Understanding maternal nutrition through the voices of community health workers and mother mentors in Limpopo Province, South Africa

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Introduction: Maternal nutrition is an important factor influencing maternal health and foetal development. Community health workers (CHWs) and mother mentors (MMs) play a critical role in assisting pregnant women, particularly in low-resource rural settings; however, their knowledge on maternal nutrition remains untapped. This study investigated the attitudes and experiences of CHWs and MMs regarding optimal maternal nutrition among pregnant women in Limpopo Province, South Africa. Methods: A qualitative exploratory descriptive design was adopted. Purposive sampling was used to recruit participants. Data were collected through in-depth interviews with 11 MMs and five focus group discussions with 34 CHWs. Data were analysed using Braun and Clarke's thematic analysis framework, supported by NVivo and manual coding. Results: Three themes emerged. The first theme focused on participants' knowledge and beliefs about maternal nutrition, including food types, dietary behaviours, and the significance of nutrition for maternal and foetal health. The second theme identified barriers to adequate maternal nutrition, such as cultural norms and beliefs, socio-economic constraints, limited resources, misconceptions about pregnancy supplements, and trust concerns. The third theme emphasised the roles of CHWs and MMs, including health education, health literacy promotion, and liaison with healthcare services and community support systems. Discussion: The findings demonstrate that maternal nutrition habits are influenced by a complex interaction of social, cultural, and economic factors, as well as individual expertise. These findings also highlighted the importance of context-specific and culturally responsive maternal nutrition interventions. Strengthening the competence of CHWs and MMs through standardised training and increased community engagement may contribute to improved maternal nutrition outcomes in disadvantaged settings.

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