This dissertation is an examination of salient factors that influence the health seeking behaviour of mothers/caregivers of pre-school children in Kwangwanase, KwaZuluNatal province, South Africa. Health seeking behaviour for pre-school children is poorly understood, and is influenced by an array of complex factors that inhibit full utilisation of available health services. Amongst other things, health-seeking behaviour is influenced by cultural beliefs about children's illnesses as well as the local availability of treatment options, and the perceived quality of care provided. This dissertation represents the findings of a combined qualitative and quantitative research approach using free listing, pile sorts, interview schedules, logbooks and observation to explore health-seeking behaviour. Research focussed on the local knowledge held in relation to childhood illnesses that affect children under age six, along with the explanatory models used to discern causation and shape decisions regarding treatment and care. Mothers and caregivers of Kwangwanase draw upon their existing knowledge of children's illnesses, including notions of disease causation, when making diagnoses and deciding between home treatments and professional consultation. Mothers and caregivers pay close attention to the well being of small children. They are constantly involved in the routine management of health and illness. Various treatment options are utilised in a pragmatic way, as mothers and caregivers pick and choose from all available health resources as and when they see fit. Cultural beliefs, accessibility, religious views and other factors influence their choice of health service. Depending on the quality of the care provided and the outcome of the therapeutic intervention, mothers and caregivers are likely to consult several different health care providers in a sequential manner. / Thesis (M.A.)-University of Natal, Durban, 2002.

The aim of this study was to assess the dietary intake, diet-related knowledge and metabolic control in children with Type 1 Diabetes Mellitus between the ages of 6-10 years attending the Paediatric Diabetic Clinics at Grey’s Hospital, Pietermaritzburg and Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal. This was a cross sectional observational study that was carried out in a total of 30 subjects out of a possible 35 subjects that qualified for inclusion in the study from both the Grey’s Hospital clinic (n=8) and IALCH clinic (n=22). The dietary intake was assessed in a total of 25 subjects using a three day dietary record (n=20) and a 24 hour recall of the third day of the record (n=16). Diet-related knowledge was assessed using a multiple choice questionnaire. Metabolic control was assessed using the most recent HbA1c and the mean HbA1c results over the previous 12 months from the date of data collection. Height and weight measurements were also carried out. Information on socioeconomic status and education status of the caregivers was obtained from 22 caregivers through follow-up phone calls. All measurements except for dietary intake were obtained from all subjects participating in the study. The mean percentage contribution of macronutrients to total energy was very similar to the International Society for Pediatric and Adolescent Diabetes (ISPAD) Consensus Guidelines (2002). The mean percentage contribution of macronutrients to total energy from the 3 day dietary records and the 24 hour recalls were as follows: carbohydrate (52% and 49%); sucrose (2% and 2%); protein (16% and 17%); fat (32% and 34%). Micronutrient intake was adequate for all micronutrients except for calcium and vitamin D which showed low intakes. The mean diet-related knowledge score for the sample was 67% with significantly higher scores in children older than 8 years of age. The latest HbA1c for the sample was 9.7% and the mean HbA1c over the previous 12 months from the date of data collection was 9.6%. There was a significant positive correlation between age of the participant and the latest HbA1c (r = 0.473; p=0.008) and a significant negative correlation between the education level of the caregivers and the latest HbA1c (r = - 0.578; p=0.005) and the mean HbA1c over 12 months (r = - 0.496; p=0.019). Significant differences were found between African and Indian children respectively for HbA1c, with higher values in African children. There was no correlation between BMI for age and latest HbA1c (r = 0.203, p=0.282) or mean HbA1c over 12 months (r = 0.101, p=0.594). Z score for BMI for age was also not correlated with latest HbA1c (r = 0.045, p=0.814) or mean HbA1c over 12 months (r = - 0.012, p=0.951). Children from the Grey’s Hospital Clinic were found to have higher HbA1c values (p=0.001) and lower diet-related knowledge scores as compared to the children from the IALCH Clinic (p=0.038). It should be noted that the ethnic and racial composition of the children attending these two clinics differed. In conclusion the macronutrient intake in this sample was found to be similar to the ISPAD Consensus Guidelines (2002) while calcium and vitamin D intakes were low. Overall this sample displayed good diet-related knowledge while metabolic control was found to be poor. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2007.

Purpose: To explore the knowledge, attitudes and practices of the Health Care Workers (HCWs) regarding the use of the child growth and development monitoring tool which is commonly known as the road to health card (RTHC)for the under- fives. Methodology: Based on the positivist paradigm, a descriptive approach was undertaken to explore the HCWs knowledge, attitudes and practices regarding the use of the child growth and development monitoring tool also known as the road to health card (RTHC) for growth monitoring and promotion in EThekwini metropolitan area. Sampling was prepared in two stages; probability random sampling to obtain seventeen clinics and non-probability purposive sampling technique was followed to obtain the study‟s participants. Fifty-one self-developed, structured questionnaires were distributed of which forty were completed and returned. This was followed by conducting one hundred and seventy observations in the clinical areas, which means ten observations per clinic. Data was analysed using the Statistical Package for Social Sciences (SPSS 18) software. Findings: The average score for the respondents‟ knowledge regarding the use of the RTHC for GMP was 62%, and that score was classified as unacceptable according to this study. The participants‟ responses regarding their attitudes about GMP tended to favour statements that indicated good practices for the use of the RTHC. However, when GMP practices/activities were observed in the clinical areas, it became apparent that the answers provided in the instrument to rate the HCWs attitudes, were not a true reflection. Some of the practices observed were good, but the average score for the observations was69%, which was also classified as unacceptable. Conclusions: HCWs knowledge, attitudes and practices regarding the use of the RTHC for GMP activities were found to be unacceptable. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.