Background: Appropriate child feeding prevents nutrient deficiencies, diseases, and deaths in children. However, only 13.3% of children aged 6-23 months in Ghana receive the minimum acceptable diet. Thus, undernutrition remains high in rural northern Ghana, especially among under-fives. This is showing no improvement despite economic development and implementation of globally recommended nutrition & feeding interventions. There is limited context specific evidence about child feeding in rural northern Ghana. Aim: To examine how culture might impact upon the feeding of children under five years of age in rural northern Ghana. Methods: A qualitative ethnographic study was completed between October 2014 and May 2015. Data were collected in a rural Ghanaian community via participant observation and sixty-one ethnographic interviews with mothers, fathers, and grandparents in 15 households, and spiritual leaders are known as "diviners". Themes were developed through inductive analysis of field notes and verbatim transcribed interviews using a framework approach. Results: The content of a child's diet and the pattern of feeding were found to be influenced by the community's notion of food, taboos, and beliefs which originated in a traditional African religion. Shared household responsibility for feeding children and the gendered and age related hierarchy of household decision making also influenced child feeding. Discussion: This study has shown multifaceted taken-for-granted social and cultural influences on child feeding. Whilst mothers are the main recipients of the official public health nutrition and child feeding advice, the communal structures, living arrangements and social interactions support, enhance, and reinforce the community inclined practices that limit mothers' independent decision making. Conclusion: To effect community change and promote uptake of public health nutrition recommendations, a community wide nutrition intervention approach may be more beneficial than the current approach which targets mothers. Furthermore, community and cultural influences must be understood and considered by health professionals if such interventions are to succeed.

Yes / Child undernutrition is a key public health issue that both causes and contributes to disease and death. Undernutrition accounts for 45% of under-five deaths globally most of which occur in Low- and Middle-income countries (LMIC). Malnutrition has a substantial and long-lasting effect on individuals, families, communities and the entire nation. This study aimed to assess the prevalence and determinants of undernutrition in under-five children in Nigeria. Methodology: This systematic review was done following the Cochrane library guidelines. A search of literature written in English language and published between 2000 and 2022 was done using PubMed, CINAHL, MEDLINE and ProQuest databases. The initial search resulted in 760 studies. These were exported to End note version 9 to remove duplicates. Titles and s were screened for studies that met the inclusion criteria. Finally, 11 studies that met the inclusion criteria were thoroughly assessed and data that were relevant to this systematic review were captured. The study findings were analyzed using descriptive statistics. Results: The prevalence of undernutrition was between 1.0% and 43.3%. The highest prevalence of underweight, wasting and stunting were 43.3%, 29.3% and 41%, respectively. Factors associated with undernutrition were age, sex, birth order, recent acute diarrhoea and acute respiratory infection, maternal literacy level, maternal income <$20 and socio-economic class among others. Conclusion: Under-five undernutrition is a huge public health issue in Nigeria. Prevalence of undernutrition varies widely across geo-political zone with a myriad of associated risk factors. Multi-level and multidisciplinary interventions are required to sustainably address the determinants of under-five undernutrition.

Parent-infant psychotherapy is a small but growing field in South Africa. Its potential to contribute to mental health services in South Africa is, by contrast, vast. This thesis contributes towards much-needed research on the state of the field in the country and its potential applications across different sectors. Drawing on Daniel Stern’s concept of ports of entry, it is argued that an expansion of ports of entry offers an important integrating tool through which different aspects of parent-infant psychotherapy can be examined and adapted to the South African context. A history of parent-infant psychotherapy in South Africa is offered, together with an analysis of the experiences of current practitioners in the field. These aspects of the thesis draw on interviews with key stakeholders. The dominant context of private practice is then explored through two case study based papers. The first explores the meaning of symptoms in parent-infant psychotherapy. The second introduces the ‘grandmaternal transference’ as an important but under developed port of entry. These different aspects of parent-infant psychotherapy in South Africa are then considered through the prism of ports of entry in order to argue for a flexing of the psychoanalytic frame. Implications for the growth of the parent-infant psychotherapy field in South Africa are considered.