More inclusive methods in community nutrition

Accepting Paul Farmer's assertion that social justice – not charity, not development – is the key to global health and healing, this presentation offers a simple suite of methods for documenting community-level food beliefs and categorizations. To promote equality and the rights and dignity of low-income groups, health interventions must recognize and utilize their specialized local knowledge. Drawing on established cognitive anthropology techniques and over nine-months of field research with food insecure households within two rural Malay kampungs [villages] in Malaysian Borneo, the author will discuss the use of (1) free-listing to elicit relevant local food items, (2) pile-sorting to establish salient categorizations, and (3) image-based result presentations that encourage community participation and discussion. Specific results will be reviewed in the context of clinic-level nutritional interventions and the Malaysian national food assistance program for children (Program Pemulihan Kanak-Kanak Kekurangan Zan Makanan, PPKZM) with the larger goal of demonstrating the utility of this methodology for limited literacy and non-English speaking populations in resource-constrained settings. Overall, free-listing and pile-sorting in combination with photographic elicitation are an efficient means of accessing local understandings and tailoring health education and programming to fit community needs, thus overcoming what Whiteford and Manderson have termed the “fallacy of the level playing field.”