Department of Global Health and Health Policy, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
PeerJ. 2023 Sep 21;11:e16099. doi: 10.7717/peerj.16099. eCollection 2023.
In patriarchal societies, female caregivers decide on food allocation within a family based on prevailing gender and age norms, which may lead to inequality that does not favor young adolescent girls. This study evaluated the effect of a community-based social norm intervention involving female caregivers in West Hararghe, Ethiopia. The intervention was engaging female caregivers along with other adult influential community members to deliberate and act on food allocation social norms in a process referred to as Social Analysis and Action (SAA).
We used data from a large quasi-experimental study to compare family eating practices between those who participated in the Social Analyses and Action intervention and those who did not. The respondents were female caregivers in households with young adolescent girls (ages 13 and 14 years). The study's outcome was the practice of family eating together from the same dish. The difference in difference (DID) analysis with the mixed effect logistic regression model was used to examine the effect of the intervention.
The results showed improved family eating practices in both groups, but the improvement was greater in the intervention group. The DID analysis showed an 11.99 percentage points greater improvement in the intervention arm than in the control arm. The mixed-effect regression produced an adjusted odds ratio of 2.08 (95% CI [1.06-4.09]) after controlling selected covariates, -value 0.033.
The involvement of influential adult community members significantly improves the family practice of eating together in households where adolescent girls are present in our study. The intervention has great potential to minimize household food allocation inequalities and thus improve the nutritional status of young adolescents. Further studies are necessary to evaluate the effectiveness of the intervention in different social norm contexts to formulate policy and guidelines for scale-up.
在父权社会中，女性照顾者根据普遍的性别和年龄规范决定家庭内的食物分配，这可能导致不平等，不利于年轻少女。本研究评估了一项涉及埃塞俄比亚西哈勒尔格社区女性照顾者的基于社区的社会规范干预的效果。该干预措施让女性照顾者和其他成年有影响力的社区成员一起参与，通过称为社会分析和行动（SAA）的过程来审议和实施食物分配社会规范。
我们使用来自一项大型准实验研究的数据，比较了参与社会分析和行动干预与未参与干预的家庭的饮食实践。受访者是家中有 13 至 14 岁少女的女性照顾者。研究的结果是家庭从同一个盘子里一起吃饭的做法。我们使用混合效应逻辑回归模型的差分差异（DID）分析来检验干预的效果。
结果显示，两组的家庭饮食实践都有所改善，但干预组的改善更大。DID 分析显示，干预组的改善比对照组多 11.99 个百分点。在控制了选定的协变量后，混合效应回归产生了调整后的优势比为 2.08（95%置信区间[1.06-4.09]），p 值为 0.033。
在我们的研究中，有影响力的成年社区成员的参与显著改善了有少女存在的家庭中一起吃饭的家庭实践。该干预措施具有很大的潜力，可以最大限度地减少家庭内食物分配的不平等，从而改善青少年的营养状况。需要进一步研究评估干预措施在不同社会规范背景下的有效性，以制定政策和扩大规模的准则。
