Mothers' Perceptions of Child Nutrition and Growth Monitoring: Insights and Challenges within Rwanda's National Nutrition Program.

Abstract Introduction: Many Rwandan children under the age of two suffer from malnutrition, which affects their physical growth and cognitive development. This study explored the perspectives and attitudes of mothers of children eligible for child growth and nutrition monitoring services to find out how attendance of such services and adherence to treatment may be improved. Methods: We conducted fifty-two in-depth interviews with purposively sampled mothers of infants below 2 years. The interview guide was developed based on the health belief model. Through deductive thematic analysis, we explored the mothers' perspectives, attitudes towards the program, including perceived strengths and challenges and factors influencing attendance. Findings: Mothers acknowledged the adverse effects of undernutrition on children’s health. They appreciated the child nutrition services, including nutrition education and food supplementation. In addition, they recognized the contributions of community health workers (CHWs) in conducting home visits and providing education and support for child nutrition. However, they encountered challenges such as long waiting times at health centers which interfered with their caregiving responsibilities and activities to make an income, and stigma associated with seeking treatment for undernutrition. Conclusion: Poverty was a major barrier to child nutrition service use, despite incentives being provided to the poorest families. Outreach programs, integration of child health services and efforts to reduce the stigma associated with seeking help for undernutrition may improve the utilization of nutrition services and adherence to nutritional advice.