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

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

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.

Double burden of malnutrition, Double-duty actions, Maternal and child health, South Africa, Upstream determinants of health
1368-9800
Erzse, Agnes
b47d7911-b2e0-4728-a0b7-2680ee254c69
Goldstein, Susan
436a0ca6-4d5f-458e-8851-427a9541a399
Norris, Shane A.
1d346f1b-6d5f-4bca-ac87-7589851b75a4
Watson, Daniella
26005c9f-779f-407b-b7e4-b7c9b812b6be
Kehoe, Sarah
534e5729-632b-4b4f-8401-164d8c20aa26
Barker, Mary
374310ad-d308-44af-b6da-515bf5d2d6d2
Cohen, Emmanuel
54d61496-8c90-47b4-a8ef-3671bc5fb02f
Hofman, Karen J.
c4f9b7ec-6446-4eae-9af1-36af699f7d47
INPreP group
Erzse, Agnes
b47d7911-b2e0-4728-a0b7-2680ee254c69
Goldstein, Susan
436a0ca6-4d5f-458e-8851-427a9541a399
Norris, Shane A.
1d346f1b-6d5f-4bca-ac87-7589851b75a4
Watson, Daniella
26005c9f-779f-407b-b7e4-b7c9b812b6be
Kehoe, Sarah
534e5729-632b-4b4f-8401-164d8c20aa26
Barker, Mary
374310ad-d308-44af-b6da-515bf5d2d6d2
Cohen, Emmanuel
54d61496-8c90-47b4-a8ef-3671bc5fb02f
Hofman, Karen J.
c4f9b7ec-6446-4eae-9af1-36af699f7d47

Erzse, Agnes, Goldstein, Susan, Norris, Shane A., Watson, Daniella, Kehoe, Sarah, Barker, Mary, Cohen, Emmanuel and Hofman, Karen J. , INPreP group (2020) Double-duty solutions for optimising maternal and child nutrition in urban South Africa: a qualitative study. Public Health Nutrition. (doi:10.1017/S1368980020002426).

Record type: Article

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.

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DD solution in Soweto_14july2020_PHN - Accepted Manuscript
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Accepted/In Press date: 22 June 2020
e-pub ahead of print date: 24 August 2020
Keywords: Double burden of malnutrition, Double-duty actions, Maternal and child health, South Africa, Upstream determinants of health

Identifiers

Local EPrints ID: 443988
URI: http://eprints.soton.ac.uk/id/eprint/443988
ISSN: 1368-9800
PURE UUID: c9111176-40c8-45fb-94e6-0c12bfd35db6
ORCID for Sarah Kehoe: ORCID iD orcid.org/0000-0003-2584-7999
ORCID for Mary Barker: ORCID iD orcid.org/0000-0003-2976-0217

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Date deposited: 18 Sep 2020 16:36
Last modified: 28 Apr 2022 01:46

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Contributors

Author: Agnes Erzse
Author: Susan Goldstein
Author: Shane A. Norris
Author: Daniella Watson
Author: Sarah Kehoe ORCID iD
Author: Mary Barker ORCID iD
Author: Emmanuel Cohen
Author: Karen J. Hofman
Corporate Author: INPreP group

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