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Objective: To identify strategies present among positive deviant (PD) caregivers of non-stunted children that influence complementary feeding practices and the raising of well-nourished children.
Design: Semi-structured interviews using a positive deviant model.
Setting: Intabazwe Informal Settlement, Harrismith, Free State, South Africa
Participants: A total of 105 child-caregiver pairs were screened and anthropometrical data was collected. From these pairs, 29 were deemed eligible for participation according to the initial screening criteria and 6 NPDs and 6 PDs were selected for qualitative interviews.
Results: Nutritional PD behaviours included consuming ‘flesh foods’ (meat) more often and practising responsive feeding and family eating. Non-nutritional PD behaviours included coping strategies involving health-seeking behaviour, financial strategy and social capital of caregivers. Practices displayed by all caregivers were poor breastfeeding practices and the early introduction of solids. Health care workers were reported to frequently give breastfeeding advice from outdated prevention of mother-to-child transmission policy.
Conclusions: Poor feeding practices highlight the need for continued advocacy and promotion of breastfeeding and complementary feeding in South Africa. Nutritional PD behaviours are key to health promotional messages relayed within the local community in which the research was conducted. The presence of both nutritional and non-nutritional PD behaviours highlights the need for a multi-sectoral response to addressing stunting and imp
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