The role of selected duty-bearers in realising the right to water of children (0-24 months) in Colesberg, Northern Cape, during the nutritional management of diarrhoea in primary health care institutions

[摘要] ENGLISH SUMMARY : Introduction: Diarrhoea and malnutrition are some of the main causes of death in children under the age of five years. They are especially prevalent in children from 0 to 24 months that are most vulnerable, since their immune systems are not yet fully developed. It is therefore crucial for their health to have access to adequate and safe water. There are various human rights instruments (both national and international) protecting children's human rights to water and health. Since children are not able to realise their own right to water, it is the role of duty-bearers to realise their right to water for them.Objectives: The main aim of this study was to investigate whether selected duty-bearers were fulfilling their responsibilities towards the realisation of the right to water of children (0–24 months) residing in Colesberg, Northern Cape, during the nutritional management of diarrhoea in primary health care institutions. The two broad objectives were to investigate if the child's right to safe and adequate water is being realised and to investigate the prevalence and management of diarrhoea in this study population.Methods: In a cross-sectional observational survey with an analytical component, caregivers of children aged 0–24 months (n=123) from the three feeder clinics of the hospital in Colesberg completed an interviewer-administered questionnaire. Eight nursing practitioners participated in semi-structured interviews. Concepts related to the perceptions, knowledge, attitudes and practices of caregivers and nursing practitioners with regard to the right to water of young children and the management of diarrhoea were investigated. Qualitative data was analysed inductively by identifying, coding and grouping emerging themes to enrich quantitative data obtained from the questionnaires.Results: The children that had not experienced diarrhoea previously were significantly (p<0.05) younger than those that had had diarrhoea (mean age 7 and 12 months respectively). It was highly significant (p<0.05) that those caregivers that knew what oral rehydration treatment (ORT) was, were also able to explain how to mix ORT correctly. Statistical significant (p<0.05) differences were found between the prevalence of diarrhoea in children (mean age 4.8 months) that were eating complementary foods and younger infants who were not yet receiving complementary foods. Caregivers perceived the lack of a constant water supply as a barrier in realising the right to water of their children. Nursing practitioners perceived the intermittent water supply, the poor quality of the water and the caregivers' actions as barriers to realising the right to water of children. Nursing practitioners were knowledgeable about the management of diarrhoea as well as the treatment and prevention of dehydration.Conclusion: It was found that caregivers and nursing practitioners were fulfilling their role as duty-bearers to the best of their ability in realising the right to water of children but faced several challenges. On behalf of Government as the primary duty-bearer, the municipal government should do more in realising the right to water of children. Recommendations included more education for caregivers with regard to what they can do to realise the right to water of their children 0–24 months with limited resources.

[发布机构] Stellenbosch University