They push their products through me: health professionals' perspectives on and exposure to marketing of commercial milk formula in Cape Town and Johannesburg, South Africa - a qualitative study

Tanya Doherty; Catherine Jane Pereira-Kotze; Silondile Luthuli; Lyn Haskins; Gillian Kingston; Sithembile Dlamini-Nqeketo; Gilbert Tshitaudzi; Chistiane Horwood

doi:10.1136/bmjopen-2021-055872

They push their products through me: health professionals' perspectives on and exposure to marketing of commercial milk formula in Cape Town and Johannesburg, South Africa - a qualitative study

BMJ Open. 2022 Apr 12;12(4):e055872. doi: 10.1136/bmjopen-2021-055872.

Authors

Tanya Doherty^{1

2

3}, Catherine Jane Pereira-Kotze², Silondile Luthuli⁴, Lyn Haskins⁴, Gillian Kingston⁵, Sithembile Dlamini-Nqeketo⁶, Gilbert Tshitaudzi⁷, Chistiane Horwood⁴

Affiliations

¹ Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa tanya.doherty@mrc.ac.za.
² School of Public Health, University of the Western Cape, Bellville, South Africa.
³ Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.
⁴ Centre for Rural Health, University of KwaZulu-Natal, Durban, South Africa.
⁵ King's College London, London, UK.
⁶ World Health Organization South Africa, Pretoria, South Africa.
⁷ UNICEF, Pretoria, South Africa.

Abstract

Objective: To understand the views of public and private sector health professionals on commercial milk formula, to describe their exposure to companies that market commercial milk formula within their workplaces and to describe their awareness of South African (SA) regulations.

Design: A qualitative study consisting of semistructured interviews.

Setting: The study was conducted in Cape Town and Johannesburg, SA.

Participants: Forty health professionals who had regular contact with pregnant or postnatal women were interviewed between February 2020 and February 2021.

Results: Analysis of the interviews revealed six themes. Health professionals in the private sector reported frequent contact with industry representatives with over two-thirds reporting exposure to industry representatives to present products, provide training or sponsor educational activities. Participants held strong opinions regarding the equivalency of breastfeeding to commercial milk formula citing information from industry representatives and product packaging. Health professionals were very knowledgeable on so-called formulas for special medical purposes and these were valued as solutions to infant feeding challenges. Of the 40 health professionals interviewed, less than half (19) had ever heard of the SA regulation related to marketing of breast milk substitutes (R991).

Conclusions: This study demonstrates clearly that health professionals, particularly in the private sector, are exposed to and promote the use of commercial milk formula among SA women. The findings of this study should be used to catalyse policy responses, social movements, consumer and professional association action to strengthen monitoring and enforcement of the Code regulations in order to protect breastfeeding and support the optimal health and well-being of the population.

Keywords: community child health; human resource management; nutrition.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Animals
Breast Feeding
Female
Humans
Infant
Marketing
Milk Substitutes*
Milk*
Pregnancy
South Africa

Grants and funding

001/WHO_/World Health Organization/International