Cash Plus Social and Behavioral Change Communication Approaches to Improve Food Security: Findings From Formative Research With Syrian Refugees in Lebanon

Abstract

ObjectivesThis study aimed to complement existing cash transfer programs and at improving food security among Syrian refugees (SR) in Lebanon by (1) examining their food literacy and food purchasing behaviors and (2) developing a social and behavioral change communication (SBCC) strategy.MethodsThis qualitative study was conducted (Jan – Feb 2020) in two phases: Phase1 included 2 focus group discussions (FGD) among 21 SR women receiving cash assistance in Tyre, Lebanon to identify food literacy gaps and preferred health communication channels. In addition, in-depth interviews were conducted with key informants (KI) from international and non-governmental organizations working with SR; Phase 2 utilized qualitative findings for the development of a culturally-appropriate SBCC strategy to improve the food purchasing and healthy dietary behaviors of SR. Five months after phase 2, key findings were shared with KI through interviews in a form of ‘member checking’ to enhance data credibility and inform the interpretations of study findings in the context of COVID-19. An inductive approach to textual analysis was used to identify key themes and sub-themes for interpretation.ResultsThree major themes emerged from phase 1 data: Theme 1 reflected the highly precarious conditions of settlement camps that make it difficult for refugees to be food secure. Theme 2 suggested several determinants of food purchasing behaviors (limited nutrition knowledge, poor dietary habits contributing to sub-optimal dietary diversity, and limited exposure to nutrition education on food resource management and budgeting). Theme 3 revealed important nutrition education needs, as well as preferred channels to receive such information (e.g., group education, one-on-one counselling sessions, and WhatsApp-based messaging). Other communication channels suggested by KI, and that differed from those suggested by the refugee community in phase 1, included mass media campaigns and community mobilization.ConclusionsDue to both environmental challenges and individual-level factors, SR living in Tyre, Lebanon were found to have poor dietary choices, thus an SBSS strategy tailored to their needs may help improve their food purchasing behaviors and alleviate their food insecurity levels.Funding SourcesUniversity Research Board grant at the American University of Beirut, Lebanon.