Complementary feeding knowledge of practitioners at early childhood development centers in Polokwane Municipality, Limpopo Province, South Africa

Background Adequate infant and young child feeding (IYCF) is vital for the prevention of malnutrition and promotion of child development. Early Childhood Development (ECD) practitioners have a crucial role in molding these practices. Their knowledge levels are under-researched in diverse settings across South African municipalities. Methodology A quantitative and cross-sectional design was employed to conduct the study among 66 ECD practitioners from semi-urban and rural areas of Polokwane Municipality, Limpopo Province. Data were collected using a structured questionnaire on knowledge of complementary feeding based on WHO guidelines. Knowledge scores were classified as poor (0-50%), moderate (51-75%) or good (76-100%). Descriptive and inferential statistics including chi-square test, Cramer's V and logistic regression were used to determine the association of demographic factors with the levels of knowledge (p < 0.05). Results Moderate knowledge was present in 57.6% of the practitioners, good knowledge in 24.2% and poor knowledge in 18.2%. 93.8% of Ga-Chuene practitioners had good knowledge. Area of practice was the strongest predictor of knowledge (Cramer's V=0.782, p < 0.001) and the sole independent predictor in multivariate analysis. Practitioners from Moletji (AOR = 0.01, p < 0.001) and Seshego (AOR = 0.00, p < 0.001) had significantly lower odds of good knowledge than Ga-Chuene. Surprisingly, primary education group had higher knowledge (75% good) than those with secondary (18.8%) and tertiary qualifications (23.3%). The knowledge gaps were more evident on micronutrients, food groups and frequency of feeding. Conclusions Knowledge of complementary feeding among ECD practitioners is highly context specific with geographic location playing a more important role than individual characteristics such as level of education. These findings challenge the notion that urban residence or higher education levels are synonymous with better feeding knowledge, and point to the need for targeted, context-specific efforts to improve ECD nutrition capacity in areas where gaps are identified.