Socio-cultural Barriers Research Articles

Carbon Neutrality in the Building Sector of the Global South—A Review of Barriers and Transformations

This work provides a review of economic, technical, sociocultural, political, and technological barriers that impede carbon neutrality in the building sector of countries in the Global South. These barriers include limitations in public and professional awareness, knowledge, and skills in the construction industry, the lack of ambitious energy codes and green building rating systems, the lack of green financing schemes and investment, costs of materials and technology, and limitations in regulations. Finally, this article recommends five transformations to address the critical barriers and enable net-zero emission status in the building sector of countries in the Global South. These transformations include environmental data collection, stringent building energy codes, and green building system certifications, lifecycle-based thinking and circular design, education enhancement and workforce development, and net-zero emission business practices.

P1114 Integral care of the non-Spanish speaking migrant population in inflammatory bowel disease units

Abstract Background In recent years, given the change in the paradigm of management of Inflammatory Bowel Disease (IBD), the different societies have been working to ensure continuous, homogeneous, multidisciplinary social and health care with the patients and their autonomy as the central axis; promoting the creation of Integrated Care Units for IBD patients (ICU-IBD). In the latest analyses of our ICU, attention was drawn to the progressive increase in the demand for care from non-Spanish-speaking migrant patients. This prompted us to carry out this study, with the aim of finding out how this population uses our unit and how it responds to their needs. Methods A retrospective longitudinal descriptive observational study with analysis of demographic, clinical and care variables of all non-Spanish-speaking migrant patients followed in the ICU-IBD of our centre until 30 June 2023. Results Thirty patients of 14 different nationalities were included, with Moroccan being the most frequent (43.3%); only one of them (3.3%) was fluent in Spanish. Other clinical and demographic characteristics of note were: mean age at follow-up of 43.2 years, predominantly female (66.6%) and predominantly Crohn's disease (63.3%) (Table 1). A total of 86.7% of the patients were referred to our ICU-IBD from the Emergency Department, which they attended due to symptoms related to flare-ups of their intestinal disease. After the initial assessments, we observed that 73.3% did not attend for check-ups, 83.3% of the patients attended the emergency department in the event of a clinical flare-up, and 93.3% showed irregular adherence to treatment. In the subsequent follow-up, we observed a significant change, 76.7% regularly attended consultations, 76.7% consulted the unit in the event of an outbreak and 60% followed treatment regularly (Figure 1). These changes coincide with a socio-health intervention carried out by the specialised nurse; in which patients and their environment were provided with information regarding their disease, treatment and use of the UAI-EII; as well as addressing socio-health problems in order to facilitate their wellbeing and integration into the community. Conclusion In view of our results and the data published in other studies, we suggest that the language barrier, the social and healthcare culture of the country of origin, the socioeconomic situation and integration into the new social environment are factors to be taken into account in order to achieve adequate comprehensive care for this migrant population. The role of the IBD nurse is fundamental in the daily work of offering individualised, continuous and comprehensive care to both the patient and their environment; even more so in this population with marked socio-cultural barriers.

Will policy help close the digital gender divide? An intersectional feminist policy analysis of Ethiopia's national digital policy

AbstractMotivationDigital technologies can enable development, but they risk further entrenching inequalities in society, such as through the digital gender divide. The divide can not only slow development, but also slow progress towards gender equality. As digital technologies become increasingly used by governments for economic development, the gendered aspects of digital technologies need to be considered.PurposeThis study aims to investigate how Ethiopia's current national policies involving digital technologies consider the digital gender divide. It asks the following research questions: (1) how do Ethiopian government policies relating to engagement with digital technologies consider gender and gendered issues? And (2) how do Ethiopian government policies capture the causes of the digital gender divide?Methods and approachI critically analyse Ethiopian policies using an intersectional feminist lens, adapted from the work of Kanenberg et al. (2019). I applied this to the Ten Years Development Plan (10YP), Digital Ethiopia 2025, Ethiopian Education Roadmap 2018–2030 (EEDR), and Education Sector Development Programme VI (ESDP VI).FindingsThe four policies show little consideration of gender and gendered dimensions of digital technologies. They rarely address the causes of the digital gender divide. Above all, they do not consider the underlying sociocultural barriers women face if they want to engage with digital technologies. The policies are thus unlikely to help close the digital gender divide. Ethiopia's integrationist approach to gender, as well as the patriarchal structures within which the policies are designed, probably explain these findings.Policy implicationsA transformational gender policy paradigm, one designed to position women and men to challenge the patriarchal structures they live within, is suggested as a means of capturing and confronting the barriers women face to engaging with digital technologies in the long term.

How can I serve you better? Unlocking the digital D2C barriers for regional food products

PurposeThe digital direct-to-consumer (D2C) approach has seen widespread adoption across many industries, but its application to regional food products has been slower. This study aims to identify and rank the most significant challenges to the widespread use of digital D2C for regional food products.Design/methodology/approachA multi-criteria decision-making method called a fuzzy analytic hierarchy process (FAHP) was used to determine the order in which these obstacles were evaluated. Thirty-five barriers were identified and categorized into six categories named technological, operational, sociocultural, financial, market and institutional and regulatory barriers.FindingsMarket barriers ranked as the top barrier, and the technological barrier ranked the least significant amongst the main barrier categories for the adoption of digital D2C model for the regional food products. Lack of consumer awareness ranked number one globally, and lack of government subsidies ranked the least amongst the thirty-five identified barriers. Operational barriers came out to be second most significant barrier followed by institutional and regulatory barrier, sociocultural barrier, financial barrier and technological barrier.Research limitations/implicationsThe findings of this research were derived through a numerical examination of data gathered from the Indian setting. It follows that the technological, sociocultural, financial, market, operational and institutional constraints, among others, outlined here are all unique to India. Because of the unique nature of the Indian setting, the results of this study can only be used there and not elsewhere. It is possible that future research will broaden the aims of this one and refine its methodology. Digital D2C adoption for regional food products may be prioritized and ranked using quantitative and qualitative data sources like ANP and TOPSIS. It is possible that similar studies may be conducted in nations which have a different set of operational, technological, sociocultural market and financial and regulatory barriers. Conceptual framework can be formed by integrating TAM and TPB to understand the buying behavior of regional food products via digital D2C.Originality/valueThis research is the first to identify challenges to the widespread use of the digital D2C model for regional food products. Policymakers and other interested parties can use this information to better understand the difficulties of expanding the distribution of regional food products beyond their immediate regions.

Local studies provide a global perspective of the impacts of climate change on Indigenous Peoples and local communities

Indigenous Peoples and local communities with nature-dependent livelihoods are disproportionately affected by climate change impacts, but their experience, knowledge and needs receive inadequate attention in climate research and policy. Here, we discuss three key findings of a collaborative research consortium arising from the Local Indicators of Climate Change Impacts project. First, reports of environmental change by Indigenous Peoples and local communities provide holistic, relational, placed-based, culturally-grounded and multi-causal understandings of change, largely focused on processes and elements that are relevant to local livelihoods and cultures. These reports demonstrate that the impacts of climate change intersect with and exacerbate historical effects of socioeconomic and political marginalization. Second, drawing on rich bodies of inter-generational knowledge, Indigenous Peoples and local communities have developed context-specific responses to environmental change grounded in local resources and strategies that often absorb the impacts of multiple drivers of change. Indigenous Peoples and local communities adjust in diverse ways to impacts on their livelihoods, but the adoption of responses often comes at a significant cost due to economic, political, and socio-cultural barriers operating at societal, community, household, and individual levels. Finally, divergent understandings of change challenge generalizations in research examining the human dimensions of climate change. Evidence from Indigenous and local knowledge systems is context-dependent and not always aligned with scientific evidence. Exploring divergent understandings of the concept of change derived from different knowledge systems can yield new insights which may help prioritize research and policy actions to address local needs and priorities.

Type 2 Diabetes Mellitus in Tanzania. A Narrative Review of Epidemiology and Disease Trend.

The prevalence of type 2 diabetes is on a rapid rise in Tanzania, driven by lifestyle modifications, nutritional changes, and increased obesity rates. This article reviews the epidemiology, and disease trends of type 2 diabetes in Tanzania and explores the economic implications and challenges in care, including policy, education, and healthcare systems. The study employs a narrative literature review from research articles, local healthcare reports, surveys, and public health records. It evaluates the economic impacts, healthcare capabilities, and patient behaviors in managing type 2 diabetes in Tanzania. The economic burden of diabetes in Tanzania is increasing due to direct healthcare costs, lost productivity, and reduced quality of life, placing significant pressure on the already resourcelimited healthcare system. Treatment dropout rates are alarmingly high, and healthcare providers' knowledge of diabetes is insufficient. Insulin and metformin availability are critically low. Cultural norms and dietary habits pose substantial barriers to effective disease management. The growing prevalence of type 2 diabetes in Tanzania presents a significant public health crisis, necessitating comprehensive strategies for prevention, early detection, and effective disease management. Priorities should include enhancing healthcare infrastructure, increasing public investment, improving healthcare education, and tackling socio-cultural barriers to disease management.

Barriers to Cervical Cancer Screening and Satisfaction with Self-Sampling among Black Women in Michigan: a Mixed Methods Study.

In recent years, cervical cancer screening among Black women in the United States has declined, followed by increased incidence and mortality. We aim to evaluate the individual, sociocultural, and structural barriers to cervical cancer screening in relationship to the exam technique barriers. Participants received cervical cancer self-screening kits in the mail. They returned their samples and a quantitative survey developed from the Health Information National Trends Survey (HINTS) modules designed to address the known individual, sociocultural, and structural barriers to screening. We established the fourteen attributes of cervical cancer screening techniques from prior work. Participants then shared their experiences in a semi-structured qualitative interview informed by the Theoretical Domains Framework (TDF) to explore the answers to the survey questions. We coded themes from the interviews. Women were grouped as younger (30-45 years) and older (46-65 years). Of the 41 women completing the study, 21 were in the younger age group (mean 37.3, SD 4.7), and 20 were in the older age group (56.5 (5.5)). All participants self-identified as African American/Black and were due for cervical cancer screening. Women indicated that individual, sociocultural, and structural barriers influenced their cervical cancer screening, but the most significant barrier was the speculum-based technique itself. Three positive attributes and eight negative attributes significantly differed by screening technique, favoring the self-screening technique. The self-screening technique for screening for cervical cancer is feasible and acceptable to this group of Black women.

Social Awareness for Women’s Health: An Endline Study in Gazaria, Munshiganj, Bangladesh

Background: The “Social Awareness for Women’s Health: Gazaria Pilot” project aimed to address menstrual health awareness and distribute free sanitary napkins in the Gazaria region. This endline survey evaluates the project’s impact on menstrual health practices, knowledge, and socio-cultural barriers among women and girls. Objective: Baseline data highlighted critical challenges, including limited awareness about menstrual hygiene, widespread use of non-hygienic materials such as old cloths, and significant emotional distress associated with menstruation. Access to reliable menstrual health information was predominantly through informal channels, with cultural taboos further exacerbating the menstrual health crisis. Methodology: A mixed-methods approach was employed, combining quantitative surveys and qualitative interviews to gather data from community members participating in the Gazaria Pilot project. Surveys were conducted to assess changes in health behaviors and attitudes, while interviews provided insights into community perceptions and experiences with project interventions. Findings: Following the project’s implementation, there was a notable improvement in menstrual hygiene practices. The use of disposable sanitary napkins increased from 5.99% at baseline to 15.36% at endline, reflecting enhanced access and acceptance of sanitary products. Additionally, knowledge about the risks of unclean menstrual practices and the benefits of personal hygiene saw significant gains, with awareness rising from 55.5% to 72.66% and from 62.0% to 75.78%, respectively. Menstruation has decreased emotional reactions, promoting mental well-being, but challenges persist like reliance on old cloths, lack of medical advice, and socio-cultural taboos affecting health behaviors. Conclusion: The project emphasizes the need for community-based interventions and sustained engagement to improve menstrual health outcomes in Gazaria, highlighting the need for ongoing efforts.

Demystifying Misconceptions on Key Tenets of Quality Basic Education in Chikomba District, Zimbabwe: A Systematic Literature Review

Educational stakeholders in Zimbabwe have been expressing sentiments on deteriorating basic quality education. Accordingly, this led to continuous updates of curriculum peculiarly over the past decade to embrace qualities of basic education. Thus, this research paper sought to: explore fundamental features of quality basic education, analyse challenges impeding it and propose strategies to overcome obstacles for quality basic education in Chikomba District, Zimbabwe. Research methodology adopted was Systematic Literature Review. A comprehensive 7 steps research design was crafted from formulation of review questions to interpretation of results. To enhance accuracy and consistency, a well detailed structured critical Systematic Review Chart was followed. Twenty-five sources were finally selected and reviewed from a total of 35. These were government publications, journals, books, articles, published research papers, newspapers and international organisations’ reports. Validity and reliability were enhanced through utilisation of in-depth analysis of data collection methods, administration of check list and use of three experienced reviewers. The findings revealed that, basic quality education should encompass qualified teachers; competency-based curriculum; inclusivity; learner’s engagement; innovativeness and creativity; practical surviving skills; digital infrastructure; abundant resources and quality assurance systems. 50% of sources reflected economic challenges, 20% technological hindrances, 10% unconducive educational policies, 15% socio-cultural barriers and 5% indicated geo-physical factors. The research proposes strategies which are linked to recommendations for attainment of quality basic education. These include: stakeholder engagement, digital infrastructure, resources mobilisation, training and employment of more teachers. Furthermore, regular competency curriculum review, quality assurance, supportive educational and inclusivity policies towards women and disabled. Conclusively, the research noted that qualities of basic education are multifaceted and Chikomba District will be used as a field for data collection to test the hypothesis.

A Qualitative Study of HIV Testing Experiences and HIV Self-Testing Perspectives among Men in Northern Nigeria.

HIV self-testing (HIVST) holds promise for accessing hard-to-reach populations by overcoming sociocultural and structural barriers to awareness of HIV status. This phenomenological qualitative study explored the experiences and perspectives of married men in Kano, northern Nigeria, regarding HIV testing and counseling (HTC) and HIVST. Twenty married men from diverse socioeconomic backgrounds participated in in-depth interviews conducted in the local language. Thematic analysis was employed to analyze the data, yielding key themes related to prior test experiences, knowledge of self-testing, and perceived ease of use, in addition to motivation for self-testing and concerns about reliability and counseling support. The findings shed light on the impact of facility-based HIV testing experiences on the perspectives of participants. Concerns related to delays, overcrowding, discomfort, fear, and unsupportive attitudes from healthcare providers influenced their perceptions. Among persons with previous self-testing experience, initial uneasiness was overcome with repeated use, highlighting the ease of use associated with HIVST. Motivations for self-testing included privacy, convenience, personal empowerment, improved infection detection, and efficiency. Concerns were raised regarding the reliability of self-testing results compared to hospital-based testing, and the absence of counseling support during self-testing. Our findings underscore the need to address infrastructural limitations, enhance counseling support, and promote awareness and knowledge of HIVST.

Exploring context for implementation of inclusive education for children with developmental disabilities in mainstream primary schools in Ethiopia.

A large gap in provision of services for children with developmental disabilities (DD) has been identified in Ethiopia, especially in the education system. Including children with disabilities in mainstream schools is encouraged by policies, but progress in this direction has been limited. This study aimed to explore stakeholders' perspectives on contextual factors relevant for inclusive education for children with DD in mainstream schools in Ethiopia, with a focus on Adis Ababa. Data were collected through semi-structured interviews with 39 local stakeholders, comprising caregivers of children with DD, school teachers and principals/managers, non-governmental organisation representatives, government officials, clinicians and academics/consultants. We used template analysis to code the data and map them onto domains of the Context and Setting dimensions of the Context and Implementation of Complex Interventions framework. Stakeholders discussed frameworks in the Legal and Ethical context endorsing the right of all children to education. However, they reported multiple reasons why children with DD in Ethiopia have limited access to education, either in special or mainstream schools. First, individual features, such as gender and support needs, discussed in the Epidemiological context, may affect the likelihood of a child with DD to be accepted in school. Transportation challenges are a key barrier in the Geographical context. Socio-economic and Socio-cultural contexts present barriers at the levels of the nation, school and family, mostly related to limited services and material and financial resources and limited awareness of DD. Stakeholders believe the currently limited but growing commitment in the Political context can support progress towards the removal of these barriers. Our findings can form the basis for development of an implementation plan that addresses such barriers and capitalises on existing facilitators.

Barriers to inclusion of Muslim migrant students in western schools. A systematic review

At present, there has been a gradual increase in the number of migrant students in schools in Western societies, in which Muslim students are one of the largest groups. Their inclusion has become the main goal for governments and schools. However, this group sometimes face different barriers to their inclusion, which limit their educational experiences, and prevent or hinder their access and participation, promoting their marginalisation. Research on migration and education generally focuses on specific cases or communities, so it is interesting to analyse from a broader perspective what recurrent forms of inclusion and exclusion occur at the global level in schools. This systematic review aims to determine the barriers to inclusion faced by first and second generation Muslim migrant students at different stages of their formal education. It followed PRISMA guidelines and a PEO research strategy, conducted in two databases, Boolean as well as truncators were used for specific terms. It included assessments of methodological quality and validity. A total of 24 articles met the selection criteria. The study finds socio-cultural, linguistic and discrimination barriers as well as barriers produced by educational policy and the availability of resources and training. There are barriers in the pedagogical practice too. Furthermore, those barriers had a greater or lesser impact according to the generation or the educational stage the students are in. This not only favours the identification of barriers, but also the search for measures and solutions to reduce or eradicate them at both the micro and macro levels, by promoting the development of policies, the provision of resources and the creation of working networks in interculturality.

Access and use of sexual and reproductive health services among asylum-seeking and refugee women in high-income countries: A scoping review.

Refugee and asylum-seeking women are known to experience a myriad of intersecting sociocultural, institutional, and systemic barriers when accessing healthcare services after resettlement in high-income countries. Barriers can negatively affect service uptake and engagement, contributing to health inequities and forgone care. Access to sexual and reproductive healthcare (e.g., family planning, cervical cancer prevention) has largely been understudied. This scoping review sought to: i) examine the use of sexual and reproductive health services among refugee and asylum-seeking women in high-income countries; and ii) identify barriers and facilitators influencing access to sexual and reproductive healthcare for refugee and asylum-seeking women in high-income countries. This review was conducted in accordance with Joanna Briggs Institute Methodology for Scoping Reviews. Ten databases (e.g., CINAHL, MEDLINE, Embase) were searched for qualitative, quantitative, mixed method studies, and gray literature published anytime before February 2024 across high-income countries (defined by the World Bank). The Health Behaviour Model was used to examine and understand factors influencing service use and access. 3,997 titles and abstracts were screened, with 66 empirical studies included. Most were conducted in the United States (44%), Australia (25%), Europe (18%) and elsewhere and were qualitative (68%). Papers largely addressed contraception, abortion, cervical cancer screening, gender-based violence, and sexual health education. Included studies indicated that refugee and asylum-seeking women in high-income countries face a greater unmet need for contraception, higher use of abortion care, and lower engagement with cervical cancer screening, all when compared to women born in the resettlement country. Frequently reported barriers included differences in health literacy, shame and stigma around sexual health, language and communication challenges, racial or xenophobic interactions with healthcare providers, and healthcare/medication costs. Studies across the globe identified consistent empirical evidence demonstrating health inequities facing refugee and asylum-seeking and myriad intersecting barriers contributing to underuse of essential sexual and reproductive health services. Facilitators included multilingual healthcare provider, use of interpreters and interpretation services, community health promotion work shops, and financial aid/Medicare.

EXAMINING PARITY LAW NR. 04/2018: OPPORTUNITIES AND CONSTRAINTS FOR WOMEN'S POLITICAL ENGAGEMENT IN GUINEA-BISSAU

This article presents a comprehensive analysis of the challenges surrounding women's political participation in Guinea-Bissau, focusing on the impact of affirmative policies, particularly Parity Law Nr. 04/2018. The study adopted qualitative methods of research. Qualitative data for this study is gathered through interviews, focus groups, and document analysis to understand the sociocultural and institutional barriers that deter women from active political engagement. I also use triangulation to collect secondary data to assess the numerical changes in women's representation in political institutions prior post the implementation of Parity Law Nr. 04/2018. The study recommends a critical evaluation of the enforcement and reception of the parity law by examining its adoption within political parties, electoral processes, and governmental structures. The study found that women's representation in the political process of Guinea Bissau is troubling and in a state of decline. The study recommends Key stakeholders, including policymakers, civil society organizations, and female politicians, be consulted for the implementation of affirmative policies geared towards women's representation in politics and governance.

L’égalité d’accès à l’enseignement supérieur dans les universités marocaines : défis et stratégies

This article examines the challenges and potential strategies for ensuring equitable access to higher education in Moroccan universities. It addresses how these strategies can contribute to the country's socio-economic development by improving inclusion. The first part identifies the main challenges faced by Moroccan universities, including regional disparities, funding, and socio-cultural barriers to education. The second part proposes improvement strategies such as increasing investments in educational infrastructure, implementing inclusive policies, and adopting modern educational technologies. The third part assesses the potential impact of these strategies on Morocco's socio-economic development, focusing on promoting educational equity and excellence. The discussions and results underscore the importance of inclusive and adapted educational policies to foster a more equitable and prosperous Moroccan society. This study contributes to the literature on higher education in Morocco and offers perspectives for future research.

Socio-cultural factors of the evolution of the urban transport system

The sociocultural urban space of a modern city is undergoing some transformational changes due to the high level of population mobility. The daily need to develop urban space determines the importance of the transport system in sociocultural interactions, the participants of which value safety, confidentiality, and rationality. In realizing their purpose, urban transport structures not only operate with economic, social and communication resources, but also involve citizens in the process of organizing urban life. This research aims to study the socio-cultural factors in the evolution of the urban transport system by systematizing theoretical scientific concepts, comparative analysis of dynamic changes in the use of public transport and summarizing some gaps in transport infrastructure. Identification of the correlation between sociocultural factors, passenger needs and the quality of transport services determines the need to develop a communicative culture, maintain moral values and overcome sociocultural barriers, which will subsequently lead to a constructive transformation of the urban transport system.

Exploring socio-cultural barriers and coping mechanisms: A study of challenges faced by women entrepreneurs in Satna District, Madhya Pradesh

Exploring socio-cultural barriers and coping mechanisms: A study of challenges faced by women entrepreneurs in Satna District, Madhya Pradesh

Navigating Socio-Cultural Barriers: Challenges and Opportunities in English Language Learning among Bangladeshi Rural Students

This research examines the influence of socio-cultural impediments on the acquisition of the English language by rural learners in Bangladesh. Utilizing a mixed-methods framework that integrates quantitative surveys alongside qualitative interviews, the study identifies critical elements that obstruct English language proficiency, such as diminished motivation, insufficient educational resources, and prevalent negative attitudes within the community. The results indicate that numerous rural learners perceive English as irrelevant to their daily lives, resulting in a lack of engagement with language acquisition. Furthermore, evident gender disparities were identified, with female learners encountering distinct challenges that curtail their opportunities for English education. This research underscores the imperative for community involvement, culturally attuned pedagogical approaches, and targeted initiatives to mitigate these obstacles. By elucidating the socio-cultural milieu of rural education, this study aspires to guide policymakers and educators in devising effective strategies to bolster English language learning among rural students.

Factors associated with exclusive breastfeeding for the first six months among caregivers of children under five years in northern Ghana: A cross-sectional study.

Despite consistent evidence highlighting the benefits of exclusive breastfeeding (EBF) for the first six months, EBF duration sometimes falls short of six months or exceeds it. This research seeks to explore factors influencing the practice of optimal duration of EBF and identify factors associated with suboptimal EBF durations. A cross-sectional survey was conducted in 16 districts across four Northern regions of Ghana with 2000 caregivers of children under five years old. The analysis specifically focused on a subset of 1761 biological mothers. Logistic regression was conducted to discern socio-demographic, care-seeking, and behavioral determinants influencing the practice of EBF for a six-month duration. Additionally, multinomial logistic regression was used to identify factors associated with suboptimal EBF durations, categorized as less than and beyond six months. All biological mothers breastfed their youngest child, varying in durations: 75% exclusively breastfed for six months, 19.2% for less than six months, and 5.9% for beyond six months. Several behavioral determinants influenced EBF for six months, with biological mothers ' confidence in their ability to EBF (aOR: 6.8 95% CI, 4.13-11.33), willingness to recommend EBF practice to friends and family (aOR: 10.5 95% CI, 4.13-26.62) and perception of practicing EBF as normative in the community showing statistically significant associations (aOR: 6.3, 95% CI, 4.41-9.10). Education and religion of biological mothers were also significantly associated with EBF for six months. While there was overlap in behavioral factors associated with EBF for less than and beyond six months, the socio-demographic characteristics of biological mothers associated with these suboptimal durations of EBF differed. Among the factors included in this study, social norms, caregiver confidence, and approval of EBF were key factors influencing the recommended duration of EBF practices. These findings highlight the importance of community and cultural contexts in shaping biological mothers' behavior and emphasize the need to address socio-cultural barriers and facilitators that influence EBF practices, as well as empower biological mothers to adopt and sustain these practices.

Identifying and understanding barriers to optimal complementary feeding in Kenya.

Optimal complementary feeding between the ages of 6 and 23 months provides children with the required range of nutritious and safe foods while continuing to be breastfed to meet their needs for essential nutrients and develop their full physical and cognitive potential. The rates of exclusive breastfeeding in the first 6 months of life have increased from 32% in 2008to 60% in 2022 in Kenya. However, the proportion of children between 6 and 23 months receiving a minimum acceptable diet remains low and has declined from 39% in 2008to 31% in 2023. The Kenyan Ministry of Health, GAINand UNICEF collaborated to understand the drivers of complementary feeding practices, particularly proximal determinants, which can be directly addressed and acted upon. A secondary analysis of household surveys and food composition data was conducted to outline children's dietary patterns within the different regions of Kenya and the extent to which the affordability of animal-source foods could be improved. Ethnographic data were analyzed to identify socio-cultural barriers to optimal complementary feeding. Furthermore, we outlined the critical steps for developing user-friendly and low-cost complementary feeding recipes. The results of all the analyses are presented in five of the six papers of this Special Issue with this additional paper introducing the Kenyan context and some of the critical findings. The Special Issue has highlighted multidimensional barriers surrounding the use and availability of animal-source foods. Furthermore, it emphasizes the need for a multi-sectoral approach in enacting policies and programmes that address these barriers.