Factors that affect men involvement in nutrition interventions of children below 5 years

in Nakivale settlement

Problem Statement

According to the Academy of Nutrition and Dietetics (2014), “the purpose of a nutrition
intervention is to resolve or improve the nutrition diagnosis or nutrition problem by
provision of advice, education, or delivery of the food component of a specific diet or meal
plan tailored to the child’s needs.” Few studies have tried to understand the complex
processes that underlie optimal child nutrition intervention at the community, household and
individual level (Menon, 2012; Chapagain, 2013; Issaka et al., 2014; Ogbo et al., 2015).
Furthermore, the studies done have focused on economic and social factors such as
household poverty, maternal level of education, and inadequate knowledge on optimal
nutrition intervention (Issaka et al., 2014; Ogbo et al., 2015). Consequently, many efforts to
improve nutrition target pregnant women, with the contribution of the father in the
nutritional well-being of both mother and children rarely being focused on. This target on
women-only does not take note of the fact that beliefs and behaviours of women do not exist
in a vacuum but that many times are influenced by their partners who also make decisions
that generally affects the household’s health and nutrition. Such decisions include what foods
to buy and how much to spend on foods, who eats what, and decisions on health care
spending.

Also, in most cases, the efforts to involve men in MCH have put more emphasis on sexual
and reproductive health, gender based violence programs as well as HIV programs as
compared to efforts to involve them more in a child’s nutritional well-being.

It is in the context of this gap in research that this study will explore factors influencing male
involvement in nutrition interventions of children below 5 years in Nakivale settlement.

Objectives of the Study

• To identify knowledge and attitudes that men have in relation to their engagement in
nutrition interventions of children below 5 years.

• To determine the factors that act as barriers to the involvement of men in nutrition
interventions of children below 5 years

• To determine the best strategies that can be used to engage men in nutrition
interventions of children below 5 years.
Research questions

• What are some of the knowledge and attitudes that men have in relation their
engagement in nutrition interventions of children below 5 years?

• What factors act as barriers to the involvement of men in nutrition interventions of

• What are the best strategies that can be used to engage men in nutrition interventions
of children below 5 years?

Significance of study

The study is expected to provide the policymakers, program planners, health care providers,

NGOs and donors with factual information necessary to develop appropriate interventions

towards improving male involvement in nutrition program of below five years of age.

The information obtained from this study can be used as a baseline or a point of reference for

researchers who have special interest in nutrition of refugees.

Independent variable Intervening variable Dependent variable

Knowledge
Knowledge on appropriate foods
and complementary feeding
Signs of malnutrition
Practices
Financial provision
Meal preparation
Clinic attendance and offering
advice Gender Analysis
Framework
Access Male involvement in
nutrition intervention
Knowledge, beliefs, and
Barriers to male involvement perceptions
Partner relationship
Decision-making dynamics Practices and participation
Gender roles and norms
Power and decision-
Social support
making

Strategies to engage men

Gender Analysis Framework

This study will apply the gender analysis framework (GAF) to explore factors influencing
male involvement in nutrition intervention. The framework was developed by Deborah Caro
for the IGWG (Interagency Gender Working Group) in 2009. It was developed as a tool for
collecting and analyzing context-specific information on gender relations and identities.

The framework is known to help program designers responsible for conducting a gender
assessment or synthesizing information from existing research and analyses. The framework
has four important components, which focus on specific aspects of social and cultural
relations within a given context. They are as follows:

Access: This basically explains the capability to use resources needed to become a
productive member of society. It can be access to resources, income, services and also
knowledge and information.

Knowledge, beliefs, and perceptions: This are value systems shaping ideas about
appropriate roles and responsibilities for both men and women thereby shaping patterns of
behaviour. For example, the association of women with child and caregiving practices shape
opportunities for women to learn more about these practices than men. Also, beliefs about
the appropriateness of women in certain domains may restrict men from those domains that
are considered as women’s only.

Practices and participation: This component of GAF refers to ideas about gender that
usually shape how people behave and influences who does what and how. Gender roles
influence participation activities such as child feeding practices, accepting and seeking out
services, attending clinics and meetings like community meetings, and other development
activities.

Power and decision-making: This can be understood as the ability of a person to decide, to
influence, and to control. Also, the capacity to make decisions freely and to exercise power
within an individual’s household and community. This can include the capacity of partners to
decide about the use of household resources as well as how to spend income.

The framework has been employed in a variety of ways in the health sector to understand the
many strategies of incorporating gender into HIV programs and other reproductive health
programmes. In the case of men’s involvement in nutrition intervention, women have
increasingly been viewed as the only target for most nutritional programs and policies
involving children such as the first 1000 years (Black et al., 2013).

It therefore looks into the interaction of both genders within relationships, hence directly
target gender relations which will help understand how men are women are expected to
behave concerning child feeding and nutrition. GAF also acknowledges the capacity of men
as partners and accelerators to the needed change, and therefore provide support for men to
challenge pre-existing roles and norms surrounding masculinity in child nutritional well-
being. It's therefore important to understand local context in relation to decision-making
power and also what is considered as a woman’s or man’s space. One cannot therefore
consider male involvement without understanding the norms that guide relationships not
only in the communities but within the households.

The framework is important as it offers a gender-transformative approach therefore

Relevance to the study

The proposed study seeks to specifically find out factors influencing male’s active
involvement in nutrition interventions. Therefore, the GAF came in handy in guiding it
through the specific objectives courtesy of its four constructs. The concepts practices and
participation and power and decision-making create a clear foundation in understanding to
what extent men should actively participate in nutrition intervention and how men make
decisions.

On the other hand, the component of knowledge, beliefs and perceptions are important in
informing the study objective on barriers to male involvement in child feeding practices.
Through this, the study is able to understand how men’s perception of barriers hindered them
from actively participating in nutrition intervention.

Also, the access component informs the study on resources such as knowledge, information,
access to income and resources influence male involvement in direct activities related to
nutrition intervention.
Study Design

The study will employ an explanatory cross-sectional research design featuring qualitative
methods. This kind of study allows for greater in-depth research into a problem that has not
well been researched before. It gives room for giving detailed explanations to the questions
being asked to help understand the problem more effectively. (Mack et al., 2005). Because
this is an area with little research, according to (Malterud, 2001), a qualitative approach gives
in-depth information on the experience of men in the nutrition intervention of their children
below five years. The study population will be children below age of five (5) and men.
Variable Measurement
Knowledge and attitude

Nutrition knowledge and attitude of the study participants will be assessed using the Food
and Agriculture Organization's (FAO) nutrition related knowledge, attitudes and practices
questionnaire (Marías & Glasauer, 2014). The study will use four modules on breastfeeding,
infant feeding, iron deficiency and vitamin A deficiency for analysis. These questions have
multiple correct answers listed. Responses will be recorded by the principal investigator if the
respondent gives one of the listed answers; responses not listed will be entered as text in the
‘other’ category and will be analysed for correctness. Responses within knowledge questions
will be summarized. For example, there are six correct answers for ‘ways to provide good
nutrition for below five-year child’ (eating more food, eating more at each meal, eating more
frequently, eating more protein rich foods, eating iron rich foods and using iodized salt for
preparing meals; Marías & Glasauer, 2014). Each item will be given 1 point, yielding a
maximum possible score of 6. In total, there are four nutrition knowledge variables per
woman and man: (1) ways to provide good nutrition for pregnant/lactating women, (2) ways
to improve diets for children, (3) knowledge of vitamin A rich foods and (4) knowledge of
iron rich foods.