Socio-cultural Construction of Child and Mother Malnutrition

Abstract

Based on fifteen months of ethnographic fieldwork, this ethnography deconstructs parental knowledge, beliefs, and experiences about inadequate household access to potential resources crucial for health and nutrition in one of the Southern and most deprived districts of Pakistani Punjab. Drawing upon UNICEF’s framework, cultural capital, and structural vulnerabilities, the research discovers how the households' experiences about care, water, and food insecurity at the micro-level are influenced or shaped by structural causes. Poor mothers are exposed to multiple unfreedoms, social injustices, and gender inequities trickled down at the local level. The research finds that the quality and quantity of water particularly in the western areas of the district are insecure and most of the houses lack proper sanitation facilities, therefore, defecation is practiced openly that causes infections and both acute and chronic forms of malnutrition. The study also reveals that poor households usually experience a limited variety of food that causes micronutrient deficiencies due to poverty, inflation, and low income. Maternal care during pregnancy and delivery is also undermined owing to intrahousehold politics, illiteracy, and high fertility. The immediacy, exclusivity, frequency, and duration of breastfeeding are constrained owing to social, cultural, and political factors. Poor, illiterate, and rural mothers‘ access to nutrition-related programs is restricted due to a lack of social capital and structural inequities. The deprioritization of nutrition programs by the health department, remote distances, traveling difficulties, gender inequities, stigmatization, and rude attitude of health and nutrition staff are the significant causes behind low socio-cultural coverage of Community Management of Acute Malnutrition (CMAM therapeutic program. Neoliberalism and development interventions to solve the problem of hunger, and malnutrition are less aligned with cultural realities so remain less successful in achieving results. The alternative responses to illness and diseases are consequently spiritual and magical. Spending lives within the disadvantaged community, poor often deprioritize health and nutrition and adopt inadequate care, feeding, reproductive, and treatment strategies in order to survive, however, such strategies are often risky and substandard. The study suggests that development practice must be guided by local cultural insights and social construction to solve the riddle of malnutrition in Pakistan.