly on problems and barriers that prevent children from reaching their full potential rather than exploring practices that help achieve good nutrition outcomes in a given context. Positive deviance nutrition studies identify successful practices and behaviors associated with a ‘satisfactory level of nutrition’ among young children and promote these practices to other community members. The objective of this study was to explore the practices and behaviors of mothers and caregivers that enable them to achieve better nutritional outcomes in their young children. The study was conducted in two estates within the Nuwara Eliya district on a purposive sample of children in the age group six to 59 months (i.e. PD and NPD). Various qualitative research methods were used to identify the successful behaviors and practices, including (i) focus group discussions among mothers; (ii) in-depth interviews with mothers/other care givers; (iii) key informant interviews with various health staff categories (field level staff, supervisory staff, administrative staff etc.); (iv) observational visits to homes of a sub-sample of children; and (v) observational visits to child development centers. The study focused on identifying the intentional and unintentional behaviors and practices of caregivers and the strategies that enable them to achieve better nutrition outcomes for their children. Data analysis compared the findings of the two groups (PD and NPD) based on a modified nutrition conceptual framework developed by the United Nations Children’s Fund. (Sri Lanka)