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Background: Nutrition-sensitive agriculture (NSA) interventions can contribute to improved food security and household dietary diversity. As well as undertaking trials, contextual factors that influence sustainability need to be scoped. Objective: To explore locals' views of an NSA initiative, designed to improve food security and reduce malnutrition in children younger than 5 years, scoping future prospects 6 months after the conclusion of the trial. Methods: The initiative that was formally trialed over 6 months (November 2014 to April 2015) entailed keeping hens and home gardens. It occurred in the ethnic hill tribes of northern Thailand. In November 2015, 20 in-depth interviews were undertaken with villagers who had been involved in the initiative. Dialogue occurred in Thai with assistance of a translator and was recorded, transcribed, and translated to English. A detailed thematic analysis was undertaken. Results: Eggs produced by the hens were appreciated and fed to children, and the message of providing children with an egg a day was widely remembered. Subsequently, the hens ceased laying or died. The home gardens had seasonal scarcity of water. Less visible, but fundamental, women lacked time for these activities due to heavy burdens of farm labor. Conclusion: Keeping hens has potential to become a sustainable activity. Home gardens need water infrastructure to be viable. Women do not necessarily have spare capacity for such initiatives. The required labor needs deliberation by villagers. [ABSTRACT FROM AUTHOR]

Background The aim of this study was to describe stunting in infants and young children in the ethnic communities of northern Thailand and to explore associations with dietary diversity and household factors including food security. Methods A cross-sectional survey of households with children under 5 years from eight villages. Adult respondents provided information on foods consumed by each child and details of the household. Heights and weights of children were measured. Results Adults from 172 households and 208 children participated. Overall, 38% of children were stunted. Exclusive breastfeeding was rare, but the proportion consuming breastmilk at 24 months (75%) was high. Few children (7%) aged 6–11 months met minimum dietary diversity. Stunted children were less likely than non-stunted children to meet minimum dietary diversity (63 versus 82%). Widespread food insecurity did not discriminate between stunted and non-stunted children. Stunting was elevated when households had little land and few animals. Conclusions Stunting was widespread in children under 5 years of age, in part reflecting poor dietary diversity, especially at age 6–11 months. Stunting was worst in households with least assets. Small increases in land or animals, or equivalent resources, appear to be required to improve child nutrition in extremely poor families. [ABSTRACT FROM AUTHOR]

Background: In Thailand, despite widespread improvements in child nutrition, stunting is still highly prevalent among northern hill tribe children., Objective: To understand how villagers and health workers (volunteers and officials) gauge health of children younger than 5 years, whether growth monitoring is salient, and the relationships of villagers with the health system in this remote location., Methods: Qualitative research was undertaken with 8 hill tribe villages. A workshop on infant and young child health and nutrition was held with 8 village health volunteers, 2 per village, selected by a public health officer. In-depth interviews were conducted with 20 villagers and 2 volunteers who had children 0 to 5 years. Eight other health workers were also interviewed. All dialogue was conducted in Thai through bilingual facilitators and recorded, transcribed, and translated into English. Transcripts were coded and analyzed thematically within and across participant groups., Results: Overall, villagers considered strength and independence of children to be hallmarks of health; the size of children featured rarely. Volunteers did not perceive local benefits of growth monitoring, and the extent of child malnutrition was unclear to them. Nutrition counseling was seldom mentioned by villagers or health workers. Across all accounts, and considering silences, relationships of villagers with the health system seemed fragile., Conclusion: Villagers understand child health in terms of functional abilities rather than size. Volunteer health workers in this remote location have limited resources and support. Together this helps explain why, against a background of poverty and food insecurity, growth monitoring does not translate to improvements in child nutrition.

Objective: To gain an in-depth understanding of infant and young child feeding practices, accompanying beliefs and their sociocultural context in the Karen and Lua ethnic communities of northern Thailand., Design: A two-day workshop and thirty in-depth interviews were undertaken in June 2014. Dialogue occurred with the assistance of translators and was recorded, transcribed and translated. A detailed thematic analysis was undertaken., Setting: Northern Thai indigenous communities in which one-third of the children under 5 years of age are stunted., Subjects: People with various roles in the local health system and twenty-six villagers who cared for infants and young children., Results: Predominant breast-feeding was said to occur for 1 to 3 months but was not exclusive due to early introduction of water and/or rice. Exclusive breast-feeding for 6 months was impeded by the need for mothers to return to farming work, with the early introduction of solids enabling infants to be cared for by other family members. Low variety in complementary foods was typical during infancy, with few local foods having appropriate texture and special preparation of foods rarely described. A pervasive underlying issue is women's responsibility to labour and lack of time to care for their young children. Poverty and food insecurity also featured in participants' accounts., Conclusions: In combination, women's limited time to care, poverty and food insecurity are perpetuating poor nutrition of children in early life. Agricultural solutions that are being explored should also attend to the burden of work for women.