{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:18:28Z","timestamp":1791497908197,"version":"4.3.4"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100009977","name":"ELMA Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009977","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Challenges"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Down syndrome (DS) affects approximately 1 in 700 to 1000 live births globally. Children with DS often face feeding difficulties that arise from low muscle tone and oral\u2010motor dysfunction, making complementary feeding initiation particularly challenging. Despite the role of caregivers in addressing these challenges, research on their feeding patterns in low\u2010resource settings like Rwanda is scarce. Therefore, we aimed at exploring the feeding patterns of caregivers of children with DS in Rwanda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We employed a qualitative exploratory design involving 34 caregivers from four hospitals. Participants were recruited through convenience sampling. Twenty\u2010eight people participated in focus group discussions (FGDs), while six took part in in\u2010depth interviews (IDIs). The level of saturation determined the number of FGDs and IDIs. Informed consent was obtained before participation, and data collectors were granted permission to audio\u2010record the interviews. The collected data were subsequently transcribed and analyzed thematically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Caregivers reported different developmental delays in children with DS, affecting timely initiation and progression of complementary feeding. Feeding challenges were more pronounced in children with DS compared to those without, with delays in food introduction and age\u2010related changes in food consistency. Financial constraints and anatomical anomalies further contributed to difficulties in adequately feeding children with DS. Participants reported receiving necessary support for caring for their children from local authorities, healthcare facilities, and family members. However, some participants reported that male partners did not provide adequate support in caring for their children, with some husbands even abandoning the household following the diagnosis of DS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Caregivers of children with DS indicated that these children have developmental delays that negatively impact their feeding. They emphasized that financial issues and their anatomical anomalies contribute to feeding difficulties. Many participants also noted that insufficient support from male partners hinders their ability to provide proper nutrition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/puh2.70230","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T14:33:49Z","timestamp":1775831629000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Feeding Experiences Among Caregivers of Children With Down Syndrome in Rwanda: A Qualitative Exploratory Study"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5200-0278","authenticated-orcid":false,"given":"Joselyne","family":"Rugema","sequence":"first","affiliation":[{"name":"College of Medicine and Health Sciences, School of Nursing and Midwifery University of Rwanda  Kigali Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4374-7441","authenticated-orcid":false,"given":"Eric","family":"Matsiko","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Sciences, School of Public Health University of Rwanda  Kigali Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vedaste","family":"Bagweneza","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Sciences, School of Nursing and Midwifery University of Rwanda  Kigali Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatilla","family":"Mukamana","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Sciences, School of Nursing and Midwifery University of Rwanda  Kigali Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5308-3706","authenticated-orcid":false,"given":"Leon","family":"Mutesa","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Sciences, School of Medicine and Pharmacy University of Rwanda  Kigali Rwanda"},{"name":"Rwanda Military Referral and Teaching Hospital  Kigali Rwanda"},{"name":"College of Medicine and Health Sciences, Center of Human Genetics University of Rwanda  Kigali Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"World Health Organization Congenital Disorders: Key Facts(World Health Organization 2023) https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/birth\u2010defects."},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023\u2010022\u201002594\u20101"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1706537"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fgene.2022.908482"},{"key":"e_1_2_13_6_1","volume-title":"Down Syndrome: Care of Adults with Chronic Childhood Conditions","author":"Jensen K. M.","year":"2024"},{"key":"e_1_2_13_7_1","volume-title":"Down Syndrome: Clinical Features and Diagnosis","author":"Ostermaier K. K.","year":"2025"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20104642(19)30400\u20106"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcped.2019.11.008"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2024.104788"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines14010162"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsad060"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.3238\/arztebl.2016.0435"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jir.12617"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2023.07.002"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1590\/1983\u201080422022301508en"},{"key":"e_1_2_13_17_1","unstructured":"Down Syndrome International Support People With Down Syndrome in Rwanda(Down Syndrome International 2023) https:\/\/www.globalgiving.org\/projects\/down\u2010syndrome\u2010support\u2010rwanda\/."},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmv065"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1017\/jns.2021.37"},{"key":"e_1_2_13_20_1","doi-asserted-by":"crossref","unstructured":"Z.Vaghri J.Zermatten G.Lansdown andR.Ruggiero Monitoring State Compliance With the UN Convention on the Rights of the Child: An Analysis of Attributes(Springer 2022) https:\/\/link.springer.com\/chapter\/10.1007\/978\u20103\u2010030\u201084647\u20103_40.","DOI":"10.1007\/978-3-030-84647-3"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.25082\/AERE.2025.01.001"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.physbeh.2021.113390"},{"key":"e_1_2_13_23_1","unstructured":"World Health Organization Complementary Feeding(World Health Organization 2025) https:\/\/www.who.int\/health\u2010topics\/complementary\u2010feeding#tab=tab_2."},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/cch.12162"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41043\u2010019\u20100207\u2010z"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/fsn3.4757"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1352\/1944\u20107558\u2010120.6.514"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.4103\/2249\u20104863.161306"}],"container-title":["Public Health Challenges"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/puh2.70230","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/puh2.70230","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/puh2.70230","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:09:34Z","timestamp":1784264974000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/puh2.70230"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,10]]},"references-count":27,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/puh2.70230"],"URL":"https:\/\/doi.org\/10.1002\/puh2.70230","archive":["Portico"],"relation":{},"ISSN":["2769-2450","2769-2450"],"issn-type":[{"value":"2769-2450","type":"print"},{"value":"2769-2450","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,10]]},"assertion":[{"value":"2025-09-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70230"}}