A stunting profile of children under the age of five visiting Bhisho hospital clinic, part of the umbrella project: a profile of stunting in children under the age of five in food insecure villages in Mqanduli, Ngqushwa and Bhisho hospital, Eastern Cape, South Africa
- Authors: Beyleveld, Janine
- Date: 2020
- Subjects: Children -- growth
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/50201 , vital:42066
- Description: Introduction and Background: Stunting is the most prevalent form of childhood malnutrition where about 149 million children under the age of five can be classified as stunted globally. South Africa has one of the highest stunting rates in the world at 27%, causing devastating effects on economic productivity as well as on an individual’s nutritional status. The presence of stunted growth in children is a strong indicator of chronic undernutrition and highlights injustices experienced within communities. Aims and Objectives: The aim of this study is to develop a stunning profile of children under the age of five, visiting BhishoHospital’s gateway clinic in the Eastern Cape, South Africa. The objectives were to determine the prevalence of stunting of the children visiting Bhisho Hospital’s clinic and to identify the drivers of stunting in the area. Methodology: A quantitative study with a descriptive, cross-sectional design was used. The study population included all children under the age of five visiting Bhisho Hospital’s clinic. Data was collected by means of an interview-administered questionnaire. Results: The prevalence of stunting in the area was 47.5%. A significant association was found between the participants' main form of sanitation and stunting category in the group of infants younger than six months (p = 0.007) and the group older than six months(p = 0.040). Discussion: The prevalence of stunting in the area was far higher than the national average of 27%, although the majority of the sample had a normal weight. The use of non-flush toilets was found to be a risk factor for childhood stunting. Recommendation: Financial and political investment in child health needs to be placed as a top priority in South Africa to reduce stunting rates.
- Full Text:
- Date Issued: 2020
- Authors: Beyleveld, Janine
- Date: 2020
- Subjects: Children -- growth
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/50201 , vital:42066
- Description: Introduction and Background: Stunting is the most prevalent form of childhood malnutrition where about 149 million children under the age of five can be classified as stunted globally. South Africa has one of the highest stunting rates in the world at 27%, causing devastating effects on economic productivity as well as on an individual’s nutritional status. The presence of stunted growth in children is a strong indicator of chronic undernutrition and highlights injustices experienced within communities. Aims and Objectives: The aim of this study is to develop a stunning profile of children under the age of five, visiting BhishoHospital’s gateway clinic in the Eastern Cape, South Africa. The objectives were to determine the prevalence of stunting of the children visiting Bhisho Hospital’s clinic and to identify the drivers of stunting in the area. Methodology: A quantitative study with a descriptive, cross-sectional design was used. The study population included all children under the age of five visiting Bhisho Hospital’s clinic. Data was collected by means of an interview-administered questionnaire. Results: The prevalence of stunting in the area was 47.5%. A significant association was found between the participants' main form of sanitation and stunting category in the group of infants younger than six months (p = 0.007) and the group older than six months(p = 0.040). Discussion: The prevalence of stunting in the area was far higher than the national average of 27%, although the majority of the sample had a normal weight. The use of non-flush toilets was found to be a risk factor for childhood stunting. Recommendation: Financial and political investment in child health needs to be placed as a top priority in South Africa to reduce stunting rates.
- Full Text:
- Date Issued: 2020
Associations between family history of diseases of lifestyle, lifestyle behaviour and anthropometric nutritional status of pre-school children in ECD centres in the Nelson Mandela Bay Municipality
- Authors: Wilson, Teresa Margaret
- Date: 2020
- Subjects: Nutrition--Evaluation
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46344 , vital:39602
- Description: Introduction: Childhood overweight and obesity is an escalating global health issue. In Africa, overweight and obesity prevalence in children has nearly doubled since 2000(World Health Organisation, 2018).TheSANHANES-1 study (2013) identified that overweight and obesity in were most prevalent in urban informal areas of South Africa, with approximately a quarter of the children classified as overweight or obese (Shisana et al., 2013).In the Nelson Mandela Bay Municipality(NMBM), a double burden of disease was identified in the lower socio-economic population (Phekana et al., 2016). This study and others recommended further study into the contributing factors and behaviours which play a role in the development of overweight and obesity in children. These include household dietary intake, family history of lifestyle diseases, as well as the children’s and parental physical activity and sedentary time (Zhang et al.,2016).Aim: The aim of the study was to determine the associations between family history of diseases of lifestyle, lifestyle behaviour and anthropometric nutritional status of pre-school children in NMBM to describe underlying causes of childhood overweight and obesity.Methods: A cross-sectional design, using a quantitative approach, was used for this study(Ethics approval: H18-HEA-DIET-004). The study population included adult parents and/or caregivers of children from urban areas of Nelson Mandela Bay Municipality attending crèches and schools in these areas, in the age group from birth to 96 months (8 years). Randomised cluster sampling of crèches and schools from an existing database of anthropometrical data of children attending these crèches and schools in the area was done and a final sample of n=155obtained. With the assistance of a trained fieldworker, respondents completed a questionnaire detailing the family history of lifestyle diseases, physical activity levels and sedentary screen time behaviours, and a graphical adjusted version of a household dietary diversity questionnaire. Data about children’s activity levels in the preschool/creche environment was collected by the fieldworker by assessing the ECD centres’daily activity schedules. The anthropometric data of the children of the respondents was accessed from an existing database of these measurements. The data was described using means and standard deviations. Inferential statistics determined any existing associations between these underlying influences of childhood obesity.Results: Only 2% (n=3) of the children were underweight and 12% (n=9) were at risk of becoming underweight as classified by WAZ. HAZ scores identified26% (n=40) of the children at risk of becoming stunted, and 6% (n=9) of the children were already stunted. WHZ classified5% (n=8)of the children as overweight and 5% (n=8)as obese. A further 22% (n=34) of the children were at risk of becoming overweight.BMI/age classificationidentified25% (n=38) of the children as overweight and a further 12% (n=19) as obese. Out of the sample, 12%(n=17) of mothers and 8% (n=7) of fathers were categorised as overweight-to-obese according to the SA specific waist circumference(WC)cut-offs. Out of the children, 15% (n=22) have at least one parent who was overweight-to-obese. Traditional WC categories were classified48% (n=67) of the mothers as overweight-to-obese and at high risk for metabolic syndrome. Of all the lifestyle diseases, hypertension was the most prevalent with 29% (n=41) of households having at least one parent with hypertension. Parental physical activity was grossly overestimated, and the results found to be invalid. The Diet Variety and Frequency score resulted in a mean of 65.00 (n=154, SD=27.37) out of a possible 100 for the households in this sample, and junk food was consumed on three to four occasions per day in 32% (n=49) of households. There were no significant associations found between the parents’ variables and underweight children. Statistically small to medium effect associations were found between parental weight (both SA specific and traditional categories) and overweight children (classified by WHZ and BMI/age). Conclusions and recommendations: The prevalence of overweight and obesity among children in the NMBM was high. The only possible underlying cause of childhood overweight and obesity in pre-school children in the NMBM that could be determined by this study was parents’ weight classified by WC. However, it must be reiterated that due to the cross-sectional nature of the study, an association does not immediately mean causation, and the results are not adequate to rule out other underlying factors influencing childhood obesity. It is recommended that the results of the study are used to incentivise the final implementation of all the intervention targets laid out in the Strategic Plan for the Prevention and Control of Obesity in South Africa 2015-2020 in NMB, and for the development of the future obesity strategy after 2020. The results have shown the necessity for future health interventions to be targeted at the family as a unit.
- Full Text:
- Date Issued: 2020
- Authors: Wilson, Teresa Margaret
- Date: 2020
- Subjects: Nutrition--Evaluation
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46344 , vital:39602
- Description: Introduction: Childhood overweight and obesity is an escalating global health issue. In Africa, overweight and obesity prevalence in children has nearly doubled since 2000(World Health Organisation, 2018).TheSANHANES-1 study (2013) identified that overweight and obesity in were most prevalent in urban informal areas of South Africa, with approximately a quarter of the children classified as overweight or obese (Shisana et al., 2013).In the Nelson Mandela Bay Municipality(NMBM), a double burden of disease was identified in the lower socio-economic population (Phekana et al., 2016). This study and others recommended further study into the contributing factors and behaviours which play a role in the development of overweight and obesity in children. These include household dietary intake, family history of lifestyle diseases, as well as the children’s and parental physical activity and sedentary time (Zhang et al.,2016).Aim: The aim of the study was to determine the associations between family history of diseases of lifestyle, lifestyle behaviour and anthropometric nutritional status of pre-school children in NMBM to describe underlying causes of childhood overweight and obesity.Methods: A cross-sectional design, using a quantitative approach, was used for this study(Ethics approval: H18-HEA-DIET-004). The study population included adult parents and/or caregivers of children from urban areas of Nelson Mandela Bay Municipality attending crèches and schools in these areas, in the age group from birth to 96 months (8 years). Randomised cluster sampling of crèches and schools from an existing database of anthropometrical data of children attending these crèches and schools in the area was done and a final sample of n=155obtained. With the assistance of a trained fieldworker, respondents completed a questionnaire detailing the family history of lifestyle diseases, physical activity levels and sedentary screen time behaviours, and a graphical adjusted version of a household dietary diversity questionnaire. Data about children’s activity levels in the preschool/creche environment was collected by the fieldworker by assessing the ECD centres’daily activity schedules. The anthropometric data of the children of the respondents was accessed from an existing database of these measurements. The data was described using means and standard deviations. Inferential statistics determined any existing associations between these underlying influences of childhood obesity.Results: Only 2% (n=3) of the children were underweight and 12% (n=9) were at risk of becoming underweight as classified by WAZ. HAZ scores identified26% (n=40) of the children at risk of becoming stunted, and 6% (n=9) of the children were already stunted. WHZ classified5% (n=8)of the children as overweight and 5% (n=8)as obese. A further 22% (n=34) of the children were at risk of becoming overweight.BMI/age classificationidentified25% (n=38) of the children as overweight and a further 12% (n=19) as obese. Out of the sample, 12%(n=17) of mothers and 8% (n=7) of fathers were categorised as overweight-to-obese according to the SA specific waist circumference(WC)cut-offs. Out of the children, 15% (n=22) have at least one parent who was overweight-to-obese. Traditional WC categories were classified48% (n=67) of the mothers as overweight-to-obese and at high risk for metabolic syndrome. Of all the lifestyle diseases, hypertension was the most prevalent with 29% (n=41) of households having at least one parent with hypertension. Parental physical activity was grossly overestimated, and the results found to be invalid. The Diet Variety and Frequency score resulted in a mean of 65.00 (n=154, SD=27.37) out of a possible 100 for the households in this sample, and junk food was consumed on three to four occasions per day in 32% (n=49) of households. There were no significant associations found between the parents’ variables and underweight children. Statistically small to medium effect associations were found between parental weight (both SA specific and traditional categories) and overweight children (classified by WHZ and BMI/age). Conclusions and recommendations: The prevalence of overweight and obesity among children in the NMBM was high. The only possible underlying cause of childhood overweight and obesity in pre-school children in the NMBM that could be determined by this study was parents’ weight classified by WC. However, it must be reiterated that due to the cross-sectional nature of the study, an association does not immediately mean causation, and the results are not adequate to rule out other underlying factors influencing childhood obesity. It is recommended that the results of the study are used to incentivise the final implementation of all the intervention targets laid out in the Strategic Plan for the Prevention and Control of Obesity in South Africa 2015-2020 in NMB, and for the development of the future obesity strategy after 2020. The results have shown the necessity for future health interventions to be targeted at the family as a unit.
- Full Text:
- Date Issued: 2020
Change of perspectives and behaviour regarding lifestyle, with emphasis on dietary habits, in a rural community
- Authors: Barnard, Mariska
- Date: 2020
- Subjects: Food habits
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46384 , vital:39565
- Description: Background: The steady increase in deaths due to non-communicable diseases (NCDs) in South Africa is raising concern, as 63% of all deaths worldwide are attributed to NCDs and these diseases cause 36 million deaths each year, with 80 % of incidences occurring in low-and middle-income countries. In rural communities where income is increasing, the prevalence of NCDs are increasing as well. Due to the lack of NCD prevention and treatment in rural communities, it is expected that, if health promotion strategies are not implemented and socio-economic development in South Africa continues, there will soon be an uncontrollable NCD epidemic. It has been found that dietary risks affected people’s healthirrespective of their age, gender or residential sociodemographic development and that dietary improvement might prevent one in every five deaths worldwide.Aim:The aim of this study was to determine the factors that influence the perceptions and behaviour in a rural community with a low socio-economic status regarding dietary habits and to use the knowledge to formulate an effective dietary modification strategy.Designand methodology:For this study,action research with a quantitative and qualitative component was followed.The quantitative component focuses on measureable aspects, and the qualitative component focuses on meaning. Data was collected following the standard operating procedure for anthropometry, blood pressure and blood glucose. Further methods used were questionnaires, 24-hour dietary recalls and focus group discussions. Data were analysed using Microsoft Excel, FoodFinder3 and other calculations.Sample and setting:A convenience sample (n = 16) wasused and this study was undertaken on request of the non-governmental organization, Karoo Angels and included all participants who earn an income and who do not work for themselves, that were willing to participate and living in Rietbron and Vondeling, in the Sarah BaartmanDistrict in the Eastern Cape. Results:Weight changes took place, both the crafters in the mild thinness category gained weight, one gained 3.9 kg and the other 0.5 kg. The three crafters in the normal category did not have to gain or lose weight, but all three ofthem gained an average of 3.6 kg. For the group who had to lose weight, no statistically significant weight change took place from before the intervention (76.08 ±17.67 kg) to after the intervention (75.81 ± 17.81 kg, t(10) = 0.692, p = 0.505). The maximum weight lost ivwas 3.1 kg and the maximum weight gained was 3.2 kg. Changes took place regarding BMI, waist circumference, waist-to-hip ratio and neck circumference. Some positively changed their BMI status.After the implementation of the intervention, there was a slight decrease in frequency of alcohol consumption, but smoking and physical activity remained mostly the same. Hypertension was the most prevalent NCD and is linked to smoking and alcohol consumption which is prevalent in this study. Fruit and vegetable consumption is low, and a slight increase in consumption was evident. A maximum dietary diversityscore of seven and minimum of two, where the mean was 3.81was found. The crafters’ diet did not meet the DASH diet recommendation,the mean energy distribution is of all macronutrients differ with ±4% and none of the participants’ mean micronutrients intake met the recommendations of the DASH diet or RDA. Factors that prevent them from reaching their goals included low income, low availability of fruit, vegetables and transport and no storage for food.Conclusion:It is important to consider the individuals’ living conditions, resources, knowledge, motivation and social group. The environment and resources available have a significant impact on the lifestyle of the individuals. Directing efforts of behaviour change to increase dietary diversity as the main objective, might be a more efficient way to change behaviour.Recommendations:Future studies should consider doing this study over a longer time period. The involvement of a psychologist would also be beneficial to assist the process of behaviour change.
- Full Text:
- Date Issued: 2020
- Authors: Barnard, Mariska
- Date: 2020
- Subjects: Food habits
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46384 , vital:39565
- Description: Background: The steady increase in deaths due to non-communicable diseases (NCDs) in South Africa is raising concern, as 63% of all deaths worldwide are attributed to NCDs and these diseases cause 36 million deaths each year, with 80 % of incidences occurring in low-and middle-income countries. In rural communities where income is increasing, the prevalence of NCDs are increasing as well. Due to the lack of NCD prevention and treatment in rural communities, it is expected that, if health promotion strategies are not implemented and socio-economic development in South Africa continues, there will soon be an uncontrollable NCD epidemic. It has been found that dietary risks affected people’s healthirrespective of their age, gender or residential sociodemographic development and that dietary improvement might prevent one in every five deaths worldwide.Aim:The aim of this study was to determine the factors that influence the perceptions and behaviour in a rural community with a low socio-economic status regarding dietary habits and to use the knowledge to formulate an effective dietary modification strategy.Designand methodology:For this study,action research with a quantitative and qualitative component was followed.The quantitative component focuses on measureable aspects, and the qualitative component focuses on meaning. Data was collected following the standard operating procedure for anthropometry, blood pressure and blood glucose. Further methods used were questionnaires, 24-hour dietary recalls and focus group discussions. Data were analysed using Microsoft Excel, FoodFinder3 and other calculations.Sample and setting:A convenience sample (n = 16) wasused and this study was undertaken on request of the non-governmental organization, Karoo Angels and included all participants who earn an income and who do not work for themselves, that were willing to participate and living in Rietbron and Vondeling, in the Sarah BaartmanDistrict in the Eastern Cape. Results:Weight changes took place, both the crafters in the mild thinness category gained weight, one gained 3.9 kg and the other 0.5 kg. The three crafters in the normal category did not have to gain or lose weight, but all three ofthem gained an average of 3.6 kg. For the group who had to lose weight, no statistically significant weight change took place from before the intervention (76.08 ±17.67 kg) to after the intervention (75.81 ± 17.81 kg, t(10) = 0.692, p = 0.505). The maximum weight lost ivwas 3.1 kg and the maximum weight gained was 3.2 kg. Changes took place regarding BMI, waist circumference, waist-to-hip ratio and neck circumference. Some positively changed their BMI status.After the implementation of the intervention, there was a slight decrease in frequency of alcohol consumption, but smoking and physical activity remained mostly the same. Hypertension was the most prevalent NCD and is linked to smoking and alcohol consumption which is prevalent in this study. Fruit and vegetable consumption is low, and a slight increase in consumption was evident. A maximum dietary diversityscore of seven and minimum of two, where the mean was 3.81was found. The crafters’ diet did not meet the DASH diet recommendation,the mean energy distribution is of all macronutrients differ with ±4% and none of the participants’ mean micronutrients intake met the recommendations of the DASH diet or RDA. Factors that prevent them from reaching their goals included low income, low availability of fruit, vegetables and transport and no storage for food.Conclusion:It is important to consider the individuals’ living conditions, resources, knowledge, motivation and social group. The environment and resources available have a significant impact on the lifestyle of the individuals. Directing efforts of behaviour change to increase dietary diversity as the main objective, might be a more efficient way to change behaviour.Recommendations:Future studies should consider doing this study over a longer time period. The involvement of a psychologist would also be beneficial to assist the process of behaviour change.
- Full Text:
- Date Issued: 2020
Grandmothers’ perceptions regarding breastfeeding following training for breastfeeding support in Nelson Mandela Bay Health District: a qualitative study
- Authors: Manyange, Rumbidzai Lynda
- Date: 2020
- Subjects: Breastfeeding promotion
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46441 , vital:39583
- Description: Rationale: Although there has been active promotion of breastfeeding for the past decades in South Africa, there has been inadequate support from multiple role players. Strategies that do not engage important family members, such as grandmothers in supporting breastfeeding are likely to fail. In many African countries, grandmothers often make critical decisions about early child feeding practices, particularly for first-time mothers. Despite the influence grandmothers have, limited studies have been done in South Africa to assess whether it is possible to change breastfeeding outcomes by empowering grandmothers as well as including them in intervention programmes. Nelson Mandela University, in collaboration with the United Nations Children Education Fund (UNICEF) and a local Non-Governmental Organisation (NGO), recently launched a breastfeeding support programme, Sakha Esethu. The aim was to capacitate both primary and secondary caregivers to enable them to provide optimal breastfeeding support for mothers in various communities. However, it was important to explore the perceptions of grandmothers regarding breastfeeding to assess whether improved breastfeeding knowledge will translate into changed perceptions and therefore improved support for exclusive breastfeeding in communities in Nelson Mandela Bay. Aim: The study aimed to describe and explore the perceptions of grandmothers regarding breastfeeding after participating in a breastfeeding support programme in Nelson Mandela Bay health district (NMBHD). Methodology: The study followed a descriptive-exploratory, contextual study design with a qualitative approach. The four ethical principles that guided the study were: autonomy, non-maleficence, beneficence and justice. The researcher conducted five focus group discussions (FGD) at ECD centres in NMBHD, where 34 grandmothers participated in the study. Participants were chosen using a purposively sampling technique and data was collected using FGD interviews. Verbatim transcription was done after every FGD and data was analysed using the eight steps of Tesch’s analysis technique. An independent coder with experience in qualitative data analysis assisted to verify the codes generated. vi Results: Four major themes and eleven subthemes emerged through data analysis. The identified themes were: (1)Participant knowledge regarding breastfeeding. Participants reflected on poor knowledge on the perceived maternal benefits of breastfeeding, variance on the optimal duration of breastfeeding and recognised myths and cultural taboos related to breastfeeding, such as the use of traditional mixes, “dirty” breastmilk and perceived milk insufficiency; (2) Views on complementary feeding. The subthemes that emerged included: Participants shared their views on the age of introduction for complementary foods and feeding practices for infants; (3) Challenges related to breastfeeding. The challenges identified included: challenges for working mothers and those attending school, lack of family support and societal support for EBF, lack of support from healthcare professionals relating to initiation and continuation of breastfeeding and difficulties coping with breast health. (4) Participants enthused about the impact of being supported to optimise breastfeeding.Participants were able to share on the camaraderie benefits experienced from the Sakha Esethu group as well as on the support grandmothers can provide. Conclusion and Recommendations: This study confirmed that participation of grandmothers in the Sakha Esethu programme had an impact on changes in grandmothers’ perceptions regarding breastfeeding. However, the programme can be further improved by placing more emphasis on aspects i.e. maternal benefits of breastfeeding, during mentor training. Furthermore, there is a need to strengthen healthcare worker support and training, especially with regards to adapting counselling strategies to include breastfeeding challenges and cultural beliefs.
- Full Text:
- Date Issued: 2020
- Authors: Manyange, Rumbidzai Lynda
- Date: 2020
- Subjects: Breastfeeding promotion
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46441 , vital:39583
- Description: Rationale: Although there has been active promotion of breastfeeding for the past decades in South Africa, there has been inadequate support from multiple role players. Strategies that do not engage important family members, such as grandmothers in supporting breastfeeding are likely to fail. In many African countries, grandmothers often make critical decisions about early child feeding practices, particularly for first-time mothers. Despite the influence grandmothers have, limited studies have been done in South Africa to assess whether it is possible to change breastfeeding outcomes by empowering grandmothers as well as including them in intervention programmes. Nelson Mandela University, in collaboration with the United Nations Children Education Fund (UNICEF) and a local Non-Governmental Organisation (NGO), recently launched a breastfeeding support programme, Sakha Esethu. The aim was to capacitate both primary and secondary caregivers to enable them to provide optimal breastfeeding support for mothers in various communities. However, it was important to explore the perceptions of grandmothers regarding breastfeeding to assess whether improved breastfeeding knowledge will translate into changed perceptions and therefore improved support for exclusive breastfeeding in communities in Nelson Mandela Bay. Aim: The study aimed to describe and explore the perceptions of grandmothers regarding breastfeeding after participating in a breastfeeding support programme in Nelson Mandela Bay health district (NMBHD). Methodology: The study followed a descriptive-exploratory, contextual study design with a qualitative approach. The four ethical principles that guided the study were: autonomy, non-maleficence, beneficence and justice. The researcher conducted five focus group discussions (FGD) at ECD centres in NMBHD, where 34 grandmothers participated in the study. Participants were chosen using a purposively sampling technique and data was collected using FGD interviews. Verbatim transcription was done after every FGD and data was analysed using the eight steps of Tesch’s analysis technique. An independent coder with experience in qualitative data analysis assisted to verify the codes generated. vi Results: Four major themes and eleven subthemes emerged through data analysis. The identified themes were: (1)Participant knowledge regarding breastfeeding. Participants reflected on poor knowledge on the perceived maternal benefits of breastfeeding, variance on the optimal duration of breastfeeding and recognised myths and cultural taboos related to breastfeeding, such as the use of traditional mixes, “dirty” breastmilk and perceived milk insufficiency; (2) Views on complementary feeding. The subthemes that emerged included: Participants shared their views on the age of introduction for complementary foods and feeding practices for infants; (3) Challenges related to breastfeeding. The challenges identified included: challenges for working mothers and those attending school, lack of family support and societal support for EBF, lack of support from healthcare professionals relating to initiation and continuation of breastfeeding and difficulties coping with breast health. (4) Participants enthused about the impact of being supported to optimise breastfeeding.Participants were able to share on the camaraderie benefits experienced from the Sakha Esethu group as well as on the support grandmothers can provide. Conclusion and Recommendations: This study confirmed that participation of grandmothers in the Sakha Esethu programme had an impact on changes in grandmothers’ perceptions regarding breastfeeding. However, the programme can be further improved by placing more emphasis on aspects i.e. maternal benefits of breastfeeding, during mentor training. Furthermore, there is a need to strengthen healthcare worker support and training, especially with regards to adapting counselling strategies to include breastfeeding challenges and cultural beliefs.
- Full Text:
- Date Issued: 2020
Older people’s perspectives on the effectiveness of eye movement integration (emi) therapy as treatment intervention for their trauma symptoms
- Authors: Visagie, Andrea
- Date: 2020
- Subjects: Post-traumatic stress disorder in old age
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46389 , vital:39601
- Description: Many research studies propose that we have an ageing population with an increased number of people living past the age of 85 years. Ageing is accompanied by a gradual decline in physical, mental and sensory abilities. Older people may have experienced trauma throughout their lives, and very often, their symptoms of trauma are regarded as part of the ageing process rather than actual symptoms of trauma. In addition, older people often do not seek help throughout their lives for various reasons. While there is research available about older people and trauma, little is known about Eye Movement Integration(EMI)therapy as a treatment intervention in treating symptoms of trauma in older persons. The purpose of this research was an explorative and descriptive study of older people’s responses to EMI therapy as a treatment intervention for their symptoms of trauma. More specifically, the study was designed to determine how older people process their symptoms through EMI therapy and whether they view it as valuable. This qualitative study used an exploratory-descriptive research design with a non-probability, purposive sampling method. The EMI therapy sessions were offered to older adults in the Knysna area who presented with symptoms of trauma. From this group, only those who were able and willing to engage in therapeutic interviews formed part of the research. As part of the study, they consented to the use of their inventories from the EMI sessions as a qualitative document analysis and taking part in qualitative interviews to explore their views on the usefulness of EMI therapy to deal with their trauma. The findings emphasise that older people are not familiar with EMI. However, they view their experience of it in a positive light and regard it as a useful treatment intervention for treating their symptoms. Moreover, EMI seems to be a brief and cost-effective trauma intervention with practical benefits for older adults. The results from this study can assist social work professionals, specifically those working with older people, to address and improve the overall health and emotional wellbeing of older people. Data verification methods ensured the validity of this study
- Full Text:
- Date Issued: 2020
- Authors: Visagie, Andrea
- Date: 2020
- Subjects: Post-traumatic stress disorder in old age
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46389 , vital:39601
- Description: Many research studies propose that we have an ageing population with an increased number of people living past the age of 85 years. Ageing is accompanied by a gradual decline in physical, mental and sensory abilities. Older people may have experienced trauma throughout their lives, and very often, their symptoms of trauma are regarded as part of the ageing process rather than actual symptoms of trauma. In addition, older people often do not seek help throughout their lives for various reasons. While there is research available about older people and trauma, little is known about Eye Movement Integration(EMI)therapy as a treatment intervention in treating symptoms of trauma in older persons. The purpose of this research was an explorative and descriptive study of older people’s responses to EMI therapy as a treatment intervention for their symptoms of trauma. More specifically, the study was designed to determine how older people process their symptoms through EMI therapy and whether they view it as valuable. This qualitative study used an exploratory-descriptive research design with a non-probability, purposive sampling method. The EMI therapy sessions were offered to older adults in the Knysna area who presented with symptoms of trauma. From this group, only those who were able and willing to engage in therapeutic interviews formed part of the research. As part of the study, they consented to the use of their inventories from the EMI sessions as a qualitative document analysis and taking part in qualitative interviews to explore their views on the usefulness of EMI therapy to deal with their trauma. The findings emphasise that older people are not familiar with EMI. However, they view their experience of it in a positive light and regard it as a useful treatment intervention for treating their symptoms. Moreover, EMI seems to be a brief and cost-effective trauma intervention with practical benefits for older adults. The results from this study can assist social work professionals, specifically those working with older people, to address and improve the overall health and emotional wellbeing of older people. Data verification methods ensured the validity of this study
- Full Text:
- Date Issued: 2020
Parents’ perceptions of the content of pre-school lunch boxes following a nutritional programme in Nelson Mandela Bay
- Authors: Midigo, Odwour Erich
- Date: 2020
- Subjects: Children -- Nutrition
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46429 , vital:39587
- Description: Rationale: Lunchboxes that parents prepare for preschool children have been noted to fall short of the recommended paediatrics dietary standards. No research has been done in Nelson Mandela Bay (NMB) to describe the perceptions of parents preparing the lunch boxes, particularly in underprivileged communities, and if nutrition education strategies can improve these practices. This study answered the following research question: How can nutrition education programmes play a role in parents’ perceptions about the content of the lunchboxes of children attending early childhood development centres (ECD) in underprivileged communities of NMB metropole? Aim: The research aimed at describing and exploring parents’ perceptions of the content of pre-school children’s lunch boxes following a nutrition programme.Methods: This descriptive, explorative study adopted a qualitative approach. Twenty-five participants were selected conveniently while five pre-schools were purposively sampled. Following the nutrition programme, data was collected through five Focus Group (FG) discussions and five interviews and was thematically analysed. The ethical principles that guided the study included justice, beneficence and autonomy. Results and Discussion: Five major themes and seventeen sub-themes emerged (1) Participants described the typical foodstuff in children’s lunch boxes which included both high quality and lower-quality foods and fluids; (2) Participants provided views (such as food preferences) on lunch box choices; (3) Principals appraised lunch box rules and the significance of revised rules to improve the lunch boxes;(4) Challenges such as poverty limited healthy food choices; (5) Participants commented on initiatives noted following the nutrition training; for instance, some schools commenced the cultivation of vegetable gardens. Conclusion and Recommendations: The study highlights that specific parent programmes helped to improve healthy lunch box choices in the study population. There is a need for parent programmes tailored to fathers. Dieticians and nutritionists in NMB can train practitioners as change agents in their respective schools.
- Full Text:
- Date Issued: 2020
- Authors: Midigo, Odwour Erich
- Date: 2020
- Subjects: Children -- Nutrition
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46429 , vital:39587
- Description: Rationale: Lunchboxes that parents prepare for preschool children have been noted to fall short of the recommended paediatrics dietary standards. No research has been done in Nelson Mandela Bay (NMB) to describe the perceptions of parents preparing the lunch boxes, particularly in underprivileged communities, and if nutrition education strategies can improve these practices. This study answered the following research question: How can nutrition education programmes play a role in parents’ perceptions about the content of the lunchboxes of children attending early childhood development centres (ECD) in underprivileged communities of NMB metropole? Aim: The research aimed at describing and exploring parents’ perceptions of the content of pre-school children’s lunch boxes following a nutrition programme.Methods: This descriptive, explorative study adopted a qualitative approach. Twenty-five participants were selected conveniently while five pre-schools were purposively sampled. Following the nutrition programme, data was collected through five Focus Group (FG) discussions and five interviews and was thematically analysed. The ethical principles that guided the study included justice, beneficence and autonomy. Results and Discussion: Five major themes and seventeen sub-themes emerged (1) Participants described the typical foodstuff in children’s lunch boxes which included both high quality and lower-quality foods and fluids; (2) Participants provided views (such as food preferences) on lunch box choices; (3) Principals appraised lunch box rules and the significance of revised rules to improve the lunch boxes;(4) Challenges such as poverty limited healthy food choices; (5) Participants commented on initiatives noted following the nutrition training; for instance, some schools commenced the cultivation of vegetable gardens. Conclusion and Recommendations: The study highlights that specific parent programmes helped to improve healthy lunch box choices in the study population. There is a need for parent programmes tailored to fathers. Dieticians and nutritionists in NMB can train practitioners as change agents in their respective schools.
- Full Text:
- Date Issued: 2020
Retrospective analysis of birth HIV PCR testing and follow-up of positive HIV PCR results in Nelson Mandela Bay Health District
- Authors: Makubalo, Nomlindo Princess
- Date: 2020
- Subjects: HIV infections -- South Africa -- Nelson Mandela Bay
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46351 , vital:39580
- Description: BACKGROUND HIV infection contributes significantly to infant morbidity and mortality, especially in high-prevalence, low-income countries. In view of this evidence-based knowledge, South Africa’s National Department of Health, in April 2015, released the National Consolidated Guidelines of Human Immunodeficiency Virus (HIV) stipulating that all HIV-exposed babies should have a HIV Polymer Chain Reaction (PCR) test performed at birth. Early infant diagnosis (EID) means early initiation of combined antiretroviral treatment (cART) and a reduction in the incidence of early infant HIV-related mortality. However, these guidelines can only be successful if implemented properly across all public sector healthcare institutions. Thus,the research question was,“How well has the Nelson Mandela Bay Health District implemented the EID?”AIM The aim of the study was to review the impact of the consolidated HIV guidelines on birth HIV-PCR testing and initiation of treatment in the Nelson Mandela Bay Health District. METHOD A retrospective quantitative longitudinal non-experimental design was used.The study consisted of two components,namely,analysis of NHLS databases, particularly HIV birth PCR results of infants over a three-year period (June 2015 to June 2018),and analysis of feedback received from the primary health care clinics. The feedback focused on infants with a positive-birth PCR test, using a purpose-designed data collection tool that was used by the clinics for the duration of the same three-year period. The paper-based tool documented antenatal care attendance, enrolment into the prevention of mother-to-child transmission (PMTCT) programme and initiation of ART. RESULTS Over the three-year period, there were approximately 13,096 live births to HIV-positive women in the study area, and a total of 11,066 HIV birth PCR tests were done over xiiithe three-year study period (84.5% of HIV-exposed infants). The birth HIV PCR was negative in 10,909 (98.6%) neonates, while 130 (1.2%) of neonates had positive-birth HIV PCR tests,and a further 27 (0.2%) had indeterminate results. The birth HIV PCR positivity rate reduced from 1.4%(2015)to 1%(2018)over the three-year study period. Of the 130 infants with positive-birth HIV PCR, the files of 42 children were excluded, and further analysis conducted on the files of 88 infants. cART was initiated within seven days in only nine of the 88 infants (10.2%). ARV initiation was delayed for 58 infants (65.9%) and 21 neonates (23.9%) were never initiated on cART. Among the 88 mothers of infants, more than one-third (38.6%) of pregnant women did not attend antenatal care, thus,compromising their opportunity to be enrolled on the PMTCT programme. Of those who attended antenatal care, only 39.1% were reported to attend antenatal care before 20 weeks CONCLUSION AND RECOMMENDATIONS The incidence of positive-birth HIV PCR has reduced from 1.4% in 2015 to 1% in 2018 whilst there has been an increase in birth HIV PCR testing. However, initiation of cART within seven days was achieved in only 10.2% of infants with positive-birth HIV PCR test results. Implementation of point-of-care birth HIV PCR testing would ensure that results are immediately available resulting in increasing the proportion of infants initiated on cART within seven days.
- Full Text:
- Date Issued: 2020
- Authors: Makubalo, Nomlindo Princess
- Date: 2020
- Subjects: HIV infections -- South Africa -- Nelson Mandela Bay
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46351 , vital:39580
- Description: BACKGROUND HIV infection contributes significantly to infant morbidity and mortality, especially in high-prevalence, low-income countries. In view of this evidence-based knowledge, South Africa’s National Department of Health, in April 2015, released the National Consolidated Guidelines of Human Immunodeficiency Virus (HIV) stipulating that all HIV-exposed babies should have a HIV Polymer Chain Reaction (PCR) test performed at birth. Early infant diagnosis (EID) means early initiation of combined antiretroviral treatment (cART) and a reduction in the incidence of early infant HIV-related mortality. However, these guidelines can only be successful if implemented properly across all public sector healthcare institutions. Thus,the research question was,“How well has the Nelson Mandela Bay Health District implemented the EID?”AIM The aim of the study was to review the impact of the consolidated HIV guidelines on birth HIV-PCR testing and initiation of treatment in the Nelson Mandela Bay Health District. METHOD A retrospective quantitative longitudinal non-experimental design was used.The study consisted of two components,namely,analysis of NHLS databases, particularly HIV birth PCR results of infants over a three-year period (June 2015 to June 2018),and analysis of feedback received from the primary health care clinics. The feedback focused on infants with a positive-birth PCR test, using a purpose-designed data collection tool that was used by the clinics for the duration of the same three-year period. The paper-based tool documented antenatal care attendance, enrolment into the prevention of mother-to-child transmission (PMTCT) programme and initiation of ART. RESULTS Over the three-year period, there were approximately 13,096 live births to HIV-positive women in the study area, and a total of 11,066 HIV birth PCR tests were done over xiiithe three-year study period (84.5% of HIV-exposed infants). The birth HIV PCR was negative in 10,909 (98.6%) neonates, while 130 (1.2%) of neonates had positive-birth HIV PCR tests,and a further 27 (0.2%) had indeterminate results. The birth HIV PCR positivity rate reduced from 1.4%(2015)to 1%(2018)over the three-year study period. Of the 130 infants with positive-birth HIV PCR, the files of 42 children were excluded, and further analysis conducted on the files of 88 infants. cART was initiated within seven days in only nine of the 88 infants (10.2%). ARV initiation was delayed for 58 infants (65.9%) and 21 neonates (23.9%) were never initiated on cART. Among the 88 mothers of infants, more than one-third (38.6%) of pregnant women did not attend antenatal care, thus,compromising their opportunity to be enrolled on the PMTCT programme. Of those who attended antenatal care, only 39.1% were reported to attend antenatal care before 20 weeks CONCLUSION AND RECOMMENDATIONS The incidence of positive-birth HIV PCR has reduced from 1.4% in 2015 to 1% in 2018 whilst there has been an increase in birth HIV PCR testing. However, initiation of cART within seven days was achieved in only 10.2% of infants with positive-birth HIV PCR test results. Implementation of point-of-care birth HIV PCR testing would ensure that results are immediately available resulting in increasing the proportion of infants initiated on cART within seven days.
- Full Text:
- Date Issued: 2020
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