Cultural Authority and Food Choices: How Intergenerational Power Shapes Maternal Diet in Rural South Africa.
5 affiliations
- 1UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland.
- 2Department of Nursing Science, University of Limpopo, Mankweng 0727, South Africa.
- 3Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
- 4Department of Public Health and Health Systems, University of Limpopo, Mankweng 0727, South Africa.
- 5UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.
Abstract
Background
Maternal malnutrition remains a persistent public health challenge in South Africa, affecting both maternal and child health outcomes. Dietary practices during pregnancy and lactation are shaped by complex social dynamics that extend beyond individual choice.Objectives
This study explored maternal dietary practices during pregnancy, defined as the foods women reported consuming, avoiding, substituting, or concealing, and examined how cultural norms and intergenerational power relations influenced these practices within the context of routine antenatal nutrition counseling.Methods
We conducted a qualitative study in Capricorn district of Limpopo province (March-October 2025). Data comprised focus group discussions (n = 22) and individual interviews (n = 13) with 150 participants including pregnant women, grandmothers, fathers, community leaders, community health workers, mother mentors (lay peer counselors attached to clinics who support pregnant women and new mothers), and healthcare providers. Data were analyzed using reflexive thematic analysis. Interpretation drew on the Social Ecological Model and Bourdieu's Theory of Practice.Results
Four interconnected themes explained dietary behavior. First, elder women, especially grandmothers and mothers-in-law, held decisive authority based on experiential knowledge framed as care, which often was accepted over healthcare advice. Second, pregnant women balanced competing guidance, using respectful deference in public and selective adherence in private. Third, poverty, distance, and poor infrastructure made clinical advice largely unattainable. Fourth, digital messaging and peer networks provided supplementary information that supported dialog but did not displace elder authority.Conclusions
Reported maternal dietary practice is shaped by intergenerational power dynamics and by resource constraints rather than by nutritional knowledge alone. Grandmothers enforce cultural dietary restrictions that conflict with clinical guidance, whereas pregnant women use public deference and private adaptation to navigate competing advice. Nutrition interventions must engage elders as partners and employ culturally respectful harm-reduction strategies.
Related
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BibTeX
@article{aivalli2026cultural,
title = {{Cultural Authority and Food Choices: How Intergenerational Power Shapes Maternal Diet in Rural South Africa.}},
author = {Praveenkumar Aivalli and Livhuwani Muthelo and Mxolisi Welcome Ngwenya and Frank Adusei-Mensah and Mabitsela Hezekiel Mphasha and Samuel Akinseinde and Joke-Folu Badejo and Fionnuala M McAuliffe and Catherine M Phillips},
journal = {Current developments in nutrition},
year = {2026},
month = sep,
doi = {10.1016/j.cdnut.2026.109542},
url = {https://europepmc.org/article/MED/42908575},
note = {CC BY},
}
RIS
TY - JOUR
TI - Cultural Authority and Food Choices: How Intergenerational Power Shapes Maternal Diet in Rural South Africa.
AU - Praveenkumar Aivalli
AU - Livhuwani Muthelo
AU - Mxolisi Welcome Ngwenya
AU - Frank Adusei-Mensah
AU - Mabitsela Hezekiel Mphasha
AU - Samuel Akinseinde
AU - Joke-Folu Badejo
AU - Fionnuala M McAuliffe
AU - Catherine M Phillips
PY - 2026
DA - 2026/09/28
JO - Current developments in nutrition
DO - 10.1016/j.cdnut.2026.109542
UR - https://europepmc.org/article/MED/42908575
AB - Background Maternal malnutrition remains a persistent public health challenge in South Africa, affecting both maternal and child health outcomes. Dietary practices during pregnancy and lactation are shaped by complex social dynamics that extend beyond individual choice.Objectives This study explored maternal dietary practices during pregnancy, defined as the foods women reported consuming, avoiding, substituting, or concealing, and examined how cultural norms and intergenerational power relations influenced these practices within the context of routine antenatal nutrition counseling.Methods We conducted a qualitative study in Capricorn district of Limpopo province (March-October 2025). Data comprised focus group discussions (n = 22) and individual interviews (n = 13) with 150 participants including pregnant women, grandmothers, fathers, community leaders, community health workers, mother mentors (lay peer counselors attached to clinics who support pregnant women and new mothers), and healthcare providers. Data were analyzed using reflexive thematic analysis. Interpretation drew on the Social Ecological Model and Bourdieu's Theory of Practice.Results Four interconnected themes explained dietary behavior. First, elder women, especially grandmothers and mothers-in-law, held decisive authority based on experiential knowledge framed as care, which often was accepted over healthcare advice. Second, pregnant women balanced competing guidance, using respectful deference in public and selective adherence in private. Third, poverty, distance, and poor infrastructure made clinical advice largely unattainable. Fourth, digital messaging and peer networks provided supplementary information that supported dialog but did not displace elder authority.Conclusions Reported maternal dietary practice is shaped by intergenerational power dynamics and by resource constraints rather than by nutritional knowledge alone. Grandmothers enforce cultural dietary restrictions that conflict with clinical guidance, whereas pregnant women use public deference and private adaptation to navigate competing advice. Nutrition interventions must engage elders as partners and employ culturally respectful harm-reduction strategies.
SN - 2475-2991
ER -