The targeting of nutritionally at-risk children attending a primary health care facility in the Western Cape Province of South Africa

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dc.contributor.authorSchoeman, SE
dc.contributor.authorHendricks, MK
dc.contributor.authorHattingh, SP
dc.contributor.authorBenadé, AJS
dc.contributor.authorLaubscher, JA
dc.contributor.authorDhansay, M A
dc.date.accessioned2021-10-08T07:15:58Z
dc.date.available2021-10-08T07:15:58Z
dc.date.issued2006
dc.description.abstractAIM: The aim of this study was to determine the practices of primary health care (PHC) nurses in targeting nutritionally at-risk infants and children for intervention at a PHC facility in a peri-urban area of the Western Cape Province of South Africa. METHODOLOGY: Nutritional risk status of infants and children <6 years of age was based on criteria specified in standardised nutrition case management guidelines developed for PHC facilities in the province. Children were identified as being nutritionally at-risk if their weight was below the 3rd centile, their birth weight was less than 2500 g, and their growth curve showed flattening or dropping off for at least two consecutive monthly visits. The study assessed the practices of nurses in identifying children who were nutritionally at-risk and the entry of these children into the food supplementation programme (formerly the Protein-Energy Malnutrition Scheme) of the health facility. Structured interviews were conducted with nurses to determine their knowledge of the case management guidelines; interviews were also conducted with caregivers to determine their sociodemographic status. RESULTS: One hundred and thirty-four children were enrolled in the study. The mean age of their caregivers was 29.5 (standard deviation 7.5) years and only 47 (38%) were married. Of the caregivers, 77% were unemployed, 46% had poor household food security and 40% were financially dependent on non-family members. Significantly more children were nutritionally at-risk if the caregiver was unemployed (54%) compared with employed (32%) (P=0.04) and when there was household food insecurity (63%) compared with household food security (37%) (P<0.004). Significantly more children were found not to be nutritionally at-risk if the caregiver was financially self-supporting or supported by their partners (61%) compared with those who were financially dependent on non-family members (35%) (P=0.003). The weight results of the nurses and the researcher differed significantly (P<0.001), which was largely due to the different scales used and weighing methods. The researcher's weight measurements were consistently higher than the nurses' (P<0.00). The researcher identified 67 (50%) infants and children as being nutritionally at-risk compared with 14 (10%) by the nurses. The nurses' poor detection and targeting of nutritionally at-risk children were largely a result of failure to plot weights on the weight-for-age chart (55%) and poor utilisation of the Road to Health Chart. CONCLUSIONS: Problems identified in the practices of PHC nurses must be addressed in targeting children at nutritional risk so that appropriate intervention and support can be provided. More attention must be given to socio-economic criteria in identifying children who are nutritionally at-risk to ensure their access to adequate social security networks.
dc.identifier.apacitationSchoeman, S., Hendricks, M., Hattingh, S., Benadé, A., Laubscher, J., & Dhansay, M. A. (2006). The targeting of nutritionally at-risk children attending a primary health care facility in the Western Cape Province of South Africa. <i>Public Health Nutrition</i>, 9(8), 1007 - 177. http://hdl.handle.net/11427/34733en_ZA
dc.identifier.chicagocitationSchoeman, SE, MK Hendricks, SP Hattingh, AJS Benadé, JA Laubscher, and M A Dhansay "The targeting of nutritionally at-risk children attending a primary health care facility in the Western Cape Province of South Africa." <i>Public Health Nutrition</i> 9, 8. (2006): 1007 - 177. http://hdl.handle.net/11427/34733en_ZA
dc.identifier.citationSchoeman, S., Hendricks, M., Hattingh, S., Benadé, A., Laubscher, J. & Dhansay, M.A. 2006. The targeting of nutritionally at-risk children attending a primary health care facility in the Western Cape Province of South Africa. <i>Public Health Nutrition.</i> 9(8):1007 - 177. http://hdl.handle.net/11427/34733en_ZA
dc.identifier.issn1368-9800
dc.identifier.issn1475-2727
dc.identifier.ris TY - Journal Article AU - Schoeman, SE AU - Hendricks, MK AU - Hattingh, SP AU - Benadé, AJS AU - Laubscher, JA AU - Dhansay, M A AB - AIM: The aim of this study was to determine the practices of primary health care (PHC) nurses in targeting nutritionally at-risk infants and children for intervention at a PHC facility in a peri-urban area of the Western Cape Province of South Africa. METHODOLOGY: Nutritional risk status of infants and children <6 years of age was based on criteria specified in standardised nutrition case management guidelines developed for PHC facilities in the province. Children were identified as being nutritionally at-risk if their weight was below the 3rd centile, their birth weight was less than 2500 g, and their growth curve showed flattening or dropping off for at least two consecutive monthly visits. The study assessed the practices of nurses in identifying children who were nutritionally at-risk and the entry of these children into the food supplementation programme (formerly the Protein-Energy Malnutrition Scheme) of the health facility. Structured interviews were conducted with nurses to determine their knowledge of the case management guidelines; interviews were also conducted with caregivers to determine their sociodemographic status. RESULTS: One hundred and thirty-four children were enrolled in the study. The mean age of their caregivers was 29.5 (standard deviation 7.5) years and only 47 (38%) were married. Of the caregivers, 77% were unemployed, 46% had poor household food security and 40% were financially dependent on non-family members. Significantly more children were nutritionally at-risk if the caregiver was unemployed (54%) compared with employed (32%) (P=0.04) and when there was household food insecurity (63%) compared with household food security (37%) (P<0.004). Significantly more children were found not to be nutritionally at-risk if the caregiver was financially self-supporting or supported by their partners (61%) compared with those who were financially dependent on non-family members (35%) (P=0.003). The weight results of the nurses and the researcher differed significantly (P<0.001), which was largely due to the different scales used and weighing methods. The researcher's weight measurements were consistently higher than the nurses' (P<0.00). The researcher identified 67 (50%) infants and children as being nutritionally at-risk compared with 14 (10%) by the nurses. The nurses' poor detection and targeting of nutritionally at-risk children were largely a result of failure to plot weights on the weight-for-age chart (55%) and poor utilisation of the Road to Health Chart. CONCLUSIONS: Problems identified in the practices of PHC nurses must be addressed in targeting children at nutritional risk so that appropriate intervention and support can be provided. More attention must be given to socio-economic criteria in identifying children who are nutritionally at-risk to ensure their access to adequate social security networks. DA - 2006 DB - OpenUCT DP - University of Cape Town IS - 8 J1 - Public Health Nutrition LK - https://open.uct.ac.za PY - 2006 SM - 1368-9800 SM - 1475-2727 T1 - The targeting of nutritionally at-risk children attending a primary health care facility in the Western Cape Province of South Africa TI - The targeting of nutritionally at-risk children attending a primary health care facility in the Western Cape Province of South Africa UR - http://hdl.handle.net/11427/34733 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34733
dc.identifier.vancouvercitationSchoeman S, Hendricks M, Hattingh S, Benadé A, Laubscher J, Dhansay MA. The targeting of nutritionally at-risk children attending a primary health care facility in the Western Cape Province of South Africa. Public Health Nutrition. 2006;9(8):1007 - 177. http://hdl.handle.net/11427/34733.en_ZA
dc.language.isoeng
dc.publisher.departmentDivision of Child and Adolescent Psychiatry
dc.publisher.facultyFaculty of Health Sciences
dc.sourcePublic Health Nutrition
dc.source.journalissue8
dc.source.journalvolume9
dc.source.pagination1007 - 177
dc.source.urihttps://dx.doi.org/10.1017/PHN2006986
dc.subject.otherBody Weights and Measures
dc.subject.otherCaregivers
dc.subject.otherChild
dc.subject.otherChild Nutrition Disorders
dc.subject.otherChild, Preschool
dc.subject.otherDietary Supplements
dc.subject.otherEducation, Nursing, Continuing
dc.subject.otherHealth Facility Administration
dc.subject.otherHealth Knowledge, Attitudes, Practice
dc.subject.otherHealth Surveys
dc.subject.otherHumans
dc.subject.otherInfant
dc.subject.otherInfant, Newborn
dc.subject.otherPractice Guidelines as Topic
dc.subject.otherPrimary Health Care
dc.subject.otherRisk
dc.titleThe targeting of nutritionally at-risk children attending a primary health care facility in the Western Cape Province of South Africa
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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