James P, Grant School of Public Health, 5th Floor (Level-6), icddr,b Building, BRAC University, 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka 1212, Bangladesh.
Reprod Health. 2013 Sep 26;10:53. doi: 10.1186/1742-4755-10-53.
Maternal malnutrition in Bangladesh is a persistent health issue and is the product of a number of complex factors, including adherence to food 'taboos' and a patriarchal gender order that limits women's mobility and decision-making. The recent global food price crisis is also negatively impacting poor pregnant women's access to food. It is believed that those who are most acutely affected by rising food prices are the urban poor. While there is an abundance of useful quantitative research centered on maternal nutrition and food insecurity measurements in Bangladesh, missing is an understanding of how food insecurity is experienced by people who are most vulnerable, the urban ultra-poor. In particular, little is known of the lived experience of food insecurity among pregnant women in this context. This research investigated these lived experiences by exploring food provisioning strategies of urban, ultra-poor, pregnant women. This knowledge is important as discussions surrounding the creation of new development goals are currently underway.
Using a focused-ethnographic approach, household food provisioning experiences were explored. Data from participant observation, a focus group discussion and semi-structured interviews were collected in an urban slum in Dhaka, Bangladesh. Interviews were undertaken with 28 participants including 12 pregnant women and new mothers, two husbands, nine non-pregnant women, and five health care workers.
The key findings are: 1) women were aware of the importance of good nutrition and demonstrated accurate, biomedically-based knowledge of healthy eating practices during pregnancy; 2) the normative gender rules that have traditionally constrained women's access to nutritional resources are relaxing in the urban setting; however 3) women are challenged in accessing adequate quality and quantities of food due to the increase in food prices at the market.
Rising food prices and resultant food insecurity due to insufficient incomes are negating the recent efforts that have increased women's knowledge of healthy eating during pregnancy and their gendered empowerment. In order to maintain the gains in nutritional knowledge and women's increased mobility and decision-making capacity; policy must also consider the global political economy of food in the creation of the new development goals.
孟加拉国的孕产妇营养不良是一个长期存在的健康问题，是多种复杂因素的产物，包括对食物“禁忌”的遵守以及限制妇女流动和决策能力的父权制性别秩序。最近的全球粮食价格危机也对贫困孕妇获得食物的机会产生了负面影响。据信，受粮食价格上涨影响最严重的是城市贫困人口。尽管孟加拉国有大量以孕产妇营养和粮食不安全测量为中心的有用定量研究，但人们对最弱势群体，即城市极度贫困人口的粮食不安全状况缺乏了解。特别是，人们对这一背景下孕妇粮食不安全状况的实际经历知之甚少。本研究通过探讨城市极度贫困孕妇的粮食供应策略来探索这些实际经历。由于围绕制定新发展目标的讨论正在进行，因此了解这些知识非常重要。
采用聚焦民族志方法，探讨家庭粮食供应经验。在孟加拉国达卡的一个城市贫民窟中，通过参与观察、焦点小组讨论和半结构化访谈收集数据。访谈对象包括 28 人，包括 12 名孕妇和新妈妈、两名丈夫、9 名非孕妇和 5 名保健工作者。
主要发现如下：1）女性意识到良好营养的重要性，并在怀孕期间表现出准确的、基于生物医学的健康饮食实践知识；2）传统上限制妇女获得营养资源的规范性别规则在城市环境中正在放松；然而 3）由于市场上食品价格上涨，妇女在获得足够质量和数量的食品方面面临挑战。
由于收入不足导致的粮食价格上涨和粮食不安全，否定了最近增加妇女对怀孕期间健康饮食知识的了解以及增强妇女权力的努力。为了保持营养知识的提高以及妇女增加的流动性和决策能力，政策在制定新发展目标时还必须考虑粮食的全球政治经济。
