Senior Consultant to conduct Ethnographic study on food
UN Children's Fund, Kigali-ngali, Rwanda
Despite impressive results in improving maternal and child health, Rwanda still faces challenges with regards to nutrition. Almost four out of every ten children (38%) younger than five are short for their age, stunted, and almost as many suffer from anemia (37%). Malnutrition, including stunting, is caused by a range of factors including limited availability of diversified foods, poor cooking and feeding practices and repeated episodes of infections such as diarrhea caused by poor hand washing practices. Data shows that only 56% of children younger than five receive complementary foods and only 19% achieve minimum acceptable diet in terms of sufficient frequency and quality of feeding. Likewise, only 12% of households have a hand washing facility, and even fewer have access to both water and soap for hand washing.
A 2016 study by Global Alliance for Improved Nutrition (GAIN), Understanding Consumer Demand for Nutritious Food in Nyanza District, Rwanda, concludes that several areas of sub-optimal feeding practices may be limiting the consumption of important nutrients by children. These are areas where, despite the generally good level of understanding that exists among consumers, local perceptions of the risk to children from specific foods are at odds with contemporary best-practice. The report finds that some foods are considered unfit to give to young children, including sweet potato and groundnut, as these are believed to cause diarrhea. Likewise, the report found indications that avocados and eggs are underused in children's food and that the use of cooking oil is limited. The study population is however limited to two sectors in Nyanza district and may not be easily generalized. Still, it points to existing beliefs and practices that may limit the use of affordable, nutritious products that are safe for children to consume.
Observations during data gathering for the Embassy of the Kingdom of the Netherlands (EKN) supported UNICEF Nutrition Programme end line survey (in draft) suggest that some mothers mainly use soap while bathing and that they will only use soap for hand washing when their hands are notably dirty. This may suggest beliefs around good hygiene being equal to appearing clean, i.e. not being visibly dirty.
Consequently, while factors related to poverty such as low access or availability of sufficient, nutritious food and hygiene facilities are likely to play a role in terms of good nutrition and hand washing practices, a more in-depth study is needed, which aims to explore the norms, beliefs and practices of pregnant women and caregivers of young children with regards to food, feeding and hand washing.
To uncover/explore beliefs and practices related to food and feeding, hand washing and hygiene of pregnant women and children to better tailor social and behavior change communication interventions (get under the skin of the behaviors hindering appropriate feeding, hand washing and hygiene of pregnant women and children).
The proposed study requires specialized knowledge and experience in ethnographic methods, to uncover norms, beliefs and practices that are usually not verbalized as well as identify enablers/motivation for improved nutrition and hygiene practices (cultural beliefs and values affect decisions about food acquisition, preparation and consumption). The importance of carrying out research with a qualitative and ethnographic approach to better understand underlying norms and believes has been amongst the recommendation from the above-mentioned studies, as well as by other quantitative or mixed-method pieces of research carried out by UNICEF.
The capacity to carry out an ethnographic research is not available within the UNICEF country team. The study will produce in-depth knowledge on local norms, beliefs regarding food (including food preparations, infant feeding and child-care practices, household diet and food patterns), feeding and hand washing in pregnant, women of reproductive age (including adolescents) and young children with a focus on potential gender differences, e.g. different practices applied when feeding girls and boys. Also, it will help identify/understand socio-cultural barriers that hinder nutrition-related behavior change, including the adoption of nutrition best practice; provide information on what influences/strengthens individuals, households and communities to adopt proper nutrition and hand washing practices.
This will greatly enrich UNICEF's support to the Government of Rwanda's social behavior change communication work to improve nutrition and hygiene by informing approaches and messages that may be tailored to address local norms, beliefs and practices hence reducing the existing gap between knowledge and practice of pregnant women and caregivers of young children with regards to food, feeding and hand washing.
This work falls within the frame of the 2018/19 annual work plan signed between UNICEF and the National ECD Programme, namely under activity 2.4.4 Support behavior change communication activities at community level.
- To discover local norms, beliefs regarding food (including food preparations, infant feeding and child-care practices, household diet and food patterns), feeding and hand washing in pregnant, women of reproductive age (including adolescents) and young children with a focus on potential gender differences, e.g. different practices applied when feeding girls and boys.
- To gain deeper understanding of socio-cultural barriers that hinder nutrition-related behavior change, including the adoption of nutrition best practice; provide information on what influences/strengthens individuals, households and communities to adopt proper nutrition and hand washing practices to inform our SBCC interventions for nutrition.
The study will use ethnographic methods which will be designed to capture explicit as well as implicit data, actions as well as words, and uncover both what is said as well as what is not said. Proposed ethnographic methods will include participant observation in communities and households and informal interviews with caregivers, both women and men.
Key informant interviews will also be used as triangulation to find out if behavior or beliefs that are observed are more individual or shared. Interviews should also be used to gather more data on beliefs, norms and practices. Interview guides will be developed based on the findings from participant observations. Key informants can include grandparents, youth (boys and girls), religious leaders, elders (who could be well versed with the notion of food, taboos and beliefs in a traditional Rwanda), community health workers, women's council representatives, sector social affairs officer etc.
The data collection will be carried out in 5 districts, 1 per province including Kigali, in one or more selected sites to be determined. The relevant number of interviews, FGD and observations will be determined during the drafting of the study manual, which will be designed in consultation with the local knowledge institution, the NECDP, RHCC and National Ethics Committee.
The consultant will carry out the following tasks:
- Draft study framework and data collection tools;
- Field test data collection tools;
- Carry out data collection and initial data analysis in 5 districts (specific sites to be determined). Initial data analysis will be done in the field to adjust the interactions and guide the proposed key informant interviews;
- Analyze data and draft report;
- Present study findings and report to relevant stakeholders in Rwanda including National Ethics Committee.
To the extent possible, the consultant will work in collaboration with a local knowledge institution, such as the University of Rwanda, Department of Human Nutrition and Dietetics, the National ECD Programme (NECDP), National Ethics Committee and the Rwanda Health Communication Center (RHCC) to build their capacity in ethnographic methodology.
Below is the list of expected deliverables:
- Study manual, including detailed description of data collection methodology, data collection tools and schedule of the field work.
- Final data collection tools revised based on feedback from UNICEF, partners and the field testing.
- Report presenting findings from the data collection including limitations and recommendations in terms of key beliefs, norms and practices that may be addressed to improve maternal and child feeding and hygiene (expected is superlative generated, strongly analyzed and well-structured qualitative data to inform our SBCC interventions).
- Power point presentation of study findings.
- A brief paper of the findings and recommendations on how to use these to inform national social behavior change communication efforts.
The consultant should have the following qualifications and experiences:
- Minimum, a Master's degree in anthropology, ethnography, public health or related fields preferably with experience in nutrition. At least 8 years of proven experience in carrying out ethnographic research related to uncovering beliefs and practices.
- Spoken and written fluency in Kinyarwanda and English is essential, and knowledge of French is an asset. The consultancy is open to qualified individuals either national or international. The consultant may be International but must provide capacity in Kinyarwanda by contracting a local interpreter (female candidates are strongly encouraged to apply).