Nutritional status and the use of child support grant among children, 6 to 23 months, visiting 3 local clinics in the Dihlabeng Local Area, Thabo Mofutsanyana District, Free State

[摘要] English: South Africa, a country that produces enough food for its population, loses 63.5% of children yearly due to malnutrition. Although South Africa produces imports and retains sufficient food to support a nutritionally balanced per capita dietary intake for its population, malnutrition, closely linked to poverty and household food insecurity, remains unacceptably high. In South Africa, one of the nine provinces, namely the Free State Province, 43.8% of children under five years of age, suffered from stunting, a chronic form of malnutrition. The Dihlabeng Local Area where the research was conducted, is situated within the Thabo Mofutsanyana District, in the Free State province. Despite the implementation of the Child Support Grant (CSG) in 1998 to minimise food insecurity and prevent malnutrition amongst children, approximately 14 million people in South Africa are still affected by food insecurity, with the majority being black South African citizens residing in rural areas. Malnutrition, particularly during the first 1 000 days of life, causes poor cognitive development, higher susceptibility to infections, poor health, decreased completed school grades and future unemployment, all of which are carried into adulthood. The validity of the South African CSG, thus, whether it is enough to meet basic needs and if is being used for children's needs and food, remain of concern. The aim of this study was to assess the nutritional status and the use of CSG amongst children, 6 to 23 months, visiting 3 local clinics in the Dihlabeng Local area, Thabo Mofutsanyana District, Free State. A descriptive observational quantitative study using convenience sampling, was conducted from September 2016 to November 2016. Data were collected from a sample size of 242 consenting children, aged six to 23 months, who attended these clinics with their primary caregiver. Sample size were calculated per clinic and distributed as follows: 97 participants from Mphohadi Clinic, 72 participants from Bohlokong Clinic and 73 participants from Bethlehem Clinic. Data with regards to socio-demographic status, household food security, dietary intake and spending patterns of the CSG, were collected via questionnaire administered in structured interviews with the primary caregiver and the anthropometry of the children were measured. The participants were black South Africans (100%) and almost equally distributed betweenmales and females, all of whom were CSG recipients. There were 17 participants who werecared for by non-biological parent-caregivers and 225 were cared for by their biologicalparents. Two thirds (65.7%) of participants resided in brick housing, but one in three (31.4%)infants were being raised in informal, corrugated iron houses (shacks), whilst 14% ofhouseholds were overcrowded.All households, in which participants resided, had access to safe running water and electricalcooking equipment were available to 85.1%, whilst 2.9% had to use an open fire to cook.Overall, 16.1% did not have access to cold storage and despite the bare minimum in terms ofhousing and household facilities, there was a high uptake of electronic, recreational andcommunication equipment, suggesting poor planning and lack of prioritising, as well as highdebt occurrence, because cellular telephones and satellite television, requires monthly repaymentsfor the service. Thus, leaving limited money left for food procurement. The highestcompleted educational levels were mainly primary school, with high unemployment ratesamongst the biological parent-caregivers (75.5%) as well as the non-biological parentcaregivers(64.7%).In 15.7% of households the participant's CSG was the only income. Household food insecuritywas experienced by 48.7% of the households and 27.7% were at risk of becoming foodinsecure. This helps to explain the fact that only 7.9% of participants had adequate dietarydiversity scores, whilst only 4.5% achieved the minimum acceptable dietary intake. Mostparticipants had a daily diet of mainly starch and dairy, with limited proteins, vitamins andminerals. This sheds light on the fact that 33.1% was stunted, 3.3% wasted and 6.3%overweight.The CSG was reportedly spent on the children alone (almost 100%), yet 14.5% caregiversreported the CSG was too little to supply in needs of the entire households. Food ranked onlyfourth amongst the basic needs of the child on which the CSG was reportedly being spent.The results of the current study indicate the urgent need to establish a more effective type ofCSG, whether cash, food parcels, vouchers or a combination, supplied to infants growing upin at-risk household to curb the high prevalence of malnutrition with its detrimental longtermconsequences in this community and in South Africa as a whole.

[发布机构] University of the Free State