By Jane Sherman, Nutrition Education Consultant
About the boys
In Uganda there is a boys’ youth club, whose members (aged 14-23) are crazy about football, television and music. If they can’t become sports stars, what they want most is a good job and a family. Some have jobs, some are apprenticed or studying, and some are unemployed. Regardless, they all live mainly on cheap street food and junk food, with no notion of what makes for a good diet or the long-term effects of a poor one. Chicken and chips, with pot noodles, washed down with a fizzy drink, is their idea of high life. They can’t cook and wouldn’t if they could. Their energy needs are huge: “They eat like they are taking on fuel,” says the club leader “they just tank up and drive on”. [i]
Two sides to the solution
Common sense sees two sides to this nutrition problem:
- On the one hand, it would be nice if there was more healthy cheap food around for the boys to eat.
- On the other hand, it would also be nice if the boys wanted to eat the healthy options, and saw them as a ‘cool’ choice which would make them fitter for football.
Demand meets supply, mind meets matter, taste meets opportunity, education meets environment. We know the two sides interact, that we need to act on both. My questions are: Does the development world know this? Is the global action program getting the balance right?
Supply side strategies
In the growing nutrition movement the main strategies are largely on the supply side, aiming to increase access and availability. There is a heavy emphasis on micronutrient supplements and cash transfers in some countries. Also widespread are food solutions such as school meals, fortified foods, biofortified foods, home gardening, increasing and diversifying the food supply, enhancing value chains in agriculture, subsidies on food/seeds/ fertiliser and sometimes taxes or subsidies to limit or enhance supply. The call [ii] is to harness whole food systems to get the good food out there.
Leading horses to the water
But we know that people’s food actions are governed not only by availability and accessibility but also by habit, outlook, taste preferences, fads and food myths, personal circumstances and time constraints, knowledge, health beliefs, cultural and social factors like social norms and social status, and commercial influences. This fact is as concrete as the need for micronutrients. Even when the physical need for better nutrition is there and the food is available, food practices are slow to change. You can take a horse to the water but you can’t necessarily make it drink.
Nutrition Education & Company
So, the question is not only what can be done for the boys but also what can the boys do for themselves if they really want to? Making healthy food available is just one side of the coin: people also need to change how they utilize food and how they think about it, while developing their own capacity to make good use of their environments for healthy living. The schools of thought and practice which claim to promote these changes are food and nutrition education (FNE), social behaviour change communication (SBCC), health promotion, social marketing and consumer education. They do not just hand out information or advice; they set up frameworks which help people improve how and what they eat. They start this process by (so to speak) talking to the horses: that is, exploring influences and circumstances to find out why people do what they do and what might lead them to change. These approaches can have large catalytic effects on consumer practice in many nutrition initiatives including social protection schemes,* community education,** home gardening, and of course infant and young child feeding.***
Fortunately, interventions which integrate FNE and SBCC are increasing and the evidence base is growing. The argument is strong that sustainable good nutrition has its roots not only in supply-side elements such as supplements, food availability and increased spending power, but also in their synergies with popular understanding, good community food practices and market demand for healthy foods.
If the youth club boys get lucky they will eventually become fathers and family men. Will they know how to feed their children well?
* Additional reference available here.
** Additional reference available here.
[i] A real case from the ENACT training course in nutrition education, Unit 6, Student’s Book, p.27.