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- ItemA qualitative exploration of perceptions of women aged 21 – 55 years from Bhisho townships in the Eastern Cape, on the intake of a diverse nutrient-dense diet(Stellenbosch : Stellenbosch University, 2023-12) Mdlokovana, Mzoxolo Emmanuel; Daniels, Lynette Daniels; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.ENGLISH SUMMARY: Micronutrient malnutrition continues to persist in South Africa, even though the South African government has implemented various strategies, including the promotion of dietary diversity. Previous research has also found that people who live in low-income neighbourhoods have the lowest dietary diversity scores (DDS) compared to other demographics in South Africa. Women normally play a pivotal role in the gathering and preparation of food for their families; they therefore have a significant influence on the dietary diversity of all members of their households. There is a paucity in the qualitative research domain in South Africa in the area of dietary diversity, particularly perceptions of women concerning dietary diversity. Therefore, the aim of the study was to explore the perceptions of women 21 – 55 years regarding dietary diversity in the townships of Bhisho in the Eastern Cape. A qualitative research study was conducted using focus group discussions (FGDs). The FGD guide was developed by the researcher, guided by the objectives of the study. Purposive sampling was used to recruit the participants, by word of mouth with assistance from identified influential women in the community. The FGDs were audio recorded and the recordings were transcribed by a professional transcriber. Thematic analysis was used to analyse the data. Four FGDs (N=18) were conducted. The participants demonstrated a general understanding of dietary diversity as they associated the concept with eating a balanced diet that consists of a variety of foods which are high in nutrients. The participants also have an awareness of the benefits of consuming a variety of foods high in nutrients. These benefits include optimal immunity, provision of energy for daily activities, as well as growth and development in children. The participants perceived lack of sufficient income due to factors such as unemployment, as the main barrier to achieving a diverse diet. Cultural influences, lack of gardening resources and environmental factors such as drought and poor soil quality, were perceived to be barriers to dietary diversity. Growing their own food in the form of home gardens was perceived as the main enabling factor for dietary diversity. Empowerment of community members with knowledge of healthy eating, encouragement of youth to study and participate in agriculture, and government assistance in matters such as job creation and community empowerment initiatives, were additional perceived enabling factors for dietary diversity. Participant perceptions around dietary diversity indicate an awareness of the challenge of low dietary diversity in poorer communities as well as a willingness to address the challenge. Community members of Bhisho need assistance and encouragement in improving their intake of a varied, nutrient-rich diet and subsequently optimising their nutrition outcomes. Dietary diversity and healthy living in general could be promoted in the community through nutrition education and skills development, home gardening resources, access to arable land for commercial agriculture initiatives, and women's forums for nutrition and healthy lifestyles. To make these initiatives sustainable, there should be a focus on fostering community self-reliance.
- ItemNutrition knowledge and practices of midwives providing maternal health services in Kanye, Kgatleng and South East Health Districts, Botswana(Stellenbosch : Stellenbosch University, 2021-12) Masesane, Anastacia; Dhlamini, Thembelile; Mbhenyan, Xilombiso; Nnyepi, Maria; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.Background: Maternal malnutrition has been identified by the World Health Organisation (WHO) as a global public health concern. Poor nutrition during pregnancy especially at the early developmental stage of the foetus has been proven to cause adverse effects for both the mother and the infant leading to maternal and child mortality. To promote adequate nutrition during pregnancy until postpartum period, midwives have been well positioned to provide antenatal care (ANC) for a positive pregnancy outcome. Therefore, their maternal nutrition knowledge and practices have an impact on the quality of the service provided. The aim of the study was to investigate midwives’ nutrition knowledge and practices and the integration of nutrition care in maternal health services at the health facilities in Kanye, Kgatleng and South East health districts in Botswana. Method: The study employed a cross-sectional descriptive design with an analytic component. Interviewer administered questionnaire and observation checklist were used for quantitative data collection. All midwives within the participating districts who met the inclusion criteria were invited to take part in the study. A total of 124 midwives were targeted to take part in the study. Statistical package for social sciences (SPSS) version 26 was used to capture and analyse the data collected. Adequate maternal nutrition knowledge and good practice were given a score of 80 percent and above each. Pearson’s correlation test was used to test for association while analysis of variance (ANOVA) test was used to test the difference between independent groups. Results: A total of 102 midwives participated in the study, achieving a response rate of 82%. Majority of midwives (89.2%) were females while 10.8% were males. The mean maternal nutrition knowledge score of midwives was 17.78±3.19 out of 34. Midwives mainly depended on their experience as their main source of maternal nutrition information. There was a significantly negative correlation between midwives’ maternal nutrition knowledge and age (p=<0.005). Midwives who were more experienced were not necessarily more knowledgeable than others. Furthermore, the study demonstrated a significantly negative correlation between midwifery experience and their maternal nutrition knowledge (p=<0.028). The mean nutrition practice score of midwives was 19.21±2.54 out of 28. Only a few midwives (10.8%) attended maternal nutrition related courses in the past two years. The findings revealed no significant difference between maternal nutrition knowledge and practices of midwives. Approximately 42.2% of midwives indicated that refresher training was necessary to improve their maternal nutrition knowledge and the quality of their nutrition practice. Conclusion: Midwives had inadequate maternal nutrition knowledge despite their many years of experience. However, nutrition care practice was moderately provided. Providing refresher courses and in-service training might improve midwives’ maternal nutrition knowledge and nutrition care. Future research should focus on exploring strategies for improving midwives’ knowledge and skills on maternal and child nutrition.
- ItemPromoting traditional and indigenous foods in South Africa : a desktop review(Stellenbosch : Stellenbosch University, 2021-12) Bobo, Zizo Nangamso; Beukes, Ronel Annamarie; Sigge, G. O.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.ENGLISH SUMMARY : INTRODUCTION: One of the most pressing issues confronting South Africa is ensuring access to sufficient, nutritious, and affordable food that is produced in a sustainable manner. However, a significant proportion of the diverse foods available in our environment have been overlooked in favour of a few commercial staple foods, resulting in a food supply that is too limited. Growing population rates, urbanization, and persistently rising food prices have resulted in a shift in dietary patterns from more traditional to more westernized diets, where healthier food options have become a luxury and highly processed and refined convenience foods are marketed as less expensive options, all of which are contributing to the emergence of a nutrition crisis in SA. This has resulted in the displacement of traditional and indigenous food crops (TIF), as well as a change in the diet of South Africans. Current dietary patterns reflect an increased intake of a small number of domesticated plant staples, while the intake of TIF, which once sustained health and nutritional status, has decreased significantly. The goal of this study is to conduct a literature evaluation on the promotion of TIF in South Africa. METHODOLOGY: This review was conducted using a systematic search of current academic literature from the following databases: Science Direct, Jstor, EBcohost, Bio-med and PubMed, and Google scholar. Abstract, title, keywords, and subject headings specific to each of the identified databases were searched. The review included studies with both analytical and descriptive study designs. RESULTS: Of the 26699 titles and abstracts screened 103 were potentially eligible. The review included five studies that included TIF as part of the intervention strategy after examination of full texts. Of the total 5 studies included in the review, 2 were cross-sectional studies, 2 were randomized control trials and 1 was a pre-test post-test control group design. All of the studies were based in rural communities. All the interventions had children, ages 1-12 years, as the primary benefactors. The studies included in this review have indicated the promotion and consumption of TIFs resulted in improved nutritional status, particularly vitamin A, zinc, and iron status. The inclusion and promotion of TIF in nutrition messages can significantly improve diet quality and ensure dietary diversification. This is attributed to the various components that form part of successful community-based interventions. CONCLUSION: The five studies discussed in the review are generally acknowledged to be successful in their own right. They have shown that the promotion, production and consumption of TIF in conjunction with nutrition messages and health-based caring practices does improve household food and nutrition security, particularly in vulnerable groups.
- ItemAssessing the knowledge and perceptions of the Road to Health Booklet by caregivers in Ekurhuleni Metropolitan Municipality, Gauteng, South Africa(Stellenbosch : Stellenbosch University, 2020-12) Mangena, Sibongile; Koornhof, Hilletjie Elizabeth; Mbhenyane, Xikombiso Gertude; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.ENGLISH SUMMARY: Introduction: Malnutrition, specifically under-nutrition in conjunction with infectious diseases, vitamin A and zinc deficiency, is one of the main causes of death in children under five years of age, globally. The Road to Health Booklet (RtHB) as a tool for Growth Monitoring and Promotion (GMP), empowers caregivers to ensure that infants and young children achieve optimum growth and nutrition. Aim: To assess the knowledge and perceptions of caregivers on the RtHB as a tool for GMP at Primary Healthcare (PHC) facilities in Ekurhuleni Metropolitan Municipality, Gauteng, South Africa. Methods: A cross sectional descriptive study was employed at four different clinics and quantitative-sociodemographic information was collected, through qualitative-in-depth interviews. Audio-recorded data was transcribed and analysed using ATLAS.ti 8 and the socio-demographic data and responses to closed-ended questions were imported into Microsoft Excel 2013 spreadsheets. Results: A total of 170 caregivers were interviewed from four different clinics, the majority (98%, n=66) were female between the ages of 24 and 35 years. Regarding the level of education, the majority (71% n=120) of the caregivers have completed secondary education (Grade 8-12). Many (63%, n=107) of the caregivers were unemployed. The study reported that caregivers were previously educated on the contents of the RtHB at birth or at the first clinic visit, and they found a lot of the information quite valuable and useful to support optimal care and growth of their child. This study also reported that there were some aspects that caregivers did not fully understand, specifically the inclusion of important information such as the HIV status of both the caregiver and child, DNA polymerase chain reaction (PCR) test results, immunisations, and developmental screening of infants and young children. The caregivers understood the importance of being able to understand the contents of the RtHB and most of them who had secondary education were able to interpret the weight-for-age growth chart and are also able understand the length-for -age growth curves adequately. Conclusion: The study reported that caregivers were previously educated on the contents of the RtHB, they found a lot of the GMP information valuable. The caregivers understood the importance of being able to understand the contents of the RtHB and the results that the growth curves present. This study revealed that there was no link between education level and caregivers’ ability to understand and interpret the growth curves, therefore there not need to have an advanced education level but basic literacy along with thorough health education is sufficient.
- ItemAssessment and management of severe acute malnutrition in children aged 6–59 months by professional nurses in primary healthcare facilities in the Johannesburg health district, South Africa : a retrospective analysis(Stellenbosch : Stellenbosch University, 2020-03) Shabangu, Simon Vally; Du Plessis, Lisanne Monica; De Lange, Christel; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.ENGLISH SUMMARY: Introduction: Severe acute malnutrition (SAM) is a public health concern, due to the high mortality rates observed in children with this condition. The correct classification of children with SAM remains a challenge. Children with SAM usually present at primary healthcare (PHC) with other illness and will only be classified and managed for SAM through the correct measurement, plotting and interpretation of anthropometric data. Children identified with SAM should be referred to the hospital and admitted for further management to reduce case-fatality rates. The management of SAM at PHC and hospitals plays a unique role in child survival. Aim: The aim of the study was to evaluate the assessment and the management of SAM in children aged 6–59 months by professional nurses in PHC facilities in the Johannesburg (JHB) health district. Methods: This was an observational study with a cross-sectional, retrospective descriptive study design. Quantitative data collection methods were used to review clinic records of children in the JHB district. Results: Records of 83 children were selected from 35 clinics. Only 81 (98%) of the children’s weights were recorded, 27 (33%) had height and only 20 (24%) of children had mid-upper arm circumference (MUAC) measurements taken. Only 12 (14%) patients had a record of oedema, 58 (66%) patients had no oedema noted while in 16 (19%) patients there were no entries recorded for either the presence or absence of oedema. Nurses assessed 51 (61%) of children for feeding, of which 18 (35%) were still breastfeeding, 49 (96%) were receiving formula milk and 26 (51%) of the children were recorded as receiving solid food. Only 12 (14%) of the children were correctly identified with SAM. Conclusion: The study concludes that the overall assessment, classification and management for children with SAM in JHB district clinics was poor and often did not adhere to the Integrated Management of Childhood Illnesses (IMCI) guidelines. The practices of professional nurses in this district point to poor recognition of the need for accurate assessment and monitoring in order to reduce the risk of death in children with SAM.