Stigma as a barrier to treatment for child acute malnutrition in Marsabit County, Kenya
Identifieur interne : 001106 ( Main/Exploration ); précédent : 001105; suivant : 001107Stigma as a barrier to treatment for child acute malnutrition in Marsabit County, Kenya
Auteurs : Jessica Robin Bliss [États-Unis] ; Martin Njenga [Kenya] ; Rebecca Joyce Stoltzfus [États-Unis] ; David Louis Pelletier [États-Unis]Source :
- Maternal & Child Nutrition [ 1740-8695 ] ; 2016-01.
Abstract
Acute malnutrition affects millions of children each year, yet global coverage of life‐saving treatment through the community‐based management of acute malnutrition (CMAM) is estimated to be below 15%. We investigated the potential role of stigma as a barrier to accessing CMAM. We surveyed caregivers bringing children to rural health facilities in Marsabit County, Kenya, divided into three strata based on the mid‐upper arm circumference of the child: normal status (n = 327), moderate acute malnutrition (MAM, n = 241) and severe acute malnutrition (SAM, n = 143). We used multilevel mixed effects logistic regression to estimate the odds of reporting shame as a barrier to accessing health care. We found that the most common barriers to accessing child health care were those known to be universally problematic: women's time and labour constraints. These constituted the top five most frequently reported barriers regardless of child acute malnutrition status. In contrast, the odds of reporting shame as a barrier were 3.64 (confidence interval: 1.66–8.03, P < 0.05) times higher in caregivers of MAM and SAM children relative to those of normal children. We conclude that stigma is an under‐recognized barrier to accessing CMAM and may constrain programme coverage. In light of the large gap in coverage of CMAM, there is an urgent need to understand the sources of acute malnutrition‐associated stigma and adopt effective means of de‐stigmatization.
Url:
DOI: 10.1111/mcn.12198
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream Istex, to step Corpus: 001F12
- to stream Istex, to step Curation: 001F12
- to stream Istex, to step Checkpoint: 000012
- to stream Main, to step Merge: 001108
- to stream Main, to step Curation: 001106
Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Stigma as a barrier to treatment for child acute malnutrition in Marsabit County, Kenya</title><author><name sortKey="Bliss, Jessica Robin" sort="Bliss, Jessica Robin" uniqKey="Bliss J" first="Jessica Robin" last="Bliss">Jessica Robin Bliss</name></author><author><name sortKey="Njenga, Martin" sort="Njenga, Martin" uniqKey="Njenga M" first="Martin" last="Njenga">Martin Njenga</name></author><author><name sortKey="Stoltzfus, Rebecca Joyce" sort="Stoltzfus, Rebecca Joyce" uniqKey="Stoltzfus R" first="Rebecca Joyce" last="Stoltzfus">Rebecca Joyce Stoltzfus</name></author><author><name sortKey="Pelletier, David Louis" sort="Pelletier, David Louis" uniqKey="Pelletier D" first="David Louis" last="Pelletier">David Louis Pelletier</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:F996599B7651353F4A908D6EBE4657E2F2FFD398</idno><date when="2016" year="2016">2016</date><idno type="doi">10.1111/mcn.12198</idno><idno type="url">https://api.istex.fr/ark:/67375/WNG-T032CKQ9-F/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">001F12</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001F12</idno><idno type="wicri:Area/Istex/Curation">001F12</idno><idno type="wicri:Area/Istex/Checkpoint">000012</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Checkpoint">000012</idno><idno type="wicri:doubleKey">1740-8695:2016:Bliss J:stigma:as:a</idno><idno type="wicri:Area/Main/Merge">001108</idno><idno type="wicri:Area/Main/Curation">001106</idno><idno type="wicri:Area/Main/Exploration">001106</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">Stigma as a barrier to treatment for child acute malnutrition in Marsabit County, Kenya</title><author><name sortKey="Bliss, Jessica Robin" sort="Bliss, Jessica Robin" uniqKey="Bliss J" first="Jessica Robin" last="Bliss">Jessica Robin Bliss</name><affiliation wicri:level="4"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Nutritional Sciences, Cornell University, New York, Ithaca</wicri:regionArea><orgName type="university">Université Cornell</orgName><placeName><settlement type="city">Ithaca (New York)</settlement><region type="state">État de New York</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">États-Unis</country></affiliation></author><author><name sortKey="Njenga, Martin" sort="Njenga, Martin" uniqKey="Njenga M" first="Martin" last="Njenga">Martin Njenga</name><affiliation wicri:level="1"><country xml:lang="fr">Kenya</country><wicri:regionArea>Concern Worldwide, Nairobi</wicri:regionArea><wicri:noRegion>Nairobi</wicri:noRegion></affiliation></author><author><name sortKey="Stoltzfus, Rebecca Joyce" sort="Stoltzfus, Rebecca Joyce" uniqKey="Stoltzfus R" first="Rebecca Joyce" last="Stoltzfus">Rebecca Joyce Stoltzfus</name><affiliation wicri:level="4"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Nutritional Sciences, Cornell University, New York, Ithaca</wicri:regionArea><orgName type="university">Université Cornell</orgName><placeName><settlement type="city">Ithaca (New York)</settlement><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Pelletier, David Louis" sort="Pelletier, David Louis" uniqKey="Pelletier D" first="David Louis" last="Pelletier">David Louis Pelletier</name><affiliation wicri:level="4"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Nutritional Sciences, Cornell University, New York, Ithaca</wicri:regionArea><orgName type="university">Université Cornell</orgName><placeName><settlement type="city">Ithaca (New York)</settlement><region type="state">État de New York</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Maternal & Child Nutrition</title><title level="j" type="alt">MATERNAL AND CHILD NUTRITION</title><idno type="ISSN">1740-8695</idno><idno type="eISSN">1740-8709</idno><imprint><biblScope unit="vol">12</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="125">125</biblScope><biblScope unit="page" to="138">138</biblScope><biblScope unit="page-count">14</biblScope><date type="published" when="2016-01">2016-01</date></imprint><idno type="ISSN">1740-8695</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1740-8695</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Acute malnutrition affects millions of children each year, yet global coverage of life‐saving treatment through the community‐based management of acute malnutrition (CMAM) is estimated to be below 15%. We investigated the potential role of stigma as a barrier to accessing CMAM. We surveyed caregivers bringing children to rural health facilities in Marsabit County, Kenya, divided into three strata based on the mid‐upper arm circumference of the child: normal status (n = 327), moderate acute malnutrition (MAM, n = 241) and severe acute malnutrition (SAM, n = 143). We used multilevel mixed effects logistic regression to estimate the odds of reporting shame as a barrier to accessing health care. We found that the most common barriers to accessing child health care were those known to be universally problematic: women's time and labour constraints. These constituted the top five most frequently reported barriers regardless of child acute malnutrition status. In contrast, the odds of reporting shame as a barrier were 3.64 (confidence interval: 1.66–8.03, P < 0.05) times higher in caregivers of MAM and SAM children relative to those of normal children. We conclude that stigma is an under‐recognized barrier to accessing CMAM and may constrain programme coverage. In light of the large gap in coverage of CMAM, there is an urgent need to understand the sources of acute malnutrition‐associated stigma and adopt effective means of de‐stigmatization.</div></front></TEI><affiliations><list><country><li>Kenya</li><li>États-Unis</li></country><region><li>État de New York</li></region><settlement><li>Ithaca (New York)</li></settlement><orgName><li>Université Cornell</li></orgName></list><tree><country name="États-Unis"><region name="État de New York"><name sortKey="Bliss, Jessica Robin" sort="Bliss, Jessica Robin" uniqKey="Bliss J" first="Jessica Robin" last="Bliss">Jessica Robin Bliss</name></region><name sortKey="Bliss, Jessica Robin" sort="Bliss, Jessica Robin" uniqKey="Bliss J" first="Jessica Robin" last="Bliss">Jessica Robin Bliss</name><name sortKey="Pelletier, David Louis" sort="Pelletier, David Louis" uniqKey="Pelletier D" first="David Louis" last="Pelletier">David Louis Pelletier</name><name sortKey="Stoltzfus, Rebecca Joyce" sort="Stoltzfus, Rebecca Joyce" uniqKey="Stoltzfus R" first="Rebecca Joyce" last="Stoltzfus">Rebecca Joyce Stoltzfus</name></country><country name="Kenya"><noRegion><name sortKey="Njenga, Martin" sort="Njenga, Martin" uniqKey="Njenga M" first="Martin" last="Njenga">Martin Njenga</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/SrasV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001106 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 001106 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= SrasV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= ISTEX:F996599B7651353F4A908D6EBE4657E2F2FFD398
|texte= Stigma as a barrier to treatment for child acute malnutrition in Marsabit County, Kenya
}}
| This area was generated with Dilib version V0.6.33. |  |