What are the roles of social, behavioural and community engagement approaches in promoting maternal and child nutrition in communities in Burkina Faso, Ghana and South Africa?

Abstract

Many families in sub-Saharan Africa have high prevalence of under-nutrition, over-nutrition and micronutrient deficiencies and nutrition interventions have inconclusive outcomes for mothers and infants. This PhD aimed to understand how social, behavioural and community engagement approaches could promote maternal and child nutrition in communities in Burkina Faso, Ghana and South Africa, as recommended by the World Health Organisation. Four phases of data were collected. In Chapter Two, a systematic review showed that nutrition intervention components tended to only target participants’ capabilities and opportunities, whereas behaviour change components also addressed participants’ motivations. The review also found three Behaviour Change Wheel Intervention Functions, environmental restructuring, incentivisation and persuasive communication, were associated with the most successful nutrition and psychosocial outcomes.
In Chapter Three, focus group discussions with men and women from communities in Nanoro in Burkina Faso, Navrongo in Ghana, and Soweto in South Africa identified that nutrition was not their first priority; persistent struggles with communicable diseases, gender hierarchy, agricultural and climate issues, violence, crime, alcohol and substance abuse were higher priorities. In Chapters four and five, the modification, implementation and evaluation of the participatory priority setting tool, Choosing All Together (CHAT), showed that this form of community engagement was successful in understanding nutrition priorities of communities in Burkina Faso, Ghana and South Africa. Behaviour change techniques and methods were also identified in two commonly used community engagement approaches, CHAT and Participatory Learning and Action (PLA).
This research has increased understanding of how social, behavioural and community engagement approaches could promote maternal and child nutrition and health in Burkina Faso, Ghana and South Africa. Engaging with and listening to the voices of community members is crucial for developing interventions that are successful in improving their nutritional health. Using social, behavioural and community engagement approaches has global and psychological implications in shifting power imbalances between intervention developers, policy makers and those with lived experiences to create meaningful, respectful and ethical ways to work together over a sustained period of time.

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Identifiers

ORCID for Wendy Lawrence: orcid.org/0000-0003-1264-0438

ORCID for Sarah Kehoe: orcid.org/0000-0003-2584-7999

ORCID for Kate Ward: orcid.org/0000-0001-7034-6750

ORCID for Mary Barker: orcid.org/0000-0003-2976-0217

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