Background
Methods
Theoretical framework (symbolic interactionist theory (SIT))
Description of the research setting
Data collection
Interviews with pregnant and post-natal women
Characteristic | Categories | Percentage (N = 154) |
---|---|---|
Maternal status | Antenatal mothers | 40 |
Post-natal mothers | 60 | |
Gravidity | First pregnancy/child | 28 |
More than one pregnancy | 72 | |
Age (years) | ≤19 | 9 |
20–24 | 29 | |
25–29 | 32 | |
30–34 | 18 | |
≥35 | 12 | |
Marital status | Never married | 18 |
Currently married | 77 | |
Separated | 3 | |
Widowed | 2 | |
Educational level | Primary education | 54 |
Secondary education | 34 | |
Post-secondary education | 12 | |
Occupation | Farming | 40 |
Business | 21 | |
Housewife | 18 | |
Formal employment | 9 | |
Student/pupil | 8 | |
Others | 4 | |
Ethnic Affiliation | Nandi | 71 |
Keiyo | 18 | |
Marakwet | 5 | |
Kipsigis | 3 | |
Tugen | 1 | |
Terik | 1 | |
Pokot | 1 |
Key informant interviews
Data processing and analysis
Ethical considerations
Results
Food type | Reason | Percentage (N = 154) |
---|---|---|
Animal organsa
| Preserved delicacy for men and burren or menopouse women, tongue makes baby and women talk much | 96 |
Meatb
| Makes the baby big and brings misfortune to mother or baby | 87 |
Eggs | Makes the baby big, causes high blood pressure and colic pain in the baby | 68 |
Oily foodc
| Causes colic pain to the baby and makes the baby’s saliva ooze | 25 |
Avocado | Makes the baby big | 20 |
Alcohol and cigarettes | Results in a retarded, underweight and stunted child | 19 |
Soil/soft stonesd
| Causes colic pain to baby and finishes baby’s blood | 11 |
Sugary foode
| Causes colic pain to baby, makes baby’s saliva drool | 11 |
Moboriet
f
| Makes the baby big, makes mother defecate a lot during birth, makes foetus docile | 10 |
Fresh milk | Makes the baby grow big | 7 |
Cabbages and kale | Are not nutritious, give the mother heartburn and nausea, use a lot of chemicals to grow | 6 |
Salt | Makes the baby’s skin crack and peel, increases blood flow/pressure of the mother | 5 |
Sheep’s head | Makes the baby have a blocked nose hence breaths with snoring sound | 5 |
Cold water | Weakens the mother’s back ache after birth and prolongs labour pain | 5 |
Plantain | Makes the baby big | 4 |
Sheep meat | Causes allergies such as rashes to the baby’s skin | 3 |
Vegetables grown on a burned soil | Cause burn-like rashes to the baby’s skin | 3 |
Beans | Give the mother heartburn and nausea | 3 |
Fermented milk | Gives the mother heartburn | 3 |
Fermented porridge | Gives the mother heartburn | 3 |
Rice and Irish potatoes | Supply less energy | 3 |
Food type | Reason | Percentage (N = 154) |
---|---|---|
Traditional vegetables (Table 4) | Increase blood of the mother, gives strength to the mother and reduces heartburn | 89 |
Milk | Gives strength to the mother, builds body and adds blood to the mother | 63 |
Fruitsa
| Increase blood to the mother and protect the baby | 35 |
Traditional herbs | Give strength to the mother, protect the baby, immunity booster to mother and foetus, reduce heartburn, ‘evil eyes’ and misfortunes and gastro-intestinal discomfort, increases uterine contractions during labour | 34 |
Ugali
b
| Gives strength to the mother | 32 |
Porridge | Gives strength to the mother and increases the mother’s blood | 32 |
Liverc
| Increases blood of the mother | 24 |
Water | Gives strength to the mother | 15 |
Animal bloodd
| Increases blood of the mother | 13 |
Beans | Gives strength to the mother and increases blood of the mother | 12 |
Fish | Builds body and increases blood of the mother | 11 |
Red soil and soft stonese
| Increases blood to mother | 7 |
Meatf
| Adds blood to, and builds body of, the mother | 7 |
Cooked bananas | Gives strength to the mother | 5 |
No. | Local name | English name | Botanical name |
---|---|---|---|
1 | Mborochet | Pig weed |
Amaranthus dubuis
|
2 | chepkerta | Pig weed |
Amaranthus gracecizane
|
3 | Sochojek | African nightshade |
Solanum nigrum
|
4 | Sagek | Wild spiderflower |
Cleome gynandra
|
5 | Nderemiat | Vine spinach |
Basella alba
|
6 | Seveve | pumpkin leaves |
Cucurbita moschata
|
7 | Mrenda | jute mallow |
Corchorus olitorius
|
8 | Mito/miroo | Slenderleaf |
Crotalaria ochroleuca
|
9 | Kundek | Cowpea leaves |
Vigna unguiculata
|
Food restrictions during pregnancy
Animal organs
Meat
“If a cow is pregnant and a calf dies in the uterus, a woman should not eat it. Also, if a cow was giving birth and the placenta refused to come out a woman should not dare eat it. If you eat it, you will be like that cow”. (150504_001)
“If a cow is born lame, when slaughtered you cannot eat it, we believe you may give birth to a lame baby. Even a stolen animal is not allowed, you will give birth to a thief.” (150621_001-53)
“Meat of an animal killed by lightening is not even allowed to be brought into the house; it is slaughtered and eaten by men at the striking spot. The leftovers including bones should be burned beyond recognition. …It can cause death to a pregnant woman if she eats it”. (150610_003-77)
“If you are pregnant and you are not sure of a certain meat, don’t attempt to eat it, you ask first. But this is something everybody knows, even the owner of the meat will not let you eat it or buy it if he notices that you are pregnant. He will stop you.” (150602_001)
“If you accidentally eat an animal that was unable to deliver and died, they must do for you cleansing rituals. This will involve people from the husband side and the wife side. After the rituals, nothing will happen to you”. (130709_006-129)
“They restrict meat from cattle too, but sheep, goats are allowed… personally I did not eat it. It is not allowed, because cattle are given a lot of drugs.” (130709_002-126)
”I did not eat mutton, even ‘gogo’ told me not to. You know if you eat mutton, when you give birth, the meat brings rashes on your baby’s skin, like those of an allergy.” (130707_005-106)
“Meat of sheep’s head is not allowed to be eaten by a pregnant woman, the child will have nasal block. Have you ever heard a child snoring strongly even when awake? They say it’s because you ate sheep’s head during pregnancy.” (150510_003-1)
Eggs
“We are told if you eat eggs, they will bring problems on the day of birth, the baby will defeat you, and you will undergo an operation [caesarean section].” (150510_002-25)“They say that if a woman is pregnant and eats eggs, there are high chances of developing high blood pressure.” (130707_004-105)“You know if you eat eggs, the baby will develop stomach pain, and she/he will be crying a lot after birth.” (150510_003-1)
“I find it a wise idea not to eat eggs when pregnant. You should eat may be once, … say after a month or two months if you have that strong urge, otherwise, you are supposed to control yourself”. (130707_004-105)“I ate twice for the entire pregnancy period but I did not eat them plainly. I mixed them in dough for making ‘chapati’ and in ‘sukuma wiki’ [Brassica Carinata].” (150610_001-75)
“We are restricted eggs from six months onwards.” (130707_008-107)“A woman cannot eat eggs from the time of conception but after finishing 6-7 months it is allowed.” (130709_006-129
Oily food
“The food that has a lot of oil for example eggs, ‘kangumu,’ ‘mandazi’, or fatty meat, you should not eat much. … I don’t know what it has that if you eat, the day of delivery it will bring problems, you will undergo an operation.” (150510_002)“You should use very little oil in frying food, not excess because a pregnant woman’s blood already flows very fast. If you add oil on top, the heart will beat excessively.” (130707_002-104)
Avocado (Persea Americana)
“Avocado can hurt you … This is something I was told by my mum and I believed it. … If you eat it, you are causing problems to yourself, you might tear during birth or you will not be able to push out the baby.” (150617_002-9)“They have said I should avoid it [avocado], though I used to it eat because I didn’t know it was wrong until I was stopped. … it is a good idea, because if you eat, the baby will grow …, and if the baby grows big, definitely you will go to theatre.” (150621_001-53)“Avocado you only eat once in a week. I personally did not eat it completely. I find it an okay advice, because if you eat, the baby will be too heavy and you will not be able to deliver.” (130709-002-126)
Alcohol and cigarettes
Sugary food
“If you eat sugarcane, your child will have this thing… we call it ‘meninek’ I mean will be oozing a lot of saliva.” (150615_002- 98)“We call it ‘surunda’ (colic pain) this stomach that disturbs newborns. Ripe bananas are not good.” (130708_001-118)
Soil and soft stones
“I did not eat soil so my baby had this normal stomach problem, but if you add the soil on top the problem becomes excess.” (150617_002-9)”I was having four pints of blood (Hb4) when I was pregnant of my other daughter … And that is why I was telling you that soil finishes blood because I used to eat a lot of it even before I conceived that pregnancy.” (130707_005-106)
Moboriet
“You should not eat moboriet when you are pregnant especially in the morning. A woman poops all the time during birth before the baby comes out. They [the midwives] will be wiping it off every time that is why they do not let us eat it.” (150609_002-89)
Other pregnancy food restrictions among the Kalenjin
Food types recommended during pregnancy
“This nderemiat [Basella alba] and miroo [Crotalaria ochroleuca) are very helpful, when you eat them you do not feel heartburn.” (150602_001)“When you are pregnant and your blood is low, you must eat these vegetables so that your blood can increase.” (150617_006-13)
“When you are pregnant and you are told your blood is less and should be increased, you need to go to the butchery, collect blood of the cow, sheep or goat depending on what animal they slaughtered, ferment it with fresh milk, stock and you be drinking it daily. It helps your blood volume to increase fast.” (130707_003-104)
“Ugali is good. It gives you energy the day of pushing the baby out.” (150602_001)
Discussion
Health and illness as determinants of food selection and restriction
Gender and age as determinants of food selection
Rituals as factors in food selection and avoidance
Food beliefs observed to enhance decency and aesthetics
Food beliefs to enhance group identity and cohesion
Conclusions
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Considering the high prevalence of food beliefs, it is advisable that when nutritious foods are restricted, nutritional interventions should rather search for alternative sources of nutrition which are available and considered to be appropriate for pregnancy.
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In this study, we also found ambiguity in the food beliefs. Some food such as meat, beans, cooked bananas, soil, and milk were reported by some respondents as restricted, while these were mentioned by others as being recommended. Intervention programs should thus design nutrition training tools tailored to these intra cultural variations in food beliefs.
-
Some of the beliefs, such as consumption of traditional vegetables, milk, beans, liver, fruits, porridge and ugali as well as the restriction of eating soil and soft stones, meat of a dead animal, excess salt, excess sugar, excess oil, alcohol and cigarettes, are supported by science and are indeed beneficial for health, hence need to be encouraged. However, it should be clarified how much should be consumed. On the other hand, restriction of nutritious food such as eggs, meat, avocadoes, animal organs, vegetables planted on ashes, as well as recommendation of red soil, need to be sparingly discouraged.
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Traditional herbs are widely consumed during pregnancy not only in Uasin Gishu but also in other parts of Africa. There is the need to study the chemical constituents of these herbs to learn how safe and relevant they are for human consumption, especially during pregnancy and foetal development.
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The major reason for food beliefs and adherence to them is to protect health of the mother and child, and ensuring a successful pregnancy outcome. Intervention programmes that provide nutritional advice need to address these health concerns and the assumptions that underlie successful pregnancy and delivery, given the deep-rooted nature of the beliefs.