Perception and practice of 'healthy' diet in relation to noncommunicable diseases among the urban and rural people in northern Ethiopia: a community-based qualitative study.

Dietary habits are related to the risks of noncommunicable diseases (NCDs), such as cardiovascular disease and diabetes, of which burdens are increasing in low-income countries including Ethiopia. Although several epidemiological studies of NCD risk factors were conducted in Ethiopia, qualitative studies on people's dietary habit in relation to NCDs have not been conducted yet. This study aims to describe people's perception and practice of 'healthy' diet, and barriers to practice 'healthy' diet, paying attention to the dynamics between the perception and practice. We conducted 16 key informant interviews and eight focus group discussions in an urban and a rural areas in northern Ethiopia between November 2014 and January 2016. Audio-records in local language were transcribed word-for-word, and translated into English. English text data were analyzed qualitatively, through constant comparative analysis following the principles of the grounded theory. Three themes have emerged: (1) dietary habit perceived as 'good' or 'bad' for health; (2) reasons for continuing current 'unhealthy' dietary habit; and (3) current dietary habit perceived as 'traditional.' People's practice was mostly consistent with their perception, while they sometimes practiced contrary to the perception because of personal preference and physical or financial obstacles. People were often indifferent of health implications of their habitual dietary practice, such as drinking a lot of sweet coffee. We showed dynamics between perception and practice of 'healthy' diet among people in northern Ethiopia. It is needed to increase awareness of NCDs both among the urban and rural people and to improve the social environment for removing the obstacles.