Exploring mothers' and grandmothers' perceptions of animal-source complementary foods in the diets of young children in The Gambia: A qualitative study [version 2; peer review: 1 approved, 1 approved with reservations]

Background: In The Gambia, many children consume diets that are lacking in nutrients that are essential for their growth and development. This study aims to explore Gambian mothers' and grandmothers' perceptions around animal source foods (meat, eggs, milk etc.) in order to inform future interventions focused on improving child feeding practices.

Methods: In July and August 2023, nine semi – structured focus group discussions were conducted with mothers and grandmothers in two settings in The Gambia. A purposeful sample of participants were recruited with the support of each local Medical Research Council clinic. Data were analysed using the framework method and thematic analysis. Participants included 19 mothers and 12 grandmothers in a semi-rural area and 12 mothers and 12 grandmothers in a rural area, caring for children 6–24 and grandmothers were in separate groups.

Results: Knowledge gaps were identified in both settings regarding aspects of complementary feeding, such as the appropriate timing and methods for introducing animal source foods to children’s diets. Differences were noted in the availability and dissemination of infant and young child feeding information in the two settings, emphasising the crucial role of contextual factors in shaping future programmes. The accessibility and affordability of animal source foods, was found to be a key determinant of their inclusion into children’s diets. A reliance on commercially available complementary foods was common in both settings.

Conclusion: This study reveals disparities between current complementary feeding practices and guidelines in this setting. It also underscores context-specific barriers caregivers encounter in offering diverse complementary foods, including animal source foods. A high reliance on commercially available complementary foods was also uncovered, particularly in Keneba. Further research is recommended to aid the development of context- specific interventions.