Food labour, consumption hierarchies, and diet decision-making in Sri Lankan households: a qualitative study
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RESEARCH ARTICLE
Open Access
Food labour, consumption hierarchies, and diet decision-making in Sri Lankan households: a qualitative study J. Renzella1* , S. Fernando2, B. Kalupahana3, P. Scarborough4, M. Rayner1 and N. Townsend5
Abstract Background: Sri Lanka faces the double burden of over- and undernutrition. To tackle this dual challenge, double duty interventions that improve the quality of the Sri Lankan diet in line with national dietary guidelines have been suggested. The success of these interventions depends upon an understanding of the context-specific factors that impact their uptake within the population. The purpose of this study was threefold: explore household responsibility for food-related labour; understand food decision-making influences; and investigate consumption hierarchies that might impact the distribution of intervention benefits. Methods: We conducted face-to-face semi-structured interviews with 93 Sri Lankan adults residing in urban Colombo (n = 56), and urban and rural sectors in Kalutara (n = 29) and Trincomalee (n = 8). Interview data were analysed thematically. Results: Findings from this study suggest that women in Sri Lanka continue to shoulder the burden of food-related labour disproportionately to men but that this responsibility is not always a proxy for dietary decision-making power. While men are often absent from the kitchen, their role in food purchasing and payment is prominent in many households. Despite these observed gender differences in food labour and provisioning, “traditional” age- and gender-based consumption hierarchies with negative nutrition consequences for women and children are not common, indicating that Sri Lankan ‘table culture’ may be changing. Conclusion: Dietary interventions with the aim of influencing day-to-day practice should be developed with an awareness of who is responsible for, who is able to perform, and who influences targeted behaviours. Keywords: Food, Cooking, Diet, Health promotion, Gender, Adults, Sri Lanka, Qualitative
Background Suboptimal diet is the leading risk factor for global morbidity and mortality, and an important preventable risk factor for noncommunicable diseases (NCDs) [1]. As urbanisation, economic development, and income growth lead to predictable shifts in diet, many low- and middleincome countries entering the fourth stage of nutrition transition now face the double burden of malnutrition * Correspondence: [email protected] 1 Centre on Population Approaches for NCD Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, UK Full list of author information is available at the end of the article
(DBM) [2–4]. What follows is the pressing and overwhelming task of tackling these coexisting and contrasting nutrition challenges; one that the World Health Organization (WHO) suggests public health policymakers approach as an opportunity to identify and implement integrated solutions [5, 6]. Sri Lanka is one such country whose progression to the fourth stage of nutrition transition ha
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