Determinants of dietary and physical activity behaviours among women of reproductive age in urban Uganda, a qualitative study

Abstract

Objective: To explore determinants of dietary and physical activity behaviours among women of reproductive age. Design: Data were collected through focus group discussions (FGD). The FGD guide was based on a modified theoretical framework; theory of planned behaviour was incorporated with constructs of health belief model, precaution adoption process model, social cognitive and social support theory. Discussions were audio recorded, transcribed verbatim and analysed thematically. Setting: Kampala, Uganda. Participants: Women were categorised into young adults; 18–34 years and adults; 35–45 years Results: Separate FGD with independent participants were conducted for dietary and physical activity behaviours until data saturation was achieved. Six FGD were conducted per behaviour. Determinants of dietary behaviours at intra-individual level included gaps in food skills, knowledge and self-efficacy, food safety concerns, convenience, finances and physiological satisfaction. The social-cultural norms were relationship between vegetable consumption and low social status, consideration of fruits as a snack for children and not food and habitual orientation towards carbohydrate foods. At environment level, social networks and increased availability of energy-dense, nutrient poor, street and processed foods influence dietary behaviour. For physical activity, intra-individual determinants were knowledge gaps and self-efficacy, while socio-cultural norms included gender stereotypes. Home (limited space and sedentary entertainment like social media and TV) and physical environment (cheap motorised transportation) influence physical activity. Conclusion: The existing cultural beliefs promote dietary and physical activity behaviours which are divergent from healthy recommendations. Therefore, a comprehensive intervention is needed to address socio-cultural misconceptions, financial and time limitations in urban Uganda.

Are We Closer to International Consensus on the Term ‘Food Literacy’? A Systematic Scoping Review of Its Use in the Academic Literature (1998–2019)

“…We found no articles using the term 'food literacy' published by first authors based in low-income countries, which has been attributed to limited research budgets, low salaries, poor infrastructure and facilities and political instability [39]. However, since our search was conducted, articles from Ethiopia [40] and Uganda [41] have been published, further highlighting the relevance of the term.…”

How do food safety concerns affect consumer behaviors and diets in low- and middle-income countries? A systematic review

“…Participants reported that food safety during meal preparation was important to keep their families safe (Kendall et al, 2019;Knight et al, 2003;Pham and Turner, 2020;. Participants' actual or perceived knowledge of how foods are produced influenced food preparation and storage practices at home (Lagerkvist et al, 2018;Li et al, 2018;Nago et al, 2012;Wertheim-Heck et al, 2014;Yiga et al, 2020).…”

“…Participants reported that cooking vegetables was time consuming and difficult, due to the preparation methods required to ensure safety, but pre-packaged vegetables from vendors were not prioritized as they were also deemed to be unhygienic (Yiga et al, 2020). One study in Vietnam demonstrated that social factors, such as an established relationship with vegetable vendors, could reduce time spent on food preparation at home: "If the seller has already washed the vegetables, I even don't have to do that myself" [Adult, Vietnam] ( Wertheim-Heck et al, 2014).…”

Evidence-based strategies needed to combat malnutrition in Sub-Saharan countries facing different stages of nutrition transition

“…Four qualitative studies looked at community solutions to malnutrition in a novel and participatory approach with the population (13)(14)(15)(16) , while one study looked at factors influencing the implementation of a multisectoral, community-level nutrition programme aimed at improving infant and young child feeding practices (17) . The other qualitative studies explored nutritionrelated behaviours of mothers (18,19) , women outside of their maternal role (20) , parents (21) , and adolescents (22) .…”

“…The conflict between traditional knowledge on infant feeding and information provided by health workers is also highlighted in a study in Rwanda (19) . The importance of social media as source of nutrition information and determinant of food choices is reflected in a study in Ghana (20) . In a study in South Africa, parents noted that preschool children even at this very young age are drawn to devices such as smartphones, tablets and laptops and that TV was regularly watched; these habits may limit physical activity, thereby favouring overweight (21) .…”