USING POSITIVE DEVIANCE BY MICRONUTRIENT STATUS TO IDENTIFY DIFFERENCES IN FOOD BEHAVIORS IN WOMEN OF REPRODUCTIVE AGE IN GHANA

Open Access
Author:
Heine, Carissa Noel
Area of Honors:
Nutritional Sciences
Degree:
Bachelor of Science
Document Type:
Thesis
Thesis Supervisors:
  • Alison Diane Gernand, Thesis Supervisor
  • Alison Diane Gernand, Honors Advisor
  • Laura E Murray-Kolb, Faculty Reader
Keywords:
  • ghana
  • nutrition
  • positive deviance
  • micronutrient status
  • micronutrient deficiency
  • malnutrition
  • food behaviors
  • women of reproductive age
  • preconception
  • qualitative data
  • nutritional science
  • low-resource
Abstract:
Micronutrient deficiencies are common in low-income countries. A previous study measured the concentrations of several micronutrients in pre-pregnant women in a low-resource, semi-rural town in Ghana and gathered information from each woman on socio-economic, demographic, and other lifestyle characteristics (n=100). For the current study, we followed the “positive deviance” approach: micronutrient status and other biomarkers from the previous study were used to identify “positive deviants” (excellent nutritional health, n=13), a normal control group (average nutritional health, n=61), and “negative deviants” (lowest nutritional health, n=24). Field staff interviewed women from both positive (n=9) and negative (n=11) deviant groups in their homes and directly observed household resources. Data was analyzed using quantitative and qualitative methods as appropriate. The study found that consumption of turkey berry (a high-iron fruit), ownership of home and agricultural land, exposure to healthcare, living in a larger household with more than two adults, living farther from the town’s market and having a consistent schedule for purchasing food were higher among the positive deviants (healthiest women), while consumption of starchy foods and sugary drinks and possession of electric or gas utilities were higher among negative deviants. Future work could explore the ability to promote the factors found to be related to better nutritional health in this community and to explore similar issues in other low-resource communities around the globe.