Thesis (PhD)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: A community-based growth monitoring (GM) project was established in a rural village in
KwaZulu-Natal. The project is an example of community-based activities that were based on a
participatory approach of problem assessment and analysis. The first phase of the study
comprised of a situation assessment. The aim was to evaluate the nutritional status and related
factors of children aged 5 years and younger. It included a cross-sectional survey
(questionnaire and anthropometric measurements), focus group discussions and interviews
with key informants. From a nutritional point of view, the situation assessment identified a
need for regular GM of infants and small children, increased availability of foods rich in micronutrients,
and nutrition education.
Relevant findings of the situation assessment were used during a project planning
workshop that was attended by community representatives. The community's concern about
the health of the preschool children and the lack of health facilities, and the need for regular
weighing of their children prompted the establishment of a community-based GM project.
The GM project was run by nutrition monitors, through home-based centres (named
Isizinda). Monthly activities at the Isizinda included GM, nutrition education, and recording of
morbidity and mortality data. Children who were either in need of medical attention or showed
growth faltering were referred to the nearest clinic. During the latter half of the study, the GM
project was integrated with a household food production project and the Isizinda served as
promotion and training centres for agricultural activities.
Project activities were continuously monitored by reviewing the attendance register,
scrutinising the Isizinda files, observation and staff meetings. Community meetings (at least
twice a year) allowed for two-way feedback and addressing questions and concerns.
Acceptability of the GM activities was measured in terms of attendance and maternal
perceptions. The coverage of the Isizinda project was estimated at approximately 90% and at
least 60% of these children were adequately covered. The Isizinda data showed an equal
distribution of child contacts over the various age categories and was representative of the
community. The attendance data suggest that community-based GM is a viable option to be
used for screening and nutrition surveillance, and as platform for nutrition education.
Most mothers comprehended the growth curve. Positive behavioural changes have
been observed in the community and the Isizinda data showed a steady decline in the
prevalence of diarrhoea. The Ndunakazi mothers were appreciative towards the Isizinda project because of a
better understanding of the benefits of regular GM. They expressed a sense of empowerment
regarding the knowledge that they have gained. The community had a strong desire for the
project to continue.
The Isizinda project showed that community-based GM can provide the
infrastructure for developing capacity for agricultural activities within the community. Data
from the household food production project showed that maternal knowledge regarding
nutritional issues can be improved through nutrition education given at the GM sessions and
that, when GM is integrated with agricultural activities, a significant improvement in child
malnutrition can be obtained. The Isizinda project falls within the framework of the Integrated
Nutrition Programme, and can bridge the gap in areas which lack health facilities. / AFRIKAANSE OPSOMMING: ’n Gemeenskaps-gebaseerde groeimoniteringsprojek is tot stand gebring in ’n landelike gebied
in KwaZulu-Natal. Die projek is 'n voorbeeld van gemeenskapsgebaseerde aktiwiteite wat
gebaseer was op 'n deelnemende benadering van probleem bepaling en analise. Die eerste fase
van die studie was a situasie analise. Die doel was om die voedingstatus en verwante faktore
van kinders 5 jaar en jonger te bepaal. Dit het 'n dwarssnit opname (vraelys en antropometriese
metinge), fokus groep besprekings en onderhoude met kern persone ingesluit. Uit 'n
voedingsoogpunt het die situasie analise 'n behoefte vir gereelde groeimonitoring van babas en
klein kinders, verhoogde beskikbaarheid van voedsels ryk in mikronutriente and
voedingsvoorligting aangedui.
Toepaslike bevindinge van die situasie analise was gebruik tydens ’n beplannings
werkswinkel wat deur verteenwoordigers van die gemeenskap bygewoon is. Die gemeenskap
se besorgdheid oor die gesondheid van voorskoolse kinders en die gebrek aan
gesondheidsfasilitieite, asook hul behoefte om hul kinders gereeld te laat weeg, het aanleiding
gegee tot die totstandkoming van ’n gemeenskaps-gebaseerde groeimoniteringsprojek.
Die program is gedryf deur monitors deur tuisgebaseerde sentrums (genoem Isizinda).
Maandelikse aktiwiteite by die Isizinda het groeimonitering, voedingvoorligting en die
insameling van morbiditeit en mortaliteit inligting ingesluit. Kinders wie mediese sorg benodig
het of wie groeivertraging getoon het, is na die naaste kliniek verwys. Die
groeimoniteringsprojek is tydens die laaste helfte van die studie met ’n huishoudelike
voedselproduksieprojek geintegreer en die Isizinda het as promosie- en opleidingsentrum vir
die landbou aktiwitiete gedien.
Projek aktiwiteite is deurgaans gemonitor deur die bywoningsregister en Isizinda leêrs
deur te gaan, waarnemings en personeel vergaderings. Vergaderings met die gemeenskap (ten
minste twee per jaar) het voorsiening gemaak vir wedersydse terugvoering en die aanspreek
van vrae en besorgdhede.
Die aanvaarbaarheid van die groeimoniterings aktiwiteite is gemeet in terme van
bywoning en persepsies. Die Isizinda projek het ongeveer 90% van die kinders gedek, van wie
ten minste 60% voldoende gemoniteer is. Die Isizinda data het ’n eweredige verspreiding van
besoeke oor die verskillende oudersdomgroepe aangetoon. Die Isizinda data was ook
verteenwoordigend van die gemeenskap. Die bywoningssyfers dui aan dat
gemeenskapsgebaseerde groeimonitoring 'n lewensvatbare opsie is vir sifting en voeding opnames, en as 'n platform vir voedingvoorligting.
Meeste moeders kon die groeikaart interpreteer. Positiewe gedragsveranderinge is in
die gemeenskap waargeneem en die Isizinda data het ’n geleidelike afname in die voorkoms
van diarree getoon.
Die Ndunakazi moeders was waarderend teenoor die Isizinda projek as gevolg van 'n
beter begrip ten opsigte van die voordele van gereelde groeimonitering. Hulle het 'n gevoel van
bemagteging uitgespreek ten opsigte van hul verbeterde kennis. Hulle was mening dat die
projek moes voortgaan.
Die Isizinda projek het aangetoon dat gemeenskapsgebaseerde groeimonitoring die
infrstruktuur kan skep vir die ontwikkeling vir kapasiteit vir landbou aktiwiteite binne die
gemeenskap. Inligting van die huishoudelike voedselproduksieprojek het aangetoon dat die
moeders se kennis ten opsigte van voedings verwante aspekte verbeter kan word deur
voedingvoorligting wat gegee word tydens die groeimonitering sessie en dat, as
groeimonitoring geintegreer is met landbou aktwiteite, 'n verbetering in die voedingstatus van
die kind verkry kan word. Die Isizinda projek val binne die raamwerk van die Geintegreerde
Voedingsprogram en kan die gaping dek in areas waar geen gesondheidsfasilteite is nie.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/52737 |
| Date | 12 1900 |
| Creators | Faber, M. |
| Contributors | Benade, A. J. S., Nel, E. D., Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | 181p. : ill. |
| Rights | Stellenbosch University |
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