African migrant women acquisition of clay for ingestion during pregnancy in London: a call for action

Abstract

ObjectivesThis study aimed to explore how African migrant women go about acquiring clay for ingestion during pregnancy in London against a backdrop of restrictions and warnings by the Food Standard Agency and Public Health England due to the potential health risks to expectant mothers and their unborn babies. Study designThis was a qualitative study using an interpretative phenomenological approach. MethodsIndividual in-depth interviews and a focus group discussion were used for data collection. Data collection took place between May and August 2020. ResultsParticipants acquired clay from African shops and markets in London, countries of origin and online/social media platforms. Due to official restrictions and warnings, transactions were conducted under the counter based on trust between sellers and the women underpinned by shared community identities. However, clay was acquired, social networks emerged as crucial facilitators. The current top-down approach, which is also lacking a regulatory policy framework, has pushed clay transactions underground, thereby leaving pregnant women potentially ingesting toxic clay with little chances of dictation by authorities. ConclusionWe call on the UK Health Security Agency (UKHSA) and public health practitioners to collaborate with communities to design multilevel/multisectoral interventions as well as the Food Standards Agency (FSA) to consider an appropriate regulatory policy framework.