The focused ethnographic study ‘assessing the behavioral and local market environment for improving the diets of infants and young children 6 to 23 months old’ and its use in three countries

Abstract

The concept of a focused ethnographic study (FES) emerged as a new methodology to answer specific sets of questions that are required by agencies, policymakers, programme planners or by project implementation teams in order to make decisions about future actions with respect to social, public health or nutrition interventions, and for public-private partnership activities. This paper describes the FES on complementary feeding that was commissioned by the Global Alliance for Improved Nutrition and highlights findings from studies conducted in three very different country contexts (Ghana, South Africa and Afghanistan) burdened by high levels of malnutrition in older infants and young children (IYC). The findings are analysed from the perspective of decision-making for future interventions. In Ghana, a primary finding was that in urban areas the fortified, but not instant cereal, which was being proposed, would not be an appropriate intervention, given the complex balancing of time, costs and health concerns of caregivers. In both urban and rural South Africa, home fortification products such as micronutrient powders and small quantity, lipid-based nutrient supplements (LNS) are potentially feasible interventions, and would require thoughtful behaviour change communication programmes to support their adoption. Among the important results for future decision-making for interventions in Afghanistan are the findings that there is little cultural recognition of the concept of special foods for infants, and that within households food procurement for IYC are in the hands of men, whereas food preparation and feeding are women's responsibilities.

Poor dietary diversity and low nutrient density of the complementary diet for 6‐ to 24‐month‐old children in urban and ruralKwaZulu‐Natal,SouthAfrica

“…According to Pelto et al . (), home fortification through the use of, e.g. micronutrient powders and lipid‐based nutrient supplements are potentially feasible interventions to be introduced in South Africa, but thoughtful behaviour change communication programmes to support their adoption would be required (Pelto et al .…”

“…micronutrient powders and lipid‐based nutrient supplements are potentially feasible interventions to be introduced in South Africa, but thoughtful behaviour change communication programmes to support their adoption would be required (Pelto et al . ), and of course, mothers of nutritionally vulnerable children should have easy access to these products. Kimmons et al .…”

‘It was caused by the carelessness of the parents’: cultural models of child malnutrition in southern Malawi

“…; Gove & Pelto ; Pelto et al . ). FES typically use several different types of ethnographic methods to collect information on behaviours and cultural understandings in a specific setting (Pelto et al .…”

The politics of reducing malnutrition: building commitment and accelerating progress

“…A process convened by the New York Academy of Sciences and WHO for setting of research agendas in nutrition emphasises crucial gaps and a framework to undertake implementation research in nutrition. 102 Examples of such research have been emerging in the form of feasibility studies and formative research, [103][104][105][106] operations research and process evaluations, [107][108][109][110][111] and costing studies. [112][113][114] However, the scientifi c literature about implementation through delivery platforms, such as community-based or health-facility-based programmes, is more developed than is that of the use of mass media or market-based approaches to scale up interventions.…”