Abstract
Adolescence is a critical period characterized by rapid physical, psychological, and social development and growth. In Bangladesh, high rates of undernutrition persist among adolescent females living in low‐income households. Prevalence of adolescent marriage and pregnancy is extremely high, with almost half of Bangladeshi women giving birth by 18 years of age. Qualitative research was carried out from April to June 2017 to examine individual, social, and environmental factors influencing eating behaviours of female adolescents between 15 and 19 years of age living in low‐income families in urban and rural settings in Bangladesh. Methods included freelisting exercises (33), key informant interviews (11), in‐depth interviews (24), direct observations (16), and focus group discussions (12). Findings show that household food insecurity necessitates adjustments in meal food quality and frequency. Gender norms prescribe that females receive small meal portions and make sacrifices in food consumption so that male family members can eat more. Work and school schedules cause long breaks between meal consumption, restricting food intake of adolescent females for extended periods. Gender discrimination and its manifestations likely amplify susceptibility to psychological stresses in adolescent females. An inferior social position makes adolescent females living in food insecure households vulnerable to undernutrition, with factors affecting food deprivation increasing as they approach childbearing. Policies to increase age of marriage and reduce adolescent pregnancy must continue. Programmes must ensure that school‐going adolescents eat adequately during the school day. Prolonging school education and strengthening the economic viability of women should alter cultural expectations regarding marriage age and normative female roles.
Highlights
Adolescence is a transitional period from childhood to adulthood characterized by rapid physical, psychological, and social development and growth (Das et al, 2017)
The few studies conducted have shown that limited dietary diversity, suboptimal energy and micronutrient intake, and undernutrition are higher in the lowest wealth quintiles, with household wealth associated with the probability of better nutritional status (Akhter & Sondhya, 2013; Alam, Roy, Ahmed, & Ahmed, 2010; Leroy et al, 2018; National Institute of Population Research and Training [NIPORT] et al, 2016)
Intrahousehold food allocation involving serving males first and bigger food portions limits the amount of meal foods reserved for adolescent and adult females, which were consistently small
Summary
Adolescence is a transitional period from childhood to adulthood characterized by rapid physical, psychological, and social development and growth (Das et al, 2017). Despite rising incomes and access to a variety of foods, widespread malnutrition persists in low‐ and middle‐income countries, in urban slums and rural areas (Abarca‐Gómez et al, 2017; Pörtner & Su, 2018) In these settings, girls are often more likely than boys to drop out of school at a young age, increasing the likelihood of social isolation, early marriage, and childbearing when girls are still maturing (Gibbs, Wendt, Peters, & Hogue, 2012; WHO, 2014a). The few studies conducted have shown that limited dietary diversity, suboptimal energy and micronutrient intake, and undernutrition are higher in the lowest wealth quintiles, with household wealth associated with the probability of better nutritional status (Akhter & Sondhya, 2013; Alam, Roy, Ahmed, & Ahmed, 2010; Leroy et al, 2018; National Institute of Population Research and Training [NIPORT] et al, 2016). Using gender as an overarching framework, qualitative research was conducted to examine individual, social, environmental, and structural factors influencing eating behaviours of female adolescents living in low‐income families in urban and rural settings in Bangladesh
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