[ca] Finalment, el tercer estudi aborda les creences i costums relacionats amb l'alimentació infantil des d'un enfocament més qualitatiu. A través d'entrevistes amb mares i líders comunitaris, s'exploren les percepcions sobre la lactància i la salut infantil, revelant que pràctiques com l'alimentació *prelacteal estan vinculades a rituals i tradicions profundament arrelades. Estes pràctiques, encara que culturals, tenen un impacte directe en la nutrició i el benestar dels xiquets, perquè durant els primers dies de vida, molts bebés reben aliments sòlids en lloc de llet materna. Este enfocament revela una sèrie de barreres socioculturals que limiten l'adopció de pràctiques òptimes de lactància, subratllant la importància de desenrotllar intervencions de salut pública que consideren i respecten el context cultural d'estes comunitats. En conjunt, esta investigació destaca la complexitat de la lactància materna en el context rural d'Etiòpia, on les *prácticasculturales, l'accés limitat a l'educació i els recursos de salut juguen un paper crucial en el desenrotllament infantil. La tesi conclou que, per a abordar efectivament la malnutrició infantil i millorar la salut matern-infantil, és fonamental implementar programes educatius i polítiques de salut que respecten les tradicions locals però que promoguen pràctiques de lactància saludables. Este enfocament podria facilitar una transició gradual cap a pràctiques de lactància més beneficioses, millorant les perspectives de salut per als xiquets en estes comunitats. La investigació proporciona una base sòlida per a futures intervencions en salut pública i oferix recomanacions per a adaptar les estratègies de salut a contextos culturals específics, assegurant un impacte positiu i sostenible en el benestar infantil en regions similars.

[en] Currently, breastfeeding is recognized worldwide as an essential practice for early childhood development, providing vital nutrients and strengthening infants' immune systems. However, in many rural regions of developing countries, this practice is influenced by beliefs and traditions that can limit its benefits. In Mechela District, Ethiopia, breastfeeding practices are deeply linked to sociocultural factors that impact infant health and contribute to the prevalence of malnutrition. Although global health organizations recommend exclusive breastfeeding for the first six months of life, local customs, such as colostrum avoidance and prelacteal feeding, present significant barriers to achieving these goals. Through a series of studies, this doctoral dissertation examines not only breastfeeding practices in this region but also the cultural, educational, and health factors that influence them. The first study of the research explores beliefs related to colostrum, perceived as a "dirty" or "harmful" substance, which leads more than half of mothers to avoid it in the first days of their baby's life. This rejection of colostrum, combined with the early introduction of local foods such as injera and shiro, prevents babies from receiving the immunological benefits that this first breast milk provides. The results show that factors such as mothers' low educational level and limited access to health services contribute to the perpetuation of these practices, which are rooted in the community's cultural context. The second study focuses on the nutritional and anthropometric assessment of children under five years of age at a nutrition center in Gimbichu, Oromia Region. Through weight, height, and age measurements, high rates of malnutrition are identified, with 36% of children showing stunting and being underweight compared to WHO standards. These findings highlight the relationship between inadequate breastfeeding practices and child development, showing that the prevalence of malnutrition in this population is alarmingly high. Furthermore, the study suggests that these practices, influenced by cultural factors and limited access to health resources, can have long-term effects on the quality of life and development of children in these rural communities. Finally, the third study addresses beliefs and customs related to infant feeding from a more qualitative perspective. Through interviews with mothers and community leaders, perceptions about breastfeeding and infant health are explored, revealing that practices such as prelacteal feeding are linked to deeply rooted rituals and traditions. These practices, although cultural, have a direct impact on children's nutrition and well-being, as during the first days of life, many babies receive solid foods instead of breast milk. This approach reveals a series of sociocultural barriers that limit the adoption of optimal breastfeeding practices, underscoring the importance of developing public health interventions that consider and respect the cultural context of these communities. Taken together, this research highlights the complexity of breastfeeding in rural Ethiopia, where cultural practices, limited access to education, and health resources play a crucial role in child development. The thesis concludes that, to effectively address child malnutrition and improve maternal and child health, it is critical to implement educational programs and health policies that respect local traditions but promote healthy breastfeeding practices. This approach could facilitate a gradual transition to more beneficial breastfeeding practices, improving the health outlook for children in these communities. The research provides a solid foundation for future public health interventions and offers recommendations for adapting health strategies to specific cultural contexts, ensuring a positive and sustainable impact on child well-being in similar regions.