Browsing by Author "Luthuli, Silondile"

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    An exploration of pregnant women and mothers’ attitudes, perceptions and experiences of formula feeding and formula marketing, and the factors that infuence decision-making about infant feeding in South Africa
    (BMC, 2022) Horwood, Christian; Luthuli, Silondile; Pereira‑Kotze, Catherine
    Background: Despite strong evidence showing the lifelong benefts of breastfeeding for mothers and children, global breastfeeding practices remain poor. The International Code of Marketing of Breastmilk Substitutes is an inter‑ nationally agreed code of practice, adopted by the World Health Assembly in 1981, to regulate promotion of commer‑ cial formula, and is supported by legislation in many countries. However, marketing of formula remains widespread and contributes to mother’s decisions to formula feed. We present South African data from a multi-country, mixedmethods study exploring women’s decision-making about infant feeding and how this was infuenced by exposure to formula marketing. Methods: Using a consumer-based marketing approach, focus group discussions (FGDs) were conducted with preg‑ nant women and mothers of children aged between 0 and 18months in two urban sites in South Africa. Participants were purposively selected according to their child’s age, infant feeding practices and socioeconomic status. Ten FGDs were conducted during February 2020 with a total of 69 participants. Thematic analysis was used to analyse the data with NVivo v.12 software. Results: Despite being encouraged by health professionals to breastfeed and intending to do so, many mothers chose to give formula in the early weeks and months of their child’s life. Mothers reported breastfeeding challenges as the most frequent reason for initiating infant formula, stating that family members and health professionals recom‑ mended formula to solve these challenges. Although participants described few advertisements for infant formula, advertisements for ‘growing-up’ formulas for older children were widespread and promoted brand recognition. Moth‑ ers experienced other marketing approaches including attractive packaging and shop displays of infant formula, and obtained information from social media and online mothers’ groups, which influenced their choice of formula brand.
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    Women’s experiences of communication and supportive care during labour: a qualitative study in rural KwaZulu-Natal, South Africa
    (BioMed Central Ltd, 2025) Doherty, Tanya; Luthuli, Silondile; Horwood, Christiane
    Background: Quality maternal care is crucial to improve outcomes for both mothers and newborns. Many initiatives to improve maternal care concentrate on improving clinical practice. However, women’s experiences of care are also important determinants of health outcomes. Establishing strong interpersonal relationships between health workers and women is essential for delivering high-quality person-centered care, with health workers who empathize with women, respect their needs and concerns, and communicate effectively. Aligned with the World Health Organization standards of care framework, this study aimed to explore women’s experiences of care during labour and childbirth, focusing on communication, respectful, and supportive care. Methods: A qualitative exploratory study was conducted with postpartum women in rural district hospitals in KwaZulu-Natal. Purposive sampling was used to recruit women from communities within the hospitals’ catchment areas. Data were collected through focus group discussions (FGDs) conducted in the local language of participants. Five FGDs were conducted between January and April 2023. Inductive thematic analysis using NVivo v12 was employed to analyze the data. Findings: A few women described positive experiences of care, but most women reported suboptimal care characterized by poor communication, lack of privacy, and disrespectful treatment. Participants described experiences of verbal and physical abuse, being called demeaning names, facing invasive procedures without providing consent, and inadequate emotional support, such as their concerns being systematically ignored and birth companions being denied entry to labour wards. Some women responded to these challenges through various coping mechanisms including staying quiet to avoid confrontation, following instructions rigidly, seeking advice from other women in the labour ward, and in some cases standing up for themselves. Some women described persistent anger and distress as a result of their experiences. Conclusion: The findings of the study highlight persistent gaps in effective communication and supportive care for women during labour and childbirth. Possible interventions could be aimed at improving communication skills of health workers as well as fostering a culture of empathy and respect for women in their care. In addition, empowering women through antenatal education and implementing birth companion policies could further improve women’s experiences during labour and childbirth.