A community-based survey in a low-income area of the City of Cape Town of the information contained in the Road-to-Health booklet of children under 5 and their actual health status.

George, Lance Michael (2021-12)

Thesis (MPhil)--Stellenbosch University, 2021.

Thesis

ENGLISH SUMMARY: Background: The present study is a community-based survey in certain low-income areas of the City of Cape Town of the information contained in the ‘Road to health booklet’ of children under 5 and their actual health status. A cross-sectional survey design with a systematic sampling strategy was employed in this study. Methods: The study took place in four low-income areas in the Kuils River area of the Cape Metropole, namely, Kalkfontein, Wesbank, Happy Valley and Eerste River. In total 250 households were randomly selected for participation in the study, when a child under the age of 5 was not present in the home, the next house with such a child was selected. The RtH booklets or cards were analysed for completeness of information. The information on demographics and health was obtained through a structured interview with the main caregiver in each household. A home inspection was performed in order to determine general living conditions. Results: A total of 278 children under the age of 5 years were included in this study. A reported 22.3% had the older RtH card, 65.5% had the newer booklet, while 11.9% had no card or a lost or missing card. When looking at the quality of information contained in the RtH cards/booklets, 18% was classified as good, 59.6% as fair and 22.4% as poor. A reported 88.6% of RtH cards/booklets were up to date but only 13.5% had complete information. The study found that both immunizations and weight-for-age were completed 91% of the time. Vitamin A was completed 83.3% of the time while deworming was 77.1% completed. The least completed sections were height-for-age at 22.4% and mid upper arm circumference at 18%. Sixty three percent of dwellings were brick houses while 37% were shacks. A reported 31.7% of household occupants had full time employment while 57.5% were unemployed. Almost 10% of households had an income of less than R600 per month while 38.8% of households had a total income between R600 and R2500. A reported 24.8% of households suffered from food insecurity. Almost 53% of households living conditions was classified as in a poor state. Conclusion: Results of that study indicated that many of the RtH cards or booklets were incomplete with the exception of weight-for-age and immunization which had an over 90% completion. Major data missing was the completion of the height-for-age and mid upper arm circumference. The RtH system is the major strategy to track development, health needs and health status of young children. It is vital to utilize all aspects of the RtH system in order to alert healthcare workers of a child with a health issue so that immediate corrective action can be taken. The study identified a need to improve the training of healthcare workers as well caregivers on all aspects of the RtH booklet in order to utilize its full potential in improving the health of children under the age of five years old. The information that could potentially be collected by an optimal RtH system can be of immense value for health planning. At present this opportunity is lost due to the poor information available from the RtH system.

AFRIKAANSE OPSOMMING: Agtergrond: Die huidige studie is 'n gemeenskapsgebaseerde opname in sekere lae-inkomste gebiede van die Stad Kaapstad. Die inligting verkry van die Pad-na-Gesondheid kaart/boekie en die gesondheidstatus van kinders onder die ouderdom van 5 jaar is versamel. 'n Dwarsdeursnit opname studie met 'n sistematiese monsterneming met ewekansige beginpunte is gebruik. Metodes: Die studie het plaasgevind in vier lae-inkomste gebiede in die Kuilsriviergebied van die Kaapstadse Metropool, naamlik Kalkfontein, Wesbank, Happy Valley en Eersterivier. 'n Totaal van 250 huishoudings is ewekansig geselekteer vir deelname. In huishoudings waar daar nie 'n kind onder 5 jaar teenwoordig was nie was die volgende huis met so 'n kind geselekteer. Die Pad-na- Gesondheid kaart of boekie is gebruik om inligting te bekom. Die inligting oor demografie en gesondheid is bekom met behulp van 'n gestruktureerde onderhoud met die hoofversorger in elke huishouding. 'n Inspeksie van die huis is uitgevoer om die algemene lewenstoestande te bepaal. Resultate: 'n Totaal van 278 kinders onder die ouderdom van 5 jaar is ingesluit in die studie. Daar was 22.3% van die kinders wat die ouer weergawe naamlik 'n kaart gehad het, 65.5% het die nuwer boekie gehad terwyl 11.9% nie 'n kaart gehad het nie of wie se kaart verlore was. Die kwaliteit van die inligting op die kaarte/boekies is beoordeel as goed in 18% van gevalle, gemiddeld in 59.6% van gevalle en swak in 22.4% van gevalle. Daar was 88.6% van die kaarte/boekies wat op datum was, maar slegs 13.5% het volledige inligting bevat. Vitamien A dosering is aangeteken in 83.3% van die rekords. Immunisasie en gewig-vir-ouderdom is aangeteken in 91% van gevalle terwyl ontwurming aangeteken is in 77.1%. Die seksies wat die swakste voltooi is, was lengte-vir-ouderdom (22.4%) en midboarm omtrek (18%). Drie-en-sestig persent van die wonings was baksteenhuise terwyl 37% krotwonings ("shacks") was. 'n Gerapporteerde 31.7% van huishoudings het 'n persoon met voltydse werk gehad terwyl 57.5% werkloos was. Byna 10% van die huishoudings het 'n inlomste van minder as R600 per maand gehad terwyl 38.8% 'n inkomste tussen R600 en R2500 per maand gehad het. Daar het 24.8% van huishoudings gerapprteer dat hulle voedselonsekerheid ondervind. Byna 53% van die huishoudings het geleef in omstandighede was as swak geklassifiseer is. Gevolgtrekking: Die resultate het aangedui dat oor die algemeen die Pad-na-Gesondheid dokumente onvolledig was met die uitsondering van gewig-vir-ouderdom en immunisasie, wat meer as 90% volledig was. Lengte-vir-ouderdom en midboarm omtrek was die swakte aangeteken. Die Pad-na-Gesondheid stelsel is die belangrikste strategie om ontwikkeling, gesondheidsbehoeftes en gesondheidstatus van jong kinders na te volg. Dit is noodsaaklik dat alle aspekte van die stelsel in orde is sodat gesondheidswerkers bewus kan wees van kinders met gosondheidsprobleme en sodat behoorlike aksies so gou moontlik geneem kan word. Die studie het uitgewys dat daar 'n behoefte bestaan om gesondheidswerkers se kennis en aanwending van al die aspekte van die Pad-na-Gesondheid stelsel te verbeter. Dit sal bydra om die gesondheid van kinders onder die ouderdom van 5 jaar te verbeter. Die inligting wat potensieel versamel kan word deur 'n behoorlik funksionerende Pad-na-Gesondheid stelsel kan van groot waarde wees vir gesondheidsbeplanning. Huidig is hierdie geleentheid verlore weens die swak inligting wat op hierdie stelsel aangeteken word.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/124256
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