Evaluation of the implementation of the nutritional supplementation programmes for pregnant women within the Cape Town Metropolitan Area

Grundlingh, Heila (2012-12)

Thesis (MNutrition )ITE))--Stellenbosch University, 2012.

Thesis

ENGLISH ABSTRACT: Introduction: The primary objective was to determine whether pregnant women visiting primary health care clinics (PHCs) were aware of the nutritional supplementation programmes: Nutrition Supplementation Programme (NSP) food, folate-, iron- and vitamin A supplementation. The secondary objective was to determine whether pregnant women qualified for the NSP food-, folate- and iron supplementation. The third objective was to determine whether those who qualified received the prescribed NSP food-, folate-, and iron supplementation and whether they were compliant with these interventions. Design: A cross-sectional descriptive study was conducted at all PHCs hosting basic antenatal clinics in the Cape Town Metropolitan Area of the Western Cape Province, South Africa. Method: One hundred and fourteen pregnant women who met the inclusion criteria were included in the study using a non-random quota sampling strategy. Pregnant women were interviewed using a validated questionnaire. The mid upper arm circumference (MUAC) was measured and the symphysis-fundus (SF) measurement was obtained from the medical files to determine whether participants met the entry criteria for the NSP. Written informed consent was obtained from participants. Results: Fifty per cent of participants were between 12 and 24 weeks of gestation. Most of them (68%) had an MUAC of between 24,7 cm and 34,4 cm. Fifty (44%) of the participants had a sufficient SF measurement. Twenty-one (18%) of the participants indicated that they were aware of the vitamin A Programme, 56 (49%) were aware of the NSP food-supplementation and 79 (70%) knew about the folicand iron supplementation that pregnant women should receive from the clinic. Six (5%) participants qualified for the NSP with an MUAC of below 23 cm. Only one (17%) participant was registered with the NSP and received the food-supplementation. Seventy (61%) of the participants indicated that they received and used the iron- and folic supplements, of which 30 (43%) did not know why they needed to take these supplements. Conclusion: Folate- and iron supplementation appears to be reasonably successfully implemented in the Cape Town Metropolitan Area among pregnant women visiting PHCs. The NSP food-supplementation, however, appears to be unsuccessfully implemented and needs further attention. Resources could be appointed to inform pregnant women about the reasons for and importance of taking these supplements.

AFRIKAANSE OPSOMMING: Inleiding: Die hoofdoelstelling was om te bepaal of swanger vroue wat primêre gesondheidsorgklinieke (PGK’s) bywoon, bewus was van die voeding supplementasie programme: Voedsel Supplementasie Program (VSP) – voedselaanvulling, folaat-, yster- en vitamien A supplementasie. Die tweede doelstelling was om te bepaal of hierdie swanger vroue in aanmerking kom vir die VSP– voedselaanvulling, folaat- en yster supplementasie. Die derde doelstelling was om te bepaal of hierdie swanger vroue die voorgeskrewe VSP – voedselaanvulling, folaat- en yster supplementasie ontvang het en hierdie intervensies nagevolg het. Ontwerp: ʼn Deursnit beskrywende studie is gedoen en data is ingesamel van al die PGK’s wat voorgeboortelike klinieke huisves in die Kaapstadse metropolitaanse gebied, in die Wes-Kaapprovinsie, Suid-Afrika. Metode: Honderd en veertien swanger vroue wat aan die insluitingskriteria voldoen het, is volgens ʼn nie-ewekansige kwotastrategie uitgesoek om aan die studie deel te neem. Onderhoude is volgens ʼn bevestigde vraelys met swanger vroue gevoer. Die omtrek van die middelboarm is geneem en die symphysis-fundus-meting is van die mediese lêers verkry om te bepaal of deelnemers aan die insluitingskriteria vir die VSP voldoen. Deelnemers het ʼn vrywaringsvorm geteken voordat hulle aan die studie begin deelneem het. Resultate: Vyftig persent van die swanger vroue het ʼn gestasie-ouderdom van tussen 12 en 24 weke gehad. Die omtrek van die meeste vroue (68%) se middelboarm was tussen 24,7 cm en 34,4 cm. Vyftig (44%) van die vroue se symphysis-fundusmeting was voldoende. Een en twintig (18%) van die deelnemers het aangedui dat hulle van die Vitamien A-program bewus was, 56 (49%) was van die VSPvoedselaanvulling bewus en 79 (70%) van die deelnemers was bewus van die folaat- en yster supplementasie wat swanger vroue van die kliniek behoort te ontvang. Ses (5%) deelnemers, met ʼn middelboarm-omtrek van minder as 23 cm, het vir die VSP in aanmerking gekom. Slegs een (17%) deelnemer was geregistreer en het die voedselaanvulling ontvang. Sewentig (61%) van die deelnemers het aangedui dat hul wel yster- en folaat supplementasie ontvang en gebruik, waarvan 30 (43%) nie geweet het waarom hulle dié supplemente neem nie. Gevolgtrekking: Dit wil voorkom asof folaat- en yster supplementasie vir swanger vroue wat PGK’s in die Kaapstadse metropolitaanse gebied besoek, redelik suksesvol toegepas word. Daarteenoor word die VSP – voedselaanvulling onsuksesvol uitgevoer en behoort dit verdere aandag te geniet. Hulpbronne kan aangewys word om swanger vroue beter in te lig oor die doel en belangrikheid daarvan om hierdie supplemente te neem.

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