(P17-036-23) Perceived Facilitators and Barriers to Complementary Feeding of Children Among South Sudanese Refugees in Post-Emergency Settlements in the West-Nile Region, Uganda

Objectives: Recent UNICEF reports maintain that poor complementary feeding practices remain challenging in low-and-middle-income countries (LMICs), higher among refugees post-emergency settlements. Yet, suboptimal complementary feeding practices are associated with child undernutrition, morbidity, and mortality. Therefore, this study aimed to elicit facilitators and barriers to child complementary feeding practices among South Sudanese refugees in the West Nile region of Uganda.

Methods: Both qualitative (triangulation) and quantitative methods were used. Four FGDs (M=32, F=63) comprising 15–16 South Sudanese refugee parents with children < 2 years were conducted in July 2019. Also, two FGDs were done with village health team members (VHTs) and interviews for nine key informants (M=8, F=1). Participants were randomly selected from the refugee settlements of Agojo, Ayilo-I, and Nyumanzi in West Nile, Uganda. The audiotaped interviews were transcribed verbatim, translated, and coded. Thematic analysis was used, and data were analyzed following COREQ guidelines using NVivo, v. 12. Descriptive statistics for key sociodemographics were determined using STATA/ SE v17.0.

Results: The majority (61.0%) of refugees were Dinka; 63.2 percent had spent more than four years in the settlements. Respondents' mean age ± SD was 31.4 ± 9.2 years, with children 13.5 ± 7.4 months. Frequently mentioned facilitators included parental consensus on child food purchases, non-governmental organizational support, complementary feeding knowledge, household hygiene and sanitation, and support from community resources such as advice from health workers and VHTs. Barriers to complementary feeding included a lack of finances, cultural traditions like children not being allowed to eat certain foods, maternal stress, and a patriarchal ideology, e.g., serving of food prioritized to adult males.

Conclusions: Supportive agencies should design interventions for refugee populations' specific needs. For example, locally adaptable strategies should focus on improving access to nutritious diets, increasing knowledge and skills related to feeding practices, strengthening health systems in post-emergency settings, and providing a supportive environment for mothers and caregivers for better complementary feeding of children.

Funding Sources: N/A