Nutritional status and the use of child support grant among children, 6 to 23 months, visiting 3 local clinics in the Dihlabeng Local Area, Thabo Mofutsanyana District, Free State

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Date
2018-01
Authors
Symington, Carol
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University of the Free State
Abstract
English: South Africa, a country that produces enough food for its population, loses 63.5% of children yearly due to malnutrition. Although South Africa produces imports and retains sufficient food to support a nutritionally balanced per capita dietary intake for its population, malnutrition, closely linked to poverty and household food insecurity, remains unacceptably high. In South Africa, one of the nine provinces, namely the Free State Province, 43.8% of children under five years of age, suffered from stunting, a chronic form of malnutrition. The Dihlabeng Local Area where the research was conducted, is situated within the Thabo Mofutsanyana District, in the Free State province. Despite the implementation of the Child Support Grant (CSG) in 1998 to minimise food insecurity and prevent malnutrition amongst children, approximately 14 million people in South Africa are still affected by food insecurity, with the majority being black South African citizens residing in rural areas. Malnutrition, particularly during the first 1 000 days of life, causes poor cognitive development, higher susceptibility to infections, poor health, decreased completed school grades and future unemployment, all of which are carried into adulthood. The validity of the South African CSG, thus, whether it is enough to meet basic needs and if is being used for children’s needs and food, remain of concern. The aim of this study was to assess the nutritional status and the use of CSG amongst children, 6 to 23 months, visiting 3 local clinics in the Dihlabeng Local area, Thabo Mofutsanyana District, Free State. A descriptive observational quantitative study using convenience sampling, was conducted from September 2016 to November 2016. Data were collected from a sample size of 242 consenting children, aged six to 23 months, who attended these clinics with their primary caregiver. Sample size were calculated per clinic and distributed as follows: 97 participants from Mphohadi Clinic, 72 participants from Bohlokong Clinic and 73 participants from Bethlehem Clinic. Data with regards to socio-demographic status, household food security, dietary intake and spending patterns of the CSG, were collected via questionnaire administered in structured interviews with the primary caregiver and the anthropometry of the children were measured. The participants were black South Africans (100%) and almost equally distributed between males and females, all of whom were CSG recipients. There were 17 participants who were cared for by non-biological parent-caregivers and 225 were cared for by their biological parents. Two thirds (65.7%) of participants resided in brick housing, but one in three (31.4%) infants were being raised in informal, corrugated iron houses (shacks), whilst 14% of households were overcrowded. All households, in which participants resided, had access to safe running water and electrical cooking equipment were available to 85.1%, whilst 2.9% had to use an open fire to cook. Overall, 16.1% did not have access to cold storage and despite the bare minimum in terms of housing and household facilities, there was a high uptake of electronic, recreational and communication equipment, suggesting poor planning and lack of prioritising, as well as high debt occurrence, because cellular telephones and satellite television, requires monthly repayments for the service. Thus, leaving limited money left for food procurement. The highest completed educational levels were mainly primary school, with high unemployment rates amongst the biological parent-caregivers (75.5%) as well as the non-biological parentcaregivers (64.7%). In 15.7% of households the participant’s CSG was the only income. Household food insecurity was experienced by 48.7% of the households and 27.7% were at risk of becoming food insecure. This helps to explain the fact that only 7.9% of participants had adequate dietary diversity scores, whilst only 4.5% achieved the minimum acceptable dietary intake. Most participants had a daily diet of mainly starch and dairy, with limited proteins, vitamins and minerals. This sheds light on the fact that 33.1% was stunted, 3.3% wasted and 6.3% overweight. The CSG was reportedly spent on the children alone (almost 100%), yet 14.5% caregivers reported the CSG was too little to supply in needs of the entire households. Food ranked only fourth amongst the basic needs of the child on which the CSG was reportedly being spent. The results of the current study indicate the urgent need to establish a more effective type of CSG, whether cash, food parcels, vouchers or a combination, supplied to infants growing up in at-risk household to curb the high prevalence of malnutrition with its detrimental longterm consequences in this community and in South Africa as a whole.
Afrikaans: Suid-Afrika, 'n land wat genoeg kos vir sy bevolking produseer, verloor jaarliks 63.5% kinders as gevolg van wandvoeding. Suid-Afrika produseer en voer voldoende hoeveelhede voedsel in om ‘n voedingstofryke dieetinname te verseker, maar wanvoeding statistieke, wat verband hou met armoede en huishoudelike voedselsekerheid, onaanvaarbaar bly steeds hoog. In die Vrystaat Provinsie, een van die nege provinsies in Suid-Afrika, ly 43.8% kinders onder vyf jaar aan groei-inkorting, ‘n kroniese vorm van wanvoeding. Die Dihlabeng Plaaslike Area waar die studie uitgevoer is, is geleë in die Thabo Mofutsanyana Distrik, in die Vrystaat Provinsie. Ten spyte die implementering van die Kindersorgtoelaag in 1998 met die doel om voedselsonsekerheid te verminder en wanvoeding te voorkom, is daar steeds 14 miljoen Suid- Afrikaners (meestal swart bevolkingsgroepe in landelike gebiede) wat deur voedselonsekerheid geraak word. Wanvoeding in die eerste 1 000 dae van lewe, veroorsaak verswakte kognitiewe ontwikkeling, verhoogde vatbaarheid vir infeksies, laer voltooide skool grade en toekomstige werkloosheid; wat alles deurtrek na die volwasse lewe. Die geldigheid van die Suid-Afrikaanse Kindersorg toelaag en of dit genoeg is om in die basiese behoeftes van kinders te voorsien en wel daarvoor gebruik word, bly rede tot kommer. Die doel van hierdie studie was om die voedingstatus en die gebruik van die Kindersorg toelaag van kinders ses tot 23 maande, wat drie plaaslike klinieke in die Dihlabeng Plaaslike Area, Thabo Mofutsanyana Distrik, Vrystaat, besoek, te ondersoek. ‘n Beskrywende kwantitatiewe studie met geriefs steekproefneming, is uitgevoer by drie plaaslike klinieke, vanaf Septebmer 2016 tot November 2016. Inligting van 242 kinders ses tot 23 maande oud, is ingesamel. Die aantal kinders wat ingesluit is in die studie, is bereken per kliniek: 97 kinders was van Mphohadi Kliniek, 72 van Bohlokong Kliniek en 73 van Bethlehem Kliniek. Inligting met betrekking tot die kinders se sosio-demografiese status, huishoudelike voedselsekerheid, dieetinname en gebruik van die Kindersorgtoelaag, is ingesamel met vraelyste wat in persoonlike gestruktureerde onderhoude met die versorgers ingevul is. Groeiparameters os op die kinders gemeet. Die kinders was almal swart Suid-Afrikaners, ongeveer ewe veel uit beide gelagte en almal ses tot 23 maande oud. Al die kinders het die Kindersorg toelaag ontvanfg Altesaam 17 kinders is deur nie-biologiese ouer-versorgers, en 225 deur hul biologiese ouers. Twee-derdes (65.7%) van die kinders was woonagtig in baksteen behuising, maar een uit elke drie (31.4%) het in informele, sink huisies grootgeword. Ongveer 14% van huishoudings was oorbevolk. Veilige watertoevoer was by meeste huise beskikbaar en elektriese kooktoerusting by 85.1%, terwyl 2.9% gebruik moes maak van ‘n oop vuur om kos te kook. Ongeveer 16% van die huishoudings het geen ys- of vrieskasgeriewe gehad nie, maar almal het wel elektroniese onstpannings- en kommunikasietoerusting gehad. Dit dui moontlik op swak beplanning en swak prioriteite, omdat sellulêre telefone en satelliet-TV, maandelikse subskripsiefooie behels, wat minder geld vir voedsel beteken. Die meeste versorgers het net primêre skool voltooi, en werkloosheid wat 75.5% onder die biologiese ouers en 64.7% onder nie-biologiese ouers-versorgers was. Kindersorgtoelaes was vir 15.7% van die huishoudings die enigste bron van inkomste. Huishoudelike voedselonsekerheid het voorgekom in 48.7% van die huishoudings en 27.7% het die risiko geloop om voedselonsekerheid te ervaar. Net 7.9% van die kinders in die studie het ‘n diverse diëetinname gehad en net ʼn skamele 4.5% het ‘n minimum aanvaarbare dieet nname gehad. Die meeste kinders se daaglikse dieet het uit stysel en suiwelprodukte bestaan, met ‘n beperkte inname van proteïene, vitamiene en minerale. altesaam 33.1% van die kinders het groei-inkorting gehad, 3.3% wat uitgeteer en 13.2% was oorgewig. Die versorgers het aangedui dat die Kindersorgtoelaag slegs vir die kinders aangewend word, maar 14.5% het gesê dit is heeltemal te min vir die behoeftes van die hele huishouding is. Die Kindersorgtoelaag is gebruik vir basiese behoeftes van die kinders en vir kos, alhoewel kos slegs vierde op die lys van uitgawes uit die toelaag was. Die resultate van hierdie studie beklemtoon die dringendheid van ‘n meer voldoene tipe Kindersorgtoelaag, hetsy kontant, kospakkies, koeponne, of ‘n kombinasie daarvan, wat aan hoë riksiko huishoudings verskaf word, om die voorkoms van wanvoeding onder kinders en die langtermyn nagevolge in die gemeenstakp en in Suid-Afrika as ‘n geheel, aan te spreek.
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Keywords
Anthropometry, Child support grant, Household food security, Malnutrition, Minimum acceptable diet, Minimum dietary diversity, Minimum meal frequency, Stunting, Wasting, Z-scores, Dissertation (M.D. (Nutrition and Dietetics))--University of the Free State, 2018
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