Thesis (M. Tech. (Food and Beverage Management, Dept. of Hospitality and Tourism)--Vaal University of Technology. / Objectives: The aim of this study was to develop and evaluate a nutrition education programme for Setlabotjha Primary School children in order to improve current knowledge. The study included all grade seven learners from two primary schools in one of the poorest areas in the Vaal Triangle. Children form Setlabojha Primary School formed the experimental group, while children from Ekujuleni Primary School formed the control group. Methods: The initial steps involved a baseline survey (Napier 2001 :78), which indicated that malnutrition exists at Setlaboljha Primary School. The baseline survey indicated stunting, wasting, underweight and poor food consumption patterns among the children. A literature survey was conducted, as a result of the findings of malnutrition, poverty and household food insecurity in Eatonside. Pre-tests were undertaken to determine current nutritional knowledge (for both groups) using a nutritional knowledge questionnaire developed by the Medical Research Council. The pre-tests results revealed poor nutritional knowledge and these results were used to develop the nutrition education tool (nutrition education playing cards) based on the South African Food Based Dietary Guidelines. The intervention, which involved the issuing, reading. playing and exchanging of the nutrition education playing cards had taken place over eleven weeks for the experimental group. The control group had received pamphlets and nutrition education lessons. After the intervention had taken place, post-tests were undertaken to compare the difference between the two groups and to determine the effectiveness of the nutrition education programme. Results: In general, the subjects of both groups had a good knowledge regarding sugar, water and salt consumption, as well as 'the key to a healthy way of eating'. Thus the inclusion of fruit and vegetables and variety were in the diet. Poor knowledge was evident in both groups pertaining to pregnancy, the importance of starch in the diet, alcohol consnmption, physical activity, vitamin A-rich foods and the inclusion of pilchards as a calcium-rich source. / NRF and Central Research Committee, VUT.

Thesis (M. Tech. (Food Service Management, Dept. of Hospitality, Tourism and PR Management)--Vaal University of Technology / Introduction. Most of the children aged between five and 15 around the world live under difficult circumstances, which lead to a high dropout rate from school before the end of the secondary level. Most of them have poor nutrition, are undernourished and are exposed to a large range of harmful, parasitic and infectious diseases (Shariff et al, (2000:265). Purpose. The purpose of this investigation was to analyze the nutritional status of primary school children in Orange Farms informal settlement in terms of their nutritional needs in order to implement a school feeding programme and assess its impact on the nutritional status of these children. Methodology. A cross-sectional baseline survey was conducted two weeks before commencing with the school feeding programme. The measurements taken during this phase were socio-demographic and health by means of a questionnaire, as well as dietary intake and food consumption patterns by means of a quantified food frequency questionnaire and 24-hour recall, weight and height measurements. The anthropometric measurements included height and weight and the biochemical measurements included serum ferritin, C-reactive protein, total protein, albumin, vitamin B 12, folate, glucose, full blood count, haemoglobin, haematocrit, red blood cell count, mean cell volume, white blood cell count, vitamins A, E and zinc. A single matched "placebo" -controlled, parallel group, clinical trial of ten months followed in a randomly selected sample of 100 participants, 50 forming part of the control group receiving a fruit and 50 forming part of the experimental group receiving com-soy blend porridge. After the 10-month period, the same measurements for the baseline survey were repeated, except for the sociodemographic and health measurements. Results. Malnutrition, including under and over nutrition, remains a major problem among primary school children globally. This was also true in both the experimental and control school groups in this study where 18.6 percent, 34.9 percent and 4.7 percent were underweight, stunted and wasted especially in the experimental group compared to 9.1 percent severe underweight, and 9.1 per cent each for severe stunting and wasting in the control group at baseline. A mainly carbohydrate based diet was consumed with limited vegetable and animal protein intakes. The socio-demographic data indicated that household food insecurity contributed to the poor dietary intake of the sample, as the majority of the caregivers were unemployed in both groups. This was further confirmed by the limited monthly household income of less than R 1000 for a relatively large family size of up to 5 members in the control group compared to 5-10 household members in the experimental group. The implementation of a school feeding programme that included a nutritious and acceptable meal in the form of enriched corn-soy blend or a fruit as part of the programme, also proved to be a relatively easy and cost-effective way to address hunger in these primary schools. Furthermore, the dietary intake levels for both groups showed statistically significant improvements for various macro- and micronutrients when compared to DRis. Conclusion Although few statistically significant differences were observed between the groups with regard to dietary intake patterns, biochemical changes and nutritional status indices, positive changes were observed in both groups, indicating that any food provision may have a positive impact on undernourished children. The results of the intervention indicated an improvement in dietary intake which could result in an improved nutritional status, specifically related to micronutrients. However, the anthropometric indices and certain biochemical parameters showed significant improvements in both groups after the intervention. School feeding programmes are a good strategy for addressing malnutrition among primary school children if monitored effectively. However, it does not impact directly on household food security. A long-term clinical intervention trial is recommended to measure the impact of a food-based approach to address specific micronutrient deficiencies prevalent among children in these age groups. / National Research Foundation

xxi, 199 leaves: ill. / Introduction and purpose: This empirical study was carried out to determine the nutritional status and level of nutritional knowledge amongst orphaned children. A cycle menu will be developed after sensory evaluations of all protein enhanced dishes. Method: Anthropometric measures were used to determine the nutritional status and to measure the nutrition knowledge of 100 orphaned children aged 9 to 13 years old in Boipatong, Vaal region. A nutritional knowledge questionnaire was administered to the study group. Furthermore the anthropometric measurement was carried out and analysed with World Health Organization software (AnthoPius) using ±2 standard deviations cut off points, and data on nutritional knowledge were captured on Microsoft Excel and analysed for frequencies, mean and standard deviation (SD) using the Statistical Package for Social Science (SPSS) version 1'7. Results: The results for nutritional status revealed that 59% of the population studied were underweight, 40% were stunted and 25% were wasted. Most of the respondents (70%) scored less than 50% on the nutrition knowledge questionnaire. The mean correct answer for multiple choice questions was 29.65% and for true/false question was 50.34%. Conclusion: The orphaned children are under-nourished and wasted. Further to this, the nutrition knowledge of the orphans is poor. It is recommended that a nutrition education programme be implemented so as to address the issue of poor food choices and malnutrition. / National Research Foundation (NRF), VUT and Hubbs and Spokes Model

Twenty Sierra Leonean rural illiterate mothers were querried about their perceptions of the factors related to Kwashiorkor. Demographic data was hand tabulated to determine the frequency of parents' occupations, pregnancies, live and stillbirths, living and dead children, and causes of children's deaths. Chi-square analyses were done to assess the distribution of responses to questions about 19 beliefs which the researcher thought were related to Kwashiorkor. Student t-test was used to determine the differences in the total number and outcome of pregnancies between women who agreed and disagreed about the role of four of the factors which tended to show or showed significance with chi-square analyses.The families were subsistence farmers. In addition, 65 percent or the husbands had other jobs. Combined, the 20 women had 191 pregnancies, 166 live births, (87 percent of pregnancies), 25 (13 percent) stillbirths, 82 living children (43 percent of pregnancies and 49 percent of live births). The women lost through death 84 (50.6 percent) of the 166 live born children.The average woman experienced 9.6 pregnancies, resulting in 8.3 live births, and 1.3 stillbirths, had an average of 4.1 living children and had lost an average of 4.2 live born children. The data indicated that the major problem with infant/child mortality occurred after birth. Protein-Energy Malnutrition accounted for 38.1 percent of the children's deaths.Of the 19 factors about which women were querried in relation to role in Kwashiorkor, to only 4, namely “Witchcraft,” “Religious beliefs,” “Grandmother's advice,” and “Mother-in-law's advice” did less than half of the women agree. The majority of women agreed that 15 of the factors were associated with Kwashiorkor.That indicated the women had supportable understanding of factors truly related to Kwashiorkor.Three constructs, beliefs about “Witchcraft,” “Introduction of other foods,” and “Immunizations,” differentiated incidence and outcome of pregnancy among women. However, belief about the importance of “Immunizations” differentiated infant/child mortality and will be most useful in future research to analyze differences and to identify groups at greatest risk of child mortality.Ball State UniversityMuncie, IN 47306

The present study looks at the socio-emotional impact of malnutrition. This is done by comparing infants who are hospitalised for malnutrition, and infants hospitalised for surgical reasons. Twenty infants were selected from the medical ward (malnutrition ward), and twenty from the surgical ward were selected as a control group. Observation was used as a method of collecting data on socio-emotional behaviour. The results of analysis of variance indicated that there was a significant difference between the two groups of children in social and emotional responsiveness. Malnourished children showed less responsiveness, which was suggested by less activity, less affect, and low reactions to situations compared to the control group. The results also indicated that females are more sensitive than males. The results of this study invite possibilities for further investigations. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 1998.

What can we learn from the programmes which have attempted to improve the conditions of an estimated 190 million children around the world who are chronically undernourished? It is evident from the literature that there is a dramatic increase in the risk of death amongst malnourished children, many of whom die from minor diseases which become fatal in the presence of malnutrition. Implementation of successful nutrition programmes seems to be an effective way of not only preventing the waste of human resources which are vital for development but also as an empowering process for communities to solve their own problems and ensure sustainable development. In addition, improved nutrition is viewed as a means to ensure the rights of children to life and an improved quality of life. At the same time it is regarded as a way of saving scarce resources which would have been spent on malnourished children and instead to spend the money in other sectors of the economy. A review of different nutrition related programmes revealed that there is no "magic bullet" for solving nutrition related problems in different communities. However, there are basic elements which need to be considered if successful and sustainable implementation of nutrition related programmes is desired. This exploratory study aims at increasing the understanding of some of the elements which enhanced successful implementation processes of the Child Survival, Protection and Development (CSPD) programme in two regions of Tanzania, namely Mara and Singida. In order to accomplish the study a combination of qualitative and quantitative methods were employed. Districts and villages involved in the study were randomly selected. The study revealed that there were eight main elements which enhanced implementation of the programme in the two regions. The elements included awareness, training, commitment, appropriate structures, an effective monitoring system, good leadership, adequate linkage with other programmes and positive outcomes within a reasonable time. Furthermore itwas found that no single element was enough on its own to facilitate adequate implementation ofthe programme and hence the combination of the elements was an important factor. Finally, recommendations are provided on how to incorporate the elements effectively into the implementation of the nutrition related programmes in order to ensure success and sustainability. / Thesis (M.Sc.)-University of Natal, Pietermaritzburg, 1998.

The high rate of malnutrition (180/1000 live births) in Sierra Leone (U N Demographic Year Book, 1985) has become a major concern to the government, development agencies, medical and nutritional personnel. This study was designed to determine whether there were any significant differences between the nutritional status of the children women who participated in an FAO project and those who did not and was conducted in six villages in the Koinadugu District of Sierra Leone.By referring to a list of local protein rich foods, three-day recall of food frequency was done to estimate the protein intake. Anthropometric measures were collected and body mass index was determined. All measures were compared with standards for African-American population.The weight-for-age was significantly greater for the the 50th percentile than that of the non-project children (NPC). Protein intake less than the average of 57 grams, were seen among older children with lower weight-for -height percentile, suggesting that total food intake was inadequate for the older children. This researcher believes that the FAO project should continue but that nutrition education should be an important component of the program. / Department of Home Economics

Background: The World Health Organisation (WHO) initially recommended F100 formula in the treatment of severe malnutrition. F100 is made with full cream milk powder, sugar, oil and water with added minerals and vitamins. Ready to-use therapeutic food (RUTF) is a highly nutrient dense food enriched with minerals and vitamins, with a similar nutrient profile but greater energy and nutrient density than F100. RUTF has shown to be effective in the treatment of severe and moderate wasting and is associated with an increased recovery rate. In South Africa no studies are available on the recovery rate of children with severe acute malnutrition treated with RUTFs. Aim: To compare the recovery of clinically stable severe acute malnourished children, between the age of 12 and 60 months, treated with either F100 or RUTF as nutrition supplement. Methods: A randomised clinically controlled trial was performed. All children referred to Clairwood hospital with severe acute malnutrition (SAM), defined as a weight for height measurement of <70 percent of the median and/or < -3 SD below the mean WHO reference values or the presence of bilateral oedema were included in this study. Children were stratified according to age and gender and subsequently randomly assigned with randomisation tables to either the RUTF or F100 group. A total of 35 children were included in this study and data from 34 were analysed with 17 in each group. Results: Most children included in this study were between 12 and 18 months with boys in the majority. Both groups had a large percentage of HIV-infected children (70 percent in the RUTF group and 76 percent in the F100 group), with Tuberculosis (TB) co-infection in some of the children. One child died due to HIV related complications. The rate of weight gain was 7.77g/kg/day in the RUTF group and 6.11g/kg/day in the F100 group. There was no statistical significant difference established between groups (p = 0.46). The majority of children recovered within 21 days on the RUTF while the majority of children in the F100 group recovered after 6 weeks. There were no changes in height during the rehabilitation of these children. MUAC changes were observed with 92 percent having a mid-upper arm circumference (MUAC) of > 11.5cm after a 6 week intervention with RUTF and F100. Conclusion: RUTF resulted in better rates of recovery and can be used efficiently in rehabilitating children with SAM in a supervised facility setting. These preliminary results also point towards significant potential savings regarding hospitalisation costs since faster recovery has been demonstrated by children in the RUTF group.

Postpartum depression (PPD) is a common perinatal mental health disorder (CPMD) extensively linked to poor child health outcomes, including increased risk of illness, stunting and underweight. Rates of PPD and child malnutrition are consistently elevated in Sub-Saharan Africa compared to other regions of the world. This includes Northern Uganda, a region devastated by armed conflict and enduring poverty. While the link between PPD and adverse child health outcomes is firmly established, the mechanisms underlying this association remain poorly understood.The current study addresses this gap in the literature through investigating in a sample of Ugandan mothers of children 0 to 23 months how maternal behaviors promoting child health differ in the presence or absence of probable depression. This study also explores how perceived social support and women’s empowerment may moderate the relationship between PPD and mothers’ engagement in these health-promoting behaviors. The study is based on cross-sectional, baseline data collected for a project sponsored by Food for the Hungry Uganda, an international relief and development organization, and in partnership with the Global Mental Health Lab at Teachers College, Columbia University and World Vision International. The study’s sample included 1028 probably depressed and 284 nondepressed Ugandan mothers with at least one child under 24 months of age at the time of interviewing. The study’s findings yielded evidence to support the reliability and validity of the Patient Health Questionnaire-9 and Multidimensional Scale of Perceived Social Support for this sample. While as expected, probable depression was positively associated with child underweight, recent child illness, delayed care seeking for sick children and unsafe disposal of child feces, positive associations were also found between depression and important health-promoting behaviors, for which there is little evidence in the extant literature, including provision of the same amount or more food to a sick child, knowledge of danger signs of childhood illness, and some WASH behaviors. Perceived social support and women’s empowerment indicators were also found to moderate the association between probable depression and some IMCI, IYCF and WASH behaviors. Study limitations, clinical implications and recommendations for further research are discussed.

Children less than five years of age are at a risk of growth failure worldwide. The South African National Food Consumption Survey (NFCS) of 1999 showed that 25.5% of children aged 1 - 3 years were stunted. Poor growth of young children in developing countries (South Africa included) has been associated with multiple micronutrient deficiencies because of the use of starchy plant-based complementary foods with little variety, especially among resource poor households. Dietary diversification through the use of crop and livestock production has been recommended as a strategy to improve the micronutrient intake and food security of households in resource poor settings. This study was a cross sectional secondary analysis of the South African NFCS of 1999 data, designed to investigate the impact of crop and livestock production on nutrient intake, dietary diversity, intake of selected food groups, hunger perceptions and anthropometric status of children aged 1 - 3 years in South Africa. Children from households producing crops only (n=211), crops and livestock (n=110), livestock only (n=93) and non-producers were compared at the national, in rural areas and among households with a total income of less than R12 000.00 per household per year. In rural areas and among households with a total income of less than R12 000.00 per household per year, children in the crops and livestock group had higher nutrient intakes for energy, vitamin 86, calcium and folate than the other groups (p<0.05), while the crops only group had higher nutrient intakes for vitamin A and vitamin C. The majority of children in all the four study groups had less than 67% of the RDAs for vitamin A, vitamin C, folate, calcium, iron and zinc. In addition , children in all the groups had a median dietary diversity score of four out of 13 food groups. In rural areas and among low income households, higher percentages (over 60%) of children in the crops only group consumed vegetables while the non-producers group was the lowest (47.7%). The non-producers group had the highest percentages of children consuming meat and meat products and the crops and livestock and livestock only groups had the lowest percentages. In both rural areas and among households withlow income, the majority of the households in all the study groups were experiencing hunger. In rural areas, one in five households were food secure. Crop and livestock production improved the nutrient intake and the intake of vegetables of children in rural and poor households. However, nutrient intakes were not adequate to meet the recommended nutrient levels. The high levels of food insecurity require support of these households to increase crop and livestock production and, integration of nutrition education to increase the consumption of the produced products. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.