When knowledge is not enough: barriers to recommended cassava processing in resource-constrained Kwango, Democratic Republic of Congo

Authors

  • Gisele Bokundabi Ministry of Health, National Program of Nutrition
  • Lyn Haskins Centre for Rural Health, University of KwaZulu-Natal, Durban
  • Christiane Horwood Centre for Rural Health, University of KwaZulu-Natal, Durban
  • Césarine Kuwa Ministry of Health, National Program of Nutrition
  • Paulin Beya Mutombo Department of Nutrition, Kinshasa School of Public Health
  • Vaughn M. John School of Education, University of KwaZulu-Natal, Pietermaritzburg
  • Mala Ali Mapatano Department of Nutrition, Kinshasa School of Public Health
  • Jean-Pierre Banea Department of Nutrition, Kinshasa School of Public Health

DOI:

https://doi.org/10.4081/jphia.2023.2052

Keywords:

cassava processing, cassava, cyanogens, Konzo, Democratic Republic of Congo, Africa

Abstract

Background. Despite interventions to provide knowledge and improve bitter cassava processing in the Democratic Republic of Congo (DRC), cassava processing is sub-optimal. Consumption of insufficiently processed bitter cassava is associated with konzo, a neurological paralytic disease.
Objective. This study aimed to explore barriers to appropriate cassava processing carried out by women in one deep rural, economically deprived area of DRC.
Methods. A qualitative design used focus group discussions (FGDs) and participant observation to collect data among purposively selected women aged 15-61 years in Kwango, DRC. Data were analyzed using thematic analysis.
Results. 15 FGDs with 131 women and 12 observations of cassava processing were undertaken. Observations indicated women did not follow recommended cassava processing methods. Although women were knowledgeable about cassava processing, two main barriers emerged: access to water and lack of money. Accessing water from the river to process cassava was burdensome, and the cassava was at risk of being stolen by soaking it in the river; therefore, women shortened the processing time. Cassava was not only used as a staple food but also as a cash crop, which led to households shortening the processing time to reach the market quickly.
Conclusion. Knowledge about the risks of insufficient cassava processing and about safe processing methods alone is insufficient to change practices in a context of severe resource constraints. When planning nutrition interventions, it is critical to view the intervention in light of the socio-economic context in which the intervention will take place to improve its outcomes.

Download data is not yet available.

References

Hoddinott J, Ahmed A, Karachiwalla NI, Roy S. Nutrition behaviour change communication causes sustained effects on IYCN knowledge in two cluster-randomised trials in Bangladesh. Matern Child Nutr. 2018;14(1). DOI: https://doi.org/10.1111/mcn.12498

Debela BL, Demmler KM, Rischke R, Qaim M. Maternal nutrition knowledge and child nutritional outcomes in urban Kenya. Appetite. 2017;116:518-26. DOI: https://doi.org/10.1016/j.appet.2017.05.042

Mayes L. Nutrition Knowledge and Dietary Habits of Farmers Market Patrons [disertation]. University of Kentucky: UKnowledge. 2013:19.

Aglago EK, Landais E, Nicolas G, Margetts B, Leclercq C, Allemand P, et al. Evaluation of the international standardized 24-h dietary recall methodology (GloboDiet) for potential application in research and surveillance within African settings. Global Health. 2017;13(1):35. DOI: https://doi.org/10.1186/s12992-017-0260-6

Akinpelu A, Amamgbo LEF, Olojede AO, Oyekale AS. Health implications of cassava production and consumption. Journal of Agriculture and Social Research (JASR) 2011;Vol. 11,(No. 1, ):118-25.

Banea M, Poulter NH, Rosling H. Shortcuts in Cassava Processing and Risk of Dietary Cyanide Exposure in Zaire. Food and nutrition bulletin. 1992;14(2):1-7. DOI: https://doi.org/10.1177/156482659201400201

Tylleskär T, Banea M, Bikangi N, Cooke RD, Poulter NH, Rosling H. Cassava cyanogens and konzo, an upper motoneuron disease found in Africa. Lancet. 1992;339(8787):208-11. DOI: https://doi.org/10.1016/0140-6736(92)90006-O

Banea JP, Bradbury, J. H., Nahimana, D., Denton, I. C., Foster, M. P., Mekob, N., Kuwa, N., Bokundabi, G., & Foley, W. J. Health factors associated with persistent konzo in four villages in the Democratic Republic of Congo (DRC). African Journal of Food Science, . 2016;10 (1):1-6. DOI: https://doi.org/10.5897/AJFS2015.1378

Bradbury JH, Cliff J, Denton IC. Uptake of wetting method in Africa to reduce cyanide poisoning and konzo from cassava. Food Chem Toxicol. 2011;49(3):539-42. DOI: https://doi.org/10.1016/j.fct.2010.04.049

WorldBank. The World Bank in DRC [Available from: https://www.worldbank.org/en/country/drc].

Holman D, Lynch R, Reeves A. How do health behaviour interventions take account of social context? A literature trend and co-citation analysis. Health (London). 2018;22(4):389-410. DOI: https://doi.org/10.1177/1363459317695630

Jagnoor J, Sharma P, Parveen S, Cox KL, Kallakuri S. Knowledge is not enough: barriers and facilitators for reducing road traffic injuries amongst Indian adolescents, a qualitative study. International Journal of Adolescence and Youth. 2020;25(1):787-99. DOI: https://doi.org/10.1080/02673843.2020.1746675

Corace K, Garber G. When knowledge is not enough: Changing behavior to change vaccination results. Human Vaccines & Immunotherapeutics. 2014;10(9):2623-4. DOI: https://doi.org/10.4161/21645515.2014.970076

Kodish S, Grey K, Matean M, Palaniappan U, Gomez C, Timeon E, et al. Improving Knowledge Is Not Enough: Multi-level Determinants of Maternal, Infant, and Young Child Nutrition Identified Through Formative Research in the Republic of Kiribati (P10-037-19). Current Developments in Nutrition. 2019;3(Supplement_1). DOI: https://doi.org/10.1093/cdn/nzz034.P10-037-19

Michie S, van Stralen MM, West R. The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science. 2011;6(1):42. DOI: https://doi.org/10.1186/1748-5908-6-42

Kelly MP, Barker M. Why is changing health-related behaviour so difficult? Public Health. 2016;136:109-16. DOI: https://doi.org/10.1016/j.puhe.2016.03.030

Downloads

Published

28-04-2023

How to Cite

Bokundabi, G., Haskins, L., Horwood, C., Kuwa, C., Mutombo , P. B., John, V. M., Mapatano, M. A., & Banea, J.-P. (2023). When knowledge is not enough: barriers to recommended cassava processing in resource-constrained Kwango, Democratic Republic of Congo. Journal of Public Health in Africa, 14(5). https://doi.org/10.4081/jphia.2023.2052

Issue

Section

Original Articles