Public health Nutritionisti am a consumate student of health sciences. Biological sciences are an excellent window into human health and wellbeing. But they require the unique capacities of social sciences to fully express our understand of the natural world. I like to stand on these two disciples to see further ahead and see clearer.
Objectives The United Nations Children Fund (UNICEF) Community based Infant and Young Child Feedi... more Objectives The United Nations Children Fund (UNICEF) Community based Infant and Young Child Feeding (IYCF) counselling package currently lacks comprehensive responsive feeding curriculum, thus limiting dissemination of these messages within IYCF counselling. Thus, project objectives were to: a) develop counselling cards based on recent evidence-based responsive feeding guidelines and b) test their feasibility in Ghana. Methods Five counselling cards were developed addressing the responsive feeding topics of: enjoying eating with family; hunger/satiety cues; introducing new foods; food texture as a function of child development; soothing a child. The UNICEF image bank was used to develop counselling cards with images compatible with the UNICEF Community based IYCF counselling package. Two peri-urban focus groups (FG) were conducted with Ghanaian mothers (N = 7) and fathers (N = 6) of children < 3 years to assess the cultural appropriateness of the cards. Card revisions were made a...
African Journal of Food, Agriculture, Nutrition and Development
Food-based dietary guidelines (FBDGs) are important tools for promoting healthy eating and nutrit... more Food-based dietary guidelines (FBDGs) are important tools for promoting healthy eating and nutrition education at the population level. Currently, more than 100 countries worldwide have developed FBDGs with majority of existing FBDGs in high-income countries. However, there are a few countries in Africa which have developed FBDGs. This review describes and compares the characteristics of existing FBDGs in Africa. Data were extracted from all existing FBDGs from African countries which have been archived in the Food and Agriculture Organization’s (FAO) online repository of FBDGs. In addition, supporting documentation from other sources linked to the identified FBDGs were also reviewed. Extracted data were coded and synthesized to describe the purpose of the FBDGs, the process for developing the FBDGs, and how healthy diets were expressed in the FBDGs. In addition, the FBDGs were examined for content on considerations for planetary health, and non-dietary recommendations. A checklist ...
African Journal of Food, Agriculture, Nutrition and Development
Anaemia among women of reproductive age (WRA) increases the risk of pregnancy-related morbidity, ... more Anaemia among women of reproductive age (WRA) increases the risk of pregnancy-related morbidity, mortality, and poor pregnancy outcomes. Globally, there is growing interest to reduce anaemia among WRA. In Ghana, anaemia among WRA declined at the national level between 2008 (59%) and 2014 (42%). There were also important declines at the sub-national level. The Eastern region (in the south) and Upper West region (in the north) provide an interesting opportunity to understand the decline. Identifying the drivers of anaemia reduction among WRA in Ghana provides important implementation science evidence for designing effective interventions. This current study examined the drivers of reduced anaemia prevalence in women of reproductive age using data from the Ghana Demographic and Health Surveys for 2008 and 2014. Anaemia was diagnosed as haemoglobin<12.0g/dl. Data were summarized using proportions and 95% confidence intervals. A weighted binary logistic-based multivariate decompositio...
African Journal of Food, Agriculture, Nutrition and Development
Diet modelling is one of the important steps in developing food-based dietary guidelines (FBDGs).... more Diet modelling is one of the important steps in developing food-based dietary guidelines (FBDGs). However, this component remains uncommon in the FBDGs of many low-and middle-income countries. A diet modelling package (DietSolve) provided by the Food and Agriculture Organization (FAO) was used to formulate a healthy diet based on estimating the daily proportions of food groups that best meet the dietary goals established for the FBDGs for Ghana. Input data for the modelling included a list of commonly eaten foods across the agreed food groups, nutrient and energy content of the foods, current energy and nutrient consumption, and energy and nutrient constraints linked to the dietary goals, as determined by the FBDG multi-Sectoral Technical Task Team (MTTT). The modelling was based on assumptions and constraints including a total daily dietary energy target of 2000 kcal/day; the percentage contribution (energy targets) of the macronutrients as follows: carbohydrates (55-70%), protein ...
African Journal of Food, Agriculture, Nutrition and Development
Food environments exert a significant effect on population dietary choices and health outcomes. P... more Food environments exert a significant effect on population dietary choices and health outcomes. Policies that influence the food environment, can have a significant impact on individual and population dietary choices. This rapid review assessed the nature and interaction within the Ghanaian food environment, and the impact that existing school, workplace, and national food policies have on dietary intake and nutritional outcomes. Online databases and university repositories were searched for relevant articles and documents. A total of forty articles and documents were included in the review. Majority of the reviewed papers (85%) used a cross-sectional design. The findings show that traditional outlets (open markets) constitute the main food source among the Ghanaian populace, while convenience stores serve as an important source of processed foods. Prepared local foods are often consumed outside the home and are mainly sourced from street food vendors. Street foods are perceived as ...
African Journal of Food, Agriculture, Nutrition and Development
In Ghana, more than four in ten deaths in 2016 resulted from non-communicable diseases (NCDs). Ph... more In Ghana, more than four in ten deaths in 2016 resulted from non-communicable diseases (NCDs). Physical inactivity and sedentary behaviours are important risk factors for NCDs. No previous systematic reviews examining physical activity and sedentary behaviour among Ghanaians were identified. Therefore, this rapid scoping review was conducted to find and synthesise what is known about the epidemiology of physical activity and sedentary behaviour of children and adults in Ghana. MEDLINE was searched for eligible studies and a narrative synthesis was conducted based on 17 identified papers as well as the 2008 Demographic and Health Survey report. Little recent high-quality data on prevalence of physical activity or sedentary behaviour in Ghana was found. Existing nationally representative data is now more than ten years old. The data identified suggest that the majority of Ghanaian adults, aged 18+ years, are physically active, achieving or exceeding World Health Organisation (WHO) rec...
African Journal of Food, Agriculture, Nutrition and Development, 2022
Anemia remains a serious public health concern, globally, affecting learning ability and physical... more Anemia remains a serious public health concern, globally, affecting learning ability and physical development of children. Anemic children are at a higher risk of diminished economic productivity and low earning capacity in adulthood due to impaired school performance and reduced work capacity. Anemia contributes to about a quarter of Africa’s nutrition-related Disability Adjusted Life Years. The objective of this study was to determine the prevalence of anemia and its associated risk factors among school-aged children (SAC) between ages 9 and 15 years in urban Ghana. The analysis included a randomly selected subsample of 1,634 children from a larger study on nutrition of SAC enrolled between 2009 and 2012 in private and public basic schools in the Accra and Kumasi Metropolis in Ghana. Socio-demographic and household characteristics were collected with questionnaires. Weight and height were taken to the nearest 0.1kg and 0.1cm, respectively. Dietary information was collected using a...
African Journal of Food, Agriculture, Nutrition and Development, 2022
As part of a process to develop food-based dietary guidelines (FBDGs), the national Multi-sectora... more As part of a process to develop food-based dietary guidelines (FBDGs), the national Multi-sectoral Technical Task Team coordinating FBDGs development in Ghana has commissioned a desk review of the nutrition and health situation, and trends for all persons living in Ghana, across the entire life cycle. Using a rapid scoping review method, multiple electronic databases were systematically searched using keywords related to nutrition and health outcomes, as well as potential drivers of nutrition and health in Ghana. The review included evidence from peer-reviewed articles, unpublished manuscripts, dissertations, reports of nationally representative surveys, and other grey literature (reports of nutrition situation evaluations commissioned by international and local agencies), spanning the decade starting from 2010. A total of 48 documents were included in this review: 15 for infants and young children, 14 for adolescents, 19 for adults and women of reproductive age, and five for the el...
Background: Small-scale mining, referred to as galamsey in Ghana, is an important source of incom... more Background: Small-scale mining, referred to as galamsey in Ghana, is an important source of income for many rural populations. Although concerns have been raised in the media about the significant threats galamsey poses to the environment, and human health and livelihoods, there is a representational paucity of evidence regarding its links with local food systems, particularly from the perspective of affected mining communities. The current study explored community perceptions and experiences of galamsey and its perceived effects on food security and livelihoods in the East Akyem Municipality in the Eastern region of Ghana. Methods: Primary data was collected in the East Akim District of Ghana, using photography, interviews based on the photographs, and a photo exhibition, all conducted . Thirty-six male and female adults were purposively selected with the help of a community focal person and advertisements in the study community. Respondents participants in a one-day photography tr...
Objective:To synthesise evidence of urban dietary behaviours (macronutrients, types of foods, die... more Objective:To synthesise evidence of urban dietary behaviours (macronutrients, types of foods, dietary diversity and dietary practices) in two African countries in relation to postulated changes in the context of nutrition transition.Design:Systematic review and meta-analyses, including six online databases and grey literature, 1971–2018 (Protocol CRD42017067718).Setting:Urban Ghana and Kenya.Participants:Population-based studies of healthy adolescents and adults.Results:The forty-seven included studies encompassed 20 726 individuals plus 6526 households. Macronutrients were within WHO-recommended ranges: mean energy intake was 1867 kcal/d (95 % CI 1764, 1969) and the proportions of macronutrients were carbohydrate 61·2 % (58·4, 64·0), fat 25·3 % (22·8, 28·0) and protein 13·7 % (12·3, 15·1). The proportion of population consuming fruit and vegetables was 51·6 %; unhealthy foods, 29·4 %; and sugar-sweetened beverages (SSBs), 39·9 %. Two-thirds (68·8 %) consumed animal-source proteins....
Background: Efficacious integrated intervention strategies to address the drivers of mal... more Background: Efficacious integrated intervention strategies to address the drivers of malnutrition at multiple levels are hardly implemented at scale, although opportunities for cross-sectoral action exist. In 2020, the Improved Feeding Practices (IFP) Project was implemented in Ghana to improve the dietary diversity and well-being of women of reproductive age(15-49 years)and children >2 years. Objective: This paper reports the perceptions and experiences of project beneficiaries and the lessons learned from the IFP project. Methods: Using a socio-ecological framework, data from the IFP project documents (n=8) and in-depth interviews with key stakeholders, including local government officers, and direct and indirect beneficiaries (n=61), were triangulated to construct an evidence-based overview of the implementation of the complementary strategies of the IFP project. The interviews explored respondents' knowledge, experiences of the project activities, and perceptions of how the project affected their lives. The data were analysed and synthesized thematically using ATLAS.ti. Results: The IFP project envisaged an impact pathway through promoting community-or home-based nutrient-rich crop production and poultry to enhance diet quality, child careand feeding practices. Multi-sectoral partners facilitated training and service delivery at community, farm, facility, and household levels. Beneficiaries reported an overall positive experience of participating in the project, including enhanced dietary knowledge, capacity to produce and use eggs andorange fleshed sweet potatoes(OFSP), earned revenues, and access to nutritious foods. Caregivers reported that the IFP project contributed to enhancing children’s diet quality, reduced disease incidence, and improved child growth. Community-level program implementers experienced capacity strengthening. The dry season, increased poultry feed input prices, diseases (such as fowl pox, Newcastle and smallpox), and poultry deaths, limited the scale of benefits. Key implementation lessons include leveraging local resources to produce poultry feed at home, crossbreeding local and commercial poultry, and enhancing disease management, leading to improved potential for project sustainability. Conclusions: Overall, the communities reported a positive experience of an integratednutrition-sensitive agriculture(NSA)intervention, leading to improved diets of households, women of reproductive age, and young children >2 years. These strategies can be adapted for use in other to improve women's and children's dietary diversity in similar settings, giving due consideration to lessons learned.
African Journal of Food Agriculture Nutrition and Development , 2024
Women's activities within the local food system are linked to their dietary quality. Their abilit... more Women's activities within the local food system are linked to their dietary quality. Their ability to consume a nutritious diet may be influenced by socio-cultural norms; often, the influence of these norms has not been adequately studied. This study examined how socio-cultural norms linked with rural food systems can potentially exert adverse effects on women's diets. The study was conducted in two rural communities, Yilkpene and Kpachilo, in Northern Ghana, between May and July 2016. Both selected study communities were chosen because they had similar population sizes, dietary patterns, and access to social services. Using a qualitative approach, sixteen key informant interviews with community and institutional leaders, 11 focus group discussions comprising 87 community members, and forty 24-hour dietary recall interviews with women of reproductive age were used to explore the nature of the local food system linked with socio-cultural norms. Transcribed interviews were coded and analyzed, thematically, using predetermined and emerging themes. A total of 143 women and men participated in the study with women dominating the sample. The components of the food system in both communities were constructed, primarily, around men. Quantities, quality, and varieties of produce, its distribution, and intra-household allocation were dominated by male perceptions and practices that determine access and ownership of productive resources, and predetermined roles and responsibilities of household members. Men dominated production of economic crops (cereals, and legumes); women produced vegetables, and limited quantities of legumes and cereals, mainly for home consumption. Men controlled allocation of cereals for household meal preparation; more expensive complementary ingredients were provided by women. Although women prepared household meals, men received the 'lion's share' of nutrient-dense components. Forty-five percent of women could not meet minimum dietary diversity of at least five food groups in their diets. The local food system in Northern Ghana is dominated by gender-driven socio-cultural norms, which constitutes a potential barrier to women achieving dietary adequacy. Interventions should deliberately address these culturally-established barriers, especially in contexts where subsistence farming is the main source of livelihood.
Objectives The United Nations Children Fund (UNICEF) Community based Infant and Young Child Feedi... more Objectives The United Nations Children Fund (UNICEF) Community based Infant and Young Child Feeding (IYCF) counselling package currently lacks comprehensive responsive feeding curriculum, thus limiting dissemination of these messages within IYCF counselling. Thus, project objectives were to: a) develop counselling cards based on recent evidence-based responsive feeding guidelines and b) test their feasibility in Ghana. Methods Five counselling cards were developed addressing the responsive feeding topics of: enjoying eating with family; hunger/satiety cues; introducing new foods; food texture as a function of child development; soothing a child. The UNICEF image bank was used to develop counselling cards with images compatible with the UNICEF Community based IYCF counselling package. Two peri-urban focus groups (FG) were conducted with Ghanaian mothers (N = 7) and fathers (N = 6) of children < 3 years to assess the cultural appropriateness of the cards. Card revisions were made a...
African Journal of Food, Agriculture, Nutrition and Development
Food-based dietary guidelines (FBDGs) are important tools for promoting healthy eating and nutrit... more Food-based dietary guidelines (FBDGs) are important tools for promoting healthy eating and nutrition education at the population level. Currently, more than 100 countries worldwide have developed FBDGs with majority of existing FBDGs in high-income countries. However, there are a few countries in Africa which have developed FBDGs. This review describes and compares the characteristics of existing FBDGs in Africa. Data were extracted from all existing FBDGs from African countries which have been archived in the Food and Agriculture Organization’s (FAO) online repository of FBDGs. In addition, supporting documentation from other sources linked to the identified FBDGs were also reviewed. Extracted data were coded and synthesized to describe the purpose of the FBDGs, the process for developing the FBDGs, and how healthy diets were expressed in the FBDGs. In addition, the FBDGs were examined for content on considerations for planetary health, and non-dietary recommendations. A checklist ...
African Journal of Food, Agriculture, Nutrition and Development
Anaemia among women of reproductive age (WRA) increases the risk of pregnancy-related morbidity, ... more Anaemia among women of reproductive age (WRA) increases the risk of pregnancy-related morbidity, mortality, and poor pregnancy outcomes. Globally, there is growing interest to reduce anaemia among WRA. In Ghana, anaemia among WRA declined at the national level between 2008 (59%) and 2014 (42%). There were also important declines at the sub-national level. The Eastern region (in the south) and Upper West region (in the north) provide an interesting opportunity to understand the decline. Identifying the drivers of anaemia reduction among WRA in Ghana provides important implementation science evidence for designing effective interventions. This current study examined the drivers of reduced anaemia prevalence in women of reproductive age using data from the Ghana Demographic and Health Surveys for 2008 and 2014. Anaemia was diagnosed as haemoglobin<12.0g/dl. Data were summarized using proportions and 95% confidence intervals. A weighted binary logistic-based multivariate decompositio...
African Journal of Food, Agriculture, Nutrition and Development
Diet modelling is one of the important steps in developing food-based dietary guidelines (FBDGs).... more Diet modelling is one of the important steps in developing food-based dietary guidelines (FBDGs). However, this component remains uncommon in the FBDGs of many low-and middle-income countries. A diet modelling package (DietSolve) provided by the Food and Agriculture Organization (FAO) was used to formulate a healthy diet based on estimating the daily proportions of food groups that best meet the dietary goals established for the FBDGs for Ghana. Input data for the modelling included a list of commonly eaten foods across the agreed food groups, nutrient and energy content of the foods, current energy and nutrient consumption, and energy and nutrient constraints linked to the dietary goals, as determined by the FBDG multi-Sectoral Technical Task Team (MTTT). The modelling was based on assumptions and constraints including a total daily dietary energy target of 2000 kcal/day; the percentage contribution (energy targets) of the macronutrients as follows: carbohydrates (55-70%), protein ...
African Journal of Food, Agriculture, Nutrition and Development
Food environments exert a significant effect on population dietary choices and health outcomes. P... more Food environments exert a significant effect on population dietary choices and health outcomes. Policies that influence the food environment, can have a significant impact on individual and population dietary choices. This rapid review assessed the nature and interaction within the Ghanaian food environment, and the impact that existing school, workplace, and national food policies have on dietary intake and nutritional outcomes. Online databases and university repositories were searched for relevant articles and documents. A total of forty articles and documents were included in the review. Majority of the reviewed papers (85%) used a cross-sectional design. The findings show that traditional outlets (open markets) constitute the main food source among the Ghanaian populace, while convenience stores serve as an important source of processed foods. Prepared local foods are often consumed outside the home and are mainly sourced from street food vendors. Street foods are perceived as ...
African Journal of Food, Agriculture, Nutrition and Development
In Ghana, more than four in ten deaths in 2016 resulted from non-communicable diseases (NCDs). Ph... more In Ghana, more than four in ten deaths in 2016 resulted from non-communicable diseases (NCDs). Physical inactivity and sedentary behaviours are important risk factors for NCDs. No previous systematic reviews examining physical activity and sedentary behaviour among Ghanaians were identified. Therefore, this rapid scoping review was conducted to find and synthesise what is known about the epidemiology of physical activity and sedentary behaviour of children and adults in Ghana. MEDLINE was searched for eligible studies and a narrative synthesis was conducted based on 17 identified papers as well as the 2008 Demographic and Health Survey report. Little recent high-quality data on prevalence of physical activity or sedentary behaviour in Ghana was found. Existing nationally representative data is now more than ten years old. The data identified suggest that the majority of Ghanaian adults, aged 18+ years, are physically active, achieving or exceeding World Health Organisation (WHO) rec...
African Journal of Food, Agriculture, Nutrition and Development, 2022
Anemia remains a serious public health concern, globally, affecting learning ability and physical... more Anemia remains a serious public health concern, globally, affecting learning ability and physical development of children. Anemic children are at a higher risk of diminished economic productivity and low earning capacity in adulthood due to impaired school performance and reduced work capacity. Anemia contributes to about a quarter of Africa’s nutrition-related Disability Adjusted Life Years. The objective of this study was to determine the prevalence of anemia and its associated risk factors among school-aged children (SAC) between ages 9 and 15 years in urban Ghana. The analysis included a randomly selected subsample of 1,634 children from a larger study on nutrition of SAC enrolled between 2009 and 2012 in private and public basic schools in the Accra and Kumasi Metropolis in Ghana. Socio-demographic and household characteristics were collected with questionnaires. Weight and height were taken to the nearest 0.1kg and 0.1cm, respectively. Dietary information was collected using a...
African Journal of Food, Agriculture, Nutrition and Development, 2022
As part of a process to develop food-based dietary guidelines (FBDGs), the national Multi-sectora... more As part of a process to develop food-based dietary guidelines (FBDGs), the national Multi-sectoral Technical Task Team coordinating FBDGs development in Ghana has commissioned a desk review of the nutrition and health situation, and trends for all persons living in Ghana, across the entire life cycle. Using a rapid scoping review method, multiple electronic databases were systematically searched using keywords related to nutrition and health outcomes, as well as potential drivers of nutrition and health in Ghana. The review included evidence from peer-reviewed articles, unpublished manuscripts, dissertations, reports of nationally representative surveys, and other grey literature (reports of nutrition situation evaluations commissioned by international and local agencies), spanning the decade starting from 2010. A total of 48 documents were included in this review: 15 for infants and young children, 14 for adolescents, 19 for adults and women of reproductive age, and five for the el...
Background: Small-scale mining, referred to as galamsey in Ghana, is an important source of incom... more Background: Small-scale mining, referred to as galamsey in Ghana, is an important source of income for many rural populations. Although concerns have been raised in the media about the significant threats galamsey poses to the environment, and human health and livelihoods, there is a representational paucity of evidence regarding its links with local food systems, particularly from the perspective of affected mining communities. The current study explored community perceptions and experiences of galamsey and its perceived effects on food security and livelihoods in the East Akyem Municipality in the Eastern region of Ghana. Methods: Primary data was collected in the East Akim District of Ghana, using photography, interviews based on the photographs, and a photo exhibition, all conducted . Thirty-six male and female adults were purposively selected with the help of a community focal person and advertisements in the study community. Respondents participants in a one-day photography tr...
Objective:To synthesise evidence of urban dietary behaviours (macronutrients, types of foods, die... more Objective:To synthesise evidence of urban dietary behaviours (macronutrients, types of foods, dietary diversity and dietary practices) in two African countries in relation to postulated changes in the context of nutrition transition.Design:Systematic review and meta-analyses, including six online databases and grey literature, 1971–2018 (Protocol CRD42017067718).Setting:Urban Ghana and Kenya.Participants:Population-based studies of healthy adolescents and adults.Results:The forty-seven included studies encompassed 20 726 individuals plus 6526 households. Macronutrients were within WHO-recommended ranges: mean energy intake was 1867 kcal/d (95 % CI 1764, 1969) and the proportions of macronutrients were carbohydrate 61·2 % (58·4, 64·0), fat 25·3 % (22·8, 28·0) and protein 13·7 % (12·3, 15·1). The proportion of population consuming fruit and vegetables was 51·6 %; unhealthy foods, 29·4 %; and sugar-sweetened beverages (SSBs), 39·9 %. Two-thirds (68·8 %) consumed animal-source proteins....
Background: Efficacious integrated intervention strategies to address the drivers of mal... more Background: Efficacious integrated intervention strategies to address the drivers of malnutrition at multiple levels are hardly implemented at scale, although opportunities for cross-sectoral action exist. In 2020, the Improved Feeding Practices (IFP) Project was implemented in Ghana to improve the dietary diversity and well-being of women of reproductive age(15-49 years)and children >2 years. Objective: This paper reports the perceptions and experiences of project beneficiaries and the lessons learned from the IFP project. Methods: Using a socio-ecological framework, data from the IFP project documents (n=8) and in-depth interviews with key stakeholders, including local government officers, and direct and indirect beneficiaries (n=61), were triangulated to construct an evidence-based overview of the implementation of the complementary strategies of the IFP project. The interviews explored respondents' knowledge, experiences of the project activities, and perceptions of how the project affected their lives. The data were analysed and synthesized thematically using ATLAS.ti. Results: The IFP project envisaged an impact pathway through promoting community-or home-based nutrient-rich crop production and poultry to enhance diet quality, child careand feeding practices. Multi-sectoral partners facilitated training and service delivery at community, farm, facility, and household levels. Beneficiaries reported an overall positive experience of participating in the project, including enhanced dietary knowledge, capacity to produce and use eggs andorange fleshed sweet potatoes(OFSP), earned revenues, and access to nutritious foods. Caregivers reported that the IFP project contributed to enhancing children’s diet quality, reduced disease incidence, and improved child growth. Community-level program implementers experienced capacity strengthening. The dry season, increased poultry feed input prices, diseases (such as fowl pox, Newcastle and smallpox), and poultry deaths, limited the scale of benefits. Key implementation lessons include leveraging local resources to produce poultry feed at home, crossbreeding local and commercial poultry, and enhancing disease management, leading to improved potential for project sustainability. Conclusions: Overall, the communities reported a positive experience of an integratednutrition-sensitive agriculture(NSA)intervention, leading to improved diets of households, women of reproductive age, and young children >2 years. These strategies can be adapted for use in other to improve women's and children's dietary diversity in similar settings, giving due consideration to lessons learned.
African Journal of Food Agriculture Nutrition and Development , 2024
Women's activities within the local food system are linked to their dietary quality. Their abilit... more Women's activities within the local food system are linked to their dietary quality. Their ability to consume a nutritious diet may be influenced by socio-cultural norms; often, the influence of these norms has not been adequately studied. This study examined how socio-cultural norms linked with rural food systems can potentially exert adverse effects on women's diets. The study was conducted in two rural communities, Yilkpene and Kpachilo, in Northern Ghana, between May and July 2016. Both selected study communities were chosen because they had similar population sizes, dietary patterns, and access to social services. Using a qualitative approach, sixteen key informant interviews with community and institutional leaders, 11 focus group discussions comprising 87 community members, and forty 24-hour dietary recall interviews with women of reproductive age were used to explore the nature of the local food system linked with socio-cultural norms. Transcribed interviews were coded and analyzed, thematically, using predetermined and emerging themes. A total of 143 women and men participated in the study with women dominating the sample. The components of the food system in both communities were constructed, primarily, around men. Quantities, quality, and varieties of produce, its distribution, and intra-household allocation were dominated by male perceptions and practices that determine access and ownership of productive resources, and predetermined roles and responsibilities of household members. Men dominated production of economic crops (cereals, and legumes); women produced vegetables, and limited quantities of legumes and cereals, mainly for home consumption. Men controlled allocation of cereals for household meal preparation; more expensive complementary ingredients were provided by women. Although women prepared household meals, men received the 'lion's share' of nutrient-dense components. Forty-five percent of women could not meet minimum dietary diversity of at least five food groups in their diets. The local food system in Northern Ghana is dominated by gender-driven socio-cultural norms, which constitutes a potential barrier to women achieving dietary adequacy. Interventions should deliberately address these culturally-established barriers, especially in contexts where subsistence farming is the main source of livelihood.
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Papers by R. Aryeetey