Submitted in fulfilment of the requirements for the degree Master of Applied Science in Food and Nutrition, Durban University of Technology, 2015. / Introduction: According to the American Dietetic Association, Child care facilities (CCFs) play an essential role in the nutritional status of children as children typically spend 4-8 hours a day at a facility. As a result, the meals should provide at least 50 – 60% of daily nutritional requirements. Worldwide CCF feeding has been found to be nutritionally inadequate as energy and most micronutrient requirements are not met by the meals provided, due to the lack of nutrition knowledge of the caregivers. Studies have shown that with appropriate training there has been improvement in nutritional standards. Aim: The aim of this study was to analyse the nutritional adequacy of menus offered; and to determine the nutritional status of children aged two to five years old in registered child care facilities in the Inanda area. Methodology: CCFs (n=10) in the Inanda area were randomly selected from multiple options to participate in the study. This study was conducted on children (boys (n= 91) and girls (n=109)) of ages two to five years old. Trained fieldworkers and teachers assisted in interviewing parents to complete the socio-demographic questionnaire. The researcher gathered menus and recipes for analysis, using Foodfinder Version 3 Software. The researcher also conducted plate-waste studies to determine consumption patterns during CCF meal times. Anthropometric measurements for weight and height were collected. In order to establish BMI-for-age and height-for-age, the WHO Anthro Software and WHO AnthroPlus Software were used. Ten food handlers (FHs) were interviewed by the researcher on food preparation and serving. Results: Most children (79.40%) originate from extended families that are female-headed. The highest form of education attained by most caregivers in the sample is standard 10 (47.74%) and 45.73% are unemployed. Of the 54.27% employed, 64.71% are informally employed. Most respondents (72.87%) are living on a total household income of less than R2500. The anthropometric results of the children show very low prevalence of severe stunting (1.74%) and stunting (5.42%). Less than halve (34.48%) of the children were at a possible risk of being overweight, 13.79% were overweight and 2.46% obese. The top 20 foods served in CCFs in Inanda were cereal-based staples of rice and maize meal more frequently than meat, dairy products and fruit and vegetables – all served far less frequently. All the CCFs did not meet the 60% of daily requirements for energy, fibre, calcium and vitamin C in foods served. The CCFs have well-equipped, designated kitchens for food storage, preparation, serving and good hygiene practices. Conclusion: Meals served to two to five year olds in registered CCFs in the Inanda area are nutritionally inadequate as most facilities do not contain 60% of the daily nutrient requirements from both daily meals served. Recommendations: CCF owners and Food handlers should receive proper training and retraining on food safety and hygiene and menu planning. The government should increase the subsidy to CCFs in order to meet the nutritional needs of children in order to aid in the alleviation of under-nutrition.

The objectives of this study were to determine the nature of data recorded on the Road to Health Card (RtHC) and its utilisation by nurses at primary health care setting, comparing it with norms and standards on the RtHC guideline, and to provide guidelines for optimal utilisation of the RtHC by health workers. A quantitative nonexperimental descriptive method was used. Two methods were used to collect data; document analysis of the RtHC and structure observation of nurses. A structured exit interview of caregivers was conducted to validate observations from nurses. A sample size of 18 nurses from all categories from six clinics was observed, and 36 RtHC of children under five years of age were analysed. Results indicated that data recorded on the RtHC was mostly inaccurate, incomplete and not interpreted. The study identified a need to train health workers on optimal utilisation of the RtHC facilitating health improvement of children under five years of age. / Health Studies / M.A. (Health Studies)

Thesis (MPhil) Stellenbosch University, 2014 / ENGLISH ABSTRACT: In an increasingly complex world where food security remains a challenge in many areas and especially Africa; it is essential to educate children about food – from production to consumption; and to ensure they eat enough as this is a crucial factor for concentration and learning abilities. How can we teach children about food in a sustainable way? This study focuses on schools in Tigray, Northern Ethiopia, which have a school feeding programme, school garden and nutrition curriculum. The question studied is: To what extent do two primary schools in central- and east Tigray (North Ethiopia) integrate the feeding scheme, school garden and nutrition curriculum? The methodology chosen is a case study and the empirical data was collected through interviews, surveys and observations. Principals of 14 schools were interviewed about the school gardens, curricula and school gardens. Two schools were then selected for a further in-depth research. The school gardens, mostly initiated by the staff, serve the purpose of creating income for the school and teaching students the skills of gardening. The curriculum is standard for Tigray and focuses on different food types and creating a balanced diet. The school food in most schools is provided by the World Food Programme (WFP), but some exceptions exist. This research shows that integration between the three objectives will be beneficial. Obstacles include getting the staff ‘on board’ as a priority and controlling the unification of the three, for example schools feel that they have less ownership over the feeding scheme because it is organised by an external NGO. This study suggests stakeholders view school gardens, nutrition education and school feeding schemes under one umbrella for the ultimate benefit of creating a sustainable model to teach about food. The case study provides an insight to the specific challenges in Tigray, Ethiopia but important conclusions can also be generalised. / AFRIKAANSE OPSOMMING: In ’n toenemend komplekse wêreld waar voedsel sekuriteit in baie gebiede, veral in Afrika ’n uitdaging bly, is dit baie belangrik om kinders oor voedsel op te voed - vanaf produksie tot by die verbruik daarvan, en ook om seker te maak dat hulle genoeg eet, wat baie belangrik is vir konsentrasie en die vermoë om te leer. Hoe kan ons kinders op ’n volhoubare manier leer oor voeding? Hierdie studie fokus op twee skole in Tigray, in Ethiopië wat skoolvoedingskemas, skooltuine en voedingkurrikula het. Die vraag wat gevra is, is: Tot watter mate integreer hierdie twee skole in Tigray die voedingskemas, die skooltuine en die voedingkurrikula? Die gekose metodologie is ’n gevallestudie. Empiriese data is ook deur middel van onderhoude, oorsigte en observasies versamel. Onderhoude oor skooltuine, voedingskemas en die kurrikula is gevoer met die skoolhoofde van 14 skole. Twee skole is toe gekies vir in-diepte navorsing. Die skooltuine bring geld in vir die skool en word ook gebruik om vir die leerling tuinmaakvaardighede aan te leer. Die kurrikulum is standaard vir die hele Tigray en word deur die Wêreld Voedsel Program verskaf. Daar is egter ’n paar uitsonderings. In hierdie navorsing is daar bewys dat die integrasie van die skooltuin, die voedingskema en die kurrikula, goeie gevolge kan hê. Dit is egter belangrik dat die skool personeel moet saamwerk en dat die vereniging van die drie beheer moet word. Skole voel bv. Tans dat hulle nie eienaarskap oor die voedingskema het nie, want dit word deur eksterne NROs beheer. Hierdie navorser stel voor dat die skooltuine, skoolvoedingskema en die voedingkurrikulum onder een sambreel beskou moet word met die doel om ’n volhoudbare model vir die onderrig van voeding te skep. Die gevallestudie verskaf insig in die spesifieke uitdagings in Tigray, Ethiopië, maar belangrike slotsomme kan ook veralgemeen word.

The objectives of this study were to determine the nature of data recorded on the Road to Health Card (RtHC) and its utilisation by nurses at primary health care setting, comparing it with norms and standards on the RtHC guideline, and to provide guidelines for optimal utilisation of the RtHC by health workers. A quantitative nonexperimental descriptive method was used. Two methods were used to collect data; document analysis of the RtHC and structure observation of nurses. A structured exit interview of caregivers was conducted to validate observations from nurses. A sample size of 18 nurses from all categories from six clinics was observed, and 36 RtHC of children under five years of age were analysed. Results indicated that data recorded on the RtHC was mostly inaccurate, incomplete and not interpreted. The study identified a need to train health workers on optimal utilisation of the RtHC facilitating health improvement of children under five years of age. / Health Studies / M.A. (Health Studies)