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Background: The use of indigenous food (IF) such as green leafy vegetables and fruits in rural communities has been the main source of food despite being replaced by food high in sugar and fats. Early Childhood Development (ECD) centres are uniquely positioned for positive influence to healthy eating of children. The aim of this study was for ECD stakeholders to co-create an IF diet for children under five in ECD centres.Method: A sequential explanatory mixed method design was employed. We conducted focus group discussion with stakeholders employing the community-based participatory research (CBPR) approach and the nominal group technique ranking method to co-create to an acceptable indigenous food diet for children. Data was analyzed using both qualitative and quantitative methods. A thematic approach to qualitative data analysis with a coding framework guided by Consolidated Framework for Implementation Research (intervention characteristics, inner setting, outer setting, characteristics of individuals involved in implementation and the implementation process) was employed to analyse focus group discussion data. Statistical analysis was employed to analyze quantitative data collected through surveys.Results: Study participants included ECD stakeholders (ECD managers, social workers and dieticians) aged 34-52. Participants identified Ditokomane, Oranges, Mabele soft porridge, Dithotse and Dinawa as components of an IF that are suitable and acceptable for children under five years in ECD centres. Conclusion: ECD stakeholders co-created an IF diet to be implemented in ECD centres for children under five. Stakeholders are of the view that IF diet will have more health benefits on children than the current menu that is being used.

Background: Access to an adequate diet is a key criterion for improving nutritional status. Indigenous food (IF) can play a big role in improving dietary variety in rural populations. The aim of the study was to assess the effectiveness of an IF diet for under-five children in Early childhood development (ECD) centres.Method: A one-group pretest-posttest experimental design study was undertaken in three ECD centres from three different villages of Sekhukhune district, the former Fetakgomo municipality, in Limpopo, South Africa. An IF diet intervention was implemented for a period of six months with 253 children aged 0-5 attending three ECD centres. Anthropometric measurements were taken pre-introduction of an IF diet and post-intervention. The dependent sample t-Test was used to compare the pre- and post-anthropometric measures, and a p-valueResults: Significant improvement in the nutritional outcomes of the participating children were recorded, a majority (50%) of who were aged three. The study showed significant differences in pre- and post-anthropometric measurements for weight pConclusion: The adapted IF diet is shown to be effective for the nutritional outcomes of children and can be used to promote the use of IF and address nutritional deficiencies amongst under-five children in Limpopo, South Africa.