An actor-oriented approach to understanding food environments, maternal knowledge and decision-making: enhancing child nutrition among (agro-)pastoral communities in Kenya's drylands

Child malnutrition remains a significant global health challenge, particularly in Sub-Saharan Africa. In Kenya’s drylands, seasonal acute malnutrition among children under five persists due to challenges such as recurrent droughts, poor infrastructure, and limited access to food, water, and healthcare. Despite numerous interventions, most organisations adopt a top-down approach that does not take context-specific challenges into account. Therefore, this thesis aims to examine (agro-)pastoral mothers' knowledge, perspectives on their food environment, child-food decision-making, and caregiving actions concerning child nutrition in Marsabit County through an actor-oriented approach. This was integrated in a transdisciplinary research project that took place in Saku, home to Borana agro-pastoralists and Burji crop farmers, and Laisamis, inhabited by Rendille pastoralists. Over 20 months of field work, we engaged nine women’s groups using mixed methods and participatory techniques including free listing, pile sorting, ranking, food frequency questionnaire, focus group discussions, and an activity knowledge analysis tool. We conducted a content analysis on the qualitative data in MAXQDA, and descriptive and correlation analysis using Excel, R and STATA. Findings show how mothers’ personal food environments, defined by accessibility, affordability, convenience, healthiness, and child acceptance, influence their child-feeding decisions and practices. These factors are interdependent, with accessibility emerging as the most influential. Contextual differences between locations shaped by climatic, ecological, socio-economic, cultural, and infrastructural conditions led to variations in children’s dietary intake. Despite facing challenges, mothers demonstrated strong caregiving agency through routine and problem-solving actions related to feeding, hygiene and child development. Their agency, is however, constrained by contextual factors, e.g. time limitations, lack of support, and poverty. This research highlights the value of actor-oriented, participatory approaches in understanding maternal agency in child nutrition. It emphasizes the need for context-specific, community-driven interventions that build on local knowledge, and strengthens maternal agency.