How do gender norms contribute to stunting in Ntchisi District, Malawi? A qualitative study

Abstract

Background and aim Despite adequate food production and nutrition intervention coverage, stunting remains an enduring problem in Ntchisi, Malawi. Globally, gender and social norms are known to influence nutritional outcomes in children. This study explores how gender norms contribute to child stunting, in Ntchisi district, Central Malawi. Research methods Informed by the UNICEF Framework for Malnutrition, nine focus group discussions were conducted with a target population of mothers (n = 24), fathers (n = 23) purposively targeted through growth monitoring sessions, and members of policy and health treatment committees (n = 21), spanning three different areas of Ntchisi district. Data were analysed through inductive thematic analysis, guided by the framework for Research in Gender and Ethics (RinGs). Results Three primary themes were identified: 1) gender unequal decision making on the consumption, sale and distribution of food; 2) enshrined community norms influence feeding practices underpinned by gender-based violence; and 3) policy disconnections and gaps that reinforce gender norms regarding nutrition. Themes encompassed practices across household, health treatment, and policy level. Conclusion Gender norms that underpin inequalities in decision making for production and consumption of food undermine children’s nourishment and contributes towards sustained child malnutrition in Ntchisi. Existing policy documents should revise their guidelines to incorporate gender norms as key determinants of malnutrition.