Caregivers’ Knowledge and Use of Fermented Foods for Infant and Young Children Feeding in a Rural Community of Odi, Gauteng Province, South Africa

Health Promotion Perspectives, 2014, 4(1), 54-60 doi: 10.5681/hpp.2014.007 http://journals.tbzmed.ac.ir/HPP Caregivers’ Knowledge and Use of Fermented Foods for Infant and Young Children Feeding in a Rural Community of Odi, Gauteng Province, South Africa *Paul K Chelule1, Mathildah M Mokgatle1, Lindiwe I Zungu2, Armelia Chaponda2 1 School of Public Health, University of Limpopo (Medunsa Campus), South Africa 2Department of Health Studies, University of South Africa, South Africa ARTICLE INFO Article type: Original Article Article history: Received: Dec 07 2013 Accepted: Feb 24 2014 e-published: July 12 2014 Keywords: Nutritional quality, Lactic acid bacteria, Health benefits, Traditional foods, Probiotics, Fermentation *Corresponding Author: Paul K Chelule Tel: +27 12 521 3330; e-mail: ABSTRACT Background: Fermented foods have positive health effects in adults and children if consumed regularly. However, lack of knowledge and perceptions towards fermented foods may limit their usage. This study aimed to assess the caregivers’ awareness and usage of fermented foods for feeding children in periurban/rural communities of Gauteng Province. Methods: A qualitative exploratory study was conducted in June, 2012, in a peri-urban/rural community to assess the awareness and use of fermented foods by child caregivers attending a local antenatal clinic through focus group discussions. Results: Thirty three caregivers participated in the study; however 29 indicated their demographic profiles. Four major themes that emerged from the analysis included knowledge on fermented foods, perceived benefits of fermentation, varied views about fermentation and feeding practices. Fermented foods that caregivers, their families and community members consume include ting, fat cakes, dumplings, sorghum beer and mageu. Findings also showed that children consumed fermented foods in form of soft ting porridge; and yoghurt, marketed as Activia and Danone commercial brands. Also, caregivers were not comfortable feeding their children with fermented foods, indicating their limited knowledge on the nutritional value of these foods. Conclusion: It is critical to promote caregivers’ knowledge and use of fermented foods for feeding infants and young children in South African rural communities. Citation: Chelule PK, Mokgatle MM, Zungu LI, Chaponda A. Caregivers’ Knowledge and Use of Fermented Foods for Infant and Young Children Feeding in a Rural Community of Odi, Gauteng Province, South Africa. Health Promot Perspect 2014; 4(1): 54-60. Introduction Foods that have been matured using probiotic microorganisms are termed fermented foods. Consumption of indigenous fermented foods dates back to pre-historic times in many indigenous countries of the world.1 Consequently, since 1960, manufacture and use of probiotics has increased significantly. In addition to improving the nutritional quality of foods, food fermentation 54 increases probiotic bacteria, such as lactic acid bacteria (LAB), in food.2,3 Probiotic fermented foods have been demonstrated to reduce childhood diseases such as diarrhea and malnutrition.4-6 For example, in clinical randomized trials (RCTs) performed in childcare centers, children fed with probiotic fermented milk had fewer and shorter episodes of diarrhea than those in the control Health Promotion Perspectives, Vol. 4, No. 1, 2014; P: 54-60 group.7-9 Similarly, probiotic fermented foods have a protective effect through the prevention of antibiotic associated diarrhea (AAD)10 and prevention of rotavirus shedding in hospitalized infants.11,12 It has also been demonstrated that long term consumption of fermented foods with live probiotic bacteria is not only safe and well tolerated by infants and young children, but leads to adequate child growth and development.13 These findings suggest that probiotic fermented foods may routinely be used for infant and children feeding. In South Africa, a number of fermented foods are available commercially while several of them are home-made. These include yoghurt, amasi, mageu and ting, for example.14 In some South African ethnic groups such as the Batswana and Tsonga, some of these fermented foods form part of their staple diet.15 However, traditional preparation of these foods is largely uncontrolled (no starter cultures used) and no laid down guidelines are available. Furthermore, when people move to the urban areas they often give up traditional foods and adopt more westernized diets. Thus, as a word of mouth is passed down the generations, misconceptions on fermented food preparation may arise. This leads to variation in quality and stability of these food products. Though they are easily available, these foods are seldom used to feed infants and young children. There is lack of researched reports on the reason why this is so. It is postulated that some of the major obstacles to consumption these important dietary foods is lack of knowledge on their preparation, usage16,17 and nutritional value.1,2 This was a baseline study, designed to gather general community knowledge on their understanding of use and nutritional value of fermented foods in a rural community in Gauteng, in South Africa. The aim was to assess the awareness and use of fermented foods by child caregivers in the feeding of infants/young children in periurban/rural communities of Gauteng Province. The project also sought to find out the communities’ awareness of the benefits de- rived from feeding their children with fermented foods. Materials and Methods Study design This study applied a qualitative design and focus group discussions, conducted at Odi Hospital in Gauteng Province. The participants were child caregivers, attending the antenatal clinic at Odi Hospital. They could be single parents (father or mother), foster parents or those entrusted with the task for one reason or the other, legally. The study was approved by Medical Research and Ethics Committee at the University of Limpopo. Permission was also sought from the clinic manager. Data was collected between January and May 2012. Data collection Focus group discussions were conducted with the child caregivers using a focus group discussion guide. As most clinic attendees were Setswana speaking, the guide was developed in English and translated into Setswana. Recruitment was done on the day that the caregivers were attending the antenatal care clinic. Caregivers were approached in the morning as they waited to be attended to by the healthcare workers. The caregivers interested in participating, and met the study criteria, were informed about the study. They were then requested to give a signed informed consent. The FGDs were conducted in Setswana. With the permission of the participants, digital audio recorders were used to capture all focus group discussions, which lasted about 45-60 minutes. A total of 3 FDG were conducted in this study with an average of 10 caregivers per FGD. Caregivers’ demographic da (...truncated)