Beyond food insecurity: How context can improve complementary feeding interventions

Keriann H. Paul, Monica Muti, Sabra S. Khalfan, Jean Hawes Humphrey, Rosemary Caffarella, Rebecca J. Stoltzfus

Research output: Contribution to journalArticle

Abstract

Background. The role of context has not been elaborated with respect to current recommendations for complementary feeding interventions, apart from a gross distinction based on food security. Objective. Our objective was to compare two foodinsecure settings in sub-Saharan Africa to determine how context (i.e., the set of local social, cultural, and physical circumstances) influences complementary feeding practices and nutrient intakes and how the results can help in the design of a suitable intervention strategy. Methods. We conducted formative research using 24-hour dietary recalls, household interviews, and focus group discussions with mothers of 6- to 12-month-old infants in rural Zimbabwe (n = 32) and Pemba Island, Zanzibar, Tanzania (n = 44). Results. In both settings, many infants had suboptimal nutrient intakes, poor dietary diversity, and poor hygiene. Breastfeeding practices were poor in Pemba, and the infants' diet had low energy density in Zimbabwe. Beyond food insecurity, contextual determinants of practices included inaccurate indigenous knowledge, time-consuming maternal livelihoods, family eating behaviors, local agriculture, and the local ecosystem. Both settings would require nutrition education, but it should target the broader indigenous ways of learning and family eating behaviors in order to achieve the necessary behavior change. A home-based fortificant would probably be enough for Pemban children, because the ecosystem of the island provides sufficient sources of macronutrients. However, Zimbabwean children appear to need a fortified food-based supplement to overcome the poor agricultural and economic context. Conclusions. Assessing context was essential to intervention design. A framework to guide future formative research is proposed.

Original languageEnglish (US)
Pages (from-to)244-253
Number of pages10
JournalFood and Nutrition Bulletin
Volume32
Issue number3
StatePublished - Sep 2011

Fingerprint

Infant Nutritional Physiological Phenomena
Food Supply
nutrition situation
Zimbabwe
Indian Ocean Islands
food security
eating habits
nutrient intake
infant
Tanzania
Feeding Behavior
Zanzibar
eating behavior
fortified foods
Islands
Ecosystem
diet recall
indigenous knowledge
food
ecosystems

Keywords

  • Complementary feeding
  • Context
  • Food supplementation
  • Infant and young child feeding
  • LiNS

ASJC Scopus subject areas

  • Geography, Planning and Development
  • Nutrition and Dietetics
  • Food Science

Cite this

Paul, K. H., Muti, M., Khalfan, S. S., Humphrey, J. H., Caffarella, R., & Stoltzfus, R. J. (2011). Beyond food insecurity: How context can improve complementary feeding interventions. Food and Nutrition Bulletin, 32(3), 244-253.

Beyond food insecurity : How context can improve complementary feeding interventions. / Paul, Keriann H.; Muti, Monica; Khalfan, Sabra S.; Humphrey, Jean Hawes; Caffarella, Rosemary; Stoltzfus, Rebecca J.

In: Food and Nutrition Bulletin, Vol. 32, No. 3, 09.2011, p. 244-253.

Research output: Contribution to journalArticle

Paul, KH, Muti, M, Khalfan, SS, Humphrey, JH, Caffarella, R & Stoltzfus, RJ 2011, 'Beyond food insecurity: How context can improve complementary feeding interventions', Food and Nutrition Bulletin, vol. 32, no. 3, pp. 244-253.
Paul KH, Muti M, Khalfan SS, Humphrey JH, Caffarella R, Stoltzfus RJ. Beyond food insecurity: How context can improve complementary feeding interventions. Food and Nutrition Bulletin. 2011 Sep;32(3):244-253.
Paul, Keriann H. ; Muti, Monica ; Khalfan, Sabra S. ; Humphrey, Jean Hawes ; Caffarella, Rosemary ; Stoltzfus, Rebecca J. / Beyond food insecurity : How context can improve complementary feeding interventions. In: Food and Nutrition Bulletin. 2011 ; Vol. 32, No. 3. pp. 244-253.
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