Risk factors associated with feeding children under 2 years in rural Malawi – a formative study

Kondwani Chidziwisano, Elizabeth Tilley, Rossanie Malolo, Save Kumwenda, Janelisa Musaya, Tracy Morse

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15 Citations (Scopus)
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Diarrhoeal disease remains one of the leading causes of morbidity and mortality in the under-five population, particularly in low income settings such as sub-Saharan Africa. Despite significant progress in sanitation and water access, faecal-oral infections persist in these populations. Therefore, a better understanding of these transmission pathways, and how potential risk factors can be reduced within low income contexts is needed. This study, conducted in Southern Malawi from June to October 2017, used a mixed methods approach to collect data from household surveys (n = 323), checklists (n = 31), structured observations (n = 80), and microbiological food samples (n = 20). Results showed that food prepared for immediate consumption (primarily porridge for children) posed a low health risk. Poor hygiene practices increased the risk of contamination from shared family meals. Faecal and nosocomial bacteria were associated with poor hand hygiene and unhygienic eating conditions. Leftover food storage and inadequate pre-consumption heating increased the risk of contamination. Improvements in food hygiene and hand hygiene practices at critical points could reduce the risk of diarrhoeal disease for children under 2 years but must consider the contextual structural barriers to improved practice like access to handwashing facilities, soap, food and water storage.

Original languageEnglish
Article number2146
Number of pages21
JournalInternational Journal of Environmental Research and Public Health
Issue number12
Early online date17 Jun 2019
Publication statusE-pub ahead of print - 17 Jun 2019


  • food hygiene
  • food safety
  • complementary foods
  • child feeding
  • Malawi


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