By Raphael Mweninguwe (Malawi), Justina Asishana (Nigeria) and Srishti Jaswal (India)
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How religious, cultural beliefs demonise beef, pork, milk, snail, others
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Taboo delicacies aid spread of malnutrition in Nigeria, Malawi, India
Aith Bikiyere, 6, was admitted to the Nutrition Rehabilitation Unit (NRU) at Mitundu Health Centre in Lilongwe, suffering from stunting (low weight for height) and her mother, Daina Bikiyere, 24, was also undernourished.
Daina said the doctors told her that their conditions were caused by poor diet. She said she had followed the advice of some women in her family and community while she was pregnant that she should not eat certain foods including okra, catfish, pork, egg, milk and banana.
“And when the child (Bikiyire) was born, she was underweight. Still, I was advised by some people not to breastfeed her or give her certain dietary foods.”
The advice she received was contrary to UNICEF’s recommendation that mothers should breastfeed their newborns exclusively for up to six months.
About 3800 kilometres away, in Nigeria, three-year-old Hamisu Garba looks like a one-year-old child as he also suffers from low weight for height. His mother, Ladi Garba, explained that Hamisu was 16 months old and near death when he was admitted in February to the Severe Acute Malnutrition (SAM) Centre at the General Hospital in Minna, Niger State.
“I never knew that the food I was told not to give to him, which included eggs and milk, were the ones affecting him,” she said.
Foods forbidden on the basis of cultural and religious beliefs are impacting negatively on the health of pregnant women and children. Studies have shown that pregnant women and children often suffer malnutrition because these beliefs prevent them from eating nutritious foods packed with vitamins and proteins.
The problem is further compounded by poor weaning practices. Statistics show that 37.1% of children under five years are stunted in Malawi, 32% in Nigeria and 35.5% in India (see info graphic)
According to UNICEF, nearly half of all deaths in children under five globally are attributable to under-nutrition, which puts children at greater risk of dying from common infections, increasing the frequency and severity of such infections and delaying recovery.
Food taboo as religious and cultural beliefs
Food taboos are not only limited to Malawi or Nigeria but are quite common in other African and Asian countries.
“In India, for instance, Hindus consider the cow a sacred animal. For them, eating beef or drinking milk and other dairy products is a taboo. Upper caste Hindus believe that eating onions and garlic leads to unholy behaviour. A practising Muslim considers it a taboo to eat pork.
“In Malawi, among the Zion City Church, Zion Christian Church and Apostolic Church, eating pork, catfish, seafood, rabbit and duck is a taboo.
Chancy Lutere, a leader of Zion Christian Church, says eating such foods is against their religious beliefs, pointing out that both the Bible and the Koran are very clear about the kind of food one should eat. Religious leaders argue that there are alternative foods that can be consumed to supplement the dietary needs of a person.
In Nigeria, for instance, Garba says that within her community in Minna, Niger State, exclusive breastfeeding is culturally not encouraged while giving children egg, milk, tea and even meat is believed to impact negatively on their lives.
She said: “When I gave birth to my son, I was told not to do exclusive breastfeeding for him. In Magama, we do not give our children egg because we believe that eating eggs will turn them into thieves and everyone wants their children to do well. I heeded it because I felt it was the best for them.”
A 2019 study among teen mothers in Malawi showed correlations “between dietary diversity and improved pregnancy outcomes, including a protective effect against low birth weight”.
A study published in 2021 in India concerning the gaps and barriers in maternal diets revealed that between 62 and 82 per cent of Indian mothers believe that various fruits, vegetables along with meat, fish and eggs should not be consumed during pregnancy because these are head-producing in nature and consequently lead to miscarriage and fetal malformations.
In Nigeria, a research, “Food taboos and myths in South-Eastern Nigeria: The belief and practice of mothers in the region” published in 2016 by Uchenna Ekwochi et al, points out that food taboos contribute to unhealthy nutritional practices during pregnancy and early childhood and are detrimental to the child’s growth and development.
The study showed that two in every ten pregnant women in South-East Nigeria avoid eggs, snails and bush meat during pregnancy, which most of them begin to eat after they give birth.
At the SAM Centre in Minna, 15 cases of malnutrition are reported each month among women and children under five years.
Aisha Abdullahi, a health worker at the centre, explained that some of the patients brought to in are often weak and sometimes do not willingly go along with the meal plan provided. They, however, follow the plan when they are told that they would die if they don’t follow the recommended dietary plan.
Children like Hamisu and Faith show improvement after a few weeks on the recommended diets.
Some members of the centre’s staff said that ignorance and lack of education coupled with poverty and cultural beliefs are the driving force of malnutrition.
Impact of food taboos on the health of mothers and children
Dr Mary Shawa, a nutritionist in Malawi, says non-consumption of foods high in nutrients coupled with the belief that having a reduced meal frequency “will help to have a smaller baby who will be easier to deliver” is causing malnutrition.
She says children who are restricted from taking foods such as eggs, fish, pork, and beef result in protein-calorie malnutrition, maternal depletion, premature ageing, and general malnutrition in women.
Hajiya Asmau Mohammed, the Niger State Nutrition Officer, noted that the state has lots of farming and food, “but misconceptions and taboos prevent people from getting optimal nutrition.”
Finding solutions
The innovation of setting up kitchen corners in hospitals and primary healthcare centres across Niger State in Nigeria are helping to end malnutrition where women are taught how to prepare different kinds of nutritious foods.
Having vegetable gardens in one’s backyard is also part of the solution. And some experts have proposed eight antenatal visits for pregnant women to have additional nutrition education.
Outreach programmes on community radio stations in Malawi such as Ulyelo Wamapha translated as ‘Good Eating’ on Chirundu Community Radio Station provides listeners with nutrition knowledge. The content is developed by the Malawi government as part of its nutrition insecurity interventions.
Another programme, ‘Foundation for Good Health’ on Madziko Community Radio tares farmers with discussions about nutrition, health and sanitation. Each radio station has its programme on nutrition which helps farmers get educated on eating a good diet.
Health workers and nutrition experts use the community radio stations as well to disseminate nutrition information. Such radio stations used include Chirundu Community Radio in Nkhata Bay District in northern Malawi, Maziko Community Radio in Kasungu District and Mudzi Wathu Community Radio in Mchinji District, all in the Central Region of the country.
Shawa stressed that malnutrition could be addressed through nutrition education during antenatal and postnatal visits.
Studies indicate that several pregnant women and children are dying of malnutrition because of beliefs that restrict them from eating certain kinds of foods such as eggs, catfish, pork, tomatoes, attached bananas, okra and groundnuts, which are nutritious and full of vitamins and proteins.
But such religious and cultural beliefs could be overcome by giving education to pregnant women and lactating mothers during antenatal and postnatal care. Using community radio stations also plays a key role in dealing with rising malnutrition.
This is why Mohammed stated that increased sensitization is key in changing perceptions of food taboos, just as she pointed out that while cultures and traditions are respected, alternatives to the food taboos can be presented to the communities to improve the nutritional status of women and children and gradually make them embrace the food they are rejecting.
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This work was supported by a Global Nutrition and Food Security Reporting Fellowship from the International Center for Journalists and the Eleanor Crook Foundation.