Double-duty solutions for optimising maternal and child nutrition in urban South Africa: a qualitative study

Abstract

Objective: To obtain a community perspective on key nutrition-specific problems and solutions for mothers and children. Design: A qualitative study comprising nine focus group discussions (FGD) following a semi-structured interview guide. Setting: The township of Soweto in South Africa with a rising prevalence of double burden of malnutrition. Participants: Men and women aged ≥18 years (n 66). Three FGD held with men, six with women. Results: Despite participants perceived healthy diet to be important, they felt their ability to maintain a healthy diet was limited. Inexpensive, unhealthy food was easier to access in Soweto than healthier alternatives. Factors such as land use, hygiene and low income played a fundamental role in shaping access to foods and decisions about what to eat. Participants suggested four broad areas for change: health sector, social protection, the food system and food environment. Their solutions ranged from improved nutrition education for women at clinic visits, communal vegetable gardens and government provision of food parcels to regulatory measures to improve the healthiness of their food environment. Conclusions: South Africa’s current nutrition policy environment does not adequately address community-level needs that are often linked to structural factors beyond the health sector. Our findings suggest that to successfully address the double burden of malnutrition among women and children, a multifaceted approach is needed combining action on the ground with coherent policies that address upstream factors, including poverty. Further, there is a need for public engagement and integration of community perspectives and priorities in developing and implementing double-duty actions to improve nutrition.

Culture and community perceptions on diet for maternal and child health: a qualitative study in rural northern Ghana

“…This study was part of a larger study called the Improved Nutrition during Preconception, Pregnancy and Post-delivery project (INPreP project). The INPreP project is a National Institute of Health Research (NIHR) sponsored collaborative research project coordinated by the University of Southampton, which seeks to engage with community and relevant stakeholders in optimising nutrition in the 1000 days plus period and to prioritise solutions for Ghana, Burkina Faso and South Africa [11][12][13][14].…”

The roles of men and women in maternal and child nutrition in urban South Africa: A qualitative secondary analysis

“…QSA uses pre-existing data derived from previous studies to investigate new research question without further burdening respondents (Heaton, 2008). We approached QSA as investigators who were interested in a concept that emerged but not fully explored in pursuing the objectives of the primary study (Erzse et al, 2020). The primary study suggested that MCN practices and perceptions of participants followed certain socially entrenched rules of behaviours; this generated new questions about gendered aspects of MCN.…”

A black dog enters the home: hunger and malnutrition in Malawi

“…Women’s productive roles mentioned during this study depict the gender imbalance in the distribution of household chores, including food preparation, which can impact household nutrition security. Many nutrition projects focus on helping children under 5 years and pregnant or lactating women (Desyibelew and Dadi 2019; Erzse et al 2020). However, proverbs such as ‘a man is at the stomach’ suggest that food may be prioritised for men more so than for women or children (Mandala 2005, 224).…”