Background: Breastfeeding is widely recognised as the ideal approach for improving child survival and feeding new-born babies and young infants. The World Health Organisation (WHO) recommends exclusive breastfeeding (EBF) for the first 6 months of life with timely introduction of complementary foods at 6 months and continued breastfeeding for up to two years and beyond. The feeding practices of mothers are widely influenced by different factors which may be embedded within different contexts of life. Aim: This study explored the infant feeding practices of mothers and/or caregivers of infants below the age of 6 months. Method: This cross sectional study was conducted in four provinces in South Africa. In total, 40 health facilities were randomly selected in the four provinces and visited including metropolitan and non-metropolitan health facilities over the geographical area of the provinces. Fixed structured interviews were conducted and data on the feeding practices of mothers were collected using a questionnaire which had both open and closed-ended questions. Qualitative data were coded under different themes. The sample size comprised of mothers and/or caregivers of babies aged 6 months and below. A 24-hour recall was completed for all infants. Dietary intake and diversity were assessed using the FAO dietary diversity list consisting of 12 different food groups. Descriptive statistics, crosstabs and Pearson chi-square tests were used. Results: A total of 580 mothers/caregivers of infants below the age of 6 months were interviewed. Ninety-five % (n=551) were biological mothers. A total of 490 (85%) were breastfeeding at the time of the interviews. Ninety % had initiated breastfeeding during the first hour after delivery. At the time of the study, 12% (n=4) of the women were practising exclusive breastfeeding (EBF) for the recommended 6 months. Sixteen % (n=90) were not breastfeeding at the time the interviews were conducted. More than two thirds (64%) had exclusively breastfed their infants but stopped at the time of the interviews and 36% (n=32) did not breastfeed their babies at all. Twelve % (n=4) of the mothers stopped breastfeeding from as early as one month. The most cited reasons by the participants for breastfeeding cessation were the need to return to work or school. Reasons for not breastfeeding at all included the mothers HIV status, poor health and insufficient milk production. Forty-one % (n=239) of the mothers believed that breastfeeding contains adequate nutrients for the child and 5.7% (33) did not know why breastfeeding is important. Nearly half (49%) were giving infant feeding formula. Seventy % (n=220) of the women were giving either infant feeding formula or other liquids in addition to breast milk. The most stated reason for giving other liquids or foods was the belief that breast milk was not enough for the infant. Almost two thirds (56%) of the mothers gave their infants fortified infant feeding formula. Only one infant (0.2%) met the minimum standard of dietary diversity. Complementary food was introduced from as early as one month, and 73% of the women reported that their infants were receiving dietary supplements. Conclusion: Breastfeeding still remains a universal practice in the country. Sustained exclusive breastfeeding is still a cause of concern and 6 month EBF rates remain very low. Both mothers and caregivers had sound understanding of the importance of breastfeeding. Early initiation of complementary foods is still a norm and wide problem in the country. The dietary diversity of complementary diets given to babies was nutritionally inadequate. / MSc (Nutrition), North-West University, Potchefstroom Campus, 2015

Background: Breastfeeding is widely recognised as the ideal approach for improving child survival and feeding new-born babies and young infants. The World Health Organisation (WHO) recommends exclusive breastfeeding (EBF) for the first 6 months of life with timely introduction of complementary foods at 6 months and continued breastfeeding for up to two years and beyond. The feeding practices of mothers are widely influenced by different factors which may be embedded within different contexts of life. Aim: This study explored the infant feeding practices of mothers and/or caregivers of infants below the age of 6 months. Method: This cross sectional study was conducted in four provinces in South Africa. In total, 40 health facilities were randomly selected in the four provinces and visited including metropolitan and non-metropolitan health facilities over the geographical area of the provinces. Fixed structured interviews were conducted and data on the feeding practices of mothers were collected using a questionnaire which had both open and closed-ended questions. Qualitative data were coded under different themes. The sample size comprised of mothers and/or caregivers of babies aged 6 months and below. A 24-hour recall was completed for all infants. Dietary intake and diversity were assessed using the FAO dietary diversity list consisting of 12 different food groups. Descriptive statistics, crosstabs and Pearson chi-square tests were used. Results: A total of 580 mothers/caregivers of infants below the age of 6 months were interviewed. Ninety-five % (n=551) were biological mothers. A total of 490 (85%) were breastfeeding at the time of the interviews. Ninety % had initiated breastfeeding during the first hour after delivery. At the time of the study, 12% (n=4) of the women were practising exclusive breastfeeding (EBF) for the recommended 6 months. Sixteen % (n=90) were not breastfeeding at the time the interviews were conducted. More than two thirds (64%) had exclusively breastfed their infants but stopped at the time of the interviews and 36% (n=32) did not breastfeed their babies at all. Twelve % (n=4) of the mothers stopped breastfeeding from as early as one month. The most cited reasons by the participants for breastfeeding cessation were the need to return to work or school. Reasons for not breastfeeding at all included the mothers HIV status, poor health and insufficient milk production. Forty-one % (n=239) of the mothers believed that breastfeeding contains adequate nutrients for the child and 5.7% (33) did not know why breastfeeding is important. Nearly half (49%) were giving infant feeding formula. Seventy % (n=220) of the women were giving either infant feeding formula or other liquids in addition to breast milk. The most stated reason for giving other liquids or foods was the belief that breast milk was not enough for the infant. Almost two thirds (56%) of the mothers gave their infants fortified infant feeding formula. Only one infant (0.2%) met the minimum standard of dietary diversity. Complementary food was introduced from as early as one month, and 73% of the women reported that their infants were receiving dietary supplements. Conclusion: Breastfeeding still remains a universal practice in the country. Sustained exclusive breastfeeding is still a cause of concern and 6 month EBF rates remain very low. Both mothers and caregivers had sound understanding of the importance of breastfeeding. Early initiation of complementary foods is still a norm and wide problem in the country. The dietary diversity of complementary diets given to babies was nutritionally inadequate. / MSc (Nutrition), North-West University, Potchefstroom Campus, 2015

The health and well-being of Indigenous Peoples, including their nutritional status, is poor compared to the general Canadian population. There are many causes of these disparities, including racism, poor access to health resources, and the nutrition transition. Before colonization, most First Nations across Canada consumed diets purely composed of Traditional Foods (TF) that were hunted or collected from the natural environment. TF are important for their nutritional quality, food security, and culture. However, rates of TF consumption have decreased in recent years contributing to poor dietary outcomes. The diversity and quantity of TF consumed is thought to be primarily dictated by the ecological biodiversity in the surrounding environment; however, this relationship remains untested in Canada. The objective of this study was to gain a better understanding of First Nations modern food systems by evaluating the relationship between ecozone biodiversity and nutritional outcomes in the form of dietary diversity in First Nations individuals across Canada. We used dietary data and household data collected by the First Nations Food, Nutrition and Environment Study and multiple biodiversity databases for analyses. Spearman’s correlations were used to investigate the relationship between dietary diversity and nutrition. A statistical model was used to evaluate the relative predictive power of biodiversity and multiple other predictive variables in determining dietary diversity. We found that individuals who consume more TF have more nutrient rich diets, and therefore, dietary diversity is a good indicator of nutrition outcomes. We also found that in contrast to previous research and assumptions, in the context of First Nations living in Canada, biodiversity has a negative relationship to dietary species richness. It was also determined that variables related to culture, and accessibility of TF were the most important factors in predicting positive nutritional outcomes. These preliminary results provide key areas for interventions essential for increasing access to TF.

No description available.

Since 2015, a U.S. Agency for International Development and Virginia Tech Education and Research in Agriculture collaboration has introduced and tested mung bean as a potential crop to alleviate malnutrition and food insecurity in Senegal. This MS thesis describes a study conducted to assess the impact of mung bean on dietary diversity of Senegalese women and children in the Kaolack, Matam and Bakel localities of Senegal. A mixed-methods research approach included individual surveys to determine dietary diversity scores (DDS) and focus groups to assess the perceived impacts of mung bean. The dietary diversity survey was conducted with 194 participants including adult women, ages 15 to 70 years (n=109) and children, ages 0-10 years (n=85). Half (52%) of the population were mung bean consumers. The dietary diversity surveys revealed an average DDS of 5.73 on a scale of one to 10, with 5.83 and 5.62 for mung bean and non-mung bean consuming groups, respectively. There was a statistically significant difference in DDS between mung-bean consuming women and both mung bean and non-mung bean children, and between mung bean and non-mung bean consumers in Bakel; however, there was no significant difference between overall mung bean and non-mung bean groups DDS. Focus groups (n=11) with mung bean consuming women identified perceived agricultural, health, and financial benefits associated with mung bean consumption. These results can increase our understanding of how mung bean may influence policy-relevant issues for the Senegalese population, including agricultural, health and financial outcomes that are not reflected in dietary diversity surveys. / Master of Science

Life in urban Africa is often mired in crisis, thus researchers and practitioners usually pay attention to the multiple urban development challenges and sometimes interpret the activities and actions of urban dwellers as their means to survive in these cities. Urban food security research has remerged in recent years as a major development agenda in sub-Saharan Africa (SSA), especially following the food price crisis of 2007/08, which translated into violent protest in many African cities. There is increased recognition that the issue of urban food insecurity encompasses more than just an availability crisis, yet there is limited attention paid to the multiscalar and multifaceted political-economic, social-cultural and environmental factors that drive food insecurity in cities. This research examines the multifaceted factors that shape food insecurity among urban dwellers in Gaborone, Botswana, by assessing household food access and choice/consumption patterns. Gaborone, the capital of Botswana, like many African cities, has experienced rapid urban growth since independence, however, with low subsistence agricultural production, Botswana depends largely on South Africa for food imports. Using in-depth analysis and research techniques, including participant observation, food diaries and discussions with 40 households, this study examines urban dwellers’ complex food experiences. The data from Gaborone show that changing urban food system, food prices, income status and people’s lifestyle influences urban residents’ ability to access appropriate foods. The research highlights the poor quality of urban diets in Gaborone among the survey population. The high consumption recorded of processed foods; sugars and oils are major contributory factors to the so-called ‘double burden’ of disease, where food insecurity and malnutrition coexist with obesity, a situation that is increasingly prevalent in low-income societies. Drawing on an easy-to-use analytical tool, the Household Dietary Diversity Score, while combining it with a political ecology approach to provide more contexts, this study highlights the political-economic, socio-cultural and ecological factors that drive urban dietary diversity. The research, therefore, contributes to the methodological debate around measures of food access, while providing empirical details on the case of urban food insecurity in Botswana. Further inquiries on the factors influencing people’s food choices and consumption patterns reveals that multiple interacting factors, including cost, convenience, commercials, culture and class influence the decision around which foodstuff households consume and that food consumption patterns within Gaborone are fluid, dynamic and hybridized. Thus, food consumption in SSA matters in its own right and by illustrating that consumption patterns in Gaborone are heterogeneous and fluid this research helps us better understand and contest the idea that globally food consumption patterns are becoming increasingly homogeneous and predictable. By providing a conceptually holistic and methodologically in-depth assessment of food experiences in Gaborone, this research calls for increased attention towards urban dwellers' agency and the complexity, dynamism and hybridity of urban processes in SSA cities / The International Development Research Centre (IDRC); International Foundation for Science (IFS) (Sweden) and The Social Sciences and Humanities Research Council of Canada

Magister Economicae - MEcon / Kenya has continued to record decreasing child mortality rates in recent years, with available data showing that the under-five mortality rate was 85 per 1000 live births in 2010, down from 117 in 1997 (World Bank, 2012). However, the country continues to battle with poor anthropometric status of children (stunting, wasting and underweight). The country also faces high incidences of food insecurity. It is estimated that one third of the country’s population is food and nutrition insecure, with about 10 million of Kenyans suffering from chronic food insecurity (ROK, 2011). The worst affected are children, who are deprived of sufficient nutrients required for proper growth and development. This study seeks to analyse the relationship between household food security and the anthropometric status of children. Specific objectives include identifying the prevalence and predictors of poor anthropometry, identifying the extent of food insecurity in the country and investigating the link between food security and the anthropometric status of children. The research uses data from the Kenya Integrated Household Budget Survey (2005/2006). The survey which was carried out for a period of 12 months covered the entire country and collected data on the demographic and socio-economic characteristics of the households. It also collected data on child anthropometric measurements and households’ food consumption patterns. The statistical software package STATA SE v.12 is used to run ordinary linear (OLS) and logistical regressions in order to analyse the relationship between household food security and the anthropometric status of children. Results show that the prevalence of malnutrition is high in the country with stunting coming out as the main form of malnutrition. Dietary diversity, a measure of food security, is found to be highest in the urban areas. Results from the regression analysis show that a Household Dietary Diversity Score (HDDS) is positively associated with better anthropometry, with the prevalence of malnutrition decreasing with an increase in the score. The study also found that other risk factors associated with poor anthropometry are age of the child, gender, area of residence, diarrhoea, education, household size and income. The paper concludes with suggestions on measures that need to be put in place to curb child malnutrition.

Dietary diversity is an indicator of the access dimensions of household food security as it relates to income, area, and seasonality. Dietary diversity refers to the number of different individual food items (food variety) and food groups (food group variety) consumed over a given reference period (Ruel, 2002:3). This may accurately predict individual nutrient adequacy and thus household food security. Inability to access enough food for a sustainable and healthy life indicates food insecurity. Food accessing refers to obtaining food for all household members at all times through own production, exchange and/or purchase. Food access depends on an adequate, stable, local food supply, and includes the availability and utilization of food (Steyn, Labadarios&Huskissom, 1999: 32). Lack of food resources often leads to food insecurity due to, among other, limited dietary diversity (different foods items or food groups) (Bellamy, 1998:24). Emphasis on dietary diversity can eliminate nutrient deficiency by increasing individual food and food group variety, thereby improving health. The aim of this research is to identify and describe the contribution of food access strategies to dietary diversity of farm worker households by identifying their dietary diversity level and its contribution to household food security. A cross-sectional research design was used to collect data from all the adult women (18-65 years) (N=21) responsible for the food in a complete community of farm worker households on a farm (Oranje farm) in the Free-State province of South Africa. A structured questionnaire was used to gather data on demographics, food access strategies with special reference to food production, purchasing, bartering, gathering and payment in kind, as well as dietary diversity. The two most common food accessing strategies used were purchasing (general dealers) and gathering (wild leaves, hunting, and fishing). Most people depended on own food production (86%) such as the cultivation of vegetables (spinach, green beans, pumpkin, turnip, tomatoes, cabbage) and fruit (apricots, peaches). Food bartering is seldom practiced (19%) due to customs and lack of knowledge. Food received as payment in kind (maize meal) was common (76%). The choice method of food access was buying (76%), gathering (19%) and producing (4%). People seldom ate outside their own home (76%), except children receiving food at school from the school feeding scheme (90%). Dietary diversity was limited for cereals consisting mainly of maize meal porridge, bread, vegetables such as wild leafy vegetables, tomatoes, onions, and potatoes, fruit (apples), unpasteurised milk, protein (eggs, chicken) and other (tea, sugar, oil, curry powder). The mean for the food variety score of the 109 food items per day varied from 23.0 to 27.9 between five seasons which relates to three to four different food items per day. Food variety score were thus lower in all the seasons when considering nutritious food. The food group diversity score was also calculated over nine nutritious food groups used over seven days. The food group diversity scores was high in almost all the seasons. The mean food group diversity score of the nine food groups varied from 7.9 to 8.8 between five seasons which relates to one and almost two food groups per day. Although most food groups were consumed in seven days, resulting in “high” dietary diversity, the numbers of food items (individual food variety) eaten within the various food groups was low. This study showed that it was possible to predict household food security of household members by simply calculating the food variety score and food group diversity score of a household as an indication of dietary diversity. The result revealed which households was food secure on insecure, and provided an overall picture of the dietary diversity of the whole community. Overall this results indicated that limited food access strategies were utilized or that many of the strategies were not used optimally, resulting in limited dietary diversity, ultimately affecting the household food security status of farm worker households. This information can be used to formulate strategies and develop interventions to increase the number of food access strategies utilized and to food improve utilization thereof in order to improve dietary diversity and household security. / Dissertation (MConsSci (General))--University of Pretoria, 2008. / Consumer Science / unrestricted

Breastfeeding is at its best when both the mother and infant benefit from the experience. Aim: To obtain data on the adequacy of the diet and nutrition knowledge of lactating women (0-6 months postpartum) living in a low socio-economic area in Nairobi. The findings could be used to plan future nutrition intervention programs. Research design: A cross-sectional survey in the quantitative and qualitative research paradigms. Health status indicators, socio-economic and cultural factors were additionally investigated as interactive factors that could influence the nutrient intake and nutrition knowledge of the lactating women. Setting: Mbagathi District Hospital, located at the edge of Kibera slum area in Nairobi. Sample: Lactating mothers (0-6 months postpartum), who were visiting the Maternal-Child Health Clinic to bring their children for immunisation, were recruited. Convenience sampling was used (N=120). Informed consent was obtained from the mothers in their home tongue. Methodology: Individual interviews in Swahili, using structured questionnaires (Socio biodemographic questionnaire, Hunger Scale, 24 Hour-recall, and Quantitative Food Frequency Questionnaire), and anthropometry (according to standard procedure) were done in the quantitative domain. Seven structured focus group discussions were employed in the qualitative domain. Descriptive and inferential statistics were used on the quantitative data, and Krueger‘s framework of analysis on the qualitative data. Ethical approval was obtained from the Ethics Committee, Faculty of Natural and Agricultural Sciences, University of Pretoria; Ref no EC 080922-039, and research permission was granted by the National Council for Science and Technology, Nairobi; Permit no NCST/5/002/R/355. Main findings: Majority of women (92%) had energy intakes between 5040 – 10080 kJ/day with the mean energy intake of 6975.5 kJ/day which was lower than the recommended 11340 kJ/day. Macronutrient intake was within the acceptable macronutrient distribution ranges, whereas the micronutrients were consumed below the recommended dietary allowances (WHO). The mean adequacy ratio (excluding niacin) was 0.74. The highest frequency of consumption (100%) was from cereals, while the lowest were for vitamin A rich vegetables/fruits (6.6%) and dairy products (1.7%). Overall, the mean Food Variety Score (FVS) was 6.6 ( ± 2.0) and the Dietary Diversity Score (DDS) was 4.3 ( ± 1.0). Hunger assessment revealed 43 households that were food secure, whereas 77 households were either hungry or at risk of hunger. Majority of women (93%) had good nutrition knowledge but the rationale for applying the knowledge was lacking for most of the nutrition concepts. Socio-economic status, cultural beliefs and practices, health status and nutrition knowledge were all identified as probable factors that influenced the dietary intake of the lactating women. Recommendation: There seems to be a need for well-designed nutrition intervention programs focusing on nutrient intake from culturally acceptable and affordable foods to increase dietary diversity and food variety of lactating women in this low socio-economic area. With a concurrent increase in nutrition knowledge such interventions would improve their nutritional status. / Dissertation (MSc)--University of Pretoria, 2010. / Food Science / unrestricted

Magister Public Health - MPH / Background: The World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) recommend exclusive breastfeeding for the first six months of life and introduction of nutritionally adequate and safe complementary foods after 6 months with continued breastfeeding to 2 years and beyond. A variety of foods in the diet is needed to ensure that the nutrient needs of breastfed and non-breastfed children are met. Price of food and affordability are the main barriers of accessing sufficient, safe and nutritious diets to meet dietary needs for an active and healthy life. Many low-income households cannot afford a healthy nutritionally adequate diet, because of the cost of nutrient-rich foods relative to income. Aim: The aim of the study was to determine whether cost of the diet is associated with dietary diversity, energy and nutrient density, and nutrient adequacy in breastfeeding and non-breastfeeding children aged 12 to 24 months. Objectives: For breastfed and non-breastfed children age 12 to 24 months, to determine: (i) dietary diversity, nutrient adequacy and cost of total dietary intake; (ii) dietary diversity, nutrient density, energy density and cost of the complementary diet; (iii) the association of cost of the diet with dietary diversity and nutrient adequacy; and (iv) the association of cost of the complementary diet with dietary diversity, nutrient density and energy density of the complementary Study design: The study is a descriptive study and used an existing dataset consisting of pooled previously collected 24-hour dietary recalls for children age 12 to 24 months from the two most recent independent studies (n=1064). The dataset included data on dietary energy and nutrients, mean adequacy ratio, nutrient adequacy ratios, micronutrient density per 100 kcal of the complementary diet and cost of food per 100g edible portion.