{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T02:36:30Z","timestamp":1772678190801,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":42,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["Cooperative Agreement AID\u2010OAA\u2010A\u201014\u201000028"],"award-info":[{"award-number":["Cooperative Agreement AID\u2010OAA\u2010A\u201014\u201000028"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In the Democratic Republic of Congo, 43% of children under 5\u00a0years of age suffer from stunting, and the majority (60%) of children, 6\u201359\u00a0months of age, are anaemic. Malaria, acute respiratory infections, and diarrheal diseases are common among children less than 5\u00a0years of age, with 31% of children 6\u201359\u00a0months affected by malaria. This qualitative implementation science study aimed to identify gaps and opportunities available to strengthen service delivery of nutrition within integrated community case management (iCCM) at the health facility and community level in Tshopo Province, Democratic Republic of Congo, through the following objectives: (a) examine cultural beliefs and perceptions of infant and young child feeding (IYCF) and child illness, (b) explore the perspectives and knowledge of facility\u2010based and community\u2010based health providers on nutrition and iCCM, and (c) gain an understanding of the influence of key family and community members on IYCF and care\u2010seeking practices. This study involved in\u2010depth interviews with mothers of children under 5\u00a0years of age (<jats:italic>n<\/jats:italic>\u00a0=\u00a048), grandmothers (<jats:italic>n<\/jats:italic>\u00a0=\u00a020), fathers (<jats:italic>n<\/jats:italic>\u00a0=\u00a021), facility\u2010based providers (<jats:italic>n<\/jats:italic>\u00a0=\u00a018), and traditional healers (<jats:italic>n<\/jats:italic>\u00a0=\u00a020) and eight focus group discussions with community health workers. Study findings reveal most mothers reported diminished quantity and quality of breastmilk linked to child\/maternal illness, inadequate maternal diet, and feedings spaced too far apart. Mothers' return to work in the field led to early introduction of foods prior to 6\u00a0months of age, impeding exclusive breastfeeding. Moreover, children's diets are largely limited in frequency and diversity with small quantities of foods fed. Most families seek modern and traditional medicine to remedy child illness, dependent on type of disease, its severity, and cost. Traditional healers are the preferred source of information for families on certain child illnesses and breastmilk insufficiency. Community health workers often refer and accompany families to the health centre, yet are underutilized for nutrition counselling, which is infrequently given. Programme recommendations are to strengthen health provider capacity to counsel on IYCF and iCCM while equipping health workers with updated social and behavior change communication (SBCC) materials and continued supportive supervision. In addition, targeting key influencers to encourage optimal IYCF practices is needed through community and mother support groups. Finally, exploring innovative ways to work with traditional healers, to facilitate referrals for sick\/malnourished children and provide simple nutrition advice for certain practices (i.e., breastfeeding), would aid in strengthening nutrition within iCCM.<\/jats:p>","DOI":"10.1111\/mcn.12725","type":"journal-article","created":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T16:26:12Z","timestamp":1549988772000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Strengthening nutrition services within integrated community case management (iCCM) of childhood illnesses in the Democratic Republic of Congo: Evidence to guide implementation"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0439-6308","authenticated-orcid":false,"given":"Justine A.","family":"Kavle","sequence":"first","affiliation":[{"name":"USAID's Maternal and Child Survival Program\/PATH  Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Pacqu\u00e9","sequence":"additional","affiliation":[{"name":"USAID's Maternal and Child Survival Program\/JSI  Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7218-5193","authenticated-orcid":false,"given":"Sarah","family":"Dalglish","sequence":"additional","affiliation":[{"name":"Independent Qualitative Research Consultants  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evariste","family":"Mbombeshayi","sequence":"additional","affiliation":[{"name":"USAID's Maternal and Child Survival Program\/PATH  Kisangani DRC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jimmy","family":"Anzolo","sequence":"additional","affiliation":[{"name":"USAID's Maternal and Child Survival Program\/JSI DRC  Kisangani DRC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janvier","family":"Mirindi","sequence":"additional","affiliation":[{"name":"Independent Research Consultants  Bukavu DRC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maphie","family":"Tosha","sequence":"additional","affiliation":[{"name":"Independent Research Consultants  Bukavu DRC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Octave","family":"Safari","sequence":"additional","affiliation":[{"name":"Independent Research Consultants  Bukavu DRC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lacey","family":"Gibson","sequence":"additional","affiliation":[{"name":"Independent Qualitative Research Consultants  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Straubinger","sequence":"additional","affiliation":[{"name":"USAID's Maternal and Child Survival Program\/PATH  Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Bachunguye","sequence":"additional","affiliation":[{"name":"Independent Research Consultants  Bukavu DRC"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,2,12]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjom.2012.20.7.484"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0153221"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60828-X"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1746-4358-7-2"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.3945\/an.111.001263"},{"key":"e_1_2_15_7_1","unstructured":"Concern Worldwide(2009). \u201cIntegrating community management of acute malnutrition into child survival programs: Concern worldwide's experience in Rwanda.\u201d"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1746-4358-5-13"},{"key":"e_1_2_15_9_1","unstructured":"FANTA\u20102. 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