Social Norms and Nutritional Realities: The tells from Lira and Karamoja, Uganda

Social norms play a significant role in shaping dietary behaviors and food production practices within communities. On the 21st and 22nd of February, CASCADE embarked on a focus group discussion with women of reproductive age and caregivers of children under 5 in Onyapo Oyere village, Ngetta sub-county, Lira City and Kangole Village, Karamoja . The major objective was to identify the social/gender norms around the consumption of healthy diets and co-design interventions with women of reproductive age, caregivers of children under five, and community influencers to address malnutrition.

The process

The group of interest(women in reproductive age) were able to identify key people in their lives(Known as Reference Groups) whom they seek advice on production and consumption of nutritious foods and the ones who actually provides the advice; they mentioned arrange of people including – Fellow women, mothers, husbands, Clan leaders, Religious leaders, Private Extension Workers from Seed Companies (e.g., Pearl Seeds) and Public Extension workers. This information from women was corroborated by the mentioned Reference Group in a subsequent interview to validate the factors influencing the production and consumption of nutritious foods.

The Social Norm Exploration Tool (SNET) exercise is a powerful tool that enables programmers not only identify norms, but also explore the nature and magnitude of the effect of the norm on the desired behaviour such as the production and consumption of nutritious foods amongst women and children, and in a participatory and inclusive way, co-design solutions to the barriers together with the communities. Thus, minimizing the perpetual intellectual biases that is normally perceived by programmers and clouds intervention deign, thereby making the solutions to addressing norms more effective.

Below are some of the prominent norms that impact the consumption of healthy diets.

Food Taboos during Pregnancy

Pregnant women avoid consuming mudfish, as it could make the baby flabby, making it undesirable to carry, and they are not allowed to eat sugarcane, as it may result in their child having skin cuts. Additionally, consuming milk during pregnancy may lead to the birth of a fat baby, potentially causing complications such as the need for a cesarean section. Women who undergo cesarean sections are considered weak because they cannot push their babies

Pregnant women can benefit from incorporating mudfish and milk into their diets due to their nutritional content. Mudfish is a rich source of protein and omega-3 fatty acids, essential for fetal brain development and overall growth. It provides minerals such as iron and calcium, crucial for supporting maternal and fetal bone health and preventing anemia. Milk is a high source of calcium, essential for bone and teeth development, and protein for muscle growth and repair. It also contains vitamin D, which aids calcium absorption and supports immune function. Moreover, milk provides B vitamins, including riboflavin and B12, essential for energy metabolism and red blood cell production during pregnancy. Incorporating mudfish and milk into a balanced diet can contribute to meeting the increased nutritional needs of pregnant women and supporting, the healthy development of the fetus.

A cesarean section, commonly referred to as a C-section, is typically recommended when vaginal delivery poses risks to the health of the mother, the baby, or both. Some common reasons for cesarean delivery include fetal distress, placenta previa (when the placenta partially or completely covers the cervix), cephalopelvic disproportion (when the baby’s head is too large to pass through the mother’s pelvis), multiple pregnancies (such as twins or triplets), or complications during labor, such as stalled progress. Additionally, certain medical conditions in the mother, such as high blood pressure or infections like HIV, may warrant a cesarean section to reduce the risk of transmission to the baby. Healthcare professionals decide to perform a C-section after careful consideration of the individual circumstances and the best interests of both the mother and the baby.

Additionally, sugarcane can be part of a healthy and enjoyable diet when consumed in moderate amounts and occasionally, and can contribute to overall energy intake. However, pregnant women should prioritize nutrient-dense foods to meet their increased nutritional needs during pregnancy.

Meat Consumption Taboo

Across some communities in Karamoja District, women are prohibited from eating the meat killed by elders for clan rituals; according to the taboo, those who disobey will suffer consequences ranging from sickness, miscarriages, and prostitution, among others, depending on what was consumed. “For us, everything said by elders is true; I have never tried any of the norms mentioned above because I know it works, and I should not be a victim,” one female participant noted.

For women, consuming meat can provide essential nutrients crucial for overall health and well-being. Meat is a significant source of iron, a vital nutrient for women due to the increased risk of iron deficiency and anemia, especially during menstruation and pregnancy. Iron from meat is more readily absorbed by the body than from plant-based sources, making it an essential component of a balanced diet for maintaining optimal iron levels and preventing fatigue and weakness. Additionally, meat contains high-quality protein necessary for muscle repair and growth, supporting an active lifestyle for men and women. While moderation is key, incorporating lean cuts of meat into one’s diet can be a valuable component of healthy living.

The discussion did not run short of positive social norms during the focus group discussions. For instance, before a man gets married, the elders ensure enough food to feed the newly married couple. Also, the community does not allow wife beating (domestic violence/gender abuse) as this will lead to the family of the bride to take away their bride, rendering the bridegroom singe (without a wife).

Marital Misfortune

When a man or woman visits his or her future mother-in-law, they should refrain from eating chicken. Ignoring this rule may prevent the marriage from happening; if it does, it could encounter troubles that could lead to a breakup.

Chicken is a highly nutritious protein source with several essential vitamins, minerals, and proteins vital for overall health. It is rich in high-quality protein essential for muscle growth, repair, and maintenance. Chicken also contains essential minerals such as phosphorus, which supports bone health, and selenium, which acts as an antioxidant and boosts immune function. Chicken is a good source of B vitamins, including niacin, which aids metabolism, and B6, which supports brain health and nervous system function. Moreover, it provides vitamins like vitamin B12, crucial for red blood cell formation and energy production. Overall, incorporating chicken into a balanced diet can contribute to meeting daily nutrient requirements and supporting optimal health; hence, it is crucial to debunk the cultural taboos around the consumption of this healthy diet.

The way to go:

By implementing targeted interventions and supporting vulnerable populations, we can work towards ensuring that everyone has access to nutritious foods and the opportunity to lead a healthy lifestyle. Positive social norms can be leveraged to promote the consumption and production of healthy diets, while negative norms may need to be addressed through targeted interventions.

As Judith Chale (Nutrition hub manager at CARE International Karamoja sub-region) maintains, social norms within the community play a critical role in shaping food and nutrition behaviors and influencing dietary choices. Understanding these norms remains vital to developing targeted interventions that will help shape perceptions and attitudes to promote the consumption of healthy diets.


Desire Oyenyboth | CASCADE Uganda
Judith Chale | Nutrition Hub Managers for South West and Karamoja Region