A Community‐Based Intervention Improves Economic, Social and Food Security Outcomes of Refugee Women‐The Healthy Kitchens Experience
Authors: Ghattas Hala , Jamaluddine Zeina , Choufani Jowel , Btaiche Rachel , Reese‐Masterson Amelia , Sahyoun Nadine R 
Published: November 2023

Palestinian refugees living in Lebanon are protracted refugees facing poverty and exclusion. Food insecurity (FI) in this population has been shown to threaten dietary diversity, physical, mental and social health. Female‐headed households are particularly at risk of FI and women in this population experience high rates of unemployment.

We established two healthy kitchens in existing community‐based organizations in Palestinian camps. These were set up as small business enterprises, using participatory approaches to develop recipes and train women in food preparation, food safety and entrepreneurship. They employed 32 women on a rotating basis to provide daily healthy meals to children attending local primary schools. We used mixed‐methods to assess the effect of participating in the healthy kitchens program on women's economic, social and food security outcomes. A questionnaire was administered to women at baseline and at a 9 month endline, which included socio‐economic, demographic, food security, health, social support (Duke Social Support Index) and empowerment modules. At endline, this was complemented by a set of embedded open‐ended questions. STATA 13 was used to analyze quantitative data with non‐parametric methods. Textual responses were transcribed and translated and analyzed using NVivo 10.

Women's median household expenditure was 818 USD per month (169 USD per capita) and 18/32 women were food insecure at baseline. Additional income due to the intervention was equivalent to 110 USD per month. This translated into a significant increase in total household and food expenditures (p=0.001), as well as a reduction in food insecurity (p<0.01) and food‐related coping strategies (p<0.01). Mental health gains were observed, but were greater amongst women who were food secure at baseline. Improvements in social support were also found between baseline and endline and were significant in women with poor mental health at baseline. These findings were supported by qualitative data which found that in addition to the economic advantages and contributions of women to the household, improvements in morale and confidence were reported. Additionally, the kitchens provided a space for women to form social bonds, discuss personal issues and share experiences regarding household management.

This study provides evidence of the potential of the healthy kitchens model, to improve economic, food security and social outcomes of women living in a marginalized low‐income community. The model created a social enterprise using the concept of community kitchens linked to schools and allowed women to significantly contribute to household expenditure and improve their food security. The availability of schools as a constant market for these social enterprises offers an opportunity for sustainable livelihood generation, and food security gains.

Support or Funding Information

This research was funded by The Nestlé Foundation for the Study of Problems of Nutrition in the World