Jane Maddock
Country: Ireland
Background - Nutritional Science
Research Project: Diet Diversity in Orphans and Vulnerable Children in an Urban Area of KwaZulu-Natal, South Africa
Background: Adequate nutrition is known to be essential for the physical and psychological health of children as well as contributing to economic development. Increasing diversity in the diet has been found to be effective in improving the nutritional status of children. Child malnutrition is a persistent problem in the KwaZulu-Natal province of South Africa. Stunting affects approximately 20% of children and it has been estimated that 10% of children are underweight in South Africa. Given South Africa’s context of HIV and AIDS and its associated numbers of orphans and vulnerable children (OVCs), it is important to understand the nutritional status of OVCs and determine the factors that influence it. In describing their nutrition status, appropriate and proven interventions can be targeted to this population. This study aims to describe the diet diversity of OVCs in an urban area and the association between diet diversity and various demographic, household and child specific characteristics. This study aims to provide baseline data in order to measure achievements from future interventions and to recommend appropriate interventions to improve diet diversity.
Methods: This was an observational, descriptive, cross-sectional study. A mixed method that combined both quantitative and qualitative techniques was utilised. A structured questionnaire was administered to 100 carers of OVCs aged 2-10 years in urban townships within the Municipality of Kokstad in the KwaZulu-Natal province of the Sisonke District of South Africa. This questionnaire included information regarding basic demographic information of the care-giver and child, the child’s diet, water and sanitation in the household and illness in the child. A 24-hour dietary recall was then conducted. This information was used later to calculate the diet diversity score (DDS) and the food variety score (FVS). Anthropometric measurements of the OVC were taken. Key informant semi-structured interviews were then conducted with 7 community careworkers, 2 community nurses, 1 paediatric doctor from the public hospital and 1 dietician from the public hospital. These were used to further describe the nutrition situation of OVCs in the area.
Results: Results showed that 59% of the subjects had a low DDS (i.e. ≤ 4). The mean DDS found was 4.2 (Standard deviation (SD) = 1.2). FVS was used to validate the results. The mean FVS found was also considered low at 7.3. No statistically significant associations (p < 0.05) were found between DDS and variables such as income, relation to child, care-givers education status or anthropometric status. DDS was found to be significantly higher in houses with indoor plumbing as opposed to houses retrieving their water from a source outside their yard. Prevalence of illness in the sample was low and therefore could not be correlated with DDS. Hand-washing practices were found to be poor as respondents reported washing their hands on 2.1 (SD = 0.7) occasions out of a total of 8 responses.
Conclusions: From the results it is clear that diet diversity needs to be improved amongst OVCs in the area. Future interventions that encompass a comprehensive education programme involving diet diversity, behavioural change and sanitation practices are recommended. Such an intervention could be evaluated after an appropriate period of time through a similar study that compares data to the baseline data obtained in this study. Future research is required to determine the best interventions to increase diet diversity and address other underlying determinants of nutritional status to ensure a productive and healthy future for OVCs.
Key words: Diet Diversity, Food Variety, Orphans and Vulnerable Children
Word Count: 14,995