Barriers of eating among rural adolescent girls in Ethiopia: a qualitative study

Short stature and thinness among adolescent girls continue to be a severe public health problem in Ethiopia, due mainly to inadequate dietary intake, which turn affected by several factors. Evidence shows that in low and middle-income countries, the factors related to culture and belief play a pivotal role in making a difference in eating, negatively affecting girls. In Ethiopia, the roles of these factors in influencing the eating behavior of adolescent girls have not been well investigated.

This qualitative study was conducted to explore the barriers of eating among adolescent girls in Ethiopia.

A qualitative study was employed in northwest Ethiopia from January to April 2021. A focus group discussion of adolescent girls and an in-depth interview of mothers and adolescent boys were separately conducted. A total of six focus group discussions involving a total of forty-three adolescent girls and an in-depth interview of twelve adolescent males and ten mothers were performed. The adolescent girls and boys were aged 15 to 19, attending grades 9-12. The participants were selected using a purposive sampling method. Content analysis was employed to identify the predominant themes. The analysis was conducted using Open Code.

Four themes emerged from the current study. These included religion, the culture of male dominancy, roles and responsibilities, and perception related to girls' body food requirements and the consequences of proper feeding of adolescent girls on their behavior. Specifically, girls start fasting at an early age due to religious reasons; girls do not eat before the males eat and outside the home out of respect for males; girls spend most of their time at home doing less energy-demanding work; girls' body food requirement is lower and girls better tolerate hunger than their counterpart boys; and if girls eat well, they would not be disciplined, were among the reasons mentioned by the study participants for girls' intake of lower quality and quantity food.

Religion, the culture of male dominancy, roles given to females and males and the perception that girls' bodies require a lower quantity of food and well-nourished girls will not be disciplined were common factors responsible for the poor dietary behavior of adolescent girls. Educating the community about the food requirements of girls, the consequences of their inadequate feeding, and the misconception existing in the community about girls' food requirements is crucial. Strengthening policies and strategies helpful for empowering women and balancing gender inequalities may be required.