Human Nutrition

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Browsing Human Nutrition by browse.metadata.advisor "Beukes, Ronel"

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    Evaluation of the supplementary feeding programme targeted at moderately malnourished children aged 6 to 59 months in Baringo County, Kenya
    (Stellenbosch : Stellenbosch University, 2018-12) Kimani, Irene Wairimu; Beukes, Ronel; Masibo, Peninah K.; Muthoka, Stellamaris; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.
    ENGLISH SUMMARY: Baringo is a semi-arid county of Kenya faced with moderate food insecurity. The County’s global acute malnutrition (GAM) rates have been on a deteriorating trend from 9.6% in 2013 to 21.1% in 2014, with moderate acute malnutrition (MAM) being the most prevalent. A supplementary feeding programme (SFP), which aims to alleviate the condition, has been implemented in the County since 2009. Persistent high malnutrition rates may be an indication that there are factors hindering the success of the programme. To assess this, the researcher conducted an evaluation study of the SFP targeted at moderately malnourished children aged 6 to 59 months. The study objectives were to assess the availability, distribution and utilisation of SFP commodities; to determine whether nutritional counselling was part of the SFP and if the advice was adopted; to assess breastfeeding practices for the moderately malnourished SFP beneficiaries aged 6 to 23 months; to assess the influence of SFP on anthropometric status of the beneficiaries; and to compare actual and expected length of stay of beneficiaries in the programme. A descriptive cross-sectional study design was employed and random sampling used to select participants. Questionnaires were administered to caregivers and anthropometric measurements of beneficiaries taken. Secondary data from health facility records was used to determine length of stay in the programme. The study duration was three and half months. A total of 407 children aged 6 to 59 months who were beneficiaries of the SFP participated in the study. The study found that almost two-thirds (62.7%; n = 255) of the participants received ready-to-use supplementary feeds (RUSF) during the distribution that preceded the study, of which the majority received their rightful fortnight ration of 14 (92 g) RUSF sachets. The fortnight ration did not last for the recommended period for at least a third of the participants, mainly due to sharing with non-SFP-registered household members. Caregivers received nutritional counselling as part of the SFP, but inadequate food access, cultural factors and poor access to health care services limited adoption. Almost all participants were fed on carbohydrate-rich grains 24 hours before the study, with minimal consumption of animal-source proteins. Anthropometric status of beneficiaries would improve whenever there was a consistent supply of SFP commodities, which was evidenced by a reduction in prevalence of underweight and acute malnutrition based on mid-upper arm circumference (MUAC) two weeks after admission. There were frequent stock-outs of SFP commodities at health facilities, hence beneficiaries would miss their rations on some distribution days. Discharge criteria was not adhered to, as more than half of the beneficiaries (57%; n = 98) that were discharged a month before the study exceeded the recommended maximum length of stay in the programme (84 days). Lack of SFP commodities at health facilities and sharing of SFP commodities at household level were key factors limiting the success of the programme. The programme stakeholders should identify sustainable solutions to challenges leading to shortage of the commodities and should link SFP beneficiaries to other food-assistance programmes that target the whole household in order to minimise sharing.
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    Factors influencing high socio-economic class mothers’ decision regarding formula feeding practices in the Cape Metropole
    (Stellenbosch : University of Stellenbosch, 2006-03) Bester, Marwyn; Marais, D.; Beukes, Ronel; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Human Nutrition.
    Objective: To identify the reasons why high socio-economic class women in the Cape Metropole decide not to breastfeed; to identify the factors that influence the decision-making process when deciding which infant formula to feed the infant aged 0–6 months of age and to evaluate whether the type and volume of infant formula selected by the mother is appropriate for the infant’s needs. Method: The study was conducted as an observational descriptive study and consecutive sampling was used. Data was collected by means of a self-administered questionnaire that was available both in Afrikaans and English. Both open and closed ended questions were included. A Likert scale comprising four possible answers was used to determine attitude. Results: A total of 55 utilizable questionnaires were obtained. The majority of the mothers decided only after the birth of their infant to rather opt for formula feeding. Evident factors that were identified as a barrier to breastfeeding include a lack of knowledge and experience as well as a lack of facilities at public places and at work to breastfeed. Perceived benefits of infant formula included that the father could help with the workload and thus the father does not feel left out if the mother is breastfeeding, the mother knows what volume of infant formula the infant receives and it is more convenient if she is working. The mothers were overall not concerned about possible side effects of breastfeeding e.g. leaking and engorgement and did not feel that their breasts were physically not of optimal physiology e.g. too small or too large to be able to breastfeed. Conclusion: Numerous internal as well as external factors influence high socio-economic class women in the Cape Metropole when they decide whether to breastfeed or formula feed their infants. The identified barriers to breastfeeding will have to be addressed in this population in order to reach the WHO/UNICEF recommendation of exclusive breastfeeding up to the age of 6 months, and thereafter breastfeeding up to 2 years of age with the introduction of appropriate complementary foods.