Child malnutrition, which is an increasing problem in Western Kenya, is addressed primarily through efforts to reach the individual mother with information about proper feeding of her children. A study carried out in Siaya, Kisumu and Busia Districts showed that mothers perceived nutrition problems differently, emphasizing their embeddedness in gender and family relations. In situations of marital conflict, male labour migration, and impoverishment, women must rely on support from others; thus health education should be addressed to husbands, grandmothers and mothers-in-law as well as mothers.
PIP: In the late 1980s, ethnographers interviewed mothers and family and community members living in the districts of Siaya, Kisumu, and Busia in western Kenya to apply information on malnutrition into a wider framework of society and culture. 38% of children were malnourished. In Siaya and Kisumu districts, the people attributed malnutrition to broken rules of family relationships. Health workers should not discard this view because mother and child are intertwined in social relations with others. The conflict between husband and wife, who were not always involved in polygynous marriages, and between mother and other adults caused malnutrition in their children. For example, a father did not give money or food for his child's care, but the child's sibling's father did provide food or money for his/her care. A woman did not return to her husband's rural home to pick up her breast fed infant because she was upset with her husband and family. Other factors leading to child malnutrition included labor migration and poverty. Women's lack of social and economic independence prevented them from caring for their children. In fact, in western Kenya, the genderized political economy perpetuated their economic dependence. Yet, the women in this study did not want independence from husbands and families, instead they wanted their support. Health education efforts in western Kenya should stress ways to encourage mothers to see themselves as having the ability and autonomy to make sound decisions concerning their children's health. Furthermore, health educators also need to convey the same messages to mothers-in-law, husbands, older siblings, and grandmothers.