Reviewed covered 60 different cultural contexts in 35 Asian, African and Latin American countries
Grandmothers and other senior female family members should play a key role in nutrition and health programmes for children and women in non-Western societies. However, they are often overlooked by health organisations that don't understand the importance of their role or see them as an obstacle to promoting good nutrition and health practices.
Those are the key finding of an extensive literature review published in the January issue of Maternal and Child Nutrition.
Community health specialist Dr Judi Aubel reviewed literature covering 60 different cultural contexts in 35 Asian, African and Latin American countries between 1995 and 2010. These included published studies in academic journals, together with unpublished material from non-governmental organisations, international development agencies and universities.
The literature, in English, French and Spanish, came from a broad range of fields, including anthropology, nursing and public health.
"My review revealed that few non-Western programmes have actively engaged grandmothers in child and mother nutrition and health programmes, despite the fact that their involvement and influence in such matters is much more significant than conventionally assumed by policy makers and programme planners" says Dr Aubel.
"The extensive research findings I studied from rural and urban areas of Africa, Asia and Latin America reveal the decisive role of grandmothers, at both household and community levels, in all matters related to mother and child nutrition and health" adds Dr Aubel, co-founder of The Grandmothers Project, a not-for-profit agency that promotes the health and development of communities in the three regions.
"The literature also reveals that, contrary to popular belief, grandmothers are not always set in their ways when it comes to nutrition and health. A few nutrition and health programmes have actively engaged grandmothers and shown them to be a valuable resource."
The term grandmother is used in Dr Aubel's review as a generic term to refer to maternal and paternal grandmothers, aunts, elder co-wives and other senior women in the family who are involved in providing support and care for children and their mothers.
The three key findings of her review of non-Western societies of Africa, Asia and Latin America are that:
1.Grandmothers play a central role in providing care for women and children and in advising younger women and male family members on nutrition and health matters, especially during pregnancy, childbirth and when children are infants or still young.
2.Social networks of senior women provide a collective influence on maternal and child nutrition-related practices, especially when women are pregnant or have recently given birth.
3.Fathers and grandfathers usually play secondary, supportive roles in non-emergency situations when it comes to maternal and infant nutrition, but their involvement generally increases in crisis situations, when special logistical and/or financial support are required.
"Despite the fact that grandmothers and other senior women are very involved in the nutrition and health of women and children, national and international policies and programmes rarely target or involve them" says Dr Aubel.
"My review clearly shows that there is a large gap between how those planning public health campaigns for non-Western settings view family dynamics and how they actually work in practice."
As a result of her review, Dr Aubel makes four key recommendations:
1.Further research should be carried out in non-Western cultural settings in order to understand the roles, norms, communication networks and decision-making patterns in household and community settings.
2.Health professionals and community workers need to re-examine their perceptions of both culture and grandmothers, so that they view grandmothers as resources rather than obstacles.
3.Health training curricula should be revised to provide more focus on how local families and cultural systems promote health and nutrition.
4.Additional research is needed to validate or reject the key findings of this review in specific non-Western cultures.
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