Barriers in Management of Malnutrition During COVID-19: Among Children Aged 6 to 71 Months in Buldhana District of Maharashtra in India

Abstract

Abstract Background The management of moderate acute malnutrition (MAM) in children is crucial to prevent the progression to severe acute malnutrition (SAM). This study aimed to identify the barriers to managing MAM in children aged 6 to 71 months in the Buldhana district of Maharashtra, India.Method The research followed a descriptive phenomenological design and involved six focus group discussions with mothers or caregivers of children aged 6 to 71 months, along with 20 in-depth interviews with nutrition rehabilitation services provider.Result Several themes emerged from the analysis, causes of child malnutrition such as a low child-caring time for the mother, lack of awareness, cultural beliefs, and poor maternal health. Difficulties were faced during identification, such as multiple rounds of child screening, inadequate treatment during screening, nutrition counselling issues, reduced follow-up visits, and effectiveness of services. Maternal-level barriers encompassed food insecurity, lack of food choice, mismanagement of self-grown food grains, and cultural barriers. The study also identified barriers and suggestions to improve the service, including feelings of shame associated with having children with malnutrition and obstacles in managing MAM. The COVID-19 pandemic had a severe impact on malnutrition management. Providing nutrition counselling to mothers of children with MAM without food supplementation increased the risk of negative outcomes for these children.Conclusion The study revealed that both maternal-level and service provider-level barriers negatively affect the management of malnutrition in study area. The government should prioritize and facilitate the integration of supplementary food into existing MAM management practices.