Local contextual factors of child stunting found via shared values of stakeholder groups: an exploratory case study in Kaffrine, Senegal

Objective: This work aims to demonstrate an original approach to identify links between locally-situated shared values and contextual factors of stunting. Stunting results from multi-factorial and multi-sectoral determinants, but interventions typically neglect locally-situated lived experiences, which contributes to problematic designs that are not meaningful for those concerned, and/or relatively ineffective. Design: This case study investigates relevant contextual factors in two steps: by first facilitating local stakeholder groups (n=11) to crystallize their shared-values-in-action using a specialised method from sustainability studies (WeValue-InSitu). Secondly, participants (n=44) have focus group discussions about everyday practices around child feeding/food systems, education, and/or family life. Because the first step strongly grounds participants in local shared values, the FGDs can reveal deep links between contextual factors and potential influences on stunting. Setting: Kaffrine, Senegal, an "Action Against Stunting Hub"site. December 2020. Participants: Eleven stakeholder groups of mothers, fathers, grandmothers, pre-school teachers, community health-workers, farmers, market traders, public administrators. Results: Local contextual factors of stunting were identified, including traditional beliefs concerning eating and growing practices; fathers as decision-makers; health worker trust; financial non-autonomy for women; insufficient water for preferred crops; merchants' non-access to quality produce; religious teachings; and social structures affecting children's food environment. Conclusions: Local contextual factors were identified. Pre-knowledge of these could significantly improve effectiveness of intervention designs locally, with possible applicability at other sites. The WeValue-InSitu approach proved efficient and useful for making tangible contextual factors and their potential links to stunting, via a lens of local shared values, showing general promise for intervention research.