Peer-reviewed article
Perceived Challenges and Solutions to Adopting Healthy Diets Among Women and Children: A Photovoice Study in Urban Ethiopia.
Worku M, Holdsworth M, Ruel M, Irache A, Baye K et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study used participatory photography with women in Addis Ababa, Ethiopia to understand why women and young children struggle to eat healthy diets. The research found that poor families face money, time and food safety problems, while wealthier families struggle with unhealthy food preferences and aggressive marketing of junk food. Women proposed solutions including job creation, nutrition education, better infrastructure and restrictions on unhealthy food promotion.
Key points
- Financial barriers and physical access to healthy foods are major obstacles to healthy diets across socio-economic groups
- Lower-income women reported limited knowledge about nutrition, inadequate family support and poor home food environments
- Higher-income groups face challenges from unhealthy food preferences and aggressive promotion of unhealthy foods
- Women identified government-level solutions including job creation, nutrition education, affordable healthy food, and investment in childcare and urban agriculture
- Study emphasises the importance of including women's voices in policy and programme decision-making
Limitations
This is a qualitative study based on focus group discussions with 31 women in one city (Addis Ababa), so findings may not represent all urban areas or rural Ethiopia. The study captures perceived challenges and proposed solutions but does not test whether implementing these solutions would actually improve nutrition outcomes.
Abstract
Ethiopia has one of the highest rates of undernutrition among children under five (U5) and women of reproductive age (WRA) globally, alongside rising overweight/obesity, particularly in urban areas. Poor diet is a shared driver of multiple forms of malnutrition. We used a participatory photography (Photovoice) approach to explore the lived experiences of WRA and their children U5 in adopting healthy diets across lower- and higher- socio-economic status (SES) groups in Addis Ababa. Women took photographs illustrating challenges to healthy diets, and five focus groups (n = 31 women) were conducted to discuss challenges and solutions, with separate sessions held for different SES groups. A hybrid thematic analysis, combining deductive and inductive approaches, identified themes/subthemes, with comparisons across SES groups. Financial and physical barriers to accessing healthy foods, time constraints and perceived poor food safety were major contributors to poor diets. In lower SES groups, women also reported limited knowledge about healthy diets, inadequate family support and poor home food environments. In higher SES groups, unhealthy food preferences coupled with easy access to and aggressive promotion of unhealthy foods were key challenges. Proposed government-level solutions included job creation, nutrition education, affordable healthy food, investment in household infrastructure, expanded childcare and restrictions on unhealthy food availability and promotion. Societal-level solutions included gender equality, strengthened community-based loan schemes and support for urban agriculture. These findings highlight that women recognise their needs and who should support them, and emphasise the importance of including women's voices in decision-making processes. Findings also underscore the need for integrated interventions targeting individual, food environment and socio-economic drivers to improve diets among women and children in urban Ethiopia.