Barriers to child nutrition in Bengaluru slums: Caregiver insights from the SCOPE strategy

Child undernutrition and protein insecurity remain a critical global issue, particularly in urban slums, driven by multiple socioeconomic and structural barriers. This study applies the Sustainable Community Partnership and Empowerment (SCOPE) strategy to assess challenges and inform the development of a culturally appropriate protein-feeding program for malnourished children in Indian slums. A qualitative approach using focus group discussions was conducted with twenty-one primary caregivers of twenty-four malnourished preschool children aged 3-6 years in Bengaluru, India, to evaluate perceptions of child nutrition, barriers to accessing protein-rich foods, economic constraints, and intervention preferences in slum settings. Data were analyzed using grounded theory and the Social-Ecological model (SEM) to categorize barriers at individual, household, organizational, community, and government levels. Key barriers included limited protein intake, picky eating, preference for junk food at the individual level, economic hardships, and lack of family support at the household level. Caregivers emphasized the need for sustainable solutions from organizational and community help, such as school meal programs and community partnerships, to improve access to affordable, protein-rich foods. Findings highlight the complex interplay of economic, cultural, and systemic factors influencing child nutrition. Results suggest a community-centered, collaborative program for sustainable interventions, prioritizing high-quality protein provision, child-friendly engagement strategies, and caregiver empowerment through education and partnerships with local stakeholders. This study underscores the necessity of integrated, context-specific, community-based programs to effectively address child undernutrition in urban slums and other resource-limited settings worldwide.