Valencia Omaira, Montoya Jenny Alexandra Hernández, López María Carolina, Damelines Juliana
Population Health Division, Fundación Santa Fe de Bogotá, Carrera 7 B # 123-90, Bogotá, Colombia.
BMC Public Health. 2025 Apr 28;25(1):1575. doi: 10.1186/s12889-025-22694-4.
Malnutrition remains a significant public health challenge in low-middle-income countries, particularly in rural and ethnic communities where structural inequalities exacerbate health disparities. This study aimed to examine the socioeconomic, cultural, and healthcare factors influencing malnutrition in children under two years old in three vulnerable regions of Colombia: Guajira, Cesar, and Chocó.
A mixed-methods approach was utilized, combining quantitative analysis with qualitative interviews exploring cultural practices and healthcare access. Data was collected from clinical records of 269 children under two years diagnosed with severe and moderate acute malnutrition, data were stratified by region, ethnicity, and maternal education levels. The socioeconomical analysis includes a geographical analysis according to the location of the households.
Socioeconomical disparities, with over 52% of households living on less than $125 USD per month, limited access to complementary foods, and high food insecurity characterized by families eating only once or twice a day. Prolonged exclusive breastfeeding over six months was observed in 10.7% of cases, influenced by cultural beliefs and food insecurity. Health complications, such as diarrhea and respiratory infections, were the most prevalent, where systemic barriers to healthcare access were most evident.
These findings align with global evidence from the WHO Global Nutrition-Report, which highlights the critical role of poverty, food insecurity, and inequitable healthcare access in perpetuating malnutrition. The study underscores the urgent need for culturally sensitive interventions, social protection programs, and infrastructural investments to address these disparities. By integrating local cultural contexts with evidence-based strategies, targeted-policies can improve maternal and child nutrition outcomes in Colombia's most vulnerable regions.
营养不良仍是中低收入国家面临的重大公共卫生挑战，特别是在农村和少数民族社区，结构性不平等加剧了健康差距。本研究旨在调查影响哥伦比亚三个脆弱地区（瓜希拉、塞萨尔和乔科）两岁以下儿童营养不良的社会经济、文化和医疗因素。
采用混合方法，将定量分析与探索文化习俗和医疗服务可及性的定性访谈相结合。从269名被诊断为重度和中度急性营养不良的两岁以下儿童的临床记录中收集数据，数据按地区、种族和母亲教育水平分层。社会经济分析包括根据家庭位置进行的地理分析。
社会经济差距明显，超过52%的家庭每月生活费不足125美元，获得补充食品的机会有限，且粮食不安全程度高，其特点是家庭每天仅进食一两次。受文化信仰和粮食不安全影响，10.7%的病例中观察到纯母乳喂养时间超过六个月。腹泻和呼吸道感染等健康并发症最为普遍，在这些病例中，医疗服务可及性的系统性障碍最为明显。
这些发现与世界卫生组织《全球营养报告》的全球证据一致，该报告强调了贫困、粮食不安全和不公平的医疗服务可及性在使营养不良长期存在方面的关键作用。该研究强调迫切需要采取对文化敏感的干预措施、社会保护计划和基础设施投资来解决这些差距。通过将当地文化背景与循证策略相结合，有针对性的政策可以改善哥伦比亚最脆弱地区的母婴营养状况。
