Social and Cultural Barriers and Facilitators Affecting Mothers' Dietary Practices in Eastern Ethiopia: A Qualitative
Ketema Degefa1, Luisa Schneider1, Freek Colombijn1
1Faculty of Social Sciences and Humanities, Department of Social and Cultural Anthropology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Background:
Inadequate dietary practices during pregnancy and breastfeeding, adversely affecting the health of both mothers and their children, are a serious public health challenge in Ethiopia. Analyzing barriers and facilitators will help take appropriate steps to facilitate change and enable better dietary practices.
Objectives:
The aim of this study is to analyze barriers to and facilitators of adequate dietary practices in Eastern Ethiopia, and to help health workers recognize existing adequate dietary practices and implement effective nutritional interventions.
Methods:
Qualitative research was conducted with in-depth interviews, focus group discussions, and participant observation. The interviews and focus group discussions involved 112 participants: 27 pregnant females, 30 breastfeeding females, 49 health workers, 3 traditional birth attendants, and 3 religious leaders (sheikhs).
Results:
The study identified the social and cultural barriers and facilitators of dietary practices. Barriers to adequate dietary practices included inadequate family income, the sale of self-produced healthy food items to purchase less healthy packed food, prioritizing family members, dietary self-restraint, khat use, and religious fasting practices. Facilitators of dietary practices included positive religious leaders' views, cooking demonstrations, and pregnancy conferences (public health forums for pregnant females in Ethiopia).
Conclusions:
Understanding the social and cultural barriers and facilitators of dietary practices can help health workers effectively implement existing interventions to support pregnant and breastfeeding females. However, the females had partly different priorities than the health workers in making dietary choices and kept more factors in mind than nutritional considerations. Cooking demonstrations and pregnancy conferences were, alongside regular health extension sessions, effective moments to encourage pregnant females to increase dietary diversity, because there the females had the opportunity to exchange experiences.
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