Sociocultural and structural influences on infant and young child feeding in pastoralist communities of Afar, Ethiopia: a qualitative phenomenological study

Abstract

BACKGROUND: Infant and young child feeding (IYCF) practices are critical for child growth and survival, yet they are strongly shaped by sociocultural and livelihood contexts. In pastoralist settings, feeding practices are influenced by traditional beliefs, mobility, environmental constraints and access to health services. However, limited evidence exists on how community norms and social structures influence IYCF in remote pastoralist communities of Ethiopia. OBJECTIVE: This study aimed to explore maternal and community perspectives on IYCF practices in the pastoralist communities of Afar Region, Ethiopia. DESIGN: Qualitative observational study using a phenomenological approach. SETTING: Pastoralist communities in the Afar Region, Ethiopia. PARTICIPANTS: 16 mothers of children aged 6-23 months participated in in-depth interviews, and 20 community members (religious leaders, elders and clan leaders) participated in three focus group discussions. METHODS: Participants were purposively selected. Data were collected using semi-structured interviews and focus group guides, audio-recorded, transcribed verbatim and translated into English. Data were analysed using an inductive thematic analysis approach. RESULTS: Four interrelated themes shaped IYCF practices. Cultural rituals and elder authority influenced breastfeeding initiation, particularly following home births, where pre-lacteal feeding linked to the Onor/Onqor ritual was described as delaying initiation. Although awareness of exclusive breastfeeding was commonly reported among participants, seasonal water supplementation and maternal workload limited consistent adherence. Complementary feeding was generally introduced at 6 months; however, dietary diversity was constrained by pastoral livelihood instability, drought, market inaccessibility and rising food prices. Gendered household dynamics shaped resource control and caregiving responsibilities, with women bearing primary responsibility for childcare, feeding and hygiene. Clan-based social networks provided support during hardship but also reinforced some traditional feeding practices. CONCLUSIONS: IYCF practices in pastoralist Afar are shaped by cultural norms, gender relations and structural constraints, including livelihood insecurity and limited service access. Interventions should integrate culturally responsive community engagement with gender-sensitive and livelihood-informed nutrition strategies.