This study examines barriers to fish consumption during the complementary feeding period in two coastal counties of Kenya with high rates of child malnutrition. Study findings indicate that young child fish consumption is impacted by factors related to accessibility, food preferences, and caregiver’s knowledge and beliefs about fish during the complementary feeding period. These factors are influenced by prominent community figures such as elder women and health workers, whose own beliefs and understandings are impacted by underlying cultural norms, potentially limiting fish consumption. To our knowledge, this is the first study conducted in the coastal region of Kenya to focus on understanding fish consumption attitudes and beliefs during the complementary feeding phase. Our findings represent a critical first step towards the creation of more effective policies and interventions to address the significant nutritional disparities that exist in the study population.

Marine foods produced by small-scale fishers can make vital contributions to sustainable, healthy food systems with multisectoral considerations of public health nutrition, gender equity, economics, and marine ecology. This pilot study aimed to map the multidimensional determinants of fish food security and young child nutrition in four coastal communities of Kenya with a view toward designing a large intervention trial. We compared anthropometric and dietary diversity indicators of children under 5 years in fishing vs. non-fishing households. Mixed methods included household surveys, 24-h recalls for dietary intake, and anthropometric measures of children. Child dietary diversity score (CDDS) and height-for-age Z (HAZ) were primary outcomes tested in ordinary least square regression modeling. Stunting was widely prevalent (20.2%), as were morbidities for acute diarrhea (29.0%) and fever (46.5%), with no statistically significant differences in fishing compared to non-fishing households. High proportions of children showed nutrient intake inadequacies for vitamins A, C, and E, iron and zinc; <50% met requirements for all nutrients except protein, which was derived primarily from plant-based foods. Regression modeling showed children living in fishing households were associated with lower CDDS. Maternal education, maternal body mass index (BMI), and household livelihood diversity were positively associated with both CDDS and HAZ, while child morbidities and north coast (of Mombasa) residence showed negative associations. Our findings highlight nutritional vulnerabilities within a coastal food system of Kenya and the need to involve multiple sectors—education, environment, health, finance, communications, and governance and policy—in deriving solutions.

Objectives To assess the potential barriers and facilitators to fish consumption during the complementary feeding period in two coastal counties of Kenya with high rates of child malnutrition. Methods This qualitative study was part of a mixed-methods formative research investigation to examine the role of sustainable fish production and access to fish foods in coastal communities in Kenya. Twenty in-depth interviews were conducted with primary caregivers of children less than five years (n = 12) and community health workers and nutritionists (n = 8) in Kilifi County and Kwale County. Interviews were transcribed, translated and analyzed. A conceptual framework was developed based on the analysis to illustrate major factors and pathways influencing decisions to feed fish in the complementary feeding period. Results Complementary feeding practices reported by caregivers showed a low level of fish consumption in young children and delayed introduction of fish to the diet. Findings indicate that fish consumption was impacted by factors related to accessibility, food preferences, and caregiver's knowledge and beliefs. Access to fish was driven primarily by cost, proximity to locations where different fish types were sold, gendered purchasing behavior and the seasonal availability of fish foods. In some cases, the high cost of fish outweighed positive associations or perceived nutritional benefits when deciding whether to feed fish to children. Caregivers’ knowledge, beliefs, and food preferences also impacted consumption, with mixed perceptions regarding the importance of fish as a source of protein and other nutrients. These direct factors were influenced by prominent community figures such as elder women and health workers, whose own beliefs and understandings were impacted by underlying cultural norms, potentially limiting fish consumption. Conclusions Understanding current attitudes and beliefs toward fish consumption during the complementary feeding phase is a critical first step towards the creation of more effective policies and interventions that incorporate sustainable fish foods to address significant nutritional disparities that exist in the study population. Funding Sources This study was supported by the United States Agency for International Development (USAID) Feed the Future Innovation Lab for Fish.

The small-scale fisheries food system, in which individuals achieve food security independently or in small groups through fishing livelihoods and/or subsistence activities, provides food sovereignty for millions globally. However, this arrangement has inequitable engagement due to strictly enforced gendered roles in many communities, including coastal Kenya. Recently, critics across environmental research disciplines have called for social justice in science through anticolonial, feminist methodologies and interdisciplinary praxis. This resistance may take form through the “carrier bag” ability of fiction: an allusion to Le Guin's visionary analysis of containers as the first cultural device and evidence of the power of a story or personal sovereignty to tell one's story. Drawing from creative, service-driven methodologies emerging from collaboration among international research team members and Indigenous research participants, this project uses the “carrier bag” framework to support local environmental justice and food sovereignty goals through a science storybook resource created and shared with fishing families in Kilifi County, Kenya. We investigate how stories shape interpersonal relations in the context of this collaboration and how health knowledge, environmental science, and representational imagery can be tools for justice by examining the connections between social identity, family values, and social-ecological change in this food system. Having a deeper understanding of the experiences, changing ecosystems, and research feedback of these families allows this work to support fisheries management and nutrition interventions in Kenya and communities elsewhere.