Table 2 Summary of focus group responses from transcripts

 Are there any special foods purchased or prepared especially for pregnant women?

Fruits and vegetables; calcium products, milk, yogurt, water, liver

Foods rich in vitamins; fresh milk, kapenta, vegetables, sour milk/yoghurt and fruits, juice, peanut butter and ground nuts

Gorgis protamine, Nshima, beans and Kapenta or fish, one fruit a day, milk and juice for vitamins, vegetables and peanuts

Calcium products, milk, water, liver, Kapenta or fish, vegetables, sour milk, yoghurt, fruits, juice, peanut butter and ground nuts, gorgis protamine, nshima.

 Do pregnant women need to take vitamins?

Yes

Yes

Yes

All responded yes

 Why or why not?

So that a child can grow healthy

To help have vitamins in the body; to help those who do not eat much food; there is no need to take since we already have a good appetite for food

There are vitamin supplements in form of tablets that are sold in chemistry’s and one is mother care which contains vitamin C, vitamin B12 and other vitamins

So that the body has vitamins and the child can grow healthy. To help those who do not each much food. A connection was made between dietary intake and need for vitamins.

 How many of you are taking vitamins while you are pregnant?

At least two participants

At least 4 participants; one respondent said none if good appetite for food

Yes, given in clinic red and yellow supplements;

Most but not all respondents are taking vitamins regularly

 Where do you get them? Do you pay for them or are they free?

We are given them in clinic when pregnant

We are given them

Given them

Given to them at the antenatal clinic

 Are there any foods that women should not eat when they are pregnant? Why?

Foods high in fat, or fried foods

Not supposed to drink alcohol, smoke cigarettes, or eat dirty clay soil or cold/old Nshima (Chimbala) because eating Nshima from previous day will cause there to be complications during delivery and cause you to soil yourself during delivery.

Alcohol and coke, carbonated drinks and okra or plants in the mallow family because soda is added when cooking it. Mould/mound built by termites because the child will be born with a hardened stomach

Foods high in fat or fried, or old Nshima. Should not drink alcohol or coke and other carbonated drinks.

 What should women eat to stay healthy when they are breastfeeding?

Proteins like fish and beans and fluids, vitamins, fruits

Nshima, vegetables, traditionally brewed drink (umukoyo) which helps with having lots of breastmilk; a balanced diet like starch, proteins, vegetables, and something with lots of iron so that the child will have enough blood; vegetables mixed with groundnuts, fruits, vegetables and sour milk, black tea and milk

Foods with proteins, carbohydrates, and vitamins like Nshima with beans and vegetables with local fruits or juice.

Proteins like fish and beans, fluids, vitamins, fruits, Nshima, vegetables, groundnuts, sour milk, black tea and milk.

 Do you eat Kapenta and fish?

8/9 yes; 1/9 no Kapenta, only fresh fish

6 yes; 1 no fish

Yes, all

Only one respondent did not eat fish at all.

 How often do you buy Kapenta and fish for your home?

Not queried

Not queried

2 times per wk. (4 participants); every day; 1 per month; twice per month; every day

 How often do you eat it in a week?

2-3times; rarely; 2–3 times; once; every day; not at all

2 times; 3 times; none; 1 time; one told to stop due to gas;

2-3times; rarely; 2–3 times; once; every day; not at all

Anywhere from daily to once a month.

 What kinds of fish do you eat?

Fresh bream; buka;

Bream; buka; Siavonga Kapenta; Mpulinga Kapenta;

Buka; makerel; bream

Most eat Buka and Bream; some Kapenta

 What kinds of Kapenta do you eat?

Mpulungu not Siavonga; any big or small

Mpulungu and Siavonga;

Mpulungu and Siavonga; Chisese (small fish)

Most eat Mpulungu and siavonga

 Do you have any allergies to the ingredients in the packet?

No direct answer. One respondent limits soy products another reacts to Kapenta (i.e. intestinal gas)

None

None

Allergies not a problem

 How does it taste?

Too much fat, excess sugar or salt

The taste is just okay

Taste of fish oil which is a put off, like the sweetness, bad aftertaste, just fine

Taste was not preferred; some remarked on the fish taste; another on salt and sweetness

 How is the after taste?

After taste of peanut butter and the texture is just fine;

Okay but the smell isn’t okay

After taste for Kapenta, milk and sugar; taste is okay; just okay

The aftertaste was similar to Kapenta. Most felt the taste was just fine, while a few suggested that the after taste was similar to peanut butter.

 Do you think other pregnant and breastfeeding women would like it?

Not everyone; some will like it, others not depending on the stage of pregnancy; pregnant women can be turned off by smell

Some would like it because it’s good for the child’s health; No, they would not; the ones who are breastfeeding would like the product more than the pregnant mother because pregnant mothers become too choosy with food

Those breastfeeding can like the product because of the omega 3; will be challenging because of the smell; will not like it because they respond differently to tastes, can like it if they remove the fish smell

Most agree the product would be acceptable if it is for the good of the child but the smell could be a problem especially for pregnant mothers who react to some foods especially smelly foods

 Why or why not?

Oil, sugar and smell in the product might make them vomit

Those who don’t eat and don’t like the smell of fish cannot manage to eat because it has an aftertaste of fish

Fish smell and aftertaste is not great, may not agree with mothers.

 How often would a pregnant or breastfeeding mother eat a product like this?

With this bad smell and texture, I can only manage to eat once a week; twice in a week due to the bad smell; twice in the week because of the needed ingredients in there; just once because its important; if improved and of the same size one can take every day; if it’s this size I can take everyday; I can take once a week; just once a week but if put on other food like bread I think I can eat everyday

They can eat but it must be taken with some other food like bread; the taste is just fine but just the bad smell; it just depends with an individual; some have no problem others have a problem with the smell

Three times a day without the fish smell; even daily without fish smell

Most responded once per week because of the smell; but the general consensus discussion was that if spread on bread or added to another food like rice, it could be eaten more often.

 How do you think you might eat this product?

As is or with food

As is or with other food

As is or with other foods like rice or bread

 What foods might you eat it with or mix it with?

Bread, tea, warm water or milk, rice

On bread, in porridge or with tea, on rice, frozen

On bread, with rice

On bread, with rice or porridge.

 What do you like about the product?

Texture, packaging, I like that it helps the baby, I like it because it has different combinations of nutrients and am sure will get used to it as we keep on eating the product.

All the nutrients are there; aftertaste of Kapenta, milk and sugar

It helps the child with development of the brain and good sight but its just the bad smell

Like that it helps the development of the baby, and is nutritious. Easy to carry and many nutrients in one package.

 Any problems or disadvantages with this product?

There is too much fat

Smell is bad, tastes like uncooked fish or Kapenta, don’t like the milk in it, bad combination of soy and fish

Prefer if it was packed in a tin so that a spoon can be used when eating; with the taste you can’t eat much because of the oil; difficult for those who are allergic to fish

Smell of the product and the oil in it is not great.

 What could be changed about it?

Smell

The peanut taste could be stronger than the fish taste, reduce the fish smell and oil

Smell and fish taste.

 Overall, do you like this product?

Yes, I like it because it’s important for the child’s health which is critical; It’s okay

I don’t like it; I like it; can eat it with bread; don’t like it but the nutrients will make me take it

Good except for the oil taste, good for it will help babies, product is just okay, think we can get used and eat daily since we have gotten used to folic acid which is not nice as well, will be forcing ourselves to eat.

Do not particularly like it, but will eat it because it is beneficial to the child.