This report looks at the challenges faced in preventing malnutrition in
Sierra Leone from a localised perspective and finds that:
- Promoting good child nutrition must go beyond dissemination of infant
and young child feeding practices to engage with key influences on
- ‘Exclusive’ breastfeeding is rarely exclusive, with traditional
remedies frequently given to infants. Decision-making around food
distribution, household finances and when to stop breastfeeding is
deeply gendered, influencing the ability of women to act on knowledge
about appropriate feeding practices.
- These social conditions that sustain malnutrition are exacerbated
during ‘lean seasons’, when there are greater labour demands,
compromised sanitation, and limited coping mechanisms.
- Sierra Leone is characterised by a plural health system, combining
state and non-state health providers. Citizens navigate this plurality
according to a number of factors, including proximity, cost,
tradition, perceived effectiveness, experience of treatment and
household power relations.
- The dominant paths of healthcare access varied across research sites
and interventions to improve healthcare will need to understand how
the above factors play out in different contexts and tailor programmes
Denney, L.; Mallett, R.; Jalloh, R. Understanding malnutrition and health choices at the community level in Sierra Leone. Overseas Development Institute (ODI), London, UK (2014) 45 pp. [Report 4]
Understanding malnutrition and health choices at the community level in Sierra Leone