abstract: 'Objective: To explore the factors affecting intra-household food

  allocation practices to inform the development of interventions to

  prevent low birth weight in rural plains of Nepal.

  Design: Qualitative methodology using purposive sampling to explore the

  barriers and facilitating factors to improved maternal nutrition.

  Setting: Rural Dhanusha District, Nepal.

  Subjects: We purposively sampled twenty-five young daughters-in-law from

  marginalised groups living in extended families and conducted

  semi-structured interviews with them. We also conducted one focus group

  discussion with men and one with female community health volunteers who

  were mothers-in-law.

  Results: Gender and age hierarchies were important in household decision

  making. The mother-in-law was responsible for ensuring that a meal was

  provided to productive household members. The youngest daughter-in-law

  usually cooked last and ate less than other family members, and showed

  respect for other family members by cooking only when permitted and

  deferring to others'' choice of food. There were limited opportunities

  for these women to snack between main meals. Daughters-in-law'' movement

  outside the household was restricted and therefore family members

  perceived that their nutritional need was less. Poverty affected food

  choice and families considered cost before nutritional value.

  Conclusions: It is important to work with the whole household,

  particularly mothers-in-law, to improve maternal nutrition. We present

  five barriers to behaviour change: poverty; lack of knowledge about

  cheap nutritional food, the value of snacking, and cheap nutritional

  food that does not require cooking; sharing food; lack of

  self-confidence: and deference to household guardians. We discuss how we

  have targeted our interventions to develop knowledge, discuss strategics

  to overcome barriers, engage mothers-in-law, and build the confidence

  and social support networks of pregnant women.'
affiliation: 'Morrison, J (Corresponding Author), UCL, Inst Global Hlth, 30 Guilford
  St, London WC1N 1EH, England.

  Morrison, Joanna; Harris-Fry, Helen; Costello, Anthony; Osrin, David; Saville, Naomi,
  UCL, Inst Global Hlth, 30 Guilford St, London WC1N 1EH, England.

  Dulal, Sophiya; Basnet, Machhindra; Sharma, Neha; Shrestha, Bhim; Manandhar, Dharma,
  MIRA, Thapathali, Kathmandu, Nepal.'
author: Morrison, Joanna and Dulal, Sophiya and Harris-Fry, Helen and Basnet, Machhindra
  and Sharma, Neha and Shrestha, Bhim and Manandhar, Dharma and Costello, Anthony
  and Osrin, David and Saville, Naomi
author-email: joanna.morrison@ucl.ac.uk
author_list:
- family: Morrison
  given: Joanna
- family: Dulal
  given: Sophiya
- family: Harris-Fry
  given: Helen
- family: Basnet
  given: Machhindra
- family: Sharma
  given: Neha
- family: Shrestha
  given: Bhim
- family: Manandhar
  given: Dharma
- family: Costello
  given: Anthony
- family: Osrin
  given: David
- family: Saville
  given: Naomi
da: '2023-09-28'
doi: 10.1017/S1368980017002646
eissn: 1475-2727
files: []
issn: 1368-9800
journal: PUBLIC HEALTH NUTRITION
keywords: 'Nutrition; Gender; Neonatal health; Qualitative; Intra-household food

  allocation'
keywords-plus: HEALTH; FOOD; STRATEGIES; ALLOCATION; AUTONOMY; MALARIA; GROWTH
language: English
month: FEB
number: '2'
number-of-cited-references: '34'
orcid-numbers: 'Dulal, Sophiya/0000-0002-2244-613X

  Harris-Fry, Helen/0000-0003-2367-908X

  Morrison, Joanna/0000-0002-9241-8863'
pages: 377-384
papis_id: 37b276e346b04b7b7e8fc6cb9baaaa70
ref: Morrison2018formativequalitative
researcherid-numbers: 'Osrin, David/C-5932-2008

  '
times-cited: '29'
title: Formative qualitative research to develop community-based interventions addressing
  low birth weight in the plains of Nepal
type: article
unique-id: WOS:000438385300014
usage-count-last-180-days: '1'
usage-count-since-2013: '7'
volume: '21'
web-of-science-categories: Public, Environmental \& Occupational Health; Nutrition
  \& Dietetics
year: '2018'