When communities face malnutrition: how context shapes the factors predicting relevant health advice in Nepal

While programmes to combat malnutrition and to lower barriers to healthcare have been developed, some children with severe acute malnutrition do not benefit at the level necessary for their condition. In this context, community health advice could help caregivers provide the required support for their children. This study looked at this issue in Nepal, with the aim of examining which factors lead to relevant health advice from community members. The data was collected through a questionnaire measuring individual variables (beliefs, emotions) and contextual variables (perceived emotions by community members, level of wealth, access to communication, beliefs in traditional healing by the female community health volunteer) carried out in two Nepalese districts: Saptari and Nuwakot. The results show that factors predicting health advice differed in the two districts, and the role of access to communication was even the opposite. The best predictors were not found at an individual level, but at a contextual level (e.g. perceived emotions by community members, access to communication, etc.). These findings suggest that malnutrition would be better tackled by acting at a more global level, i.e. targeting representations associated to malnutrition and circulating at the national and community level.