Wave 1 Findings from a Prospective Cohort Evaluation of the Flourish Mother and Child Programme
1
Grow Great, Midrand, South Africa
2
The DG Murray Trust, Cape Town, South Africa
3
SADC Research Centre, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A2280
ABSTRACT
INTRODUCTION:
The first 1000 days are critical for lifelong health and development. Yet a third of children under two in South Africa are stunted and unable to reach their full potential. To support parents and address the lead indicators of stunting, Grow Great Flourish offers structured antenatal and postnatal peer support group sessions for pregnant women and new mothers. Sessions are delivered online and in community settings by trained facilitators.
METHODS:
A prospective cohort study design was used to assess maternal and child health outcomes associated with participation in Flourish. Baseline (Wave 1) data were collected prior to participation through telephone surveys conducted in July 2025. Mothers were grouped according to exposure: antenatal-only, postnatal-only, or both. A total of 683 mothers from Gauteng and Limpopo participated: 462 antenatal-only, 87 postnatal-only, and 134 antenatal-and-postnatal participants.
RESULTS:
Most mothers (>98%) reported positive health attitudes related to antenatal clinic visits, iron and folate supplementation and hygiene practices. Approximately one in four screened positive for possible depression or emotional distress. Twenty-two percent of infants were born with a low birth weight (<2.5 kg). While 69% of mothers reported exclusive breastfeeding, only 57% reported exclusive breastfeeding in the previous 24 hours. Among mothers who intended to exclusively breastfeed, 62% planned to do so for six months. Nearly all mothers (94%) reported playing, talking, and singing with their infant. Maternal dietary diversity was low (2.8 out of 10).
CONCLUSIONS:
Baseline findings indicate high maternal health knowledge and pro-health attitudes, alongside gaps in practices linked to stunting risk, including maternal diet, breastfeeding consistency, and maternal mental health. Discrepancies between reported exclusive breastfeeding and 24-hour feeding practices suggest possible social desirability bias. Findings contribute early evidence from a middle-income, African context on how scalable, peer-led maternal support can identify and address modifiable drivers of stunting.
The first 1000 days are critical for lifelong health and development. Yet a third of children under two in South Africa are stunted and unable to reach their full potential. To support parents and address the lead indicators of stunting, Grow Great Flourish offers structured antenatal and postnatal peer support group sessions for pregnant women and new mothers. Sessions are delivered online and in community settings by trained facilitators.
METHODS:
A prospective cohort study design was used to assess maternal and child health outcomes associated with participation in Flourish. Baseline (Wave 1) data were collected prior to participation through telephone surveys conducted in July 2025. Mothers were grouped according to exposure: antenatal-only, postnatal-only, or both. A total of 683 mothers from Gauteng and Limpopo participated: 462 antenatal-only, 87 postnatal-only, and 134 antenatal-and-postnatal participants.
RESULTS:
Most mothers (>98%) reported positive health attitudes related to antenatal clinic visits, iron and folate supplementation and hygiene practices. Approximately one in four screened positive for possible depression or emotional distress. Twenty-two percent of infants were born with a low birth weight (<2.5 kg). While 69% of mothers reported exclusive breastfeeding, only 57% reported exclusive breastfeeding in the previous 24 hours. Among mothers who intended to exclusively breastfeed, 62% planned to do so for six months. Nearly all mothers (94%) reported playing, talking, and singing with their infant. Maternal dietary diversity was low (2.8 out of 10).
CONCLUSIONS:
Baseline findings indicate high maternal health knowledge and pro-health attitudes, alongside gaps in practices linked to stunting risk, including maternal diet, breastfeeding consistency, and maternal mental health. Discrepancies between reported exclusive breastfeeding and 24-hour feeding practices suggest possible social desirability bias. Findings contribute early evidence from a middle-income, African context on how scalable, peer-led maternal support can identify and address modifiable drivers of stunting.
| eISSN: | 2654-1459 |
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