Co-Creating a Digital Maternal Nutrition Intervention in Rural South Africa Using a Design Thinking Framework
1
1 Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
2
2 Department of Nursing Science, University of Limpopo, Mankweng, South Africa
3
3 Department of Public Health and Health Systems, University of Limpopo, Mankweng, South Africa
4
4 UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Dublin, Ireland
5
5 UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
Popul. Med. 2026;8(Supplement Supplement 1):A2312
ABSTRACT
BACKGROUND:
Maternal and child malnutrition remains a major public health challenge in low resource settings, contributing significantly to preventable morbidity and mortality. Although mobile health (mHealth) interventions offer scalable opportunities to improve health literacy and antenatal care, many fail due to limited contextual fit, and weak integration into health systems. This study applied a design thinking, participatory framework to co create a maternal nutrition mHealth solution—the mobile app—for rural communities in Limpopo Province, South Africa.
METHODS:
Embedded within the AMEN project, this study used mixed methods comprising of survey (n= 392) plus sequential participatory rounds with 319 additional stakeholders (April-December, 2025) in the Capricorn District. Overall, 711 stakeholders were consulted, including pregnant women, community health workers, nurses, midwives, dietitians, mentor mothers, farmers, fathers, grandmothers and community leaders. Data collection explored lived-experiences, beliefs, affordability, m-health and health-system barriers.
RESULTS:
Thematic analysis identified five domains informing intervention design: (1) maternal nutrition knowledge and perceived importance; (2) implementation realities within antenatal care workflows; (3) pervasive cultural myths and food taboos; (4) structural inequities including staffing shortages, digital divides, and food insecurity; (5) opportunities for digital support. Stakeholders emphasized the need for offline access, local language options, picture first content, myth busting features, affordability adapted meal guidance, and protocol aligned clinical decision support. These insights informed the development of high fidelity prototype featuring localized dietary guidance, interactive modules, myth correction libraries, and links to community based nutrition initiatives such as household gardens.
CONCLUSIONS:
The participatory design thinking approach improved cultural relevance, usability, and perceived feasibility within real world health system constraints. This study demonstrates how human centered design can strengthen digital public health interventions in low resource settings by amplifying community voices, addressing sociocultural determinants. Future phases include pilot testing, user acceptance evaluation, and implementation research to assess behavioural and clinical impacts.
Maternal and child malnutrition remains a major public health challenge in low resource settings, contributing significantly to preventable morbidity and mortality. Although mobile health (mHealth) interventions offer scalable opportunities to improve health literacy and antenatal care, many fail due to limited contextual fit, and weak integration into health systems. This study applied a design thinking, participatory framework to co create a maternal nutrition mHealth solution—the mobile app—for rural communities in Limpopo Province, South Africa.
METHODS:
Embedded within the AMEN project, this study used mixed methods comprising of survey (n= 392) plus sequential participatory rounds with 319 additional stakeholders (April-December, 2025) in the Capricorn District. Overall, 711 stakeholders were consulted, including pregnant women, community health workers, nurses, midwives, dietitians, mentor mothers, farmers, fathers, grandmothers and community leaders. Data collection explored lived-experiences, beliefs, affordability, m-health and health-system barriers.
RESULTS:
Thematic analysis identified five domains informing intervention design: (1) maternal nutrition knowledge and perceived importance; (2) implementation realities within antenatal care workflows; (3) pervasive cultural myths and food taboos; (4) structural inequities including staffing shortages, digital divides, and food insecurity; (5) opportunities for digital support. Stakeholders emphasized the need for offline access, local language options, picture first content, myth busting features, affordability adapted meal guidance, and protocol aligned clinical decision support. These insights informed the development of high fidelity prototype featuring localized dietary guidance, interactive modules, myth correction libraries, and links to community based nutrition initiatives such as household gardens.
CONCLUSIONS:
The participatory design thinking approach improved cultural relevance, usability, and perceived feasibility within real world health system constraints. This study demonstrates how human centered design can strengthen digital public health interventions in low resource settings by amplifying community voices, addressing sociocultural determinants. Future phases include pilot testing, user acceptance evaluation, and implementation research to assess behavioural and clinical impacts.
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
