Perceived barriers and enablers for consuming a diverse diet in women residing in resource-poor communities in Cape Town, South Africa: a qualitative study

Abstract

Background: Several studies have shown that South Africans consume a diet low in variety. Objective: To explore the barriers and enablers for consuming a diverse diet in resource-poor communities around Cape Town. Design: A qualitative study design was used. Data were collected from focus-group discussions (FGDs) conducted in Afrikaans, IsiXhosa, and English, using a semi-structured guide. Setting: Twelve community sites in Cape Town, South Africa. Subjects: Study participants were 24 Black and 21 Mixed-ancestry women (n = 45) with a mean age of 49.7 ± 7.8 years. Results: Fourteen FGDs were conducted with an average of three participants per FGD. Six themes were identified from the FGDs, which included nutrition knowledge, perceptions of dietary diversity and its impact on health, individual factors, and social, physical environment, and societal influences on food choices. Perceived barriers to consuming a diverse diet included financial constraints, high food prices, and family taste preferences. Perceived enablers identified were individual taste preferences, access to food stores, community food aid, and food-store specials. Proposed facilitators to achieving a diverse diet included budgeting, income-generation activities, lowering food prices, and increasing community food aid. Conclusions: The findings of this study suggest that financial constraints, high food prices, and social factors limit the ability of women from resource-poor communities to consume a diverse diet and make healthy food choices. Public health interventions aimed at promoting healthier food choices and reducing diet-related diseases should address financial barriers and the cost of food.