Development of community-based, cultural-specific infant and young child feeding education material in rural Eastern Cape Province, South Africa: a study protocol

Background: Undernutrition, including stunting, continues to impact child health globally. Stunting remains persistent in low and middle-income countries, including South Africa. The Eastern Cape Province has a high stunting prevalence. Contributing factors include poor infant and young child feeding, lack of infant and young child feeding knowledge, and detrimental cultural-specific practices. Understanding specific barriers preventing improved infant and young child feeding is important to ensure the United Nations’ sustainable development goals are met by 2023. The Health Belief Model contributes to developing effective, cultural-specific nutrition education, resulting in positive behaviour change. Applying design thinking while developing education material encourages engagement with local stakeholders/communities to deliver cultural-specific content. This paper outlines the protocol designed to develop material for a community-based, cultural-specific infant and young child feeding education for mothers/caregivers living in rural areas of the Eastern Cape Province, South Africa. Methods The study will be conducted in three phases. Phase 1 will use qualitative and quantitative secondary data to conduct a situational analysis of socio-demographic factors, anthropometric profiles, and feeding practices of infants and young children (0–24 months). In Phase 2, a knowledge, practices, and perceptions questionnaire will be developed to quantify infant and young child feeding knowledge, practices and perceptions and to measure the impact of the intervention. Published literature, focus group discussions, and expert opinion will be used. Phase 3 will use the Health Belief Model to develop a conceptual framework, with design thinking constructs as a method to develop the content of the infant and young child feeding education material. Discussion This study will provide a detailed analysis of the situation in the community, develop a questionnaire to quantify the effect of knowledge, practices and perceptions on nutrition, and ultimately provide cultural-specific infant and young child feeding education material. It is anticipated that, when implemented, this approach will positively improve maternal/caregiver knowledge, practices and perceptions, provide valuable information on the impact of culture, and ultimately result in improved child growth and diet.