Understanding maternal dietary behaviour and perceived attributes of foods in the context of food insecurity in rural Bangladesh: a qualitative study

Abstract

Background Evidence shows inadequate dietary diversity among women in resource poor settings in developing countries. We explored women’s perceived attributes related to food choices to understand their eating habits during pregnancy and lactation, in rural Bangladesh. Methods We conducted a qualitative study in two villages in Jamalpur District in northern Bangladesh. These villages experience high levels of poverty according to the 2010 Bangladesh Poverty Map. We undertook in-depth interviews (n=36) with pregnant and lactating women and conducted focus group discussions (n=2) with their husbands. We used the ProPAN (Process for the Promotion of Child Feeding - a tool to improve infant and young child feeding) methodology to develop a key food list to conduct the food attribute exercise. Data was audio-recorded, transcribed in Bangla, and translated into English. The transcripts were manually coded and analyzed using the inductive thematic approach. Results We found that: (i) animal-source foods and fruits were the least consumed in the women’s diet resulting in low dietary diversity; (ii) Consumption of diversified foods was influenced by access to food at home, while accessibility depended on affordability and availability in the local market or homestead gardens; and (iii) even though food was available and accessible at the household level, individual food choice and consumption were subject to personal preference, cultural norms and lack of knowledge about nutritious foods and subsequent health benefits during pregnancy and lactation. Conclusions The findings will assist in planning appropriate interventions to improve dietary diversity of pregnant and lactating women. Insights from this study will be useful for designing appropriate nutrition behaviour change communication in Bangladesh and other low-resource settings.