A feminist geographic analysis of perceptions of food and health in Ugandan cities

Abstract

This article contributes to a feminist geographic analysis of how urban food and health environments and noncommunicable disease experience may be being constructed, and contested, by healthcare professionals (local elites) in two secondary Ugandan cities (Mbale and Mbarara). I use thematic and group interaction analysis of focus group data to explore material and discursive representations. Findings make explicit how healthcare professionals had a tendency to prescribe highly classed and gendered assumptions of bodies and behaviours in places and in daily practices. The work supports the discomfort some have felt concerning claims of an African nutrition transition, and is relevant to debates regarding double burden malnutrition. I argue that a feministic analysis, and an intersectional appreciation of people in places, is advantageous to food and health-related research and policy-making. Results uncover and deconstruct a dominant patriarchal tendency towards blaming women for obesity. Yet findings also exemplify the co-constructed and malleable nature of knowledge and understandings, and this offers encouragement.

Of fatness, fitness and finesse: experiences and interpretations of non-communicable diseases in urban Uganda

“…These ideas were common in my male interviewees, but a good number of women themselves made such statements. My earlier research with local healthcare professionals revealed similar discussions (Mackay 2019a). In my interviews, I probed such claims by asking about women who stayed at home (so-called urban housewives 9 ).…”

“…Awareness of how unequal and unjust socioeconomic and health systems, together with features of the urban built environment, work as factors contributing to NCD experience, was apparent in many of my individual interviews, and in earlier discussions with local healthcare professionals (Mackay 2019a). Policy or practical intervention strategies to combat growing NCD burden must investigate not only the medical/biological causes, but also the socio-cultural and environmental influences (SDHs).…”

“…. They also devalued care, connection, femininities, social reproduction, feminism, and racialized women (Parker 2016(Parker , p. 1353 My findings also link to conceptualisations of 'provider man' (Wyrod 2008, Miller et al 2011, Mackay 2019a, 2019b. The claims and counter claims surrounding urban dietary and social environments suggest to me both the need for further investigations of gendered and occupationally diverse physical activity patterns and personal food environments.…”

“…Finesse as a verb can mean to: '[s]lyly attempt to avoid blame or censure when dealing with (a situation or problem)' (Lexico 2019). The initial postulation of all respondents when considering causes of rising NCDs in Mbale and Mbarara was always behavioural, tending to deflect responsibility by blaming women (see (Warin 2015) and Mackay (2019aMackay ( , 2019b). Yet my research reveals diverse influences on local interpretations of NCDs that go beyond behavioural choices to include wider social determinants of health (SDH).…”

“…Yet, as soon as the child is old enough most women need to do something to contribute to family survival, as Innocent so clearly describes above. Nailah was also disbelieving of claims of female laziness, greed, or specific consumption practices: Much in accord with Warin's claim that women and mothers are often scapegoated as responsible for their own, and others' obesity (Warin 2015) were these assertions of women's complicity in obesity (see Mackay (2019a)). In response to such suggestionsthat women eat while they are cooking, picking the best bits, or mothers at home eat more in quantity and frequency-Innocent again was incredulous:…”