Addressing unmet social needs for improved maternal and child nutrition: Qualitative insights from community-based organisations in urban South Africa

Figures & data

Table 1. Overview of data collection methods.

Methodology	Information collected
Method 1: Semi-structured interviews with 18 employees from 10 CBOs working in Soweto. Interviewer: The first author. Language: English.	The way CBOs determine their priority actions The extent to which CBOs consider social needs and the way they address these Other ways social needs could be addressed
Method 2: Document review of 6 annual reports produced by 6 of the 10 CBOs. Reviewer: The first author. Language: English.	Social needs highlighted Relevance of services in addressing social needs Any evaluation of these interventions Recommendations for further services

Table 2. Participant characteristics.

Participants	CBO	Role at CBO	Gender	No of years working with CBO	Participant lives in area CBO serves
1	CBO1	Service provider	Woman	>4 (4)	Yes
2	CBO1	Service provider	Woman	>4 (4)	Yes
3	CBO1	Service provider	Woman	>4 (4)	Yes
4	CBO1	Service provider	Woman	>4 (4)	Yes
5	CBO2	Executive Director	Woman	>4 (4,5)	No
6	CBO1	Service provider	Woman	>4 (4)	Yes
7	CBO1	Service provider	Woman	<4 (1)	Yes
8	CBO3	Director	Woman	>4 (28)	Yes
9	CBO4	Social worker	Woman	>4 (6)	Yes
10	CBO5	Founder and Director	Woman	>4 (15)	Yes
11	CBO5	Social worker	Woman	<4 (1)	Yes
12	CBO5	Social worker	Woman	<4 (1)	Yes
13	CBO5	Social worker	Woman	<4 (1)	Yes
14	CBO6	Project Manager	Woman	>4 (>5)	Yes
15	CBO7	Founder and Director	Man	>5	Yes
16	CBO8	Project manager	Woman	>5 (6)	Yes
17	CBO9	Volunteer	Woman	>4	Yes
18	CBO10	Social worker	Woman	>5	No

Table 3. CBO characteristics.

CBO	Primary beneficiaries	Primary Focus	Beneficiary enrolment	Ways priority actions are determined	Sustainability
CBO1	Mothers and pregnant women	Empower moms in the first 1000 days, prevent stunting	Open-door and outreach	Skills assessment	Funding: private foundations. Partnership: other CBOs. Reporting: yes. Monitoring and evaluation: yes.
CBO2	Children and adolescents (orphans and vulnerable)	Food insecurity	Open-door and outreach	Needs assessment	Funding: private foundations, government. Partnership: other CBOs, health system. Reporting: yes. Monitoring and evaluation: no.
CBO3	Children and adolescents (orphans and vulnerable)	Early childhood development	Open-door	Needs assessment	Funding: private foundations, government. Partnership: other CBOs. Reporting: yes. Monitoring and evaluation: no.
CBO4	Children and adolescents (orphans and vulnerable)	Childcare and development	Open-door and outreach	Needs, skills, and health assessment	Funding: private foundations. Partnership: other CBOs, health system. Reporting: yes. Monitoring and evaluation: no.
CBO5	Children and adolescents (orphans and vulnerable)	Child nutrition and development	Open-door and outreach	Needs, skills, and health assessment	Funding: private foundations, government. Partnership: other CBOs. Reporting: no. Monitoring and evaluation: no.
CBO6	Children and adolescents (orphans and vulnerable)	Child nutrition and development	Open-door	No data	Funding: private foundations. Partnership: other CBOs. Reporting: no. Monitoring and evaluation: no.
CBO7	Children and adolescents (orphans and vulnerable)	Provide care and support to children	Open-door	No data	Funding: private foundations. Partnership: other CBOs. Reporting: no. Monitoring and evaluation: no.
CBO8	Children and adolescents (orphans and vulnerable)	Keep girl children in schools	Open-door and outreach	Needs and skills assessment	Funding: private foundations. Partnership: other CBOs. Reporting: no. Monitoring and evaluation: no.
CBO9	Children and adolescents (orphans and vulnerable)	Prevent child abuse and neglect	Open-door	Needs and skills assessment	Funding: private foundations, government. Partnership: other CBOs. Reporting: yes. Monitoring and evaluation: yes.
CBO10	Women	Prevent violence against women and children	Open-door and outreach	Needs and skills assessment	Funding: private foundations. Partnership: other CBOs. Reporting: no. Monitoring and evaluation: no.

Table 4. Overview of available CBO services and perceived pathways of impact on six social needs.

CBO services (no. of CBOs providing the service)	Perceived impact pathway	Social need
Resource management (incl. financial literacy) (3/10)	Promoting resourcefulness	Financial planning for nutrition
Fostering entrepreneurship mentality (8/10)	Promoting resourcefulness	Personal income stability
Skills development (e.g., sewing, beading, crafting, baking, planting) (5/10)	Improving mothers’ asset base
Income generating groups (4/10)
Material assistance (e.g., clothing, toiletries) (6/10)	Freeing up personal income
Furniture donation (1/10)	Freeing up personal income	Appropriate and affordable housing
Referral and assistance with government service (8/10)	Improving mothers’ asset base	Access to civic services, welfare, and labour market
Job readiness assistance (e.g., writing CVs, printing documents, interview preparation, job search) (5/10)
Skills assessment and links to jobs (5/10)
Computer access and literacy (4/10)
Child educational support (e.g., afterschool homework) (8/10)	Creating a supportive environment
Day-care (ECD) (3/10)	Freeing up personal income, Creating a supportive environment
Individual psychosocial counselling (7/10)	Creating a supportive environment	Social support Psychosocial
Family counselling (e.g., communication and relationship building) (3/10)
Mental-health referrals (5/10)
Parenting skills and maternal identity (3/10)
Peer support groups (with interpersonal skills) (7/10)		Community cohesion
Recreational youth activities (e.g., poetry, sports, library, camps) (7/10)
Food parcels (4/10)	Freeing up personal income	Affordable healthier foods
Food vouchers (1/10)
Cooked meal provisioning (3/10)
Access to community food garden (6/10)
Parental nutrition and health education (e.g., child growth monitoring) (3/10)	Creating a supportive environment

Table

Social needs	Perceived impact pathway	CBO services	Total	CBO1	CBO2	CBO3	CBO4	CBO5	CBO6	CBO7	CBO8	CBO9	CBO10
Financial planning for nutrition	Promoting resourcefulness	Resource management (incl. financial literacy)	3	1	0	0	0	1	0	0	0	0	1
Personal income stability	Promoting resourcefulness	Fostering entrepreneurship mentality	8	1	1	1	1	1	1	0	0	1	1
	Improving mothers’ asset base	Skills development (e.g., sewing, beading, crafting, baking, planting)	5	0	1	1	1	0	1	0	0	1	0
		Income generating groups	4	0	1	1	1		0	0	0	1	0
	Freeing up personal income	Material assistance (e.g., clothing, toiletries)	6	0	1	1	1	1	0	0	1	1	0
Appropriate and affordable housing	Freeing up personal income	Furniture donation	1	0	0	0	1	0	0	0	0	0	0
Access to welfare, legal, education and labour system	Improving mothers’ asset base	Referral and assistance with government service	8	1	1	0	1	1	1	0	1	1	1
		Job readiness assistance (e.g., writing CVs, printing documents, preparation, job search)	5	1	0	0	1	0	0	1	1	0	1
		Skills assessment and links to jobs	5	1	0	0	1	1	0	0	1	0	1
		Computer access and literacy	4	0	1	1	1	1	0	0	0	0	0
	Creating a supportive environment	Child educational support (e.g., afterschool homework)	8	0	1	1	1	1	1	1	1	1	0
	Freeing up personal income; Creating a supportive environment	Day-care (ECD)	3	0	1	1	0	1	0	0	0	0	0
Social support	Creating a supportive environment	Individual psychosocial counselling	7	0	1	0	1	0	1	1	1	1	1
Psychosocial		Family counselling (e.g., communication and relationship building)	3	0	1	0	0	1	0	0	1	0	0
		Mental-health referrals	5	1	0	0	1	1	0	0	1	1	0
		Parenting skills and maternal identity	3	1	1	0	0	0	0	0	1	0	0
Community cohesion		Peer support groups (with interpersonal skills)	7	1	1	1	0	0	1	0	1	1	1
		Recreational youth activities (e.g., poetry, sports, library, camps)	7	0	1	1	1	1	1	0	1	1	0
Affordable healthier foods	Freeing up personal income	Food parcels	4	0	1	1	0	1	0	0	1	0	0
		Food vouchers	1	0	0	0	0	1	0	0	0	0	0
		Cooked meal provisioning	3	0	1	1	0	0	0	0	1	0	0
		Access to community food garden	6	0	1	1	1	1	0	0	1	1	0
	Creating a supportive environment	Parental nutrition and health education (e.g., child growth monitoring)	3	1	1	0	1	0	0	0	0	0	0
Total services by CBO				9	17	12	15	14	7	3	14	11	7

Notes: 1 indicating that a service was provided and 0 meaning it was not.

Data availability statement

The dataset generated and analysed during the current study is not publicly available due to limitations of ethical approval regarding participant confidentiality but are available from the corresponding author on reasonable request.