Food For Thought: Reflections on Positionality in Global Health Research

^{The research team from left to right: Alison Kabanda (AAPH), Lexi Farina (HSPH), Dr. Elizabeth George (AAPH), and Dr. Kevin Kashamba (AAPH).}

By Lexi Farina
Rose Service Learning Fellow
MPH Candidate, Nutrition

Think back to your secondary or middle school days. Did you count down the minutes until the bell would ring to signal lunch time? What did you eat for lunch? Was it something you purchased at school or packed from home?  How did it taste?

Many of us have both fond and unfavorable memories of our school lunches. But no matter the taste, these meals were essential to fuel our bodies and minds to facilitate our learning. School lunches vary widely around the world, reflecting different cultural contexts. When examining school food environments or any setting different from our own, it’s important to recognize how our own background and experiences can shape our perspectives. This concept is known as positionality—the way our personal background, experiences, and social identity, such as nationality, culture, and socioeconomic status, influence how we see and interpret information.

This summer I set out to explore the school food environment for adolescents in Dar es Salaam, Tanzania. My project involved using qualitative methods to explore the role that food vendors play in providing diverse and nutritious food choices for students. What I discovered extended far beyond the contents of a school meal – it taught me valuable lessons about positionality in global health research.

When I started this project, I imagined a setup like what I grew up with in Massachusetts where grilled cheese sandwiches and chicken fingers were served with a side of fruit on plastic trays by school cooks in our cafeteria. What I saw was very different. In Tanzania, the schools I worked with do not have a national school feeding program and many lack cafeterias. Instead, food vendors, who are small-scale entrepreneurs and often parents of the students, sell snacks, drinks, and prepared items such as rice and fried cassava.

This experience challenged my preconceptions and highlighted how my positionality shapes my perspective. My initial assumptions about school lunches reflected my own experiences and expectations. As an outside researcher collaborating with the Tanzania-based research organization, Africa Academy for Public Health (AAPH), I found myself confronting my own subjectivity and embracing the role of a learner, adapting my thinking to support a more objective and culturally sensitive analysis. Recognizing my positionality was essential for refining my research methods and deepening my understanding of the school food environment.

I learned two key lessons from this experience.

First, embrace learning through different forms.

In qualitative research, learning typically happens through speaking directly with participants. However, the data collection activities for my project were conducted in Swahili, a language I do not speak. This was difficult for me as I did not want to miss out on hearing the direct dialogue and interacting with the community. Recognizing this limitation as part of my positionality, I adapted my methods and instead focused on observing my environment and the non-verbal cues of the participants. I was so surprised by how much I learned through the power of observation. I became more attuned to the school setting, including food vendor stations, the smells and tastes of foods, and the body language of participants during research discussions. For example, I observed that most students choose to purchase from vendors who serve fried cassava during snack time compared to other types of foods. This experience taught me that acknowledging my limitations can actually open new pathways for learning and help me to appreciate my surroundings free of judgment or bias.

Second, prioritize and rely on local partnerships.

I had the privilege of partnering with the amazing AAPH research team, who were instrumental to my project. The team already worked closely with the school community and had established trust and strong relationships with its members. The AAPH researchers not only facilitated the data collection activities in Swahili, but also provided insight into cultural and contextual nuances within the conversations which I would have missed otherwise. By embracing my position as a learner and relying on local expertise, I was able to generate more nuanced and relevant insights for the community. For example, the research identified a gap in nutrition knowledge among food vendors. Initially, we considered using adolescents to informally share this knowledge. However, through cultural exploration, we learned that due to age dynamics, food vendors would not be receptive to this approach and would prefer education from a trained professional. Additionally, working with experts in this area allowed me to expand my knowledge of various aspects of adolescent health in connection with school nutrition.

As global health researchers, it is our responsibility to approach each new setting with humility and curiosity, understanding that our perspectives are only one part of a much larger picture. As I reflect on my experience this summer, I am grateful I not only learned what students eat for lunch in Dar es Salaam, but the importance of recognizing and adapting to my own positionality.

While data analysis is still ongoing, the research has revealed three major themes: the knowledge of nutrition among food vendors and adolescents, the factors driving adolescent food choices and vendor offerings, and the challenges and opportunities for leveraging food vendors to improve the school food environment. By understanding these dynamics, the research can propose actionable steps for the school community to promote diverse and nutritious food options for all students. Embracing my positionality allowed me to see beyond my initial assumptions, engage more deeply with the community, and ultimately produce richer and more meaningful findings.