When knowledge is not enough: barriers to recommended cassava processing in resource-constrained Kwango, Democratic Republic of Congo
Accepted: 3 July 2022
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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.
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
Supporting AgenciesThis work was supported with funding from the Norwegian Agency for Development Cooperation through the Norwegian Programme for Capacity Development in Higher Education and Research for Development (NORHED) under the GROWNUT project. The funder had no role in the design, analysis or reporting of the results for this article.
Copyright (c) 2023 the Authors
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.