A qualitative exploration of reasons for improvement in nutritional status of children under-three during the pandemic in an informal settlement in Mumbai

Authors:
Nikhat Shaikh, Rijuta Sawant, Jennifer Spencer, Sushmita Das, Sonali Patil, Sushma Shende, Shanti Pantvaidya, Armida Fernandez, Anuja Jayarman

Abstract

Objective: To study the reasons for improvements in nutrition among children under three years of age in an informal settlement in Mumbai, India, during the COVID-19 pandemic.

Design: In-depth telephonic interviews were conducted and data were analysed using thematic framework analysis.

Setting: An informal settlement in Mumbai, Maharashtra, India.

Participants: The participants of this qualitative study included mothers with children less than three years of age. Mothers were selected based on the following nutritional status of the children:

1) improvement in their nutrition status from being wasted to no longer being wasted; 2) remaining well-nourished or not wasted; and 3) continuing to be wasted, between two time periods (before and during the pandemic).

Results: Various behavioural and systemic aspects contributed to improvements in the nutrition status of under-three children in a slum settlement in Mumbai during the COVID-19 pandemic.
Appropriate feeding practices such as the timely introduction of complementary foods, low consumption of junk food, availability of nutritionally diverse food, migration to the village, a positive home environment, support from family and a low frequency of child illness were some of the contributing reasons for the improvement in nutrition status.

Conclusions: This study highlights the need for a multi-dimensional approach to improve child health and to strengthen nutrition programs to cope with future emergencies. Learning from what worked well for mothers among positive deviance cases needs to be sustained and scaled to enable more holistic interventions for child nutrition.