Human Nutrition
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Browsing Human Nutrition by browse.metadata.advisor "Beukes, Ronel"
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- ItemThe availability and diversity of food items sold in spaza shops around the Moletši area in the Limpopo Province : a cross-sectional study(Stellenbosch : Stellenbosch University, 2022-04) Setati, Matlou Bartina; Beukes, Ronel ; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.ENGLISH SUMMARY: Despite interventions through various community programmes, poverty, inequality, and food insecurity still exist in South Africa. Many rural areas still lack good infrastructure for accessibility and availability of nutritious and diverse food products. Spaza shops have and continue to be the main channel through which food is sold in remote areas without formal retail and provincial markets. It is therefore possible that these shops, if well supported, could play a major role in enhancing accessibility and availability of diverse food products to support food and nutrition security. Aim: Due to the rural challenges in formal retail and infrastructure, it was important to understand the availability and diversity of food products sold by spaza shops as well as the challenges these shops may be encountering in ensuring the availability of food products in villages around the Moletši area, Limpopo Province. Method: The study was based on exploratory and descriptive research designs and a quantitative method was undertaken by using a questionnaire to collect the data. The sample size consisted of 41 spaza shops. The collected data was analysed using the latest version of Statistical Package for the Social Sciences (SPSS) software with a focus on the descriptive output. Results: Among others, the study found that the Dietary Diversity Score (DDS) for spaza shops in the area was generally high and not dependent on the period in business and ownership, among spaza shops operating in the Moletši area. The results showed that there is no significant difference between foreign or local ownership nor the period of years in business and the DDS of the spaza shop. The study determined that the most predominantly available products in spaza shops are egg (95.1%), fish, condiments, and maize meal groups (92.7%), sugar-based and fats/oil-based food groups (90.2%), beans food groups (87.8%), meat, mostly chicken organs (85.4%), followed by fruits (70.7%), Vegetables (65.9%) and lastly potatoes (56.1%). The study also sought to understand the reasons behind the lack of availability of some food products. High on the list was the rate at which fruits and vegetables spoiled, making them unfit for human consumption; followed by the inability to stock up on potatoes due to storage and transport challenges. Another reason was the lack of funds for the shops to stock up on products. Socio-economic challenges found in the study correlate with previously reported research and the results indicated that lack of funds (24%), high level of competition (20%), lack of purchasing power/bulk purchasing ability (15%), lack of business management knowledge (12%) and lastly lack of stocking opportunities and transport challenges (7%) were prevalent. Recommendations: Concerning the results presented earlier, opportunity exist in more villages for entrepreneurs to enter the spaza shop sector if financially supported and equipped to mitigate against the challenges indicated. Spaza shops have a critical role to play in providing dietary diversity and spaza shop owners could plough back any profits, if any, equip themselves with business management skills and reach out to government support for additional support to maintain and even expand their businesses. Implications: The research is aligned to previous research in the case of challenges and less availability of fruits and vegetables, although the study area had a high DDS. Spaza shops (local or foreign owned) and related businesses in other rural areas, municipalities, traditional leadership, government business development and funding agencies and policymakers may draw vital lessons from this study.
- ItemEvaluation of the supplementary feeding programme targeted at moderately malnourished children aged 6 to 59 months in Baringo County, Kenya(Stellenbosch : Stellenbosch University, 2018-12) Kimani, Irene Wairimu; Beukes, Ronel; Masibo, Peninah K.; Muthoka, Stellamaris; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.ENGLISH SUMMARY: Baringo is a semi-arid county of Kenya faced with moderate food insecurity. The County’s global acute malnutrition (GAM) rates have been on a deteriorating trend from 9.6% in 2013 to 21.1% in 2014, with moderate acute malnutrition (MAM) being the most prevalent. A supplementary feeding programme (SFP), which aims to alleviate the condition, has been implemented in the County since 2009. Persistent high malnutrition rates may be an indication that there are factors hindering the success of the programme. To assess this, the researcher conducted an evaluation study of the SFP targeted at moderately malnourished children aged 6 to 59 months. The study objectives were to assess the availability, distribution and utilisation of SFP commodities; to determine whether nutritional counselling was part of the SFP and if the advice was adopted; to assess breastfeeding practices for the moderately malnourished SFP beneficiaries aged 6 to 23 months; to assess the influence of SFP on anthropometric status of the beneficiaries; and to compare actual and expected length of stay of beneficiaries in the programme. A descriptive cross-sectional study design was employed and random sampling used to select participants. Questionnaires were administered to caregivers and anthropometric measurements of beneficiaries taken. Secondary data from health facility records was used to determine length of stay in the programme. The study duration was three and half months. A total of 407 children aged 6 to 59 months who were beneficiaries of the SFP participated in the study. The study found that almost two-thirds (62.7%; n = 255) of the participants received ready-to-use supplementary feeds (RUSF) during the distribution that preceded the study, of which the majority received their rightful fortnight ration of 14 (92 g) RUSF sachets. The fortnight ration did not last for the recommended period for at least a third of the participants, mainly due to sharing with non-SFP-registered household members. Caregivers received nutritional counselling as part of the SFP, but inadequate food access, cultural factors and poor access to health care services limited adoption. Almost all participants were fed on carbohydrate-rich grains 24 hours before the study, with minimal consumption of animal-source proteins. Anthropometric status of beneficiaries would improve whenever there was a consistent supply of SFP commodities, which was evidenced by a reduction in prevalence of underweight and acute malnutrition based on mid-upper arm circumference (MUAC) two weeks after admission. There were frequent stock-outs of SFP commodities at health facilities, hence beneficiaries would miss their rations on some distribution days. Discharge criteria was not adhered to, as more than half of the beneficiaries (57%; n = 98) that were discharged a month before the study exceeded the recommended maximum length of stay in the programme (84 days). Lack of SFP commodities at health facilities and sharing of SFP commodities at household level were key factors limiting the success of the programme. The programme stakeholders should identify sustainable solutions to challenges leading to shortage of the commodities and should link SFP beneficiaries to other food-assistance programmes that target the whole household in order to minimise sharing.
- ItemFactors influencing high socio-economic class mothers’ decision regarding formula feeding practices in the Cape Metropole(Stellenbosch : University of Stellenbosch, 2006-03) Bester, Marwyn; Marais, D.; Beukes, Ronel; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Human Nutrition.Objective: To identify the reasons why high socio-economic class women in the Cape Metropole decide not to breastfeed; to identify the factors that influence the decision-making process when deciding which infant formula to feed the infant aged 0–6 months of age and to evaluate whether the type and volume of infant formula selected by the mother is appropriate for the infant’s needs. Method: The study was conducted as an observational descriptive study and consecutive sampling was used. Data was collected by means of a self-administered questionnaire that was available both in Afrikaans and English. Both open and closed ended questions were included. A Likert scale comprising four possible answers was used to determine attitude. Results: A total of 55 utilizable questionnaires were obtained. The majority of the mothers decided only after the birth of their infant to rather opt for formula feeding. Evident factors that were identified as a barrier to breastfeeding include a lack of knowledge and experience as well as a lack of facilities at public places and at work to breastfeed. Perceived benefits of infant formula included that the father could help with the workload and thus the father does not feel left out if the mother is breastfeeding, the mother knows what volume of infant formula the infant receives and it is more convenient if she is working. The mothers were overall not concerned about possible side effects of breastfeeding e.g. leaking and engorgement and did not feel that their breasts were physically not of optimal physiology e.g. too small or too large to be able to breastfeed. Conclusion: Numerous internal as well as external factors influence high socio-economic class women in the Cape Metropole when they decide whether to breastfeed or formula feed their infants. The identified barriers to breastfeeding will have to be addressed in this population in order to reach the WHO/UNICEF recommendation of exclusive breastfeeding up to the age of 6 months, and thereafter breastfeeding up to 2 years of age with the introduction of appropriate complementary foods.
- ItemRisk factors of maternal overweight or obesity in pregnancy in Mowbray Maternity Hospital, Cape Town : a cross sectional study(Stellenbosch : Stellenbosch University, 2024-03) Cele, Nokukhanya Prudence; Beukes, Ronel; Henney, Nicolette; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.ENGLISH SUMMARY: Background: Maternal overweight and/ obesity is a growing public health concern globally, particularly in low- and middle-income countries. The risk factors contributing to maternal overweight/obesity in pregnancy include age, income, marital status (socioeconomic data), previous pregnancy complications, HIV status, non- communicable diseases in pregnancy (medical profile) excessive weight gain in pregnancy (anthropometric measurements), knowledge gaps and perceptions about overweight/obesity in pregnancy. These risk factors can affect the pregnancy outcome. Aim: To assess the risk factors of maternal overweight or obesity in pregnancy, in Mowbray Maternity Hospital (MMH), Cape Town. Method: This hospital-based cross-sectional study involved 200 pregnant women from their second trimester of pregnancy attending MMH, Cape Town, between September and October 2021, using the consecutive sampling method. The participants were categorized according to the Body Mass Index (BMI) in their first trimester based on the World Health Organisation (WHO) cut-off values for overweight/ obesity (BMI ≥ 25 kg/m2); non-overweight/obese and underweight (BMI 18,5-24,9 kg/m2 and BMI ≤ 18.5 kg/m2 respectively). The risks of maternal overweight/obesity in pregnancy in MMH, Cape Town were compared between two groups i.e. participants with a BMI in the first trimester of either ≥ 25 kg/m2 (overweight/obese) or BMI ≤ 25 kg/m2 (non-overweight/obese and underweight). Data was collected by means of anthropometric measurements and self-administered questionnaires for the five sections of the study to meet the study aim and objectives. Data was analysed using multiple binomial regression analysis due to the outcome variable (first trimester BMI) being binary. Multivariate binomial regression analysis was performed to assess the risk factors for maternal overweight/obesity in pregnancy. Results: Of the total sample of n=200 participants, n=135 (67,5%) were overweight/obese (BMI in the first trimester ≥25 kg/m2.) and will be referred to as the overweight/obese group. The remaining n=65 (32.5%) is referred to as the non-obese group (BMI in the first trimester ≤ 24.9kg/m2). There were statistically significant relationships reported for the following risk factors of and maternal overweight/obesity in pregnancy: Age [OR] 1.03 [95% Cl, 1.01-1.04]), HIV/AIDS [OR] 1.15 [95% Cl, 1.02-1.31], Gestational diabetes [OR] 1.31 [95% Cl, 1.10-1.55], Pregnancy complications [OR] 1.24 [95% Cl, 1.03-1.50], Gravida [OR] 7.38E-44 [95% Cl, 7.38E-44-7.38E-44], and “Big is normal in my family” (p<0.0001). Gestational hypertension [OR] 1.20 [95% Cl, 0.99-145] indicated borderline statistical significance (p=0.057). Conclusion: This study assessed the risk factors of maternal overweight and/obesity during pregnancy. The Null hypothesis “There is no statistically significant relationship between maternal overweight or obesity and risk factors of maternal overweight and/ obesity in pregnancy in MMH, Cape Town”, is rejected for the following risk factors: Age, HIV/AIDS, Gestational diabetes, Pregnancy complications, Gravida, “Big is normal in my family” and “Big is attractive”. In cases where risk factors indicated statistically insignificant relationships, clinically important higher odds of maternal overweight/obesity were indicated that could have far reaching implications for pregnant mothers and their babies. A larger study sample may have achieved more statistically significant results.