Development of contextualised food-based strategy to improve the dietary diversity and nutritional status of children aged 12 to 36 months in rural farming households in central Uganda
| dc.contributor.advisor | Mbhenyane, Xikombiso | en_ZA |
| dc.contributor.advisor | Ekesa, Beatrice | en_ZA |
| dc.contributor.advisor | Faber, Mieke | en_ZA |
| dc.contributor.author | Nabuuma, Deborah | en_ZA |
| dc.contributor.other | Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition. | en_ZA |
| dc.date.accessioned | 2020-12-01T06:54:17Z | |
| dc.date.accessioned | 2021-02-01T07:55:33Z | |
| dc.date.available | 2020-12-01T06:54:17Z | |
| dc.date.available | 2021-02-01T07:55:33Z | |
| dc.date.issued | 2020-12 | |
| dc.description | Thesis (PhD)--Stellenbosch University, 2020. | en_ZA |
| dc.description.abstract | ENGLISH SUMMARY: Food insecurity, low dietary diversity, and malnutrition remain prevalent in sub-Saharan Africa. Food-based strategies have a high potential of improving diet quality in agriculture-dependent communities and their development and effectiveness can be enhanced by systematic approaches. This study aimed to develop a food-based strategy to improve the dietary diversity of children aged 12 to 36 months from rural smallholder farming households in Central Uganda. An embedded-sequential, mixed-methods research design was used: i) quantitative situation analysis using household and market surveys, ii) qualitative assessment of community perspectives using focus group discussions, iii) design of the food-based strategy using intervention mapping, and iv) qualitative validation using key informant interviews and focus group discussions. The results showed household food production and food consumption were mainly based on cereals and grains, roots, tubers, cooking bananas and legumes. There was low dietary diversity; 78% of six- to 23-month-old children did not meet the minimum dietary diversity and 71% of children ≥ 24 months were consuming less than three food groups. The most accessed markets had limited diversity of food groups (six out of 11 (55%)) compared to other markets in the community. Food production and consumption focused on priority crops that alleviated hunger and contributed to income – mainly maize, cooking bananas, sweet potatoes, cassava and beans. Food production was influenced by access to land, production costs, income potential, climate and farmer knowledge. The cost of food and market availability influenced the type and quantity of food bought and consumed. Poor perception towards meetings/training and inadequate nutrition information and skills were noted. These findings, relevant theory and literature were applied using intervention mapping to systematically identify determinants, outcomes, objectives, and pathways to improve dietary diversity. The resulting contextualised food-based strategy (CFBS) aims to improve dietary diversity of children in smallholder farming households through improved household production, income utilisation, and food consumption practices by: i) increasing diversity of foods produced, particularly fruits and vegetables, ii) increasing access to diverse foods through appropriate income and market, including an increase in diversity of foods in consumer markets and financial literacy, and iii) improving the quality of diets consumed, especially diversity, frequency, nutrient quality and safety through nutrition education. Actors included policy makers, development organisations, extension workers, community-level groups, community champions and smallholder farmers. Validation results rated the factors and actors in the CFBS as important for improving productivity, food availability, dietary diversity, livelihoods of smallholder farmers, thereby verifying the strategy and design process used. To improve dietary diversity among rural smallholder farmers, their food security and production challenges need to be addressed. This increases the relevance and motivation to participate and implement recommended practices. Markets have the potential to significantly contribute to dietary diversity. However, this requires adequate supply and demand of diverse foods in rural consumer food markets, as well as income and financial literacy to facilitate financial decisions that promote dietary diversity. The CFBS empowers smallholder farmers to decide on a course of action that achieves dietary diversity, having been equipped with information and skills on agriculture, nutrition and finances. | en_ZA |
| dc.description.abstract | AFRIKAANSE OPSOMMING: Voedselonsekerheid, min verskeidenheid ten opsigte van eetgewoontes en wanvoeding is steeds algemeen in Afrika suid van die Sahara. Voedselgebaseerde strategiee het groot potensiaal om die dieetkwaliteit in die landbouafhanklike gemeenskappe te verbeter en die ontwikkeling en doeltreffendheid daarvan kan deur middel van sistematiese benaderings verbeter word. Hierdie studie het ten doel gehad om 'n voedselgebaseerde strategie te ontwikkel om die dieetverskeidenheid van kinders tussen 12 en 36 maande van landelike huishoudings ten opsigte van kleinboere in Sentraal-Uganda te verbeter. 'n Navorsingsontwerp met ingebedde sekwensiële gemengde metodes is gebruik: i) kwantitatiewe situasie-analise met behulp van huishoudelike en markopnames, ii) kwalitatiewe assessering van gemeenskapsperspektiewe met behulp van fokusgroepbesprekings, iii) die ontwerp van die voedselgebaseerde strategie deur intervensie-kartering te gebruik en iv) kwalitatiewe bekragtiging deur van belangrike onderhoude met segspersone en fokusgroepbesprekings gebruik te maak. Die resultate het aangedui dat huishoudelike voedselproduksie en voedselverbruik hoofsaaklik op graankos, wortels, knolle, piesangs, en peulgewasse gebaseer was. Daar was min dieetverskeidenheid met 78% van kinders van ses tot 23 maande oud wat nie aan die minimum dieetverskeidenheid voldoen nie en 71% van die kinders ≥ 24 maande wat minder as drie voedselgroepe verbruik het. Die mees toeganklike markte het 'n beperkte verskeidenheid voedselgroepe gehad (ses uit 11) en 'n beperkte verskeidenheid voedselitems per voedselgroep, in vergelyking met ander markte in die gemeenskap. Voedselproduksie en -verbruik het gefokus op prioriteit-oeste wat honger verlig en tot inkomste bydra – hoofsaaklik mielies, piesangs, patats, kassava en boontjies. Die koste van voedsel en die beskikbaarheid in die mark het die soort en hoeveelheid voedsel wat gekoop en verbruik is, beïnvloed. 'n Swak persepsie ten opsigte van vergaderings/opleiding en onvoldoende voedingsinligting en -vaardighede is opgemerk. Hierdie bevindings, relevante teorie en literatuur is toegepas deur ingrypings-kartering te gebruik om uitkomste, doelstellings en wysigingswyses stelselmatig te identifiseer. Die gevolglike gekontekstualiseerde landelike voedselgebaseerde strategie (CFBS) is daarop gemik om die dieetverskeidenheid van kinders in kleinboerhuishoudings deur middel van verbeterde huishoudelike produksie, inkomsteverbruik en voedselverbruikspraktyke te verbeter deur: i) die verskeidenheid voedselprodukte te verhoog, veral vrugte en groente, deur gebruik te maak van volhoubare produksiepraktyke wat hulpbronne optimaliseer; ii) groter toegang tot diverse voedsel deur die toepaslike gebruik van inkomste en markte, insluitend 'n toename in diversiteit van voedsel in markte wat landelike gemeenskappe en finansiele geletterdheid bedien en iii) die verbetering van die kwaliteit van verbruikte diete, veral diversiteit, frekwensie, kwaliteit van voedingstowwe en veiligheid deur voedingsopvoeding. Rolspelers wat geteiken is, het beleidmakers, ontwikkelingsorganisasies, voorligtingswerkers, groepe/netwerke op gemeenskapsvlak, gemeenskapskampvegters en kleinboere ingesluit. Valideringsresultate het die faktore en rolspelers in die CFBS as belangrik beskou vir die verbetering van produktiwiteit, voedselbeskikbaarheid, dieetverskeidenheid, lewensbestaan en gesondheid van kleinboere, en sodoende word die doelstellings, strategie en die ontwerpproses wat gebruik is, bekragtig. Om hul uitdagings op die gebied van voedselsekerheid en produksie aan te pak, moet die dieetverskeidenheid van kleinboere op die platteland verbeter word. Dit verhoog die relevansie en motivering om aan aanbevole praktyke deel te neem. Markte kan die grootste bydrae tot die dieetdiversiteit lewer. Dit verg egter voldoende vraag en aanbod van uiteenlopende voedselsoorte in landelike verbruikersvoedselmarkte, sowel as inkomste en finansiele geletterdheid om finansiele besluite te fasiliteer wat die diversiteit van diete bevorder. Die CFBS bemagtig kleinboere om 'n plan van aksie te beraam wat dieetverskeidenheid bewerkstellig nadat hulle inligting en vaardighede oor landbou, voeding en finansies verkry het. | af_ZA |
| dc.description.version | Doctorate | |
| dc.format.extent | xxi, 258 pages : illustrations, includes annexures | |
| dc.identifier.uri | http://hdl.handle.net/10019.1/109447 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | Stellenbosch : Stellenbosch University | |
| dc.rights.holder | Stellenbosch University | |
| dc.subject | Food insecurity -- Uganda | en_ZA |
| dc.subject | Malnutrition in children -- Uganda | en_ZA |
| dc.subject | Children -- Nutrition -- Uganda | en_ZA |
| dc.subject | UCTD | |
| dc.title | Development of contextualised food-based strategy to improve the dietary diversity and nutritional status of children aged 12 to 36 months in rural farming households in central Uganda | en_ZA |
| dc.type | Thesis | en_ZA |