Official websites use. Share sensitive information only on official, secure websites. In the absence of adequate and affordable care, people diagnosed with NCDs seek to manage their symptoms through the adoption of healthy diet. However, in households built on collective eating, dietary change is extremely challenging.
Drawing on participant observation, biographical interviews, and focus groups with women in six households in the Dakar suburb of Pikine, this paper presents a relational analysis of the reception and translation of dietary advice within low-income households. I show that relational approaches open up new intervention and health promotion strategies for the prevention and management of Non-Communicable Diseases outside of the global North. Non-Communicable Diseases, in particular hypertension and diabetes, are increasingly common among people in middle and older age in Senegal Macia et al.
In the low-income, food-insecure households in which I conducted my research, diagnoses of hypertension and diabetes were almost ubiquitous and the majority of older people I spoke to told me that they were taking steps to eat a healthy diet and improve their health. However, making these changes was, in practice, extremely challenging.
The task of nourishing an older person diagnosed with a chronic disease was challenging and, as older people were acutely aware, diabetes and hypertension were not the only manifestation of diet-related debility and disruption present in urban families. The households that I discuss in this paper were affected by multiple forms of malnourishment Branca et al. In this paper, I use a relational approach to examine how chronic disease impacts on and reshapes intra-household bargaining, the process of negotiating equitable food allocation among household members.
Attempts by individuals to enact dietary advice can result in changes to the organisation of the collectivities in which they are embedded. Research participants who sought to change the way that food was sourced, prepared and shared found that they often triggered intense conflict, not only over the material question of what to eat, but over social questions of which family member holds the authority over food preparation and consumption.
