Exploring the Enablers and Barriers to Healthy Eating for Lactating Mothers in Underserved Settings in Ghana

Background: Optimal nutrition for lactating mothers has remained at the top of the health policy agendas of many developing countries because of the consensus that it is an effective channel for achieving positive maternal and child health outcomes. Objectives: This study draws on the socio-ecological theory to explore barriers and enablers of healthy eating among lactating mothers in the Wa West District of Ghana. Previous studies tended to focus on the barriers and merely experimented with the enablers and opportunities for engraining and sustaining healthy eating for lactating mothers in underserved settings. Methods: We employed an exploratory case study design and used convenience sampling procedures to select 30 lactating women and purposive sampling to select 6 midwives and 2 nutrition officers to participate in the study. Semi-structured interview guides and thematic analytical frameworks were used to collect and analyze the data, respectively. Results: Availability of nutritious foods, strong social support from health care personnel, and lactating mothers' awareness of healthy eating practices emerged as the enablers of healthy eating among lactating mothers. The barriers include limited income, seasonal availability of fresh foods, food myths and taboos, and patriarchal practices. Conclusions: These findings have implications for maternal and child nutrition practice and policy in developing settings. An integrated development approach is needed to expand and sustain awareness of the importance of optimal nutrition for maternal and child health, ensure year-round local food production, and implement interventions that aim to remove the barriers to women's dietary decision-making autonomy in the study setting and beyond.