In many societies particularly in Africa, the role of older women or grandmothers as managers of indigenous knowledge in infant and young child feeding and care is well recognized. Grandmothers often take the role of mentoring the younger generations in child feeding and care, and pass the indigenous knowledge across generations (http://www.worldbank.org/afr/ik/iknt89.pdf).
We conducted a study across various regions in Kenya to establish cultural influences in maternal, infant and young child nutrition, and hence to establish innovative, public-informed approaches of community engagement in baby friendly community initiatives, in order to inform effective implementation of the proposed baby friendly initiative (BFCI) program in Kenya. In particular, the participatory action research at the community level was to understand community’s own perspective of best practices in their involvement in baby friendly community initiatives including different roles to be played by different categories of community members, best ways of executing the roles and best communication channels.
The study involved qualitative interviews (focus group discussions and key informant interviews) and community dialogues with community leaders, community members (including mothers, grandmothers and fathers), health care workers, traditional birth attendants and herbalists and religious leaders. We did this across six counties in six different regions in Kenya including Vihiga (Western region), Machakos (Eastern region), Kwale (Coastal region), Kajiado (Rift Valley region), Kiambu (Central Region) and Nairobi (Nairobi region).
Across the different counties, the role of grandmothers in infant and young child feeding and care was considered very important. They were considered as custodians of indigenous knowledge hence advisors on issues of child feeding and often the decision makers especially where the mothers were young. In many instances, they were considered the caregivers for children especially in instances where the mothers were young and needed to go back to school, were busy with other businesses like job seeking or were working, or where the mothers had neglected their children. In many of the discussions, it was clear that grandmothers’ role in the implementation of the baby friendly community initiative needs to be well recognized. However, communities also indicated that these grandmothers are not very well informed on optimal infant and young child nutrition and care as it is recommended today, as their indigenous knowledge may not be in tandem with the current recommendations for infant and young child feeding and care. This leads to poor health of children in the various communities, and the various communities recommended that these older women need to be trained/sensitized on the new recommendations for them to be more effective in their role.
“The main problem we are facing now is that if you go to any school you will find more than 40% of the children in those schools are children whose mothers are our daughters……born out of wedlock and these children are left with grandmothers….and this grandmothers is not strong enough to look for food, she gives the baby that porridge and throws the cup wherever without really caring. And so you find the children are unhealthy completely because they lack proper parental care”. (Vihiga County)
Since they (grandmothers) have already given birth they will advise you on how to breastfeed and also how to feed the baby maybe the baby does not want to eat they will show you how to feed the baby, some maybe do not know how to hold the baby they will show you how to do it … They normally use the information of the past since the grandmothers have come from far, so if they give guidance they give the information of the past but what is said in the hospitals they may not be aware. (Kwale County).