The goal of this observational study is to examine how urban slum food environments influence caregivers' feeding practices for children under five years of age in Pune. The main questions it aims to answer are:
* What are the characteristics of the food environment in selected slums of Pune using the 5 A's framework: availability, accessibility, affordability, acceptability, and accommodation? * What are caregivers' perceptions of food safety, food prestige, and convenience as additional drivers of food choice within the slum context? * Are caregivers' aware, and have understanding about the use of packaged food labels, especially in relation to identifying foods for young children? * How do the local food environment and food choice (FEFC) drivers interact to influence caregivers' feeding practices, with a particular focus on the consumption of unhealthy foods and sugar-sweetened beverages among children under five years of age? Participants will be interviewed using digital forms to assess their food environment and food choice drivers. Anthropometric measurements of all children under five years of age in the household will be taken.
Families who had participated in the previous house-to-house survey to determine maternal healthcare utilization and infant and young child feeding practices.
Families where all the female caregivers are willing to participate.
Food vendors who regularly carry out business in the 500 m radius of the household.
Willingness to participate in the study.
1. Families who were a part of the earlier project but have moved out of the survey area.
1. The study population will consist of Infant and young child caregivers living in slums who have a child or children less than five years of age and had enrolled in an earlier study to assess utilization of maternal healthcare services in these slums. 2. Food vendors (stores, mobile informal vendors and hawkers, and restaurants) who function in the 500 m radius of the household.
Family-based
Cross-sectional
Not listed
Percentage food items in each of the 28 food groups available in each of the 4 study locations
Food Availability in each study location will be assessed as the percentage food items available for purchase in each of the 28 food groups. The Food Outlet Census (https://sites.rutgers.edu/food-environment-toolbox/community-food-environment-mapping-food-outlet-census/) tool is being used to collect data on the foods available but the tool does not have any specific scoring criteria.
Percentage of families in each study location who can afford to buy a healthy diet
Food Affordability of families will be assessed as the percentage of families who can afford a healthy diet. For this purpose then investigators will calculate Cost of a Healthy Diet (CoHD) using the tool available from Tufts University: https://sites.tufts.edu/foodpricesfornutrition/tools/. Per capita income of each household will also be calculated. These two parameters will help the investigators calculate the percentage of families in each location who can afford a healthy diet.
Percentage of food items considered convenient by households in each location
Convenience will be assessed as percentage of food items in each of the 28 food groups which participants consider convenient because their ease of storage, low perishability, ease of preparation.
Gender and Family Role of the primary food-related decision maker
The gender and family role of primary food-related decision maker will be assessed as percentages and illustrated using pie-charts
Number and types of food outlets in the study location
The number and types (grocery, wholesaler, specialty stores, etc) in the study location will be calculated and presented.
Type of foods being promoted in the study locations
The type of foods being promoted by roadside promotions in the study locations will be calculated.
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