Nutritional Citizenship: Anticipation and Responsibility in Childhood Malnutrition Programs in Colombia

This article-based PhD dissertation explores how state and humanitarian efforts to improve child nutrition and care in Colombia redistribute responsibilities for children’s survival, growth, and future development between institutions and families, with particular attention to the Colombia–Venezuela border region.

Focusing on early childhood health and nutrition programs informed by contemporary global health agendas such as the First 1,000 Days framework, the study examines how interventions are no longer conceived solely as forms of immediate protection, but as investments oriented toward future returns for the child, the family, and the nation. Within this paradigm, caregivers, especially mothers, become central actors in securing not only children’s present well-being but also their future potential. I conceptualize this sociomaterial redistribution of care, risk, and responsibility as nutritional citizenship.

The research draws on three ethnographic case studies conducted in Yopal, Puerto Carreño, and Cúcuta, cities across the broader Colombia–Venezuela border region and characterized by high rates of malnutrition, fragile infrastructures, Indigenous communities, and migrant/floating populations. These case studies include an ambulatory nutritional care initiative, a Nutritional Rehabilitation Center, and a preterm Kangaroo Mother Care (KMC) program.

Fieldwork was conducted across three periods of engagement with varying degrees of temporal immersion and combined sustained observation of care practices, semi-structured interviews with caregivers, health professionals, coordinators, and program participants, as well as documentary analysis of policy documents, technical guidelines, operational manuals, and nutritional protocols.

Using a sociomaterial analytical approach, the dissertation focuses on how caregivers and health workers engage with practices such as anthropometric monitoring, therapeutic feeding, breastfeeding, and skin-to-skin contact. These routine practices do more than manage malnutrition or prevent neonatal complications; they constitute the mother-child dyad as the fundamental unit of intervention and become key sites where care, risk, and responsibility are negotiated.

Rather than operating only at a discursive or normative level, the redistribution of responsibilities is materially enacted through these low-tech devices, bodily routines, and intimate forms of care. In this way, state-led health and nutrition interventions become materially sustained by women’s largely invisible caregiving labor, as institutional expectations of securing the child’s “good future” ultimately rest on their shoulders.