Sociocultural Determinants of Nutritional Status Among Children Under Five Years of Age: An Ethnographic Study From Gujarat.

Background The magnitude of child malnutrition, including severe child malnutrition, is high in India, and Gujarat has a higher prevalence of child malnutrition. Prior studies have employed anthropometric measures to identify the prevalence and associated factors of children's undernutrition. The present study explored community-level determinants of malnutrition among malnourished and well-nourished children in Devbhumi Dwarka district of Gujarat State, India. Methods A qualitative research employing focused ethnographic methodologies was used. In-depth observations of 60 families in a home food environment were carried out. Each child was observed at their respective homes for three consecutive days. Data were analyzed using thematic analysis techniques. Results The study revealed that lack of knowledge on malnutrition, inadequate feeding practices, poor socioeconomic status, insufficient hygiene and sanitation practices, lack of food variety, use of health facilities, and birth complications were the major community-based determinants of malnutrition. Conclusion The study identified community-level determinants of malnutrition among children under five years in the Devbhumi Dwarka district. To tackle the immediate and underlying causes of malnutrition, interventions are urgently needed to create community awareness about malnutrition as a disease and optimal infant and young child feeding (IYCF) practices using behavior change communication strategies.