Language matters: exploring the language barriers between dietitians and mothers during nutrition counselling related to the first 1000 days of life

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Date
2023
Authors
Jansen, Phozia
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Publisher
University of the Free State
Abstract
𝗜𝗻𝘁𝗿𝗼𝗱𝘂𝗰𝘁𝗶𝗼𝗻 South Africa is a rich melting pot of culturally and linguistically diverse citizens. Historically, the development of indigenous South African languages has been stunted while English and Afrikaans were prioritized. There has been a growing concern by healthcare professionals to serve linguistically diverse patients. Dietitians often do not share the same language as their patients. The role of language is particularly important in nutrition education and assists in achieving behavioural change. The double burden of malnutrition is a serious public health concern. The first 1000 days of life refers to the critical period of development between conception and two years of age. Adequate nutritional care is invaluable during this period; without it, poor health outcomes will track into adulthood. Nutrition education is essential in addressing the double burden of malnutrition during the first 1000 days of life. It is well known that language barriers may lead to ineffective communication between dietitians and patients. Therefore, this study aimed to determine the language barriers between dietitians and Sesotho-speaking mothers during dietetic consultations related to the first 1000 days of life. 𝗠𝗲𝘁𝗵𝗼𝗱𝘀 A phenomenological qualitative study design was used. A total of 22 dietitians were interviewed at ten public health institutions in the Free State province. The study involved unpacking the dietitians' lived experiences and collecting data through conversational interviewing techniques. The interviews were voice-recorded and transcribed verbatim. The data was analysed and three major themes, with subthemes, were identified. 𝗥𝗲𝘀𝘂𝗹𝘁𝘀 Most participants were White Africans who spoke Afrikaans as their first language; the rest were Black Africans and spoke various indigenous South African languages. Many reported experiencing language barriers, including, amongst others, dietitians lacking proficiency in Sesotho, the predominantly spoken local language. Other issues included mothers lacking proficiency in English or Afrikaans and some Sesotho- speaking mothers' resistance to receiving healthcare services in English. The role of power and privilege in language was also highlighted. Furthermore, the dietitians reported difficulty in explaining nutrition concepts in Sesotho. Strategies were identified to overcome the language barriers, including interpreters, visual aids, codeswitching, language learning and nutritional education in Sesotho. 𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻 Despite the country's eleven official languages, there is limited research on language barriers in healthcare within the South African context. This study provides evidence of language barriers experienced by dietitians and mothers of young children in a Free State public health setting and highlights that practical solutions are crucial to ensure the success of healthcare interventions as language barriers between dietitians and mothers result in communication gaps, which impact nutrition outcomes, particularly in the first 1000 days of life. It is recommended that the research be repeated for different professions and indigenous languages to explore the true complexity of language barriers in the South African healthcare system. The study also highlights the lack of research regarding appropriate Sesotho nutrition and medical terminologies. Therefore, this study provided a rationale for developing a Sesotho nutrition glossary.
Description
Dissertation (M.Sc.(Dietetics))--University of the Free State, 2023
Keywords
language barriers, malnutrition, dietitians, communication, nutrition education, indigenous languages, health education, health disparities, intercultural communication, health communication
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