HOUSEHOLD CHANGING FOOD CHOICES AND HEALTH STATUS OF FAMILY

MEMBERS IN KIAMBAA CONSTITUENCY, KIAMBU COUNTY

ROSEMARY WAMBUI NGUGI

A Research Proposal Submitted to the Department of Peace,

Security and Social Studies in partial fulfillment of the

requirements for the Award of Masters of Arts degree in

Sociology of Egerton University

EGERTON UNIVERSITY

i

AUGUST, 2014

ii

DECLARATION AND RECOMMENDATION

DECLARATION

This proposal is my original work and to the best of my

knowledge has not been presented for the award of a degree in

any university.

Signed:…………………………………… Date:………………………………………….

Rosemary Wambui Ngugi

Reg. No. AM17/2949/11

RECOMMENDATIONS

This research proposal has been submitted for examination with

our recommendation

as Uuniversity supervisors.

Prof. Wokabi Mwangi

Department of Peace, Security and Social Studies

Egerton University

Signed:…………………………………….. Date:……………………………………

Dr. Francis M. Apollos

Lecturer

Department of Peace, Security and Social Studies

ii

Egerton University

Signed :…………………………………….. Date:……………………………………

ABSTRACT

This study will focus on changing households food choices and

health status, and in demonstrating often underlying health

disparities among different households. The cultural and

ethnic composition of Kiambaa household show people eat mainly

based on cultural beliefs. The changing household food choices

and health status in Kiambaa needs to be examined to expound

on how cultural factors affect health status. Health is

directly threatened by these food choices and consequently the

health status keeps on changing. Solutions will continue to be

less than satisfactory if they fail to address the particular

ways in which household are influenced. Gender is a concern of

this study because of their vulnerability to debilitating on

food choices and health status thus explaining the research

problem of high mortality rate from non-communicable diseases.

This study will examine specific objectives that are social

cultural factors affecting household, how gender are affected

differently and determine the relationship between food

choices and cultural foods. This study is based on two

sociological theories with focus on food choices and health

status. Structural functionalism theory examines food choices

while Bourdieu Theory of Practice explains health status in

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villages and the logistics of their existence. Descriptive

research design will be used to give a detailed understanding

of the objectives. Cluster sampling technique will be employed

in this study. Four villages in the location will be selected

in purposive sampling technique. From each village, 20

households will be interviewed, making a total of 80

respondents. Selection of the households will be through

systematic random sampling. Data for this study will be

obtained from both primary and secondary sources. Primary data

will be obtained from interview schedules and questionnaires

within the selected households, Municipal Council of Kiambaa

(MCK) officials, and NGO and health personnel will be the

secondary sources. Data analysis will be done through

statistical packages of social sciences (SPSS). .

Include the expect outcome or contribution of the study to

knowledge

ContentsDECLARATION AND RECOMMENDATION ii

iv

ABSTRACT iii

LIST OF ABBREVIATIONS AND ACRONYMS vi

CHAPTER ONE 1

INTRODUCTION 1

1.1Background tothe Study 1

1.2 Statement of the Problem 2

1.3 Broad Objectives 2

1.4 Specific objectives 3

1.5 Research Questions 3

1.6 Justification of the study 3

1.7 Scope and Limitation of the study 3

1.8 Definitions of Terms 4

CHAPTER TWO 5

LITERATURE REVIEW AND THEORECTICAL FRAMEWORK 5

2.1 Introduction 5

2.2.1Social cultural factors, food choices and health status

5

2.2.2 Gender food choices andthe health status 7

2.2.3The relationship between food choices, household health

status and cultural heritage 10

2.3Theoretical Framework 13

v

2.3.1 Structuralism Functionalism Theory 13

2.2.2 Bourdieu Theory of Practice 14

2.4 Conceptual Framework 15

CHAPTER THREE 17

METHODOLOGY 17

3.1 Introduction 17

3.2 The study Area 17

3.3 Research design 18

3.4 Unit of analysis 18

3.5 Population and sampling procedure 18

3.6 Method of data collection 18

3.7 Data analysis 18

WORK PLAN 20

BUDGET 21

REFERENCES 22

APPENDICES 25

vi

LIST OF ABBREVIATIONS AND ACRONYMS

MCK Municipal council of Kiambaa

NGO Non-Governmental Organization

UNEP United Nations Environmental programs

WHO World Health Organization

CBO Community Based Organization

UNCHS United Nation Center for Human Settlement

NCD Non communicable Disease

vii

LIST OF FIGURES

Figure 1 Conceptual Framework

Figure 2 Map of Kiambaa Constituency

viii

ix

1

CHAPTER ONE

INTRODUCTION

1.1Background to the StudyThis study will focuses on changing food choices and the

health status in Kiambaa households. Food is used as

demonstrating group acceptance, conformity, mood and

personality. Public, media and political interest on food

choices and health status is of great attention. Food choices

is a major determinant of Non-communicable diseases in

influencing present health and determine whether that

individual will develop such diseases as cancer,

cardiovascular disease and diabetes much later in life (WHO,

2003). Different cultures may encourage or discourage

consumption of different foods thus also influence health

status.

Global changes in food habits have ensured the systematic

diminishing of indigenous and traditional food habits in East

Africa. These indigenous and traditional foods habits,

associated with many health benefits, have been progressively

replaced by the globalized food system of the multinational

corporations, a system inherently associated with the creation

of non-communicable disease (NCD) epidemics throughout many

regions and globally (WHO 2011).By 2020, it is predicted that

NCDs will account for 80% of the global disease burden, and

will cause 70% of deaths in developing countries. Many world

groups for example Caribbean people consume food which

contains a lot of wheat and rice. The Eastern mainly Asians

1

eat food with herbs and spices. The Western Europe consumes

mainly foods which are drier and plainer with high content of

meat and fat (WHO, 2011).

African countries consume varied types of foods influenced

mainly by their geographical area thus varied areas will have

preference to certain type of food. Food choices may be based

on some expectations and attitudes, health-related beliefs,

ethical concerns or socio-cultural elements. Several studies

have focused on describing the factors poor health can be

improved by a more balanced diet. The choice of food consumed

in Africa is determined by a number of factors, including

availability of natural resources, religious beliefs, social

status and traditional taboos (FAO 2003).Because these factors

place limits in one way or another on the intake of food,

communities and individuals are deprived of essential

nutriments and, as a result, physical and mental development

may be impaired. This is generally the case in most developing

countries, but especially throughout Africa. (WHO, 2011)

In Kenya and Uganda, dietary patterns have shifted away from

the use of indigenous crops e.g. millets, sorghum, pulses and

starchy roots to a greater consumption of introduced staple

foods, including wheat, rice and hydrogenated vegetable fats

(Oniango, 2005) .Kenya has 42 ethnic groups this diversity

represent different food choices and health beliefs passed on

from one generation to another (UNCHS, 2010). Many food

choices and health status have been passed on from one

2

generation to another in Kenya. Kiambaa is such town the

inhabitant emphasizing on consumption of certain foods.

According to Government of Kenya (KNBS, 2010), the population

of Kiambaa constituency was 1,766,058 and was projected to be

2,032,464 by 2017. The Municipal council of Kiambaa (MCK) is

responsible for the provision of basic health services.

However there is disequilibrium especially to household who

are vulnerable to food choices and therefore their health

status influenced by cultural values. Household members, spend

most of their time close to home. Understanding the inter-

relationships between food choices and health status is

important for the study.

1.2 Statement of the ProblemOver the past several decades, Kenya has experienced a rapid

upsurge of non-communicable diseases (NCDs), which includes

epidemics of diabetes, cardiovascular disease (CVD) and

various cancers. The health-care systems in Kenya are either

non-existent or are grossly inadequate to deal with this

double burden of disease and its repercussions. The NCD

epidemics currently sweeping Kiambaa have been directly

attributed to the food choices transition, whereby traditional

foods and food habits have been progressively replaced by the

globalized food system of the multinational corporations. This

transition in dietary practices has resulted in the increased

consumption of refined flour, cheap vegetable fats, refined

sugars and food additives. Household habit on food intake has

changed to reflect on changing lifestyles and income. The

3

environment determines the food available to household members

and their potential for good health is translated into

adequate food intake and prevention of disease

1.3 Broad ObjectivesThis study examines changing food choices and health status at

household level in Kiambaa constituency.

1.4 Specific objectivesi. Examine social cultural factors affecting household food

choices and health status in Kiambaa constituency.

ii. Establish food choices by gender in relation to health

status in the household of Kiambaa Constituency.

iii. Determine the relationship between food choices,

household health status and cultural heritage in Kiambaa

constituency.then?

1.5 Research Questionsi. How are social cultural factors affecting food choices

and health status in Kiambaa constituency?

ii. How are food choices and health status of different

gender in households of Kiambaa Constituency?

iii. What is the relationship between food choices,

household’s health status and cultural heritage in

Kiambaa constituency?

4

1.6 Justification of the study at least four points why food choices? Why now? Why the objectives?Many studies on food choices and health status have been done

on nutrition value. This research will therefore highlight

smaller but significant town of Kiambaa food choices and

health status to understand how (NCD) diseases affect

different family members. Firstly the study will cover the

cultural factors extensively. Secondly expose how household

members are affected differently and determine the

relationship between food choices, household health status and

cultural heritage. Kiambaa has one of the highest mortality

rates of male household heads thus there is need to understand

whether it is food choices related or health beliefs

situation.

1.7 Scope and Limitation of the studyThe geographical area of study will be limited to the town of

Kiambaa’s constituency. It would have been desirable to cover

other variables influencing food choices and health beliefs

like religion and nutrition to gain a broader perspective

however the study will be silent. Therefore the study covers

gender issues in household food choices and health beliefs in

Kiambaa constituency.

1.8 Definitions of TermsHousehold

This refers to a basic residential unit in which consumption;

child rearing and shelter are organized and carried out. It

also mean a group of individuals who eat together ,live under

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one roof and share domestic responsibilities as a means of

survival.

Food choices

According to this study it refers to how people select food

they eat with the influence of cultural. Food choices are

shaped by cultural history of ancestors, geographical

location, religious and social customs

Health status

According to study health status denotes a behavior of ideas

or principles that we believe in thus continuous adaptation

the same kinds of unhealthy behaviors and food habits which

are influenced by food beliefs predicated by history and

experience in a particular environment.

Gender issues

This is used in this study to explain gender difference

between female and male in relation to social and cultural

construct underlying perception food choices and health

beliefs so as to understand health implications.

Cultural Heritage

According to the study it refers to traditional beliefs

associated with food choices and health beliefs passed on from

one generation to another. Cultural influence leads to

difference in the habitual consumption of certain foods.

6

Non Communicable disease

According to the study it a medical condition which is non-

infectious and non-transmissible which may be chronic and may

result in sudden death.

CHAPTER TWO

LITERATURE REVIEW AND THEORECTICAL FRAMEWORK

2.1 IntroductionThis section covers extensive information to understand the

research problem, identify gaps in literature that will be

filled by the study and record findings from other

researchers. Literature has been reviewed as per objectives

that are to examine social cultural factors affecting

household food choices, investigate gender differences in food

choices and health status and determine the relationship

between food choices, household health status and cultural

heritage. The section further covers theoretical and

conceptual framework to give understanding food choices and

health beliefs at the household level.

2.2.1Social cultural factors, food choices and health statusSocial cultural factors affecting food choices include

ethnicity, social class, age, food practices, religious and

health beliefs which are ideals and principals that we believe

in and think of as true (Ayittey 2005).Eating, drinking and

food choices are among the most frequent human behaviors.

Although seemingly simple, they are complex behaviors that are

determined by many factors and their interactions. Traditional

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cultural practices reflect values and beliefs held by members

of a household for periods often spanning generations. These

differences are reflected in groups of people who live in a

given environment. Food habits come into being and are

maintained because they are practical or symbolically

meaningful behaviors in a particular culture (FAO 2003). In

other words, food habits are passed on through a process of

socialization from one generation to the next and these mould

household preferences.

The onset of cash-crop farming in Kenya dramatically reduced

the domestic availability of robust, nutrient-dense,

traditional crops, including sorghum, pearl and millet (Maundu

et al 2003).Millet, cowpea and groundnut all of which are

drought tolerant to a considerable extent have been ignored.

The introduction of foods of modern commerce such as refined

sugar, refined wheat and maize flour, canned food and

condensed milk, occurred rapidly as there was little respect

shown by the colonial powers towards cultural benefits of

indigenous and traditional food habits.

Poulter et al (2008) asserts that planners and policy makers

involved in health provision and community upgrading tend not

to take into account food choices and health status or

understand what impact their policy decisions may have on

society. Interventions are generally targeted at diseases

(Kiambu Strategic plan 2012).In the attempt to establish more

general priorities; food choices and health status may easily

8

be overlooked. There is an implicit assumption that improved

conditions for a community at large will affect household in

the same way that they affect everyone else.

The WHO (2011) states that while now many communities are

equipped with the knowledge on how to improve household health

and enhance the prosperity of future generations, there is a

considerable gap between understanding what needs to be done

and the ability to put it into practice. Priority given to

provision of health services does not reflect its importance

to household nor do the standards set for such provision

routinely take into account health requirements of gender,

culture and challenges faced by household in a given

environment (Fisher, 2006). Many household members die each

year, mostly from causes related to their food choices and

health beliefs, and those who survive are frequently

compromised in health and development (WHO, 2011). This study

will highlight these gaps so that societies consider food

choices and health beliefs as they plan for cultural influence

on food. Every social grouping in the world has specific

traditional cultural practices and beliefs, some of which are

beneficial to all members, while others are harmful.

The WHO and FAO joint report (2011) asserts that effective

health communication has the capacity to create awareness,

improve knowledge and induce long term changes in individual

and social behaviors in this case consumption of healthy

diets. The report goes on to explain that persuasive nutrition

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messages can promote healthier eating amongst children if

modern media are sought, if the messages are sustained and if

the environment in which such consumption can take place is

provided. The Kiambaa health authorities have been aware for

some years of the negative status of Kiambaa people’s health

arising from less desirable eating habits, as well as the need

for preventive actions starting with young children.

Traditional practices may also influence the responses of a

patient or client to a Western medical protocol.

A survey done by Kiambu Municipal Council/UNCHS (Habitat) in

2010, found out that changing food choices and health status

are most common in Kiambaa constituency especially affected by

social cultural factors. In the second report on health

services in Kenya (2008), it was reported that relative to

other cities in Kenya, Kiambaa had a higher proportion of

households affected by food choices and health status. These

two conflicting findings create confusion on what the true

picture is in Kiambaa. The current study will address such

anomalies and highlight the actual situation on ground in

Kiambaa and especially how it affects household. The cultural

beliefs and values influence the decision to eating “Githeri”

and drinking “Muratina” during ceremonies. This is especially

with eating Kikuyu heavy traditional dishes and is very

important in Kikuyu culture (Kiambaa Strategic Plan 2012).

Evidence from around the world has demonstrated that investing

in health is fundamental to improving human welfare and

economic growth as well as reduces poverty. Food fulfill roles

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in our lives like social and cultural pleasure, express

status, culture and religion preference.

The growing mix global rules on food make life complicated on

the choice of food (Hollingsworth et al 1986). The role of

indigenous people and their role of traditional foods have

been ignored. The high mortality rate from diet related

diseases among Kenyan communities strongly suggests need to

investigate the problem. However African beliefs prevail due

to traditions surrounding food choices and health status

therefore there is need to understand symbolism self and

cultural identity of Kiambaa constituency related to food

choices and health status of family members. Food choices and

health status in the household have an enduring health impact

that can result in a long-lasting economic burden to the

household and on the nation. This study, therefore, will

investigate this condition with a view of establishing how

family member are affected. It is assumed that with a lot of

information it automatically enable people to make food and

healthy choices but decisions are mainly constrained by

social, economic and cultural which influences the choices

that individual and household make. What is more worrying is

that in the absence of adequate data on food choices and

health status that are easily measured and affecting household

are ignored.

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2.2.2 Gender food choices and the health statusMutwa et al (2009) explains there is a huge diversity of

gender in particular social and food difference. Family

members affect women's decision to cook and eat a healthy diet

Traditional cultural practices reflect values and beliefs held

by members of a household for periods often spanning

generations Disruption of the family unit and the absence of

women from the family unit has increasingly displaced

traditional foods which are time consuming to prepare compared

with easily prepared import grains and high-calorie low-

nutrient fast foods and street foods (Abegaz et al 2005)In

Kenya where many people live in poverty and the health

infrastructure is poor male as well as female suffer. However

women face unique risks because of their reproductive cycle

and in a country which is still experiencing mortality rate

there is danger. Womend is proportionate poverty; low social

status and reproduction role expose them to high health risks,

resulting in needless and largely preventable suffering and

death. A woman’s health is a national as well as an individual

welfare concern because it affects the next generation through

impact on her children and economic productivity (WHO

2011).Women health status is affected by complex biological,

social and cultural factors that are highly interrelated. To

reach to women effectively, health system needs to take into

account the biological factors that increase health risk for

women and sociocultural determinants of health.

Maundu et al (2003) discusses urbanization in East Africa

has contributed to a shift away from traditional high-fibre,12

home-cooked foods to the consumption of pre-prepared, packaged

and processed ready to eat foods. The elevated consumption of

fats, refined sugars, refined flours and preservatives, and

low intake of dietary fiber and vital micronutrients, as a

result of these new foods, has resulted in adverse health

effects in the urban East African population. Recent evidence

from the urban center of Dar es Salaam in Tanzania revealed a

positive relationship between the consumption of a Westernized

(globalized) diet and the prevalence of NCDs, including risk

factors which comprise the metabolic syndrome. In Kiambaa

constituency the shift from traditional foods is mainly

because of the proximity to capital which spill over it

influence greatly especially in food choices.

Geoff et al (2008) explains that distribution of resources

whether due to harsh geographical or climatic conditions in a

region, or to poverty resulting from a lack of purchasing

power contributes greatly contribute to the severe imbalance

of food choices throughout Africa. However beliefs placed on

food for religious or cultural reasons are necessary practice

which exacerbates the situation. The reasons for such taboos

are many, but all are steeped in culture. Many taboos are

upheld because it is believed that the consumption of a

particular animal or plant will bring harm to the individual.

Permanent taboos are also placed on female members of most

communities throughout Africa. From infancy, the female child

is given a low-nutrition diet. Female are weaned at a much

earlier age than the male infant, and throughout her life she

13

will be deprived of high-protein food such as animal meat,

eggs, fish and milk. (Dubowitz 2006) .In Kenyan culture,

hospitality and the showing of generosity are central to

women's beliefs and values. It is a common practice for women

to meet in ‘chama’ invites each other out to lunch or to

gather daily in each other’s homes to communicate, celebrate

and share ideas. During these daily gatherings, social

courtesy is extended by serving various kinds of traditional

foods and drinks. On these occasions, women often feel

pressured to eat because the visitor's refusal to accept food

and drinks may offend the hosts.

Temporary taboos which are applicable only at certain times in

the life of an individual also affect women

disproportionately. Most communities throughout Africa have

food taboos especially for pregnant women. Often these taboos

exclude the consumption of nutrients essential for the

expectant mother and foetus. These nutritional taboos are

unnecessary impositions made on women, who could be already

malnourished. It is perhaps not surprising that maternal and

infant mortality rates are so high and life expectancy low in

third world countries. But nutritional taboos also have far-

reaching implications for women in the field of work, where

their levels of productivity can be affected. On the other

hand, social desirability may have had a stronger impact on

girls’ responding, because of the greater importance that

females attach to diet (Curtis 2004).Many young women are

especially prone to keep fit and maintain shape.

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Men consume more beef, eggs, and poultry; while women eat more

fruits and vegetables and consume less fat than do men

(Johansson and Andersen 2008). Consumption of fruits and

vegetables is considered an efficient strategy in balancing

diet, fighting obesity, and maintaining health. The gender

differences in preferences for healthier foods begin in

childhood. There are differences in choices and higher (lower)

preferences for healthier foods. Among others is informational

gaps s that females are more aware of and have better

knowledge of nutrition than do males (Johnson and Andersen

2011). Nutrient knowledge is a necessary, though not by itself

sufficient condition, for making wise food choice

knowledgeable results from differing media exposure, where

media sectors that target women place higher emphasis on

health, style, education, and other topics that are believed

to arouse their audience’s interest. The WHO/FAO (2011) report

recommends that the scientific complexities of the food and

health link should not obscure the simple food-based messages

required to guide consumers towards healthy eating patterns.

Family member’s differences in perceptions calorie of the

positive that is male population in contrast to negative vast

majority of females consequences on physical appeal. While

males try to build their bodies by lifting weights, females

are trying to get rid of their butts and waists by targeting

their physical workout efforts on aerobics. The psychology

links weight to perceptions of body image, which both affects

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and is affected by self-esteem. The correlation between self-

esteem and body image holds for both genders but with

different strength (Van and Staveren 2001). Since physical

attractiveness is a stronger determinant of desirability by

the opposite sex for women than for men, then its importance

is commensurately greater for women. Furthermore, body weight

affects body image of males and females differently: While

females associate their body image with their body weight,

males associate their body image with their physical strength,

muscles, and attractiveness that is being tall, hairy in the

right places, and other physical qualities unrelated to body

weight. Women are more likely than men to describe themselves

as fat, to weigh themselves often, and to diet frequently and

on average are less satisfied with their physical appearance

than are men (Cooper et al 1983).

Hartmut (1999) explains that information on health hazards may

change perceptions, attributes, and importance weights; and

both attribute perception and importance weights, if

perception of food choices is negatively associated with

health, we should expect the importance weight of the health

attribute to increase information. An incline in the

importance of the health attribute increases the likelihood

that consumers will now consider a tradeoff between health and

taste (Tansey 1995). The direction of changes in perceptions

and the corresponding changes in the importance weights

depends on the opinion as to whether calories are good or bad

for health and physical attractiveness.

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2.2.3 The relationship between food choices, household health status and cultural heritageMaundu et al (1999) asserts that throughout history, external

influences have brought about changes in African food culture.

Approximately 5000 years ago much of East Africa was occupied

by hunter and gatherers commonly called the Ndorobo. These

ancestors primarily consumed wild game, wild birds and eggs,

wild fish, wild insects e.g. Grasshoppers, ants, caterpillars,

termites and wild plant foods e.g. fruits, nuts, tubers,

honey. The Ndorobo were later assimilated by migrants and lost

much of their cultural identity, which included the loss of

these food habits. Interestingly Allen (2009) explains that

advanced awareness of food changes over several millennia in

Africa, have concluded that the human diet was far superior

with the hunting and gathering subsistence of palaeolithic

times compared with the current globalized food system. In the

Agikuyu community cultivated and wild vegetables, especially

wild green leaves including amaranth, black nightshade and

redsorrel, as well as various other wild plant foods were

important ingredients for accompanying the carbohydrate

(Taylor 1970). The traditional Agikuyu diet was also based on

high amounts of fat soluble vitamins which enabled proper

physical development, low susceptibility to chronic diseases,

high tolerance to infectious diseases and an absence of tooth

decay. Food habits were drastically altered by the

introduction of new agricultural techniques assimilated for

the production of cash crops. These techniques promoted the

17

adoption of higher yielding monocultures of maize, rice and

wheat. Monocultures displaced traditional African food crops

grown with traditional cultivation techniques including

shifting cultivation and intercropping which historically

evolved to suit the local agricultural conditions. Traditional

cultivation patterns protected the soil, minimized weeds,

provided communities with a variety of food, and reduced the

risk of crop failure, pests and plant diseases, whereas

monocultures provide none of these benefits.

Brombach (2004) emphasizes from a population perspective the

importance of increased voluntary individual and overall

public engagement in the pursuit of improved health,

particularly in the context of conditions associated with

variables such as food choice, health beliefs, exercise and

culture. Dhow et al (2004) emphasizes the significance of

well informed and appropriately supported food choice in

promoting better public health in modern economic and social

settings, that guarantee most people access to clean water,

adequate housing and plentiful food. Current government

policies are aimed at facilitating increased food choice and

supporting healthy life styles throughout the health and

social care sectors, and society more widely. Enormous

challenge face the household in ensuring a sustainable,

secure, safe, sufficient, culturally appropriate food for all.

Food influences set of relationship and activities that

interact to determine what, how much and what method is used

for cooking. Human beings are very adaptable and can have wide

18

variety of diet. These diet changes absorbing new plants and

animal yielding new products as human spread and new

delicacies. What different habitat eats has history of and

that history is not simply a history but history of culture

and society. Specific cirmstances and trend at an area

influence challenges and priorities these include food intake

and consumption patterns and public health status.

Michille (2006) notes that street foods and foods from kiosks

are the major sources of non-home prepared foods in the urban

and peri urban areas in East Africa. The fact that street

foods are inexpensive, time-saving and convenient are the main

purchasing incentives among poorer among many residence of

Kiambaa Constituency often street foods are prepared using the

least expensive ingredients, including refined flour, maize

and hydrogenated oils. These foods contain few essential

nutrients, and are high in refined sugars. In addition,

problems of hygiene and food safety are bound to arise in the

unsanitary conditions of the shanty towns and slums where the

poorest groups live and consume street foods. The consumption

of street foods may also be coupled with adverse eating

patterns, including such behaviors as eating alone and

frequent snacking. Kiambaa has a high incidence of adult death

as a result of non-communicable diseases, such as cancer (WHO,

2011).Diabetes is considered a major national health disorder,

contributing significantly towards morbidity and mortality.

Other conditions such as elevated blood pressure, elevated

19

blood cholesterol and diabetes are also highly prevalent

amongst the Kiambaa people. (Ministry of Health, 2011)

The responsibility of educators to look at the various

cultural needs of the household and how nutritional

requirements can be met and still preserve cultural heritage.

Major factors influencing food preferences are traditional

foods and beliefs. It is important must to be aware of the

cultural length of a meal and the time of the day or year it

takes place (Brombach, 2001). Nutrition programs need to

understand culture and the relationship of food preferences.

This will improve the quality of services. The factors that

most influence food choices are taste and enjoyment and

childhood memories associated with cultural heritage. Programs

need to embrace their participant diversity and serve familiar

ethnic food. (Charlton, 2007)

According to Gassier (2008) household are disproportionately

affected by many of the food choices and health beliefs. The

overall women mortality declined significantly in the 1990s,

but the environmental hazards kill at least 3 million women

(WHO, 2011). Although such women make up roughly 10 percent of

the world’s than 40 percent of the population suffering from

health problems related to the food chokes. This study will

establish whether the proportion of the population of

household in Kiambaa constituency affected by food choices and

health status. A survey done by Kiambaa Strategic Plan (2012)

reveals that food choice and health beliefs are the leading

20

health complaints among household in Kiambaa. This study

examines food choices and health beliefs in a household. In

line with the objectives of this study, this research wishes

to explore the particular health beliefs that household are

exposed to cultural heritage and gender perspective in Kiambaa

constituency.

2.3Theoretical Framework

2.3.1 Structuralism Functionalism TheoryBeards worth and Keil (1997) proposed a two category

classification of approaches to the analysis of food systems.

These are functionalism, structuralism and developmental.

Functionalisms based on an analogy between a society and an

organic system. Just as the body is made up of different

parts, each one having a unique and indispensable role in the

maintenance of the living system, society is seen as made up

of a set of features and institutions which make their own

contribution to the cohesion and continuity of the social

system. Functionalism has been used primarily by social

anthropologists studying food systems in non-European or less-

developed countries. Its drawback is that it offers a static

view of human social organization and fails to account for the

origination of certain features in a society. In relation to

the study, it is useful in developing certain food related

questions for example (a) what are the social patterns of food

choices and consumption amongst Kiambaa constituency? E.g.

food provision may reinforce gender differences); or (b) Can

dysfunctional features in food systems be identified and what

are their implications for Kiambaa constituency? E.g.

21

analyzing food availability and their potential impact on

household health).

Structuralism explains beyond the relationship seeking goal of

functionalism, delving deeper to uncover the principles and

structures behind the surface linkages. It aims to analyze the

every structure of human thought processes; in the case of

food, looking at the rules and conventions that govern the

ways in which food items are classified, prepared and combined

with each other. A structuralist approach explains that food

can be treated as a code and the messages that it encodes are

messages about social events and about social relations (e.g.

hierarchy, inclusion, exclusion, boundaries, and transactions

across boundaries). The employed framework for the description

of eating, with the uppermost categories being the daily menu,

followed by the meal, the course and finally the mouthful.

Then showed how this scheme was capable of being applied to a

range of meals in British society, from the most mundane to

the most festive. In deconstructing the meanings embedded in

meals, Douglas demonstrated that the repetition of the same

ingredients and of the structured serving, positioning of both

food, people enabled expressing and experiencing family

membership. Douglas approach is of relevance to this study

because of the argument that each component of the meal has

meaning and because of the insistence that the social analysis

of food behavior must be a bottom-up rather than top-down

exercise. Birch (1999) states that a position within

structuralism comes about from the assertion that an item of

22

food constitutes an item of information. Barthes proposes that

food signifies cultural meanings to those who consume it; but

not all varieties of foodstuffs are necessarily significant at

a collective social level. Some are significant only at a

household level. This distinction, allowing for the

accommodation of personal meanings within a system of shared

meanings, permits the identification of the most important

foods in a given social setting.

2.2.2 Bourdieu Theory of PracticeStructuralism functionalism explains on symbolic value of food

and eating and to the role of food socialization in shaping

changing food behaviors however the theory does not explain

health status. Bourdieu exploits the concept of symbolic

significance of food practices and relates these to health

status. Some also implied that social differentiation in food

consumption has diminished, particularly with regard to the

dimension of social class. A strong argument for continued

class differences in the sphere of food behaviors, especially

as manifested in valuation of food, is evident in Bourdieu’s

(1977) Theory of Practice. The theory especially stresses the

competitive dimension of taste and how, through actual

consumption practices, it creates and sustains distinctions.

Bourdieu’s theory proposes conceptual tools with which to

study health status social worlds and their identities. Thus

it is useful theory for exploring health status differences in

Kiambaa household foodchoices. Behaviors, as reflected in

their own actions or those of their food providers. The four

23

major concepts involved in the theory of practice are habitus,

capital, field and distinction. Bourdieu uses habitus to

illustrate how individuals are active in the food choices they

make, but are simultaneously constrained to a significant

extent. The choices one makes do not come from an endless

range of possibilities, but are limited to what one knows .One

of the functions of the notion of habitus is to account for

the unity of style which forges the practices and goods of a

single individual or group. Thus, the notion of habitus

generates classificatory schemes, providing principles of

distinct and distinctive practices of what an individual.

The four types of capital conceived by Bourdieu are economic,

cultural, social and symbolic

capital. Cultural capital goes beyond knowledge of the arts

and other distinctive practices. It

also involves all the learnable skills and competences which

enable individuals to handle the

social potentials of scientific information and everyday

pleasures. The dominant forms of capital within a society are

defined and developed through various discourses. Discourses

on gender, for example, define and organize the social world

into what is masculine and what is feminine, setting out the

characteristics associated with each. These characteristics

relating to notions of masculinity and femininity then provide

the basis of the dominant forms of capital that boys and girls

strive for. For instance, a child may perceive the existence

of foods for girls and foods for boys’, thereby leading the

24

child to consume foods which have more value when amongst same

sex peers.

2.4 Conceptual FrameworkThe conceptual framework below indicates the relationship

between food choices and health status and how the two factors

are influenced by many factors in Kiambaa constituency. Food

and health issues are mainly because of altitudes and culture

that shape our perceptions and behavior towards what we

believe to generally acceptable.

25Food choicesAltitudesBeliefs

Health StatusMeaning of healthCulturally shaped disorders

26

Health StatusMeaning of healthCulturally shaped disorders

Households ChangingFood Choices and Health Status

Household membersfood and health status difference in male, female and children

Cultural HeritageSocietal practices in regard to food choices and health status

Global changing standards set regarding food choices and health status

The above conceptual framework show changing household food

choices as the independent variable while health status as

dependent variable. Household member are affected by both

changing food choices and health status. Globalized foods are

the new food introduced to the market and society which

contribute to change from traditional foods. The culture

shapes our belief for which food is generally accepted.

CHAPTER THREE

METHODOLOGY

3.1 Introduction

In methodology, procedures that will be used in the study are

explored. These include Study area, sampling and sample size,

unit of analysis, population of study and sources of data,

data collection and data analysis.

27

3.2 The study Area

Kiambaa is located in Central Province use county and about

20 kilometers to the south of Nairobi Kenya. There are unique

features, varying landscape and hilly areas. There are two

main Rivers namely Gichi and Karia. Kiambaa municipality has a

population of 191,162 and estimated that half of this about

105,400 lives in Banana, Kiambaa district State of

Environment, 2003 .This area also covers the main farmland

area of Kiambaa. The 2009 census approximated Kiambaa’s

population to be approximately 905,400 and projected it to be

over 1 million be 2020 (Kiambaa Strategic Plan, 2012).

3.3 Research designDescptive analyses will be used to describe the objectives that is socio

cutural factors affecting food choices and health status ,gender dfferences

and the relationship of the two variables in the research.

28

3.4 Unit of analysisThe unit of analysis will be households drawn from selected

villages of Kiambaa Constituency. This will be an appropriate

group because they will highlight food choices and health

status.

3.5 Population and sampling procedureCluster sampling technique will be employed in this study. The

population of Kiambaa is about 905,400 (KNBS, 2011).Four

villages that are Banana, Raini, Karuri and Muchatha will be

sampled out using purposive sampling so as s to include

different clusters. A small sample size of 80 respondents will

be selected on the basis that there is homogeneity in the food

choices and health status conditions in Kiambaa. This makes it

possible to employ the use of small samples without affecting

the results. Selection of these households will be through

systematic random sampling. The number of clinics to be

sampled will be determined within the study period and a

random sample will be decided. The same will be done to the

NGOs operating in the area of study. The MCK will guide the

study on the relevant line officials and departments to be

interviewed.

3.6 Method of data collectionThe data for this study will be obtained from both secondary

and primary sources. The secondary data will be collected from

records of existing health facilities, central and local

government area officials, NGOs and faith based organizations.

The secondary data will include; most prevalent food choice

and health beliefs affecting household in the area, category

29

of gender affected, those food choices and health beliefs that

are related to cultural heritage factors among others. Primary

data will be obtained directly from the field by means of

questionnaire and interview schedules directed to household

members. Questionnaires will comprise of questions meant to

obtain information on food choices and health beliefs.

3.7 Data analysisData analysis will be done through statistical package of

social sciences (SPSS). Qualitative approaches will be used

for data analysis. Descriptive statistics will include the use

of frequency tables, means, percentages, histograms and pie-

charts. Inferential statistics will be used to look at the

relationship between food choices and health beliefs. Focus

group discussions will be the qualitative approach to

supplement the acquired information through interviews and

questionnaire

30

WORK PLAN

Jan-

Aug,

2013

Sep

t-

Dec

,

201

3

Aug

-

Sep

201

4

Oct

-

Nov

201

4

Nov

-

Dec

201

4

Jan

-

Feb

201

4

Mar

-

Apr

i

201

5

May

-

Jun

201

5

Jul-

Aug

2015

Proposal

writingDepartmental

Proposal

31

presentationProposal

correctionFaculty

Proposal

presentationProposal

correctionPiloting

Data

collectionData analysis

Thesis writing

Supervisor

examination of

thesisThesis

submission for

examinationThesis defense

BUDGETEQIUPMENT/ACTVITY DESCRIPTION UNIT

COSTNO.OFUNITS

AMOUNTKshs

32

KshsProposal Typing&

printing 30pgs @ Kshs 10

10 30 300

Photocopying proposal

20 copies of 30pgs for department

300 20 6,000

Pilot survey Transport to and from field

7000 2 14,000

Food & Accommodation

1day 2,500 2,500 1 2,500

Photocopying Questionnaire

10 copies of 15pgs @30shs

30 10 300

SPSS Computer package

Data Analysispackage

30,000 1 30,000

Internet services Data bundles 4,000 1 4,000Photocopying Questionnaire

200pgs@3030 200 6,000

Field supervision 2supervisors@4,000

7,000 1 7,000

Principal researcher

Travel to & from researcharea

6,000 2 12,000

Food& Accommodation

20 days@2,000 2,000 20 40,000

Thesis typing& printing

100pgs@ 20 20 100 2,000

Thesis photocopying

25 of 100pgs@kshs 500

500 25 12,500

Thesis binding Biding at Egerton University Press

500 8 4,000

Contingencies 10% of total 15,960Total 179,120

Source of funding-self33

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Appendices pre-test to see if the tool makes sense, I highlydoubt if you can collect data with these

Appendix 1: Questionnaire for residents Part one: Food

choices

1. For how long have you lived in this village?

{a} <5 years {b} 5-10

years

{c} 11-15 years {d} 16-20 years

{e}>20yrs and more

38

2.What kinds of influences, beliefs, and needs beyond what tastes good influence your decisions about what to eat and what not to eat? ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

3.What kind of food would be in your ideal meal? ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

4. Highest level of education attained

a) Primary level

b) Secondary level

c) Tertiary level(college and university)

d) Others (specify)

6. Marital status

{a[ Single {b}Married

{c]Widowed [d] Divorced

[e]Separated

9.What did you eat at your last meal? ............................................................................................................................................................................................................................................................................................................................................................................................................................................................................

10. What factors determined what you ate? ..............................................................................................................................................................................................

39

.................................................................

.................................................................

.................................................................

.................................................................

.................................................................

.................................................................

......................................

11. In general, what are the main factors that influence what youchoose to eat? ................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

12. How would you classify the food you use? What kind of

answers do you expect here????

……………………………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………………………

………………………………………………………………

13. What are some different ways in which individuals expresstheir identities through food

choices?.........................................................

.................................................................

.................................................................

.................................................................

40

.................................................................

.................................................................

.................................................................

.................................................................

.................................................................

.................................................................

.................................................................

............................................................

14. What are the most important factors for you and your familyin deciding where to buy your food and what kind of food to buy?

……………………………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………………………

………………………………………………………………

15.What kinds of foods make up a healthy, balanced diet?

…………………………………………………………………………………………………..

…………………………………………………………………………………………………...

………………………………………………………………………………………………….

16 .How do people decide to allocate food within the

household?

……………………………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………

17. Who is likely to get the least food in the family?

……………………………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………

18. What are young children typical foods and how frequent are

their meals?

41

……………………………………………………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………………….

19. What food habits, customs and preferences? Respondents

won’t understand

……………………………………………………………………………………………………………………………………………………………………

………………………………

20. What the food that would consider culturally acceptable?

……………………………………………………………………………………………………………………………………………………………………

………………………………..

21. What are the historical factors that concern food choices?

……………………………………………………………………………………………………………………………………………………………………

………………………………..

22. What level of household awareness to different types of

food?

……………………………………………………………………………………………………………………………………………………………………

……………………………….

42