Masters Degrees (Human Nutrition)

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    A 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.
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    Nutrition 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.
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    Promoting 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.
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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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    School feeding programmes in Malmesbury : does the national policy match what is on the plate? a pilot study
    (Stellenbosch : Stellenbosch University, 2021-03) Taljaard, Marli; Ebrahim, Zarina; Sigge, Gunnar; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.
    ENGLISH SUMMARY: The National School Nutrition Programme (NSNP) is a nation-wide programme that provides macro- and micronutrient-rich meals to all learners in primary and secondary schools daily. In quintile 1–3 schools, all learners are able to receive a meal at school; however, in Quintile 4–5, only 40% of learners receive meals at school (Devereux et al., 2018). School-aged children experience an increase in motor skills, cognitive, social and emotional development. Nutrients are essential to ensure this optimum physical and psychosocial development health (França et al., 2018). NSNP’s can improve, promote and maintain healthy eating habits and assist in preventing nutritional deficiencies, excess weight gain and chronic diseases (França et al., 2018). It has been found that younger children benefit more from NSNPs than older children (Powell et al., 1998), therefore the earlier NSNPs can be initiated in younger children, the bigger the impact on their development. As part of the NSNP, schools are encouraged to cultivate school food gardens that can supplement the menus (DBE, 2018a). The aim of this study was to investigate the implementation of the NSNP in primary schools in the Malmesbury area of the Western Cape. The objectives were: to determine the content of the served meals and whether it followed the predetermined menu guidelines; to evaluate the procurement, storage, preparation and serving conditions in the schools; and to observe whether a school food garden was established. The study area includes Quintile 1–3 primary schools (12) in the Malmesbury district of the West Coast region. The study was a cross-sectional observational design. Data was collected at the selected primary schools, using an observational checklist and a self-administered questionnaire for the food handlers, NSNP coordinators and food gardener. The findings of the study indicated that the schools implemented the NSNP well. Although the food served at the schools followed the predetermined menus, the recommended daily allowance (RDA) % for energy was not met according to the NSNP guidelines at any of the schools participating in the study. In terms of the food delivery system used, the procurement of raw materials was satisfactory and the storage conditions at the schools were clean and adequate. Preparation of meals was done by food handlers who all displayed a good sense of personal hygiene, and safe food-handling practices were observed. Food gardens at schools that had these were well maintained and the produce contributed toward the NSNP menu. In general, the schools observed implemented the NSNP according to the guidelines, allowing the programme to reach its potential aims and have a positive impact on the learners attending school.