Abstract
Objectives
As obesity increases in sub-Saharan Africa, information is needed about factors influencing food choices in households with overweight members. The objective of this study was to assess women's food purchasing decisions in overweight mother-child dyads in Malawi.
Methods
We enrolled 50 mother-child (age 6–59 months) dyads in which either the mother, the child, or both were overweight in Lilongwe and Kasungu Districts. Research assistants accompanied each woman on a food shopping trip and filled out a structured observation form on the types of food purchased and locations of purchases. Upon returning to the woman's home, research assistants conducted an in-depth interview about the factors that influenced the woman's purchases, including asking them to sort 12 factors into piles that always, sometimes, or never influence their food purchasing choices.
Results
Observations showed that women most often purchased small quantities of foods needed to prepare relish (the dish accompanying the staple food), such as tomatoes (76%), green leafy vegetables (66%), cooking oil (56%), onions (44%), and fish (41%) at outdoor markets. Pile sorts and open-ended responses revealed that taste, cost, and food quality were the strongest factors influencing food purchases. Women explained that if a food is too expensive, they buy a smaller quantity or buy something else (e.g., fish instead of meat). Cooking food that their family enjoys eating influenced the foods women bought. Adding tomatoes, onions, and oil to relish was commonly described as making the food tastier. To make the child happy, >50% of the women said they buy food, such as sweets, packaged snacks, fruit, or fried food (e.g., doughnuts), specifically for their child.
Conclusions
Cost, taste, and food quality were the most important drivers of women's food purchasing choices. Women used some of their minimal funds to buy unhealthy foods for their children, despite their overall emphasis on food cost and quality. These findings can be used by programs to reinforce healthy and decrease unhealthy food purchases.
Funding Sources
Drivers of Food Choice (DFC) Competitive Grants Program, funded by the UK Government's Department for International Development and the Bill & Melinda Gates Foundation, and managed by the University of South Carolina, Arnold School of Public Health.
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