Masters Degrees (Human Nutrition)

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Browsing Masters Degrees (Human Nutrition) by browse.metadata.advisor "Daniels, Lynette"

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    Achievements and challenges of facilities implementing human milk banks in the KwaZulu-Natal province, South Africa
    (Stellenbosch : Stellenbosch University, 2021-03) Kadir, Zaheeda; Daniels, Lynette; Boatemaa, Sandra; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.
    ENGLISH SUMMARY: Purpose: Human milk banks (HMB) (as a supporting mechanism) have a role to play in providing support to vulnerable infants to survive and thrive in the clinical setting. Human milk is better tolerated as it tends to reduce the length of stay in hospital and late onset sepsis, and decreases the risk of necrotising enterocolitis (NEC). With very few milk banks initiated and those that have been initiated struggling for sustainability, this research in the African context should assist in creating awareness of the importance of human milk banks (HMBs). The aim of the study was to analyse the activities of all human milk banks in KZN and to establish challenges and achievements between 2016 and 2019. Study Design: A longitudinal review study, with an analytical component, was conducted. Quarterly and annual reports from HMB in the KZN between 2016 and 2019 were used. Quantitative analysis on the performance indicators reported in the HMB reports and thematic analysis of achievements and challenges using the World Health Organization (WHO) system building blocks were used. Findings: A total of 91 reports were used in this study. New Donors increased from 264 in 2016 to 1 870 in 2019. A specialised facility was cited as having the largest number of infants receiving donor human milk, from 43 in 2016 to 194 in 2019. The amount of pasteurised milk transferred to other facilities was highest in 2016. The main achievement cited by the HMB reports was the increase in number of donors at district, regional, tertiary and specialised levels. The main challenge cited by the HMB reports was the lack of skilled HMB health workers. Conclusion: This study examined the activities of all human milk banks in KZN and established the challenges and achievements between 2016 and 2019. The various achievements such as acceptance of mothers donating human milk, assistance to other facilities that do not have an established HMB, and challenges such as lack of trained skilled staff, lack of consumables and non-functional equipment, should be considered. A national core model for implementation of HMB in South Africa will assist with a more standardised implementation of the HMB.
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    Complementary feeding practices and the anthropometric status of children aged six to 23 months among the pastoralist communities of Isiolo county, Kenya
    (Stellenbosch : Stellenbosch University, 2015-03) Amunga, Dorcas P. A.; Daniels, Lynette; Ochola, Sophie; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.
    ENGLISH SUMMARY : Introduction: Adequate nutrition is vital to a child’s development, with the period from pregnancy to two years of age being the most critical basis for future optimal growth, health and development. Current global public health recommendations on infant and young child feeding (IYCF) state that an infant should be exclusively breastfed for the first six months of life. Thereafter complementary foods should be introduced to the child’s diet while they continue breastfeeding up to two years of age and beyond. Timing, type and quality are important considerations in complementary feeding, and if compromised, often result in malnutrition and mortality. Aim: The aim of the current study was to determine complementary feeding practices and the anthropometric status of children aged six to 23 months among pastoralist communities of Isiolo County, Kenya. Methods: Cross-sectional analytical study. Two-stage cluster sampling methodology was used to select a sample of 288 mother/caregiver-child pairs from pastoralist communities. The children were aged from six to 23 months. The mothers/caregivers were interviewed through a researcher-administered questionnaire. Weight and length measurements of the children were taken to establish their anthropometric status. Ethical approval to conduct the study was obtained from Stellenbosch University (South Africa) and Kenyatta University (Kenya). Permission to conduct the study was obtained from the Kenyan National Council of Science and Technology and the Isiolo County Commissioner. Results: Overall, the prevalence of stunting and underweight among the children six to 23 months old was low according to the World Health Organization (WHO) classification for severity of malnutrition (19.1% and 7.3%, respectively) while the severity of wasting prevalence (5.2%) which, according to WHO thresholds, was medium. Of the children studied, 2.4% were overweight which was low. The percentage of children with stunting, wasting and underweight rates increased with an increase in age (measured in months). Complementary feeding practices were poor. Of the children participating in the study, 60.4% achieved minimum meal frequency, with 35.4% achieving minimum dietary diversity and 25.3% achieving the minimum acceptable diet. Significant relationships were found between socio-demographic factors (child gender, child age, caregiver’s age and caregiver’s education level), and complementary feeding practices (ρ < 0.05). In addition to this, there was a significant association found between child gender and anthropometric status, whereby female children were more likely to have better anthropometric status than their male counterparts (ρ < 0.05). Conclusion and recommendations: The study established that among pastoralist communities, poor feeding practices starts early, thereby predisposing older children (18 – 23 months) to nutritional inadequacies. Interventions need to put more emphasis on nutrition-specific and nutrition-sensitive strategies focussing on the critical period from gestation to two years. Improving education levels for women in pastoralist communities may have a positive impact on the anthropometric status of the child. Qualitative studies are necessary in order to identify specific sociocultural issues that might affect complementary feeding practices and anthropometric status such as gender bias in feeding practices.
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    The knowledge, attitudes and practices regarding food fortification among mill managers and the contribution of maize meal to the micronutrient intake of a national sample of South African adults
    (Stellenbosch : Stellenbosch University, 2015-12) Danster-Christians, Natasha; Wolmarans, Petronella; Daniels, Lynette; Burger, Hester-Mari; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.
    ENGLISH SUMMARY : The knowledge, attitudes and practices regarding food fortification among mill managers and the contribution of maize meal to the micronutrient intake of a national sample of South African adults Aim: The aim of this study was to determine the knowledge, attitudes and practices regarding food fortification among maize meal and wheat flour mill managers and to determine the contribution of maize meal to the micronutrient intake of a national sample of South African adults. Methods: Staff members overseeing fortification at mills in South Africa were recruited for participation. Data were collected by means of a self-administered questionnaire distributed to 211 participants via email, post and fax. Secondly, South African adults who reported consuming maize meal (n = 2 344) as part of a national consumer survey, were included in the secondary analysis of data. Data were collected by means of a short quantified food frequency questionnaire focussing on maize. Nutrient intakes of participants who consumed maize meal were determined using the South African Food Composition Database and compared to the Dietary Reference Intakes. Results: Thirty maize meal and wheat flour mill staff (14.2%) completed the questionnaire. More than half (n = 16; 53.3%) of the participants knew when food fortification became mandatory. Only 43.3% of the mills tested the final product at the mill to ascertain if it was fortified. Only 58.3% (n = 14) of the mills obtained their fortification premixes from suppliers that were registered with the Department of Health. The overall knowledge score of mill staff was average (52.2%). The secondary analysis of data showed that the average portion of cooked maize meal consumed per day (n = 2 344) was 585 g (SD = 543 g) and contributed the following: riboflavin (20%), vitamin A (25%), zinc (34%), vitamin B6 (45%), niacin (46%), thiamin (57%), folate (67%) and iron (72%) of the Estimated Average Requirements (EAR). Hundred percent of the EAR was met for iron, thiamin and folate for 773 (33.0%), 483 (20.6%) and 621 (26.5%) of the maize meal consumers respectively. The average portion size of maize meal consumed by the unemployed (696 g) were significantly (p<0.001) higher than the employed (564 g) consumers. As a result of the higher portion size, all the micronutrients which form part of the fortification programme was significantly (p<0.001) higher for the unemployed. Vitamin A, thiamin, riboflavin, niacin, vitamin B6, folate, iron and zinc intakes were significantly lower for consumers from households earning above R6 000 compared to consumers of maize meal earning below the poverty line (R2 000). Conclusions: About half of the participants correctly answered the knowledge questions on food fortification. Despite this, there were shortcomings regarding practices amongst staff overseeing food fortification at the mills. Areas of food fortification practices at the mill level could possibly be improved, making use of results from this study. In the second study maize meal was shown to be a significant contributor in the diets of the participants. Unemployed and lower household income groups consumed more maize meal in terms of portion size and micronutrient contribution. The results underline the important contribution that the food fortification programme could potentially make to micronutrient intake through the consumption of fortified maize meal.