Individual‐level drivers of dietary behaviour in adolescents and women through the reproductive life course in urban Ghana: a photovoice study

International audienceEvidence on the individual‐level drivers of dietary behaviours in deprived urban contextsin Africa is limited. Understanding how to best inform the development and delivery ofinterventions to promote healthy dietary behaviours is needed. As noncommunicablediseases account for over 40% of deaths in Ghana, the country has reached an advancedstage of nutrition transition. The aim of this study was to identify individual‐level factors(biological, demographic, cognitive, practices) influencing dietary behaviours amongadolescent girls and women at different stages of the reproductive life course in urbanGhana with the goal of building evidence to improve targeted interventions. QualitativePhotovoice interviews (n= 64) were conducted in two urban neighbourhoods in Accraand Ho with adolescent girls (13–14 years) and women of reproductive age (15–49years). Data analysis was both theory‐and data‐driven to allow for emerging themes.Thirty‐seven factors, across four domains within the individual‐level, were identified ashaving an influence on dietary behaviours: biological (n= 5), demographic (n=8),cognitions (n=13) and practices (n= 11). Several factors emerged as facilitators orbarriers to healthy eating, with income/wealth (demographic); nutrition knowledge/preferences/risk perception (cognitions);andcookingskills/eatingathome/timeconstraints (practices) emerging most frequently. Pregnancy/lactating status (biological)influenced dietary behaviours mainly through medical advice, awareness and willingnessto eat foods to support foetal/infant growth and development. Many of these factorswere intertwined with the wider food environment, especially concerns about the cost offood and food safety, suggesting that interventions need to account for individual‐level aswell as wider environmental drivers of dietary behaviours