Field testing of the revised Paediatric Food-Based Dietary Guidelines among mothers/caregivers of children aged 12–36 months in the Stellenbosch Municipality in the Western Cape province, South Africa

Date
2016-12
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY: Introduction In order to address the poor nutritional and micronutrient status of children in South Africa, strategies promoting appropriate infant and young child feeding (IYCF) practices are fundamental. One such strategy is the development and revision of the South African Paediatric Food-Based Dietary Guidelines (PFBDG) which promote optimal feeding practices for children between the ages of 0–5 years. Before the PFBDGs are adopted and utilised by the Department of Health (DoH) as an educational tool in South Africa, they require thorough testing for adequacy and comprehension among specific groups, particularly mothers and caregivers. Aim The aim of this study was to determine the appropriateness and understanding of the revised PFBDGs among mothers/caregivers of children aged 12–36 months in the Stellenbosch Municipality in the Western Cape province, South Africa. Methodology A descriptive cross-sectional qualitative study was conducted. Data was collected from focus-group discussions (FGD) to assess the overall understanding and interpretation of the PFBDGs and to gain insight into previous exposure and the perceived barriers to and enablers of the implementation of the PFBDGs. Nine FGDs were conducted, ranging from 4–11 participants each. A total of 65 mothers/caregivers participated in the study. Results This study revealed that participants expressed a general understanding and interpretation of the core messages contained in the PFBDGs. The PFBDGs regarding breastfeeding and hand washing were the two guidelines that were the most understood by participants. Misinterpretation and confusion arose regarding certain PFBDGs, namely guidelines three, four, eight and nine, which refer to the importance of protein-rich foods, Vitamin A-rich fruit and vegetables, five small meals, and the inclusion of starchy foods, respectively. This was as a result of unfamiliar terminology ambiguity, and examples not being provided. With regard to previous exposure, the findings from this study suggested that participants were familiar with and recognised the majority of the concepts conveyed by the PFBDGs. The predominant sources of nutrition information, listed by participants from informal areas, were clinics, hospitals and nurses. Those from formal areas reported mainly utilising the Internet and books. Strong themes emerging from discussions around the perceived barriers to the implementation of the PFBDGs included cost and affordability, time constraints, accessibility, as well as marketing, while perceived enablers included education, visual effects, improved marketing techniques, and improved accessibility and availability of food. Conclusion In order for the PFBDGs to be implemented successfully, certain aspects need attention. Only through addressing common barriers and making the necessary adaptations, will the PFBDGs be implemented effectively, and thus have the intended outcome on IYCF practices.
AFRIKAANSE OPSOMMING: Inleiding Om die gehalte van die voeding- en mikronutriëntstatus van kinders in Suid-Afrika aan te spreek, is strategieë vir die bevordering van gepaste baba en jong kind voeding (BJKV) fundamenteel. Een so strategie is die ontwikkeling en hersiening van die Suid-Afrikaanse Pediatriese Voedselgebaseerde Dieet Riglyne (PVDR) wat die optimale voedingspraktyke vir kinders tussen die ouderdomme 0–5 jaar bevorder. Voor die implementering van die PVDR as ’n opvoedkundige middel in Suid-Afrika kan geskied, vereis die gesondheidsdepartement ’n deeglike evaluasie van die riglyne vir toereikendheid en begrip onder spesifieke groepe, veral moeders en versorgers. Doelwit Die doel van die studie was om die toepaslikheid en begrip van die hersiene PVDR onder moeders/versorgers van kinders tussen die ouderdomme 12–36 maande in die Stellenbosch Munisipaliteit in die Wes-Kaap provinsie, Suid-Afrika te bepaal. Metodiek ’n Beskrywende deursnit kwalitatiewe studie is uitgevoer. Data is ingesamel vanaf fokusgroepbesprekings (FGB) om sodoende die algemene begrip en interpretasie van die PVDR te evalueer en insigte te versamel rakende vorige blootstellings en die moontlike hindernisse en bemagtigers tot die implementering van die riglyne. Nege FGBs is gehou met 4–11 deelnemers elk. ’n Totaal van 65 moeders/versorgers het aan die studie deelgeneem. Resultate Die studie het bepaal dat die deelnemers ’n algemene begrip en interpretasie in lyn met die kern boodskappe van die PVDR toon. Die riglyne oor borsvoeding en hande was het die hoogste vlak van begrip geregistreer. Waninterpretasies en verwarring het met riglyne drie, vier, agt en nege voorgekom. Hierdie PVDR dek die belangrikheid van hoë-proteïen kosse, Vitamiene-A ryk vrugte en groente, vyf klein maaltye, en die insluit van styselkosse, onderskeidelik. Die hoofredes hiervoor is die gebruik van onbekende terminologie, dubbelsinnigheid en ’n tekort aan voorbeelde. Rakende vorige blootstelling het die studie bevind dat deelnemers bekend is met, en herkenning toon vir die meerderheid van die konsepte wat in die PVDR vervat is. Die hoofbronne van voedinginligting wat genoem is deur deelnemers uit informele areas, is klinieke, hospitale, en verpleegsters. Deelnemers uit formele areas het die Internet en boeke as hoofbronne genoem. Sterk temas het navore gekom uit die besprekings oor die moontlike hindernisse vir die implementering van die PVDR, insluitend bekostigbaarheid, tydbeperkings, toeganklikheid, en bemarking. Moontlike bemagtigers is geïdentifiseer, naamlik opvoeding, visuele effekte, verbeterde bemarkingstegnieke, asook verbeterde toeganklikheid en beskikbaarheid van voedsel. Gevolgtrekking Ten einde die PVDR suksesvol te implementeer moet sekere aspekte aandag geniet. Slegs deur die algemene hindernisse aan te spreek, en die nodige aanpassings te maak, kan die PVDR suksesvol geïmplementeer word en sodoende die gewenste uitwerking op BJKV hê.
Description
Thesis (MNutr)--Stellenbosch University, 2016.
Keywords
Paediatric Food-Based Dietary Guidelines, Infant and young child feeding, Food-Based Dietary Guidelines, Children -- Nutrition -- South Africa -- Stellenbosch, Children -- Nutrition -- Guidelines, Nutrition counseling, UCTD
Citation