scholarly journals Intersectoral (in)activity: towards an understanding of public sector department links between water, sanitation and hygiene (WASH) and childhood undernutrition in South Africa

2020 ◽  
Vol 35 (7) ◽  
pp. 829-841 ◽  
Author(s):  
D J Momberg ◽  
P Mahlangu ◽  
B C Ngandu ◽  
J May ◽  
S A Norris ◽  
...  
Keyword(s):  
South Africa ◽  
Public Sector ◽  
Nutritional Status ◽  
Physical Growth ◽  
Human Right ◽  
Poor Child ◽  
Middle Income ◽  
Sanitation And Hygiene ◽  
Nutritional Status Of Children ◽  
The Impact

Abstract Associations between different forms of malnutrition and environmental conditions, including water, sanitation and hygiene (WASH), contribute to poor child health, nutritional status and physical growth. The primary responsibility for the provision of water and sanitation, as a basic service and human right, lies with the State, as such, a number of stakeholders are involved. Despite relatively high levels of WASH infrastructure coverage in South Africa, enteric infections and stunting remain high for a middle-income country. The aim of this study is to elucidate the landscape of WASH in South Africa in relation to nutritional status of children under the age of 5 years in the South African, Gauteng and City of Johannesburg contexts. The authors detailed the national and provincial public sector departments and through purposive sampling proceeded to map the various departments and associated policies that are responsible for the provision of WASH facilities, as well the nutritional status of children. Of the six policies identified for review, three mentioned WASH, nutrition and children; however, none explicitly linked WASH to nutritional status in children. An in-depth review and analysis of these three crucial policy documents was conducted. Finally, a set of expert interviews were conducted and a consensus development conference convened, with experts at the intersection between WASH and nutritional status. The authors found that the public sector would benefit from better integration of the concept of WASH into their policy, planning and implementation frameworks. The WASH sector should emphasize the role in which WASH plans consider the impact of WASH on the nutritional status of children. The various public sector departments involved in WASH service provision, and other WASH stakeholders, including community-based organizations, non-governmental organizations and intergovernmental organizations, should be involved in the decision-making of the nutrition sector.

scholarly journals Doctor retention and distribution in post-apartheid South Africa: tracking medical graduates (2007–2011) from one university

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Ann George ◽  
Duane Blaauw ◽  
Jarred Thompson ◽  
Lionel Green-Thompson
Keyword(s):  
South Africa ◽  
Public Sector ◽  
South African ◽  
Rural Areas ◽  
Specialist Training ◽  
Financial Loss ◽  
Cross Sectional ◽  
Middle Income ◽  
The Public ◽  
The Impact

Abstract Background Doctor emigration from low- and middle-income countries represents a financial loss and threatens the equitable delivery of healthcare. In response to government imperatives to produce more health professionals to meet the country’s needs, South African medical schools increased their student intake and changed their selection criteria, but little is known about the impact of these changes. This paper reports on the retention and distribution of doctors who graduated from the University of the Witwatersrand, South Africa (SA), between 2007 and 2011. Methods Data on 988 graduates were accessed from university databases. A cross-sectional descriptive email survey was used to gather information about graduates’ demographics, work histories, and current work settings. Frequency and proportion counts and multiple logistic regressions of predictors of working in a rural area were conducted. Open-ended data were analysed using content analysis. Results The survey response rate was 51.8%. Foreign nationals were excluded from the analysis because of restrictions on them working in SA. Of 497 South African respondents, 60% had completed their vocational training in underserved areas. At the time of the study, 89% (444) worked as doctors in SA, 6.8% (34) practised medicine outside the country, and 3.8% (19) no longer practised medicine. Eighty percent of the 444 doctors still in SA worked in the public sector. Only 33 respondents (6.6%) worked in rural areas, of which 20 (60.6%) were Black. Almost half (47.7%) of the 497 doctors still in SA were in specialist training appointments. Conclusions Most of the graduates were still in the country, with an overwhelmingly urban and public sector bias to their distribution. Most doctors in the public sector were still in specialist training at the time of the study and may move to the private sector or leave the country. Black graduates, who were preferentially selected in this graduate cohort, constituted the majority of the doctors practising in rural areas. The study confirms the importance of selecting students with rural backgrounds to provide doctors for underserved areas. The study provides a baseline for future tracking studies to inform the training of doctors for underserved areas.

Randomized clinical trial of the impact of a nutritional supplement “multimixture” on the nutritional status of children enrolled at preschools

2007 ◽  
Vol 0 (0) ◽  
Author(s):  
Denise P. Gigante ◽  
Márcia Buchweitz ◽  
Elizabete Helbig ◽  
Ângela S. Almeida ◽  
Nelson A. Neumann ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Nutritional Status ◽  
Randomized Clinical Trial ◽  
Nutritional Supplement ◽  
Nutritional Status Of Children ◽  
The Impact

scholarly journals Nutritional Status of Children 24–60 Months Attending Early Child Development Centres in a Semi-Rural Community in South Africa

2020 ◽  
Vol 18 (1) ◽  
pp. 261
Author(s):  
Onwaba Makanjana ◽  
Ashika Naicker
Keyword(s):  
South Africa ◽  
Child Development ◽  
Nutritional Status ◽  
Energy Intake ◽  
Vegetable Consumption ◽  
Childhood Development ◽  
Early Child Development ◽  
Serum Retinol ◽  
Early Child ◽  
Nutritional Status Of Children

Despite the numerous efforts to improve the nutritional status of children, a high prevalence of malnutrition still exists in South Africa. This study aimed to determine the nutritional status of children attending Early Child Development centres in South Africa. In this baseline study, we randomly selected two Early Child Development centres comprising 116 children aged 24–60 months, separated into two cohorts, of 24–47 months and 48–60 months. Dietary intake was measured through the 24 hDR and analysed using Food Finder software. The food frequency questionnaire was used to calculate the food variety and food group diversity scores. Anthropometric measurements were taken and the WHO Anthro software was used to convert it to nutritional data indices. Blood samples were collected through dried blood spot cards in order to determine serum retinol and haemoglobin levels and they were assessed using WHO indicators. The findings showed that participants between 24 and 47 months had a high mean energy intake (4906.2 kJ and 4997.9 kJ for girls and boys, respectively). For the 48–60 months age group, energy intake was lower than the EER (5936.4 kJ and 5621.2 kJ; p = 0.038). There was low fruit and vegetable consumption (24–47 months; 63.8 g and 69.5 g (p = 0.037), 48–60 months; 68.3 g and 74.4 g (p = 0.038) and the top five foods consumed were carbohydrate rich foods for girls and boys, respectively. Stunting was noted in 7% and 20% (48–60 months) (p = 0.012) and overweight in 8% and 17% (24–47 months) and 17% and 13% (48–60 months) (p = 0.041) in girls and boys, respectively. Low serum retinol levels (<0.070 µmol/L) were found in 9.1% of boys (24–47 months), and 8% and 7.4% of girls and boys (48–60 months), respectively. Low haemoglobin levels (<11.0 g/dL) were found in 50.0% and 30.4% (24–47 months) and 8.6% and 39.3% (48–60 months) of girls and boys, respectively. Malnutrition, despite many national and provincial initiatives, still exists in Early Childhood Development centres in South Africa, calling for the application of contextualized nutrition interventions to suit resource-poor settings.

scholarly journals Childhood Malnutrition and the Association with Diarrhea, Water supply, Sanitation, and Hygiene Practices in Kersa and Omo Nada Districts of Jimma Zone, Ethiopia

2021 ◽  
Vol 15 ◽  
pp. 117863022199963
Author(s):  
Negasa Eshete Soboksa ◽  
Sirak Robele Gari ◽  
Abebe Beyene Hailu ◽  
Bezatu Mengistie Alemu
Keyword(s):  
Nutritional Status ◽  
Water Supply ◽  
Open Pit ◽  
Breastfeeding Initiation ◽  
Childhood Malnutrition ◽  
Hygiene Practices ◽  
Sanitation And Hygiene ◽  
Jimma Zone ◽  
Nutritional Status Of Children ◽  
Critical Times

Background: Inadequate water supply, sanitation, hygiene practices, and diarrhea are related to malnutrition, but there is limited evidence in Ethiopia about their association. Thus, the objective of this study was to describe childhood malnutrition and the association with diarrhea, water supply, sanitation and hygiene practices. Methods: A case-control study design was performed from December 2018 to January 2019 in Kersa and Omo Nada districts of the Jimma Zone, Ethiopia. Both children aged 6 to 59 months were chosen randomly from malnourished and well-nourished children in 128 cases and 256 controls, respectively. Bodyweight, length/height, mid-upper arm circumference, and presence of edema of the children were measured according to the WHO references. Then, the nutritional status of the children was identified as a case or control using the cutoff points recommended by the WHO. To see the association-dependent and independent variables, logistic regression analysis was used. Results: A total of 378 children were included in this study (98.44%). Malnutrition was significantly increased among children who delayed breastfeeding initiation(AOR = 3.12; 95% CI: 1.62-6.00), had diarrhea (AOR = 9.22; 95% CI: 5.25-16.20), were living in households indexed as the poorest (AOR = 2.50; 95% CI: 1.12-5.62), defecated in a pit latrine without slab/open pit (AOR = 2.49; 95% CI: 1.17-5.30), collecting drinking water from less than/equal to 1 km distance (AOR = 4.77; 95% CI: 1.01-22.71) and sometimes practiced hand washing at the critical times (AOR = 2.58; 95% CI: 1.16-5.74) compared with their counterparts. However, lactating during the survey (AOR = 0.35; 95% CI: 0.18-0.67), water collection from unprotected sources (AOR = 0.22; 95% CI: 0.05-0.95) and collection and disposal of under-5 children feces elsewhere (AOR = 0.06; 95% CI: 0.01-0.49) significantly reduced the likelihood of malnutrition. Conclusions: Early initiation of exclusive breastfeeding, diarrhea prevention, and the use of improved latrine and handwashing practices at critical times could be important variables to improve the nutritional status of children.

scholarly journals Impact of Bolsa Família Program on the nutritional status of children and adolescents from two Brazilian regions

2017 ◽  
Vol 30 (4) ◽  
pp. 477-487 ◽  
Author(s):  
Naiara SPERANDIO ◽  
Cristiana Tristão RODRIGUES ◽  
Sylvia do Carmo Castro FRANCESCHINI ◽  
Silvia Eloiza PRIORE
Keyword(s):  
Nutritional Status ◽  
Children And Adolescents ◽  
Nearest Neighbor ◽  
Positive Impact ◽  
Overweight Children ◽  
Impact Measurement ◽  
Measurement Analysis ◽  
Bolsa Familia ◽  
Nutritional Status Of Children ◽  
The Impact

ABSTRACT Objective: To assess and compare the impact of the Bolsa Família Program (Family Allowance) on the nutritional status of children and adolescents from the Brazilian Northeastern and Southeastern regions. Methods: The study used data from a database derived from a subsample of the Family Budget Survey conducted from 2008 to 2009. The ratios of underweight, stunted, and overweight children were calculated. Impact measurement analysis was preceded by propensity score matching, which matches beneficiary and non-beneficiary families in relation to a set of socioeconomic features. The nearest-neighbor matching algorithm estimated the program impact. Results: The ratio of underweight children and adolescents was, on average, 1.1% smaller in the beneficiary families than in the non-beneficiary families in the Northeastern region. As for the Southeastern region, the ratio of overweight children and adolescents was, on average, 4.2% smaller in the beneficiary families. The program did not affect stunting in either region. Conclusion: The results showed the positive impact and good focus of the program. Thus, once linked to structural actions, the program may help to improve the nutritional status and quality of life of its beneficiaries.

scholarly journals Physical Growth and Echocardiographic Findings in Children with Down Syndrome

2017 ◽  
Vol 38 (3-4) ◽  
pp. 54
Author(s):  
Sudigdo Sastroasmoro ◽  
Mathilda Y. Lnkiriwang ◽  
Bambang Madiyono ◽  
Lsmet N Oesman
Keyword(s):  
Down Syndrome ◽  
Nutritional Status ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Physical Growth ◽  
Normal Children ◽  
Children With Down Syndrome ◽  
Significant Difference ◽  
Nutritional Status Of Children ◽  
Echocardiographic Findings

We compared the physical growth, nutritional status, and echocardiographic findings in children aged 3-7 years with Down syndrome who had no congenital heart disease. Thirty such patients who consecutively referred to the Division of Cardiology, Department of Child Health, Medical School, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, were compared with sex and age matched controls consisted of normal children attending the Department. It appears that growth and nutritional status of children with Down syndrome tended to be retarded when compared to those of the controls. However, no significant difference were found on the M-mode echocardiographic values of the left ventricle, except that the left ventricular posterior wall thickness in study subjects was more that that of the controls. We concluded that although the pulmonary architecture of patients with Down syndrome is thought to be less developed than that of normal children, it does not affect the left ventricular measurements and function as measured by M-mode echocardiography.

scholarly journals Asthma prevalence and the impact of nutritional status on prescribed asthma medications in children

2020 ◽  
Vol 73 (9-10) ◽  
pp. 265-270
Author(s):  
Vesna Petrovic ◽  
Vesna Vujic-Aleksic ◽  
Tanja Rozek-Mitrovic ◽  
Aleksandra Hristov
Keyword(s):  
Nutritional Status ◽  
Normal Weight ◽  
Asthma Prevalence ◽  
Obese Children ◽  
Primary Health Center ◽  
Cross Sectional ◽  
Asthma Symptoms ◽  
Children With Asthma ◽  
Nutritional Status Of Children ◽  
The Impact

Introduction. Asthma and obesity are the most common chronic health disorders in children. Although heredity plays a significant role in their development, environmental factors and early exposure have contributed to the increasing incidence of both disorders in recent decades. The aim of the study was to estimate asthma prevalence in schoolchildren in Indjija, Srem District, Serbia, and to investigate differences in nutritional status of children with asthma as well as differences between their nutritional status and prescribed asthma medications. Material and Methods. A cross-sectional retrospective cohort study was conducted at the Primary Health Center in Indjija. Of all the medical records of children aged 6 - 14 years, a cohort of children with asthma was formed. The retrospective study evaluated their nutritional status and the prescribed asthma medications. Results. The prevalence of asthma in children aged 6 - 14 was 6.9%. Children with asthma were significantly more overweight and obese (40.5%) than children without asthma. Boys accounted for 63.7% of children with asthma, with a statistically significant gender difference. Abnormal nutritional status was found in 44.3% of children with asthma and boys with asthma were significantly more obese (23%) compared to girls (7.8%). Overweight and obese children with asthma were not prescribed significantly more medications to relieve asthma symptoms than normal-weight children. Conclusion. The prevalence of asthma among schoolchildren in Indjija was 6.9%. Children with asthma were more likely to be overweight and obese than children without asthma, whereas boys with asthma were significantly more obese than girls. No significant differences were found between their nutritional status and prescribed asthma medications.

Association of childhood undernutrition with water supply, sanitation and hygiene interventions in Kersa and Omo Nada districts of Jimma Zone, Ethiopia: A case-control study

2020 ◽  
Author(s):  
Negasa Eshete Soboksa ◽  
Sirak Robele Gari ◽  
Abebe Beyene Hailu ◽  
Bezatu Mengistie Alemu
Keyword(s):  
Nutritional Status ◽  
Water Supply ◽  
Case Control Study ◽  
Case Control ◽  
Sanitation And Hygiene ◽  
Jimma Zone ◽  
Childhood Undernutrition ◽  
Nutritional Status Of Children ◽  
Control Study ◽  
Critical Times

Abstract Objective: This study aimed to describe the association of childhood undernutrition with water supply, sanitation, and hygiene interventions in Kersa and Omo Nada districts of the Jimma Zone, Ethiopia.Design: A case-control study design was undertaken from December 2018 to January 2019.Setting: Kersa and Omo Nada districts of the Jimma Zone, Ethiopia.Subjects: 128 cases and 256 controls were randomly selected from malnourished and well-nourished children, respectively.Outcome measures: Bodyweight, length/height, mid-upper arm circumference and presence of edema of the children were measured according to the WHO references. Then, the nutritional status of children was identified as case or control using cutoff points recommended by the WHO based on the Z-score, edema, and MUAC values recorded.Results: A total of 378 children were included in this study, with a response rate of 98.44%. Undernutrition was significantly increased among children who delayed breastfeeding initiation (AOR=2.60; 95% CI: 1.02-6.65), diarrhea (AOR=9.50; 95% CI: 5.19-17.36), living with households indexed as the poorest (AOR=2.57; 95% CI: 1.09-6.07) and defecated in a pit latrine without slab/open pit (AOR=2.49; 95% CI: 1.17-5.30), and sometimes practiced hand washing at the critical times (AOR=2.52; 95% CI: 1.10-5.75) compared with their counterparts. However, lactating during the survey (AOR=0.35; 95% CI: 0.18-0.71) and collection and disposal of under-five children feces elsewhere (AOR = 0.08; 95% CI: 0.01-0.75) significantly reduced the likelihood of undernutrition.Conclusions: Early initiation of exclusive breastfeeding, diarrhea prevention, the use of improved latrine, and always handwashing practices at critical times could be important variables to improve the nutritional status of children.

scholarly journals Doctors’ Extended Shifts as Risk to Practitioner and Patient: South Africa as a Case Study

2020 ◽  
Vol 17 (16) ◽  
pp. 5853
Author(s):  
Koot Kotze ◽  
Helene-Mari van der Westhuizen ◽  
Eldi van Loggerenberg ◽  
Farah Jawitz ◽  
Rodney Ehrlich
Keyword(s):  
South Africa ◽  
South African ◽  
Medical Practice ◽  
Health And Safety ◽  
Working Hours ◽  
Middle Income ◽  
The Impact ◽  
Safe Working ◽  
Working Hour

Extended shifts are common in medical practice. This is when doctors are required to work continuously for more than 16 h, with little or no rest, often without a maximum limit. These shifts have been a part of medical practice for more than a century. Research on the impact of fatigue presents compelling evidence that extended shifts increase the risk of harm to patients and practitioners. However, where the number of doctors is limited and their workloads are not easily reduced, there are numerous barriers to reform. Some of these include a perceived lack of safer alternatives, concerns about continuity of care, trainee education, and doctors’ preferences. As such, working hour reorganisation has been contentious globally. South Africa, a middle-income country where extended shifts are unregulated for most doctors, offers a useful case study of reform efforts. The South African Safe Working Hours campaign has promoted working hour reorganization through multi-level advocacy efforts, although extended shifts remain common. We propose that extended shifts should be regarded as an occupational hazard under health and safety legislation. We suggest options for managing the risks of extended shifts by adapting the hierarchy of controls for occupational hazards. Despite the challenges reform pose, the practice of unregulated extended shifts should not continue.

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