Field-testing of the revised South African Paediatric Food-Based Dietary Guidelines among mothers/caregivers of children between the ages of 3-5 years in the Northern Metropole, City of Cape Town, Western Cape Province, South Africa

Rohrs, Stephanie (2019-03)

Thesis (MNutr)--Stellenbosch University, 2020.

Thesis

ENGLISH SUMMARY : INTRODUCTION: While child underweight and wasting in South Africa decreased in early 2000, overweight and obesity are on the rise and stunting has not declined significantly and remains a public health problem. South Africa continues to experience economic and urban development, coupled with the nutrition transition, contributing to malnutrition in all its forms, especially among women and children. Recognising the link between dietary practices and many current South African health issues, Food-Based Dietary Guidelines for all South Africans were developed, by following the accepted international protocol. This was later followed by the development of a series of Paediatric Food-Based Dietary Guidelines (SA PFBDGs) for children between the ages of 0-5 years. The aim of this study was to test the appropriateness and understanding of the SA PFBDGs among mothers/caregivers with children between the ages of 3-5 years, residing in the City of Cape Town, Northern Metropole (Atlantis, Witsand, Du Noon and Blouberg areas) of the Western Cape Province. The study also identified barriers and enablers to the implementation of the SA PFBDGs. METHODOLOGY: The qualitative study followed a descriptive, cross-sectional design. Focus group discussions (FGDs) were conducted in English, Afrikaans and isiXhosa with eligible, voluntary participants (n=55). FGDs were audio recorded and transcribed and content analyses were performed on the data. RESULTS: The FGDs revealed detailed, contextually-relevant responses regarding comprehension, acceptability and applicability of the SA PFBDGs in these communities. Study participants had heard of all the guidelines in some form or were to some extent aware of safe, healthy eating habits. Where there was uncertainty, or where some participants claimed not to know about the guidelines or certain food items, fellow participants offered some explanation. Understanding of nutrition among the participants was generally good and they discussed valid concerns within the focus groups, but myths regarding certain foods also existed. Cultural differences and taste preferences, ultimately resulted in poor implementation of their healthy eating knowledge, specifically with the guidelines relating to lean meats and chicken, dry beans, split peas, lentils and soya, salt, fat, and sugar. With regards to dietary variety and fresh fruit and vegetables, obstacles such as availability and financial constraints featured prominently. Understanding nutritional needs of children, supportive communities and education were strong enabling factors supporting the implementation of the SA PFBDGs. CONCLUSION: This study revealed a general understanding and know-how by mothers/caregivers regarding many of the SA PFBDGs across various environments. There is a need however, to further clarify the understanding of some guidelines, with additional focus on those pertaining to sugar, salt and fat. The design of specific community appropriate SA FBDG educational materials, to complement national actions, could be instrumental in minimising inconsistent messages on young child nutrition and creating a supportive environment for improved nutritional health.

AFRIKAANSE OPSOMMING : INLEIDING: Terwyl ondergewig en uittering in kinders in Suid-Afrika vroeg in 2000 afgeneem het, het oorgewig en obesiteit toegeneem en dwerggroei het nog nie betekenisvol afgeneem nie en is nog steeds ‘n openbare gesondheidsprobleem. Suid-Afrika ervaar steeds ekonomiese en stedelike ontwikkeling, tesame met die voedingsoorgang wat bydra tot wanvoeding in al sy vorme, spesifiek in vrouens en kinders. Na erkenning van die verbintenis tussen dieёtpraktyke en die veelvoudige huidige gesondheidsprobleme in Suid Afrika, was voedsel-gebaseerde dieёtriglyne (SA VGD) vir alle Suid-Afrikaners ontwikkel deur die internasionale erkende protokol te volg. Dit was later gevolg deur die ontwikkeling van die pediatriese voedsel-gebaseerde dieёtriglyne (SA PVGD) vir kinders tussen die ouderdomme van 0-5 jaar. Die doel van hierdie studie was om die toepaslikheid en begrip van die SA PVGD onder moeders/versorgers van kinders tussen die ouderdomme van 3-5 jaar, wat woonagtig is in Kaapstad se Noordelike Metropool (Atlantis, Witsand, Du Noon en Blouberg areas) in die Wes-Kaap Provinsie, te toets. Die studie het ook hindernisse en faktore wat die SA PVGD implementering kan beïnvloed, geïdentifiseer. METODES: Hierdie kwalitatiewe studie het ‘n beskrywende, deursnit ontwerp gevolg. Fokusgroepbesprekings (FGB) was gehou in Engels, Afrikaans en isiXhosa deur insluiting van vrywillige, gekose deelnemers (n=55). Oudio-opnames van die FGB is getranskribeer en inhoudsanalise was op die data toegepas. RESULTATE: Die FGBs het gedetaileerde, kontekstueel relevante response ten opsigte van die begrip, aanvaarbaarheid en toepaslikheid van die SA PVGD in hierdie gemeenskappe aan die lig gebring. Studie deelnemers het al van die riglyne in een of ander vorm gehoor of was tot ‘n mate bewus van veilige, gesonde eetgewoontes. Wanneer daar enige onsekerheid was of wanneer enige van die deelnemers beweer het dat hulle nog nooit van ‘n riglyn of sekere voedselitems gehoor het nie, het mede-deelneemers ’n verduideliking aangebied. Die begrip van voeding onder die deelnemers was in die algemeen goed en hulle het geldige bekommernisse bespreek, maar mites oor sekere kosse was ook genoem. Kulturele verskille en smaakvoorkeure het uiteindelik tot swak implementering van hul gesonde voedingkennis, spesifiek vir die riglyne oor maer vleis en hoender, gedroogde bone, sout, vet, suiker en peulgewasse, lensies en soja gelei. Met betrekking tot dieёt verskeidenheid en vars groente en vrugte, was struikelblokke soos beskikbaarheid en finansiёle beperkings prominent genoem. Begrip van kinder-voedingsbehoeftes, ondersteunende gemeenskappe en onderrig was belangrike faktore wat die implementering van die SA PVGD kan ondersteun.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/105643
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