Knowledge, Attitudes and Practices Study on Offal Consumption among the Somali Population
By Louise Masese Mwirigi and Joseph Waweru
Ms Masese-Mwirigi works as a Nutrition Analyst for the Food and Agriculture Organization of the United Nations (UNFAO) - Food Security and Nutrition Analysis Unit (FSNAU), Somalia. A postgraduate of nutrition, she has over eight years of experience in conducting food security and nutrition assessments in addition to monitoring and evaluation activities, especially in Somalia, Kenya and in the East Africa region. She has worked previously with WFP, Kimetrica International, UNICEF and Feed the Children.
Joseph Waweru is a Nutrition Analyst in FSNAU Unit of the UNFAO in Somalia, where he has worked for the last six years. A post-graduate of nutrition, he has over five years of experience in conducting multi-sectoral assessments, surveillance and analysis mainly in nutrition, food security and livelihoods. He is also the technical focal point on infant and young child feeding.
The co authors would like to express sincere thanks to Grainne Moloney, Chief Technical Advisor at FSNAU, for her technical input and guidance and Sergio Innocente, SJ Muchina Munyua, Wamalwa Kinyanjui (FAO/RRRLP project), Erin McCloskey (UNICEF) and the Nairobi nutrition team, Tom Oguta, Mohamed Borle, Abukar Yusuf and Ahono Busili for review of the article. Thanks also to Nura Gureh, Fuad Hassan, Osman Warsame, Abdullahi Warsame, Khalif Nur and Abdikarim Duale for data collection in the field and to the local authorities for all the logistical support in sanctioning this study.
The livestock sector remains the most important production sector of Somalia, with approximately 3 million animals being exported each year, generating about 40% and 80% of Somalia's gross domestic product (GDP) and foreign currency earnings respectively. It is important to ensure that livestock related infrastructure, such as slaughterhouses and meat and meat related facilities, are of the required standard and quality to reduce the risk of human and animal diseases and to optimise production to benefit households and the overall community. Consequently, through the Rapid Response Rehabilitation of Rural Livelihood's Project (RRRRLP) being implemented by the UN Food and Agriculture Organisation (FAO) Somalia in Somaliland and Puntland, a range of infrastructural interventions that aim to construct and equip slaughter facilities at community level have been undertaken.
The overall aim of the World Bank funded RRRRLP is to mitigate the chronic food crisis in Somalia, by increasing domestic food production and reducing livestock losses for poor rural households. One of the key expected outcomes is the promotion of sale of quality animal byproducts and the consumption of offal as a means of improving community and household incomes and nutrition well being (see Box 1). The consumption of micronutrient rich food is essential, especially in light of findings from the recently conducted micronutrient study in Somalia that identified micronutrient deficiencies among women and children1. This study, conducted by FSNAU and partners in 2009, revealed high levels of iron and vitamin A deficiency in the country, especially among women and children. The overall anaemia and iron deficiency anaemia prevalence among children aged 6-59 months was above 45% in both Somaliland and Puntland. This level exceeds the 40% WHO threshold, classifying anaemia as a high public health priority. The prevalence rates of iron deficiency and anaemia for women of reproductive age (15-49 years) and schoolaged children (6-11 years) were also of public health concern4. Similarly, prevalence of vitamin A deficiency indicated a severe situation with prevalence levels exceeding the 20% WHO cut off for a severe public health problem.
Box 1: The nutritional benefits of offal
Offal can be defined as those parts of an animal which are used as food but which are not skeletal muscle2, including internal organs such as the heart, liver and lungs, all abdominal organs and extremities i.e. feet, and head (including brains and tongue). Offal, especially the liver, kidney and heart, are good sources of protein, fats and micronutrients, with the liver being particularly rich in iron, vitamin A and other micronutrients.
The slaughterhouses in the region have ancillary facilities that ensure that quality and wholesome offal is available to the communities. In order to promote the health and nutrition well being of the population, the community should be encouraged to consume offal meats.
For this to be achieved, an effective communications strategy aimed at promoting consumption of offal, especially by vulnerable groups (women and children), is imperative. The fundamental factor for a successful communication campaign strategy would be to ensure delivery of accurate, acceptable and appropriate messages that are accessible and understandable by the community. It was, therefore, crucial for proponents of the awareness campaign to have a full understanding of the practices, attitudes and level of knowledge the community has in relation to the consumption of offal. It was on this basis that RRRRLP commissioned the Knowledge, Attitudes and Practices (KAP) study that was undertaken by FSNAU.
A woman lures a camel into a newly constructed slaughterhouse in Boroma town
KAP study method
Between 28th May and 6th June 2010, FSNAU and partners conducted a KAP study in relation to offal consumption among the communities in Boroma, Bossaso and Burao towns. The aim of the study was to gain further insight and understanding of the population's common practices, beliefs and level of knowledge with regard to consumption of offal. The findings could then be utilized to inform the design of an appropriate nutrition communication campaign targeting the promotion of offal consumption in the community as a means of combating micronutrient deficiencies.
Focus Group Discussions (FGDs), Key Informant Interviews (KIs) and informal observations were the main data collection techniques used. The respondents were represented by various groups based on gender, age, occupation and socio-economic background ensuring all groups were given a chance to express their views and opinions openly. Analysis involved collating and interpreting all the information collected and analysing it for consistency and commonality of views.
Results
Results indicated that offal consumption is generally acceptable among the Somali population. The main factors affecting offal consumption included availability, cost, cultural beliefs and practices, socio-economic status and known or associated health benefits. The main types of offal consumed were liver, kidney, stomach/intestines, head, heart and bones (bone marrow). These types of offal are culturally acceptable, considered palatable, associated with known benefits to the body and are consumed by people of all ages. Offal is traditionally consumed mainly by women, apart from liver and kidney which are also consumed by men. Offal is generally prepared by first washing it thoroughly and then boiling or frying. The main accompaniments served with offal include bread, rice, canjera or pasta.
Conclusions and recommendations
The general cultural acceptability of offal consumption offers a positive opportunity to initiate the promotion of nutrition education packages that aim at promoting offal consumption for better health and well-being. However, some negative cultural beliefs and socio economic attitudes and lack of adequate supply are factors that limit the optimum consumption of offal in the community, especially by the vulnerable groups. Negative attitudes such as offal meat being considered "food for the poor" or liver not being fed to children under the ages of 2 years, are some of the negative factors affecting consumption of offal.
In spite of these alarming micronutrient deficiency rates reported in 2009, the consumption of locally available and micronutrient rich food groups is low. Promotion of the consumption of readily available local micronutrient rich foods, such as offal, is fundamental and by far the most sustainable strategy in combating the high levels of vitamin A and iron deficiency anaemia in Somalia.
The acceptance and inclusion of offal as part of the daily diet would result in increased income for the various actors along the livestock production and marketing chains and access to cheaper and more affordable animal protein at household level. This development would improve household food and economic security, while having a positive impact on the nutritional and health situation of the community at large.
Advocacy ensuring that the community is made aware of the benefits of offal consumption especially for vulnerable groups is very important and should be considered a priority. The frequent consumption of offal as part of regular meals should be encouraged. This will involve ensuring that the population is made aware of the nutritive and health benefits associated with offal consumption and countering the negative beliefs and social perceptions that see offal as food for the poor. An advocacy strategy should include the training of health workers.
The micronutrient survey highlighted that the consumption of micronutrient rich foods such as fruit, vegetables, eggs and even offal is very low, especially amoungst children under 2 years who are especially vulnerable to high rates of malnutrition. This is therefore a key target group to promote the consumption of offal.
It is also important to educate the community about inhibitors to iron absorption such as tea, and to encourage consumption of vitamin C rich foods to aid iron absorption. Traditionally, although offal is mainly consumed by women, liver and kidney are generally reserved for men and the well off. Women are generally only given liver as a curative measure when diagnosed with anaemia. Women with the support of men and other community members should be encouraged to consume liver and kidneys as well as other offal meat to promote their health. Communication campaigns should emphasis intra household distribution of these offal meats, ensuring that women are able to access a favourable amount of liver and kidney. If prepared and cooked well, offal meat can be very tasty. Proper preparation ensures that the offal tastes good and has a pleasant smell. As part of the communications strategy and awareness creation, handling of offal from slaughter to the table including cooking demonstrations should be conducted to illustrate cooking methods and recipes on how offal is prepared.
Finally, the provision of cold storage facilities to slaughterhouses or traders will help ensure that offal can be available for purchase at all times, and for all, even those without slaughterhouses nearby.
For more information, contact: Louise Masese Mwirigi, P.O. Box 1230- 00621, Nairobi, Kenya. Tel: 254-20-4000000/4000527 or +(254) 733 442929 Fax: 254-20-4000555
e-mail: louise.masese@fao.org or joseph.waweru@fao.org
1National Micronutrient and Anthropometric Nutrition Survey, Somalia 2009, FSNAU, MOHL and Partners
Imported from FEX website