TY - JOUR
T1 - “Good Food Causes Good Effects and Bad Food Causes Bad Effects”
T2 - Awareness, Meanings and Perceptions of Malnutrition among Pakistani Adolescents Living in Slums through Photodiaries and Interviews
AU - Estecha-Querol, Sara
AU - Zaidi, Syeda Kisa Zehra
AU - Al-Khudairy, Lena
AU - Gill, Paramjit
AU - Iqbal, Romaina
N1 - Funding Information:
This work was supported by the NIHR Global Health Research Unit on Improving Health in Slums at the University of Warwick (16/136/87). P.G. is also an NIHR senior investigator for the NIHR Department of Health and Social Care. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© 2022 by the authors.
PY - 2023/1
Y1 - 2023/1
N2 - Around 30% of the urban population of Southern Asia lives in a slum setting where basic necessities such as sanitation, education, employment, infrastructure are lacking, and people are more exposed to health problems. Children living in slums are at high risk of malnutrition. However, there is limited knowledge on adolescents living in slums. We explored awareness and meanings of malnutrition (under and over-nutrition) as well as examining malnutrition risk factors among adolescents living in a slum. A qualitative approach was undertaken using photodiaries and semi-structured interviews with 14 adolescents (13–16 years old) living in a slum in Karachi (Pakistan). An inductive strategy was used moving from open-ended data to patterns using reflexive thematic analysis. We identified widespread malnutrition awareness amongst these adolescents. Food consistently underpinned participants’ narratives and photodiaries, which was reflected in how they made sense of malnutrition: undernutrition was understood as lack of food, while overnutrition as excess of food. This study identified malnutrition drivers: sanitation, exercise, families, peers, wellbeing, gender, nutritional knowledge, media, and most importantly, food. People’s responsibility to eat healthily was highlighted by the participants, implying that people are to be blamed for their poor lifestyle choices. Following this responsibility discourse, most participants contemplated merely individually focused health interventions in order to overcome the problem of malnutrition in their area. It is necessary to study slum food environments better to implement effective nutrition programs and interventions to reduce malnutrition in slum settings.
AB - Around 30% of the urban population of Southern Asia lives in a slum setting where basic necessities such as sanitation, education, employment, infrastructure are lacking, and people are more exposed to health problems. Children living in slums are at high risk of malnutrition. However, there is limited knowledge on adolescents living in slums. We explored awareness and meanings of malnutrition (under and over-nutrition) as well as examining malnutrition risk factors among adolescents living in a slum. A qualitative approach was undertaken using photodiaries and semi-structured interviews with 14 adolescents (13–16 years old) living in a slum in Karachi (Pakistan). An inductive strategy was used moving from open-ended data to patterns using reflexive thematic analysis. We identified widespread malnutrition awareness amongst these adolescents. Food consistently underpinned participants’ narratives and photodiaries, which was reflected in how they made sense of malnutrition: undernutrition was understood as lack of food, while overnutrition as excess of food. This study identified malnutrition drivers: sanitation, exercise, families, peers, wellbeing, gender, nutritional knowledge, media, and most importantly, food. People’s responsibility to eat healthily was highlighted by the participants, implying that people are to be blamed for their poor lifestyle choices. Following this responsibility discourse, most participants contemplated merely individually focused health interventions in order to overcome the problem of malnutrition in their area. It is necessary to study slum food environments better to implement effective nutrition programs and interventions to reduce malnutrition in slum settings.
KW - Pakistan
KW - adolescent
KW - malnutrition
KW - photodiary
KW - qualitative research
KW - slum
KW - thematic analysis
UR - http://www.scopus.com/inward/record.url?scp=85145891718&partnerID=8YFLogxK
U2 - 10.3390/nu15010033
DO - 10.3390/nu15010033
M3 - Article
AN - SCOPUS:85145891718
SN - 2072-6643
VL - 15
JO - Nutrients
JF - Nutrients
IS - 1
M1 - 33
ER -