Browsing by Author "Klopper, J M L"
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- ItemOpen AccessA nutritional and socio-economic study of Philippi farm children and their mothers during November 1986(1987) Whittaker, Stuart; Klopper, J M LA community based survey to determine the nutritional status using anthropometric methods, of children and mothers and to assess certain socio-economic factors was carried out during November and December 1986 in Philippi, a predominantly vegetable farming area. Twenty-one (43%) of the 49 vegetable farms which were included in the study were selected by stratified random sampling. All children in the 0-6 year age group and their parents on the selected farms were included in the sample which consisted of 129 children and 212 parents. Questionnaires were administered and subjects' weights and heights were measured. It was found that 47% of children were below the National Centre for Health Statistics 5th percentile weight for age and 58% were under the 5th percentile height for age. There were 47 child deaths out of 279 births over a six-year period, thirty-four of which had occurred in the first year of life. Twenty eight percent of children had a birth weight of less than 2.5 kg. The number of cases of tuberculosis (10%) and severe diarrhoea (31%) contracted within the first year of life is unacceptably high. Twenty four percent of mothers were malnourished in terms of body mass index and fifty five percent of mothers were illiterate. Fifty nine percent of mothers were regular farm workers who worked for an average of 10.2 hours per day and a wage of R0.44 per hour. Grossly inadequate facilities existed for the care of children while the mothers worked. The average amount spent on food was insufficient to maintain normal nutrition. Although 91.5% of mothers breast fed their children and fed for a mean duration of 13.4 months, breast feeding was not exclusive. Supplementary feeding was introduced on average at 3 months of age. The long working hours of working mothers made it difficult for them to breast feed their children satisfactorily. Acceptance of the family planning services was high and immunisation cover was good. These statistics reflect the effects of extreme poverty and neglect of a community which is totally reliant on its employers for its livelihood. The parents poor educational level, coupled with their meagre financial and other physical resources gives them and their children little opportunity to improve their station in life and leaves them open to the scrounge of malnutrition and disease. Similarly, the dearth of educational and other child care facilities will ensure that this disastrous trend continues. A multidisciplinary approach, including active community involvement of both farmers and workers, to the many physical and social problems is urgently needed if the unacceptable human suffering is to be stopped.
- ItemOpen AccessRegionalization of health services in the Cape Province : a framework(1989) Pick, William M; Klopper, J M LPost-graduate students specializing in Community Health, are attached to different health authorities during their training. During these attachments they are exposed to the day-to-day management of health services and experience at first hand, the difficulties as well as the successes that are encountered in tending to the health needs of communities. It is also expected that post-graduate students do research projects during their attachments, usually on topics on which the health services managers need information. The topic discussed in this report was an assignment given to the author at the start of his attachment to the department of Hospital (Health) Services of the Cape Provincial Administration. The period of attachment was from February to May 1987. The whole question of the regionalization of health services is a complex one, and it is necessary that any proposals for a system of regionalization benefit from the inputs of many experts in different fields. However, as has been the experience in the United States of America, such inputs are no guarantee -that a successful system of regionalization will result. (1) In the local front, the Department of Works, at the request of the Director of Hospital Services, began an investigation into the existing system of regionalization of hospital services in 1985. This attempt was aborted, possibly because of the magnitude of the task, among other things. (2). What follows hereafter should therefore be seen as merely a framework for the development of a system of regionalization rather than as a blueprint for such a system. Perhaps a few remarks about the age-old problem of line-staff conflict would not be amiss at this stage. During the development of this framework, it became apparent that line officials might be expecting a quick proposal of regions and/ or sub-regions for the delivery of health services based on a purely management approach. As a staff official, the author naturally had different expectations. The report is an attempt to marry the two sets of expectations and it is left to the reader to judge to what extent, if at all, the author has succeeded in this attempt. Much of the data used in the study are new, and computation was done largely by hand. The generation of the data, was therefore time-consuming and much of the first phase of the study was devoted to the generation of the data and collection of data that were available from other sources. The study has proved to be a fascinating one and it is hoped that permission will be obtained to pursue the study in more detail. This report should therefore be seen as a preliminary report which addresses the question of regionalization of health services in the Cape Province in 'macro' terms. And finally, the author hopes that some of the information in this report may prove of value to those responsible for the delivery of health services to the people of the Cape Province.