Evaluating implementation of the FIGO Nutrition Checklist for preconception and pregnancy within the Bukhali trial in Soweto, South Africa

Abstract

Objective To evaluate implementation of the FIGO Nutrition Checklist in a low/middle‐income South African setting. Methods This is a mixed‐methods study. Following administration of the FIGO Nutrition Checklist by a dietitian between July 2021 and May 2022, quantitative responses from pregnant (n = 96) and nonpregnant (n = 291) participants with overweight or obesity were analyzed, using logistic regression. Qualitative data from in‐depth interviews with the dietitian and a subgroup of participants (n = 15) were analyzed using reflexive thematic analysis. Results Of 387 participants, 97.4% (n = 377) answered ‘no’ to at least one diet quality question on the FIGO Nutrition Checklist, indicative of an at‐risk dietary practice. Food insecurity was positively associated with having more than three at‐risk practices (OR 1.87; 95% CI, 1.10–3.18; P = 0.021). Themes from the dietitian interview included ease of use of the checklist; required adaptations to it, including explanation and translation; and benefits of the tool. Despite challenges to healthy nutrition, participant interviews identified that the checklist is acceptable and supported improved awareness of dietary intakes. Conclusion Considering the high incidence of at‐risk dietary practices identified by the FIGO Nutrition Checklist in this population, further research into use of the tool across South African healthcare settings is warranted.

Diet Quality and Nutritional Risk Based on the FIGO Nutrition Checklist among Greek Pregnant Women: A Cross-Sectional Routine Antenatal Care Study

“…In the present study, nearly all participants exhibited at least one nutritional risk factor, whereas 36% of the sample exhibited five or more nutritional risk factors, as indicated by a total FIGO score < 5. Similar findings have also been noted in South Africa, with 97.4% of the participants (pregnant and non-pregnant women) demonstrating at least one nutritional risk using the FIGO nutrition checklist [43]. Among the most common nutritional risk factors identified herein are the frequent consumption of packaged foods (59.5%), inadequate sun exposure (52%), and the inadequate intake of fruit, vegetables, and fish (43.5%).…”

“You go an extra mile”: a qualitative study of community health worker perspectives in a health promotion intervention in urban South Africa

“…The Bukhali process evaluation has thus far explored trial implementation (32)(33)(34)(35), as well as participants' perceptions and experiences (36-39); however, HHs' perspectives have not been fully explored. The aim of this article is therefore to explore and describe their perspectives and experiences as CHWs of delivering the Bukhali intervention, in the context of living in Soweto.…”

Impact of pregnancy on long‐term health: Advances in postpregnancy care—An opportunity to improve long‐term maternal health

“…This checklist has been validated against a robust dietary assessment tool-the Food Frequency Questionnaire 20 -and has been found easy to use in many settings in Europe, 21,22 India, Hong Kong, and South Africa. 23 The FIGO Nutrition Checklist is now available online via the FIGO website and can be adapted for local dietary practices. 24 M-health accessible from women's smart phones can also be a useful resource for nutrition advice.…”

“…The FIGO Nutrition Checklist has been developed as an easy tool to facilitate these discussions. This checklist has been validated against a robust dietary assessment tool—the Food Frequency Questionnaire 20 —and has been found easy to use in many settings in Europe, 21,22 India, Hong Kong, and South Africa 23 . The FIGO Nutrition Checklist is now available online via the FIGO website and can be adapted for local dietary practices 24 .…”