Through a mothers eyes: Using photography to understand barriers and motivators to child nutrition in Jordan

Summary:

In recent years, Jordan has experienced a nutrition transition where undernutrition coexists with non-communicable diseases associated with other forms of malnutrition (including overweight and obesity). The problem of micronutrient deciencies in Jordan has been heightened by the recent influx of refugees coming into the country from neighbouring Syria. The World Food Programme in Jordan is developing a SBCC programme to help tackle these issues focused on school-aged children. To support the development of the programme, a community-based prevention marketing (CBPM) approach is being taken. CBPM is a community-directed social change process that applies marketing theories and techniques to design and implement health programs, working with local communities as partners and active participants, thereby spurring action by a community, for that community. Co-creation (human-centred design) workshops are being used, as well as photos taken by the local mothers to explore, through their own eyes, the challenges around healthy eating and the motivators for change. The mothers are also developing the messages and interventions to ensure commitment to the interventions developed and empower them to take ownership of the problems and solutions. The photos and images taken by the mothers, along with the full messages and intervention mix will be shared at the 2020 SBCC Summit.

Background/Objectives:

In recent years, Jordan has experienced a nutrition transition where undernutrition coexists with non-communicable diseases associated with other forms of malnutrition (including overweight and obesity). The problem of micronutrient deciencies in Jordan has been heightened by the recent influx of refugees coming into the country from neighbouring Syria. The World Food Programme in Jordan is developing a SBCC programme with the aim of reducing micronutrient deciencies and malnutrition rates of school-aged children. The primary audience is the mothers, with fathers and mothers-in-law the secondary audiences.

Description of Intervention and/or Methods/Design:

To develop the SBCC programme, a community-based prevention marketing (CBPM) approach has been undertaken. CBPM is a community-directed social change process that applies marketing theories and techniques to design and implement health programs, working with local communities as partners and active participants, thereby spurring action by a community, for that community. To understand the barriers faced around healthy eating and possible motivators to change, co-creation (human-centered design) workshops were held. Instead of traditional methods being used, the mothers took photos to explore: What pictures express your challenges in getting your children to eat healthier food? What does a good mother look like? What makes you smile? These images were then discussed to help WFP gain a unique understanding of the world through the mothers own eyes. The mothers then took the lead to develop the interventions and messages for their local communities.

Results/Lessons Learned:

Motivators and barriers identified: Parents do not always feel they can control their childrens lifestyle or what they are eating. A little fat is seen as a good thing. Pester power is strong and mothers prioritise immediate happiness over longer term health gains. Malnourishment appears to follow a cycle: Children are malnourished and suffering, then they want something tasty because it feels good. They eat fast food and snacks instead of healthy options; this further reduces their intake of vitamins and minerals. Mothers aspirations for their children to be happy and successful can be framed to encourage the feeding of a diverse diet. Based on the insights and through co-creation, the mothers are developing the messages and interventions to motivate and support the behaviour change and reduce the barriers. The final messages, images and intervention mix, and results, will be available for presented at the 2020 SBCC Summit.

Discussion/Implications for the Field:

Encouraging women to work as active participants can be challenging, especially where some women are not often asked to express their opinions and may have low self-confidence. However, by the women taking photos, they felt WFP staff were genuinely understanding the barriers and motivators. The women felt empowered to develop the solutions (in the form of the mix of interventions they developed). The mothers explained how often organisations simply ask them what the problem is, then employ experts to solve these problems. However, the mothers felt that CBPM allowed them to take ownership of the problems and solutions.

Abstract submitted by:

Rowena Merritt - World Food Programme (WFP)
Jacqueline De Groot - WFP
Nitesh Patel - WFP