The physical, psychological and social development of school children has been neglected - partly because they were seen as healthy "survivors" of the ravages of childhood illnesses, and partly because of the way in which health services are organized (such as the traditional under-five maternal and child health (MCH) services and the curative PHC clinic services). From the age of five years children undergo rapid and profound bio-psycho-social development, to emerge in adolescence as the next generation of leaders and workers. Securing their future growth and development is vital for any society to be economically and socially productive. A substantial body of national and intemational literature has recognised the detrimental impact of helminthic infections and micronutrient deficiencies on the physical and psychological health and development of school children; which requires appropriate nutritional interventions. Concern has been expressed that these adverse biological, physical and social deprivations have a cumulative impact on several dimensions of children's growth. Most important, apart from stunting physical growth, is the inhibition of educational development of school children. Recent evidence strongly suggests a powerful interaction between physical and psychosocial growth and development of children. Inhibition of either component of a child's well-being has adverse implications. Conversely, investments in the physical and psychological development of children are likely to generate substantial health and educational benefits and are a worthy investment to secure a healthy future generation. In summary, there are a number of reasons for, and benefits of, investing in school-based health and nutrition interventions. They are likely to improve learning at school and enhance educational outcomes; create new opportunities to meet unfulfilled needs; redress inequity; build on investments in early child development and promote and protect youth and adolescent development. Health and nutrition interventions such as school feeding programmes, micronutrient supplementation and deworming aim to improve primary outcomes of macro and micro-nutrient deficiencies, parasitic and cognitive status; as well as secondary outcomes of developing integrated comprehensive school health policies and programmes. This rationale served as the conceptual framework for this study. This theoretical framework views improvements of the health, nutritional, cognitive and scholastic development status of school children as the primary focus of policies, strategies and programmes in the health and education sector. This focus constitutes the central core of this thesis. Optimum social development requires investments in both the health and educational development of school children, so as to maximise the synergies inherent in each sector and to operationalise national and international strategies and programmes. As part of the larger RCT study a comprehensive nutritional, health and psychological profile of rural school children was established through a community-based cross-sectional study. Eleven schools were randomly selected from the Vulamehlo Magisterial District in southern KwaZulu-Natal (KZN). Within each school, all Standard 1 pupils, aged between 8 - 10 years, were selected giving a final study sample of 579 children. Some of the observed prevalence's were stunting (7.3%), wasting (0.7%), anaemia (16.5%) (as measured by haemoglobin below 12 g/dl), vitamin A deficiency (34.7%) (as measured by serum retinol below 20 ug/dl) and serum ferritin below 12ng/ml (28.1%). This study established that micronutrient deficiency, parasitic infestations and stunting remain significant public health problems among school-aged children in South Africa. Combining micronutrient supplementation and deworming are likely to produce significant health and educational gains. To determine the impact of single and combined interventions (anthelminthic treatment and micronutrient supplements) on nutritional status and scholastic and cognitive performance of school children, a double-blind randomised placebo controlled trial was undertaken among 579 children 8-10 years of age. There was a significant treatment effect of vitamin A on serum retinol (P<0.01), and the suggestion of an additive effect between vitamin A fortification and deworming. Vitamin A and iron fortification also produced a significant treatment effect on transferrin saturation (P<0.05). Among the dewormed group, anthelminthic treatment produced a significant decrease in the prevalence of helminthic infections (P<0.02), but with no significant between-group treatment effect (P>0.40). Scholastic and cognitive scores and anthropometric indicators were no different among the treated or the untreated children. Fortified biscuits improved micronutrient status among rural primary school children; vitamin A combined with deworming had a greater impact on micronutrient status than vitamin A fortification on its own; while anthelminthic treatment produced a significant reduction in the overall prevalence of parasite infection. The prevalence's of Ascaris lumbricoides, Trichuris trichiura and Schistosoma haematobium declined significantly sixteen weeks post-treatment. The levels of both prevalence and intensity in the untreated group remained constant. The cure rates over the first two weeks of the study were 94.4% for Ascaris lumbricoides, 40% for Trichuris trichiura, and 72.2% for Schistosoma haematobium. The benefits of targeted school-based treatment in reducing the prevalence and intensity of infection supports the South African government's focus of using school-based interventions as part of an integrated parasite control programme. These strategies and programmes were found to be consistent with the recommendations of WHO and UNICEF. The nutritional transition facing developing and middle-income countries also has important implications for preventive strategies to control chronic degenerative diseases (Popkin B, 1994; WHO 1998; Monyeki KO, 1999). This descriptive study, comparing BMI data of school children over three time periods, found a rising prevalence of overweight and obesity among South African school children. Obesity as a public health problem requires to be addressed from a population or community perspective for its prevention and management. Environmental risk factors such as exposure to atmospheric pollution remain significant hazards for children. Lead poisoning is a significant, preventable risk factor affecting cognitive and scholastic development among children. The prevalence of elevated blood lead (PbB) levels in rural and semi-urban areas of KwaZulu-Natal (KZN) as well as the risk factors for elevation of PbB among children in informal settlements were examined. This study investigated over 1200 rural and urban children in two age groups: 3-5 and 8-10 years old. Average PbB level in peri-urban Besters, an informal settlement in the Durban metropolitan region, was 10 ug/dl with 5% of the children showing PbB level of greater than 25 ug/dl. By comparison, average PbB value in Vulamehlo, a rural area located 90-120 km from Durban, was 3.8 ug/dl and 2% of the children's PbB levels were greater than 10 ug/dl. Since the cognitive and scholastic performance of school children was a primary outcome measure in this study, it was important to explore other factors that influenced this variable. The performance scores of all four tests in the battery, among the cohort of a thousand rural and urban children, were in the lower range. The educational deficit identified in this test battery clearly indicates the impact of the inferior "Bantu" educational system that African children have experienced in South Africa. Aspects of the School Health Services that were investigated in this descriptive study included the services provided and their distribution; assessment of health inspection; health education and referral processes undertaken by the School Health Teams; perceptions of managers, providers and recipients of the service; as well as the costs of the provision of the service in KwaZulu-Natal. In KwaZulu-Natal, there were School Health Teams In all the 8 health and education regions in the province. In total, there were 95 teams in the province, consisting of nearly 300 staff members. The School Health Teams were involved in a wide range of activities - 74% of all teams were involved in health inspection and 80% were involved in health education. The total annual cost of delivering School Health Services in the province in 1995 was estimated to be approximately R8 750 000. Given the rise of HIV and AIDS in the province, School Health Services need to play a central role not only in prevention, but also in assisting with the acceptance of HIV-positive children within schools. It is recommended that the current and future draft SHS policy guidelines be approved by the relevant authorities for immediate implementation. Districts should consider developing "Health Promoting Schools", with School Health Teams being a central resource. This thesis has explored several aspects of the epidemiological profile of school children in rural and urban settings in KwaZulu-Natal. It has established that school children are exposed to a range of risk factors ranging from nutritional deficits, parasitic infections, atmospheric lead poisoning and a rising prevalence of overweight. All of these risk factors may compromise their physical, psychological and social development. A number of health interventions have been identified, which have the potential to address these problems. Such investments are essential to secure the health of future generations. / Thesis (M.D.)-University of Natal, Durban, 2001.

Thesis (M. Sc. Agriculture (Agricultural Economics)) -- University of Limpopo, 2021 / This study investigated the food security indicators in the rural communities of Ba-Phalaborwa Local Municipality of the Limpopo Province. Quantitative data were gathered from five villages in the municipality using the probability proportionate to size. Data were collected from 185 households. The analytical tools that were used in this study include: Descriptive Statistics, Food Security Indicator Measures and the Logistic Regression Model. Food security is a multidimensional concept; thus it is difficult to measure it comprehensively. Hence, three food security indicators measures, namely; the Household Food Insecurity Access Scale (HFIAS), Household Dietary Diversity Score (HDDS) and Coping Strategies Index (CSI) were combined in this study to measure food security in the study. Each indicator measure was used independently. The Logit Regression Model was used to determine the factors affecting the status of household food security. Certain explanatory variables, namely; household size, marital status and receiving government grant, had a negative relationship with the dependent variable. On the other hand, other variables such as educational level, employment status, gender distance to the markets and health status of the household head were positively correlated with the household’s food security status. The study rejected the null hypothesis which stated that socioeconomic factors do not have influence on the households’ food security status in the Ba-Phalaborwa local municipality. Out of the 11 variables, only four variables were significant, with the household size at 10%, educational level at 5%, household monthly food expenditure at 1% and distance to the market at 10%, respectively. Therefore government should direct more focus should on the introduction of feeding schemes in order to reduce the burden on the poor and at the same time, make it easier for young children to attend school to improve their educational statuses. The households in the study area are not food secured because 65.4 % of households could not afford the food that they preferred and were depending on borrowing food from their relatives and creating debts.

Submitted in fulfilment of the requirements of the Master of Applied Science in Food and Nutrition, Durban University of Technology, Durban, South Africa, 2016. / Background: The occurrence of absenteeism observed at the Coastal KZN FET College is very large. However, absenteeism of this magnitude is not inconsistent with observations from other educational institutions and work places around the world. Generally, absenteeism is coupled to the absence of good health, the presence of one or more non-communicable disease and the paucity of physical exercise undertaken by the personnel. Absenteeism in the work place results in avoidable financial costs to the employer, the employee, and the country as a whole. The wealth of literature shows that health concerns concerning adults are diet related. Diabetes, heart disease, hypertension, obesity, cancer and other non-communicable diseases (NCD’s) are increasing at an alarming rate, daily. A double-burden plagues South Africa: on the one hand there is over-nutrition (an excessive consumption of nutrients); while on the other there is under-nutrition (an insufficient intake of nutrients by certain groups of individuals). Factors such as urbanisation, globalisation, physical inactivity and consumer financial buying power have a significant influence on these health concerns. Aim: The data gathered in this study will be used to develop nutrition wellness education material as a component of a wellness programme for staff members at the Swinton Campus of the KZN Coastal FET College in Mobeni. Methodology: A needs analysis was undertaken to determine whether nutrition wellness education material as a component of a wellness programme for the institution was appropriate. Three 24-hour recall questionnaires gathered from the staff, data on eating habits and nutrient intake were undertaken/collected. A food frequency questionnaire collected data on the frequency and variety of foods eaten. A health questionnaire gathered data on self-reported illnesses, consumption of alcohol, and smoking habits. The demographics of the group, living conditions, and amount of money earned and spent on food was assessed through a socio-demographic questionnaire. Anthropometric measurements assessed included blood pressure, waist circumference, BMI and Waist-to-height-ratio (WHtR). Results: The sample consisted of 138 participants of which 44% (n=61) were men and 56% (n=77) were women. Less than 50% of the respondents were food secure: only 65 persons (47.1%) in the sample always had money to purchase food. In this group 63.93% of the men and 71.43% of the woman were obese. Subsequently 86% of the women exceeded the waist cut-off point of 88cm while 16.39% of the men were above the 102cm cut-off point. Findings revealed that 42.62% of the men and 25.9% of the women had pre-hypertension while 8.20% of the men and 5.90% of the women were hypertensive. This study indicated that this group was nutrient deficient. The fruit and vegetable intake was between 134.44g - 175.69g per day for men and 124.00g - 183.30g per day for women. Energy, dietary fibre, vitamin A, vitamin D, calcium, magnesium and iodine were below the nutrient adequacy ratio. There were positive correlations between age and systolic blood pressure, waist circumference and systolic blood pressure, waist circumference and diastolic blood pressure and waist-to-height ratio and BMI. Conclusion: Central obesity and to a lesser extent hypertension as well as deficiencies in nutrients and minerals were present in this group. Although the participants indicated a good variety of food, the quality and quantities consumed were not adequate. A link between diet, physical activity and diseases of lifestyle has been demonstrated. A need for nutrition education as a component of the wellness programme is indicated. Nutrition education is important both within and outside the workplace. To make lifestyle changes it is essential that education and knowledge is made available. Behavioural habits including eating habits are principally learnt. If bad behaviour habits can be learnt, good behaviour habits can also be instilled. The proposed intervention is aimed at reducing the incidence of absenteeism and decreasing the presence of non-communicable diseases. It is important for staff members at a FET college to be present in the classroom so that education of quality can be conveyed to learners. Further, the good health of staff members facilitates the ability of teachers to perform their important task of educating young minds at all educational institutions. / M

The collection and utilisation of statistical data is an integral component of rendering primary health care services. This study aimed to assess the utilisation of statistics on certain statistical forms submitted regularly to the Department of Health, by professional nurses at local authority primary health care clinics. Results revealed the following important shortcomings: • Statistics on different forms are viewed in isolation, resulting in a lack of necessary comparisons being made to determine trends. • Several targeted issues in the Reconstruction and Development Programme received insufficient attention, for example, immunisations, teenage pregnancies, tuberculosis treatment, sexually transmitted diseases. • A general managerial inability to analyse, display and utilise collected data by professional nurses. Recommendations centred around increasing the knowledge regarding maternal health care, more focus on prioritised areas of the Reconstruction and Development Programme, appropriate training regarding analysis and utilisation of collected statistics at local primary health care level. / Health Studies / M.A. (Nursing)

Health practitioners collect health data on a daily basis at health facility levels in order to monitor and evaluate the performance of priority national health programmes (District Health Plan 2012:6). Routine data quality for health programmes monitoring need a collective intervention to ensure clear understanding for what data to be collected at primary health care setting. The aim of the study is to explore the understanding of routine health data, determine the use of routine data and feedback mechanism at primary health care clinic setting. Quantitative descriptive research design was used to answer the research question on this research study. Structured data collection questionnaire was used for the study to accomplish the research purpose and reach the study objectives. A total of 400 participants was sampled, and 247 responded. One of the findings was that the understanding of routine health data by Health Practitioners was at 82.6% (% = f/n*100, f= 3242 and n= 3926). / Health Studies

Health practitioners collect health data on a daily basis at health facility levels in order to monitor and evaluate the performance of priority national health programmes (District Health Plan 2012:6). Routine data quality for health programmes monitoring need a collective intervention to ensure clear understanding for what data to be collected at primary health care setting. The aim of the study is to explore the understanding of routine health data, determine the use of routine data and feedback mechanism at primary health care clinic setting. Quantitative descriptive research design was used to answer the research question on this research study. Structured data collection questionnaire was used for the study to accomplish the research purpose and reach the study objectives. A total of 400 participants was sampled, and 247 responded. One of the findings was that the understanding of routine health data by Health Practitioners was at 82.6% (% = f/n*100, f= 3242 and n= 3926). / Health Studies

The collection and utilisation of statistical data is an integral component of rendering primary health care services. This study aimed to assess the utilisation of statistics on certain statistical forms submitted regularly to the Department of Health, by professional nurses at local authority primary health care clinics. Results revealed the following important shortcomings: • Statistics on different forms are viewed in isolation, resulting in a lack of necessary comparisons being made to determine trends. • Several targeted issues in the Reconstruction and Development Programme received insufficient attention, for example, immunisations, teenage pregnancies, tuberculosis treatment, sexually transmitted diseases. • A general managerial inability to analyse, display and utilise collected data by professional nurses. Recommendations centred around increasing the knowledge regarding maternal health care, more focus on prioritised areas of the Reconstruction and Development Programme, appropriate training regarding analysis and utilisation of collected statistics at local primary health care level. / Health Studies / M.A. (Nursing)