Graduation Year

2009

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Anthropology

Major Professor

Linda M. Whiteford, Ph.D.

Co-Major Professor

David A. Himmelgreen, Ph.D.

Keywords

Child health, Nutritional programming, Cultural consensus, Biocultural theory, Sarawak, Malaysian Borneo

Abstract

Supplementary feeding continues to be a widespread strategy for child health promotion though its efficacy remains contested. The long-standing, Malaysian national food assistance program for children - Program Pemulihan Kanak-Kanak Kekurangan Zat Makanan (PPKZM) - fits this pattern, receiving severe criticism for its limited impact on child nutritional status. Still, the program remains, producing a seeming paradox and prompting questions of how it fits into (1) the larger political context of national health policy and (2) more localized village and clinic environments. This research combines historical inquiry with the in-depth, ethnographic study of two predominantly Malay coastal villages in Malaysian Borneo, where child anthropometry and household food insecurity rates establish a clear need for the PPKZM despite low coverage rates.

This study assesses the ways in which common, local foods are perceived and categorized and the degree to which these understandings are shared both (1) within the communities and (2) between the communities and the clinics that serve them. Community members do not share a single core set of well-known food items. Instead, multiple microenvironments within the fieldsites likely dictate differential diets and prioritize distinct sets of foods. Agreement is more pronounced among clinic workers, who display a simple food classification system based almost exclusively on taxonomic differences with the rationale for these distinctions expressed in nutritional terms. Although community members recognize the same constitutive kinds, their categories are more nuanced and reflect the concerns of day-to-day practice, encompassing when and how a food item is encountered; its origins, relative expense, and common usage; and who will likely consume it.

The dissertation relates cultural models for food classification to health education messages, PPKZM programming guidelines, community conditions, and food beliefs and practices. It facilitates an understanding of place - as viewed through the lens of food security - and addresses the relative fit of current nutritional programming within this context. The study offers concrete design recommendations for a successful, child-specific food package in the short-term while arguing for a more holistic, household-level solution.

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