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

Objective: To assess the appropriateness and understanding of the revised, draft South African Paediatric Food-Based Dietary (SA-PFBDGs) among mothers/caregivers of children between the ages of 3 and 5 years. Exposure to similar messages, barriers and enablers were also assessed. Design: A qualitative, descriptive, cross-sectional study design was followed. Participants were purposively recruited to participate in 9 focus-group discussions (FGDs) conducted in isiXhosa, English and Afrikaans totalling 55 participants. Setting: Formal and informal urban communities along the West Coast, in the Northern Metropole, City of Cape Town, Western Cape, South Africa. Subjects: Mothers/caregivers older than 18 years who provided informed consent. Results: The majority of the participants mentioned previous exposure to messages similar to the revised, draft SA-PFBDGs mainly from healthcare workers, health facilities and the media. Cultural differences and taste preferences contributed to poor following of healthy eating guidelines, specifically regarding lean meats and chicken, dry beans, split peas, lentils and soya, salt, fat and sugar. With regard to dietary variety and fresh fruit and vegetables, availability and financial barriers existed. Understanding nutritional needs of children, supportive communities and education were strong enabling factors for following of the revised, draft SA-PFBDGs. Conclusion: Overall, the guidelines were familiar and understood. However, the comprehension of some guidelines must be clarified further, specifically those pertaining to sugar, salt and fat. The design of appropriate educational materials for the revised draft SA-PFBDGs, complementing national actions, could help to minimise inconsistent messages on young-child nutrition and create a supportive environment for improved nutritional health.