Involving Men in Infant and Young Child Feeding (IYCF) Practices and Decision Making: A Formative Community Assessment in Ainaro and Lautem Municipalities, Timor-Leste

Abstract

Background: The prevalence of chronic malnutrition in Timor-Leste is very concerning: nearly 46% of children under age five are stunted. Exclusive breastfeeding and complementary feeding practices are very crucial in supporting child nutritional outcomes. During this period, male partners play important roles as decision-makers at the household level in ways that may influence nutritional outcomes. Objectives: This study aims to explore and compare community norms and individual behavior and experiences in caring and feeding children in the first two years of life in two communities in Timor-Leste. A particular focus is the role of male partners in Infant and Young Children Feeding (IYCF) practices. Methods: Using a qualitative approach, the study used semi-structured in-depth interviews (IDI) and Focus Groups Discussions (FGD) for data collection. There were 61 study participants in total, with 24 IDIs and five FGDs conducted in two municipalities, Ainaro and Lautem. Results: In both communities, there was very minimal reported male involvement in caring for children, including their feeding practices. Most mothers did not express any expectations about their partners’ roles in caring for and feeding their children, saying that the ideal role of a husband is to work and earn money for the family. Furthermore, male partners did not see themselves as being targeted in nutrition health promotion campaigns conducted by health workers. Dietary diversity was a major problem for families, along with lack of knowledge of the importance of diet diversity and lack of cash to purchase high quality food items such as fish, meat, and eggs. There were no major differences in male involvement in the two municipalities, although informants living in a village located in coastal area reported to eat fish more frequently. Conclusion: To address malnutrition in small children, targeting and engaging fathers for health education is essential. More aggressive interventions to promote adequate complementary feeding practices and good nutrition is fundamental to increase the knowledge of male and female partners and to affect household level behavior change. Actively supporting and engaging female partners in economic activity is highly encouraged to support household finances that could allow more households allocation for high protein food.