Co-designing maternal nutrition support: frontline health workers' perspectives on antenatal care in Vanuatu — ASN Events
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  3. Co-designing maternal nutrition support: frontline health workers' perspectives on antenatal care in Vanuatu

Co-designing maternal nutrition support: frontline health workers' perspectives on antenatal care in Vanuatu (#484)

Eliza Kitchener 1 2 , Rex Turi 3 , Tominic Turi 4 , Ali Moloney 1 2 , Debbie Fred 5 6 , Matthew Cornish 7 , Georgia Kafer 1 2
  1. School of Health, The University of the Sunshine Coast, Moreton Bay, QLD, Australia
  2. Australian Centre for Pacific Islands Research, Moreton Bay, Queensland, Australia
  3. Health Clinic, Wan Smolbag Theatre, Port Vila, Efate, Vanuatu
  4. Nutrition Centre, Wan Smolbag Theatre, Port Vila, Efate, Vanuatu
  5. Reproductive, Maternal, Newborn, Child & Adolescent Health Program, Vanuatu Ministry of Health, Port Vila, Vanuatu
  6. James Cook University, Townsville, Australia
  7. Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, Georgia, USA

1.Introduction

Maternal nutrition shapes maternal health and fetal development. Antenatal care (ANC) and primary health care (PHC) are well positioned to deliver this support through nutrition education and micronutrient supplementation during routine contacts. In Pacific lower-middle-income countries such as Vanuatu, these systems face geographic, resource, and sociocultural challenges that may constrain maternal nutrition guidance. Previous research among Ni-Vanuatu women identified limited nutrition literacy and suboptimal adherence to WHO ANC recommendations (Kitchener et al., under consideration), yet drivers for this remain poorly understood from frontline health workers' perspectives. Using a co-designed approach, this study explored health workers' perspectives to identify barriers and enablers to equitable maternal nutrition support.

2.Methods

Semi-structured interviews co-designed with local stakeholders explored maternal nutrition knowledge, practices, training experiences, and confidence among Ni-Vanuatu health workers. Fifteen frontline health workers were interviewed, including village health workers (n=2), a nurse aide (n=1), nurses (n=8), midwives (n=3), and a doctor (n=1). Interviews were conducted in English or Bislama (lingua franca of Vanuatu) and analysed thematically using the Braun and Clarke framework [1].

3.Results

Health workers described systemic constraints limiting their capacity and confidence to provide effective maternal nutrition guidance. Key themes included workforce shortages, insufficient nutrition-specific training, and disparities in resource provision and professional development, particularly in rural settings. Substantial knowledge gaps were identified regarding optimal maternal-fetal nutrition; for example, most participants (n=13, 87%) were unaware of dietary sources of folate, the risks of inadequate intake for fetal development, or the WHO-recommended therapeutic window for folic acid supplementation.

4.Conclusions

Improving maternal and offspring health outcomes will require targeted, context-appropriate workforce upskilling alongside stronger PHC support. Although set in Vanuatu, these findings reflect constraints common to rural and under-resourced communities globally. Co-designed, locally-led approaches that centre frontline health workers' knowledge offer a transferable model for implementing effective, sustainable interventions in such settings.

  1. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101