Theses and Dissertations

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Complementary feeding education programme for caregivers of infants aged 3-12 months in Polokwane Municipality, Limpopo Province
(2025-09-05) Makwela, Maishataba Solomon; Mushaphi, L. F.; Makhado, L.
Background The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months, with the introduction of Complementary feeding (CF) and continued breastfeeding for two years or beyond. The importance of exclusive breastfeeding and a smooth transition to balanced and informed complementary feeding has been reported. However, there remains a gap in knowledge regarding whether this information is practiced at the caregiver level. An appropriate complementary feeding has the potential to improve growth and development in infants from six months to two years of age. Purpose: This study aimed to develop and implement a complementary feeding education programme for caregivers with infants aged 312 months in Polokwane Municipality, Limpopo Province. Methods A non-randomized, quasi-experimental intervention study was conducted with 187 caregivers at baseline, with 150 completing the study. Initially, the intervention group comprised 95 caregiver-infant pairs, whereas the control group included 94. Post-intervention, 77 caregiver–infant pairs in the intervention group received complementary feeding education and six months of follow-up support from a dietitian researcher, whereas 71 pairs in the control group did not receive any intervention. Data were gathered from caregivers’ households at baseline and postintervention using a pretested, structured questionnaire to ensure consistency across both time points. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 29 for descriptive and inferential statistics. Spearman’s correlation was utilized to measure the strength and direction of monotonic association between variables, whereas chi-square tests were conducted to analyse relationships between variables. The effectiveness of the intervention was evaluated using difference‒in‒differences analysis, which compared changes in anthropometric measurements between the intervention and control groups. A significance level of p < 0.05 was applied. The study adhered to fundamental ethical research principles, including confidentiality, beneficence, privacy, and minimizing bias. Ethical clearance was obtained from the University of Venda, and necessary permissions were secured from relevant gatekeepers. Results There were no significant differences between the groups regarding sex, marital status, education level, occupation, housing type, or water source. Most caregivers were female and unmarried, with similar employment and housing conditions. Water scarcity was a concern in both groups, particularly the experimental group. A significant difference was observed in food availability, with nearly 70% of the control group reporting food insecurity (p=0.002). Waste disposal also varied, as more caregivers in the experimental group discarded rubbish in their yards (p=0.048). While most births were through normal delivery, the experimental group had a significantly higher rate of caesarean section (35%) than the control group (p=0.007). The mean(±SD.) age of the infants was 4.4 (±1.1) months in the intervention group and 5.5 (±0.2) months in the control group. At baseline, the mean (±S.D.) of infant weight was 7.37 (±0.83) Kg in the intervention group and 6.69 (±0.13) kg in the control group. The average (±S.D.) length was 61.00 (±0.53) cm for the intervention group and 62.30 (±0.79) cm for the control group. Of 198 participants, 77 in the intervention group and 71 in the control group completed the study. A significant weight increase was observed in the intervention group (DID mean = 1.82 kg, p<0.001), along with a notable length gain (DID mean = 7.78 cm, p<0.01) from baseline. Additionally, the intervention group presented a significant increase in Mid-Upper-Arm Circumference (MUAC) by 1.68 cm (p=0.0465). However, the intervention had a minimal effect on head circumference, with a negligible difference (DID=0.16 cm; p=0.95). At baseline, the mean knowledge score was 29.70±0.83 in the control group and 25.10±0.97 in the intervention group. By the end of the study, the control group's mean score remained at 25.0±0.99, whereas the intervention group’s score significantly improved to 38.10±0.31. Caregivers also demonstrated improvements in key complementary feeding practices. Conclusion A community-based nutrition intervention programme implemented through demonstrations can significantly enhance caregivers' knowledge and practices related to complementary feeding while improving the anthropometric nutritional status of children aged three months to one year.
Open Access
Dietary salt intake, dietary practices and hypertensive status among pregnant women in Thulamela municipality
(2022-07-15) Munyai, Tshifhiwa Elphas; Mushaphi, L. F.; Mbhatsani, H. V.; De Villiers, A.
Salt intake in South Africa is beyond the 4 to 6g/day as recommended by the World Health Organization (WHO); no doubt, this is due to a high-salt diet. It is well known that high-salt diets are related to hypertension, which is the most prevalent maternal complication worldwide, and is associated with significant morbidity and mortality of the mother and foetus. Pre-eclampsia and eclampsia are the two hypertensive disorders of pregnancy; these are considered as the main causes of maternal and perinatal morbidity and mortality. High maternal deaths have been recorded in South Africa where eclampsia was the direct cause. The aim of this study was to describe dietary salt intake, dietary practices and hypertensive status among pregnant women in Thulamela Municipality (Limpopo Province). The study adopted a quantitative cross-sectional survey design where three local areas were purposively selected. Two clinics from each local area were randomly selected to give a total of three Community Health Centres (CHC) and six clinics. Pregnant women were selected by means of convenience sampling. The sample size was calculated using Slovin’s formula which resulted in a total number of 379 pregnant women. Data obtained were captured using Microsoft Excel 2016 and exported to the IBM Statistical Package for Social Sciences (SPSS) version 26 for analysis. The dietary intake was analysed using Medical Research Council of South Africa (SAMRC) Food Finder 3 (version 1.1.3) computer software. Logistic regression was used to identify factors associated with high Blood Pressure risk. Most of the participants (62.0%) were single and had passed Grade 12; majority of participants (88.1%) were unemployed and depended on parents/parents-in-law and social grant. At the time of the study, 38.3% of participants’ gestational age was 31 to 38 weeks. Analyses of the macronutrient intake by the pregnant women indicated that the mean energy intake was 5304.4±2217.5KJ per day and the mean protein intake was 35.1±16.8g per day. Majority of participants (81.0%) had received nutrition education and they usually ate three meals or more per day. Most participants (71%) indicated that they bought salt from supermarkets and added salt when cooking. Almost all the pregnant women (99.7%) were below the EAR reference values for iron while 15.0% of pregnant women were within the Estimated Average Requirement (EAR) reference value for folate intake. The study revealed that the mean diastolic pressure was 73.56±9.5mmHg and systolic pressure was 113±11.2mmHg. The majority of these pregnant women were at low risk of developing high BP. High BP risk was not associated with marital Page v of 141 status, however, there was a significant association with the educational level. Gestational age was significantly associated (p<0.05) with having a HBP risk, with those 38+ weeks having the highest risk. The study concluded that pregnant women were not meeting their daily nutrient intake, hence, there is a need to advocate for improved nutrient intake. There is also a need for other research projects to be conducted on dietary salt intake and dietary practices of pregnant women in the Thulamela Municipality.
Open Access
The effect of consuming instant-maize porridge fortified With Termites and Moringa Oleifera Leaf powders on the nutritional status of children aged three to five years old in Thulamela Municipality, South Africa (RCT)
(2023-05-19) Netshiheni, Khavhatondwi Rinah; Nesamvuni, C. N.; Mushaphi, L. F.
This chapter introduces the topic of the study, giving relevant background and highlighting the problem statement. It ends with the study's hypothesis, aim, specific objectives, significance, and conceptual framework. Malnutrition is the cause of deaths of eight million children under five years worldwide. Undernutrition is the leading cause of over one-third of children's deaths, mainly from pneumonia and diarrhoea. Additionally, in 2015, zinc deficiency and anaemia prevalence in the Vhembe District preschool children in Limpopo Province was 42.6% and 28%, respectively. This study investigated the effect of consuming instant-maize porridge fortified with termite and Moringa oleifera leaf powders on the nutritional status of children aged three to five years old. The research method used was quantitative. The study was conducted in Thulamela Municipality, one of the four municipalities in the Vhembe District. A randomised controlled trial was used, whereby participants were randomly assigned into either an experimental or control group. Twenty children from six preschools (three for the control and three for the experimental groups) participated in the study. The study was conducted in four phases, namely, Phase 1: the preparation of fortified instant-maize porridge and the assessment of safety and nutrient content of the product; Phase 2: a baseline study was done; Phase 3: participants were assigned to experimental and control groups. The consumption of 100% instant-maize porridge by the control group and fortified (80% maize, 15% termite powder and 5% Moringa oleifera powder) maize porridge by the experimental group for six months was done and Phase 4: post-intervention data collection and comparison of Phases 2 to 4 were made. The samples were prepared at the Department of Food Science & Technology at the University of Venda. Ethical certification was sought from the University of Venda Research Ethics Committee to conduct the study.
Open Access
An evaluation of the implementation of vitamin a supplementation protocol in health institutions in Mookgophong Municipality: a case study of Waterberg District
(2015-02-04) Mamaregane, Dihlolelo Vivian; Mbhenyane, X. G.
Aim: The main purpose of this study was to evaluate the implementation process of the Vitamin A Supplementation Protocol in institutions in the Mookgophong sub-district of Waterberg, Limpopo Province. Design: Multi-stage sampling was used. setting: The study was conducted in 6 clinics in Mookgophong sub-district and in one hospital in Mogalakwena which supports the clinics with resources. Subjects: There were 13 nurses, 2 pharmacists and 1 medical doctor. These health professionals served as informants. Methods: Self-reported questionnaires were used to collect data. The researcher did observations during data collection using a checklist. Descriptive statistics were used to analyse the data. Results: The results indicated that Vitamin A supplements were not always available at the health institutions studied. Most of the health workers were not trained on the Vitamin A Protocol although they could describe it. The staff said they adhered to the protocol. Conclusions: The Vitamin A Protocol was not well implemented because most staff was not trained and the capsules were not always available. T
Open Access
Household food access and nutritional status of 2-5 years old children residing at Lambani Village in Vhembe District of Limpopo Province
(2015-07-15) Tshifhango, Pfarelo Percy; Mandiwana, T. C.
Open Access
The influence of caregivers nutrition knowledge and feeding practices on the nutritional status of children 2 to 5 years old in the Makhuduthaga Municipality, South Africa.
(2018-05-18) Motebejana, Tubake Tinny; Mbhenyane, X. G.; Nesamvuni. C. N.
Malnutrition is a problem facing virtually every country in the world. Inappropriate feeding practices such as bottle feeding, early introduction of weaning foods, lack of variety in the diet are a known major cause of the onset of malnutrition in young children. Lack of nutrition knowledge, particularly about feeding practices, is critical as it affects the nutritional status of children. The purpose of this study was to determine the influence of caregivers’ nutrition knowledge and feeding practices on the nutritional status of 2 to 5 years old children in the Makhuduthamaga Municipality, South Africa. A crosssectional study with an analytical component was carried out in the Makhuduthamaga Municipality in the Limpopo Province, South Africa. One hundred and twenty children aged 2 to 5 years and their caregivers were conveniently sampled from four villages. A validated questionnaire was used to gather demographic information, caregivers’ nutritional knowledge and feeding practices. Anthropometric measurements taken were weight, height and mid-upper arm circumference (MUAC) of the children as well as weight and height of the caregivers. Descriptive and inferential statistics were utilized. Chi-square was used to determine the influence of caregiver’s nutrition knowledge and feeding practices on the nutritional status of children. The significance level was set at p< 0.05. Most caregivers (66.7%) were between the ages of 19 and 35 years. More than half (54.2%) of the children were male. Most of the caregivers (70%) had attended school up to secondary level and only 4.2% had obtained a tertiary qualification. Most of the caregivers (85%) were unemployed. Children were mostly (70.2%) cared for by their biological mothers. Some caregivers reported not to have any source of nutrition education (41.7%), while 43.3% reported that health professionals were their source of nutrition education. Both nutrition knowledge and feeding practices were not satisfactory in the current study. Almost all children (94.2%) were breastfed at some stage in their lives. However, 47.5% were given infant formula while they were still less than six months old. It was found that more than half of the caregivers (62.5%) introduced solids foods before 6 months. Maize meal soft porridge was reported as the main solid food first introduced to 66.7% of the children, followed by infant cereals (25%). Stunting was found in 41.7% of children. Prevalence of overweight and obesity was observed amongst both caregivers and children. Overweight and obesity prevalent of caregivers was at 30.8%. No significant correlation was observed between the caregivers’ nutrition knowledge, the feeding practices and the nutritional status of children. However, family income showed positive correlation with the nutritional status of children. Nutrition education strategies intertwined with economic empowerment of mothers should be enforced to capacitate caregivers to voluntarily make proper feeding practices.
Open Access
The investigation of eating and lifestyle habits of overweight and obese teenager aged between 13-18 years in Thulamela Municipality
(2019-05-18) Ligege, Ntovhedzeni; Mbenyane, X. G.
Context: A survey made worldwide (including South Africa) revealed that most teenagers are overweight and obese and that they eat little nutritious food. Obesity and overweight are public health problems and need to be addressed from a community perspective. The reason for exploring this problem in this study was that South Africa has one of the highest rates of overweight and obesity in the world among urban and rural black women. Objective: Investigating the eating and lifestyle habits of overweight and obese female teenagers in Thulamela Local Municipality, Limpopo province, South Africa. Design, setting and participants: This was an exploratory, descriptive study conducted in 2006–2007 amongst 125 female teenagers aged 13 to 18 years from rural schools in Thulamela Local Municipality. A hundred and twenty-five questionnaires were completed and data were gathered on the demographics, social and lifestyle habits, nutrition-related problems, dietary patterns and dietary history of the participants. Measurements: Eating and lifestyle habits, physical activity, meaning of healthy and unhealthy dietary habits, weight, height and body mass index were measured. Results: Seventy percent of the respondents actively consumed three meals in a day, 83% consumed starchy snacks between meals, whilst 72% of the respondents carried lunchboxes to school. Regarding lifestyle habits, 88% of the respondents slept more hours than recommended (8 hours) 88% performed sedentary activities and 66% did physical activities such as walking. Conclusion: The results pointed out unhealthy eating and lifestyle habits influencing teenagers’ weight. Identified factors must be considered in order to develop tailored nutrition interventions to improve teenagers’ consciousness about adopting a healthy lifestyle.
Open Access
An investigation of the interppretation of the growth chart and feeding practices of caregivers of children under five years from the Greater Tzaneen Municipality, Limpopo Province, South Africa
(2016-03-08) Sibanda, M. N.; Mbhenyana, X. G.; Mushaphi, L. F.
Open Access
Iodine content of salt used in the National School Nutrition Programme at Mopani and Vhembe Districts in Limpopo Province, South Africa
(2020-09-09) Ramugondo, Mpho; Mushaphi, L. F.; Mabapa, N. S.
Background: The National School Nutrition Programme (NSNP) aims to foster better quality education by enhancing children’s learning capacity, encouraging regular attendance and punctuality, addressing micronutrient deficiencies and alleviating short term hunger. Iodine is one of the micronutrient which is used in NSNP in the form of iodised salt. Iodine deficieny affects an estimated 60 million school- age children in the developing world and is also associated with low test scores and cognitive function. Aim: The main aim of the study was to determine the iodine content of salt used in the NSNP. Methodology: A cross sectional study was conducted. The researcher aimed at describing the iodine content of salt used in schools and the iodine nutrition knowledge of the food handlers in various schools in the Mopani and Vhembe districts. The study was conducted in selected schools of Mopani and Vhembe districts receiving NSNP. The target population was food handlers employed in schools receiving NSNP from the two districts. A total of 318 schools were visited and 359 food handlers were interviewed. The salt samples were collected and analysed using standard procedures. The demographic information and the iodine nutrition knowledge were obtained using a validated questionnaire. Results: A total of 318 salt samples (Mopani=159 and Vhembe=159) were collected and analysed, representing 100% of successfully analysed. The study comprised of 359 (Mopani=200 and Vhembe=159) food handlers from two districts. Almost two thirds (64%) of the participants in Mopani district and 82.4% in Vhembe district had grades 8-12 as their highest level of education, while 4% and 5% had tertiary education in Mopani and Vhembe districts respectively. The mean iodine content was 36.53ppm and 34.24ppm in Mopani and Vhembe districts respectively which signifies adequately iodised salt. Almost three quarters (71%) of salt samples in Mopani and 65% in Vhembe were adequately (15-64ppm) iodised in this study. The results of the study suggest that almost half (47.5%) of the participants in Mopani and 34% in Vhembe had poor iodine nutrition knowledge as they could not answer the questions in the knowledge test correctly. Only 27% of the participants in Mopani and 30% in Vhembe had good knowledge. Conclusions- There are still salt samples that are inadequately iodised or not iodised at all used in the preparation of meals for NSNP in the two districts. Such instances make the programme designed to eliminate IDD fail. It can be deduced that without public awareness on the importance of iodine in the human body, the universal iodine programme will be unsuccessful.
Open Access
Iodine status of lactating mothers and infants aged 0 to 6 months in Vhembe and Mopani district of the Limpopo Province, South Africa
(2020-09-03) Hlako, Seemole Cedrick; Mushaphi, L. F.; Mabapha, N. S.
Introduction: Iodine is an essential nutrient required by humans for the synthesis of thyroid hormones, which are vital for normal growth and development. Objective: The primary aim of the study was to describe the iodine status of lactating mothers and infants aged from 0 to 6 months in the Vhembe and Mopani Districts. Methods: A cross-sectional study conducted on 246 infant-mother pair, from the Mopani and the Vhembe Districts. Data was gathered using a questionnaire. Breastmilk, mother urine, infant urine, household salt and drinking water were collected to be analysed for iodine content. Results: The median of breastmilk iodine concentration level amongst lactating mothers in the Vhembe District was 101.4 µg/l (IQR 62.9 – 175.1 µg/l) and 154.4 µg/l (IQR 92.6 – 211.8 µg/L) in Mopani. The median UIC of mothers in Vhembe was 98.5 (IQR 57.66 – 153.93), whereas in the Mopani District the median UIC of mothers was 126.08 µg/l (IQR 69.89 – 206.71 µg/L). The median UIC of infants in Vhembe was 220 (IQR 106.67 – 418.43 µg/l) and in the Mopani District was 321.94 µg/l (IQR 167.96 – 482.66 µg/l). Conclusion: The BMIC in the study signifies iodine sufficiency in both the Vhembe and the Mopani Districts. The results of this study suggest that the BMIC be included in studies assessing iodine status in lactating mothers since the UIC only reflects iodine that was consumed recently. The UIC may under estimate the maternal iodine status if it is not complemented by the BMIC data.
Open Access
Iodine status of pregnant women and children aged 6 to 12 years feeding from the same basket in Mopani District, Limpopo Province, South Africa
(2015-02-26) Mabasa, Eric; Mbhenyanem X. G.; Mabapa, N. S.
Introduction: Iodine deficiency (ID) is a worldwide problem that leads to impaired cognitive development, clinical goiter and the syndrome of endemic cretinism. Pregnant women and school age children are the most vulnerable groups for ID. Sufficient iodine is required during pregnancy to ensure adequate maternal thyroid hormones production. ID in utero and early childhood damages the developing brain, leading to the loss of millions of intelligent quotient (IQ) points globally. Objectives: The aim of the study was to assess iodine status of pregnant women and children aged 6 to 12 years feeding from the same food basket in Mopani district, Limpopo Province, South Africa. Methods: The study was cross-sectional conducted in five municipalities of Mopani District in Limpopo Province. The total number of clinics selected was 41. A total of 565 pregnant women and 116 children aged 6-12 years were recruited. Urine iodine concentration (UIC) and drinking water iodine concentration were analyzed using the Sandell-Kolthoff reaction. The salt samples were analyzed by means of the iodometric titration method. Dried blood spots on filter paper were analyzed for whole blood thyrotropin /Thyroid Stimulating Hormones (TSH) with an immunoassay. Results: The findings showed that 52.5% of household salt had iodine concentration level more than 15ppm. Most of household drinking water (41.3%) had iodine concentration level greater than 60µg/L. The median iodine concentration of drinking water in Mopani District was 46.2µg/L. Almost half of pregnant women (44.9%) had UIC level less than 150µg/L. The maternal overall median UIC level was 164µg/L indicating maternal iodine sufficiency. However, median UIC in the first and third trimesters was below 150µg/L, indicating iodine insufficiency. The TSH levels of pregnant women were measured per trimester and majority of study participants had normal TSH levels. Most children (64.3%) had UIC level greater than 300µg/L. The median UIC level of children was 386µg/L indicating excessive iodine status. Conclusion: Iodine status of children in this study was excessively high. It was twice times higher than the iodine status of pregnant women. It is difficult to explain this significant difference in iodine status of these two groups since they were feeding from the same food basket. It can then be concluded that the median UIC of school aged children may not be an adequate surrogate for monitoring iodine nutrition in pregnant women as was previously assumed.
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Menu availability, food handling practices and nutrition knowledge of food handlers in the Early Childhood Development centres at Elias Motsoaledi Local Municipality, Limpopo Province
(2025-09-05) Mphagi, Thabelo Winnie; Mushaphi, L. F.; Chauke, R. C.
Background: Nutrition is important for children's growth and development because it provides the essential components needed for physical growth, brain function, and mental development. Aim of the study: The aim of the study was to determine the food handlers' nutrition knowledge, food handling practices, and daily menu availability in Early Childhood Development centres at Elias Motsoaledi Local Municipality, Sekhukhune District. Methodology: A quantitative cross-sectional survey was conducted at Sekhukhune District, in Elias Motsoaledi Municipality. The convenience sampling method was used to select the population, which comprised of 60 registered and funded ECD centres, and 113 food handlers. A researcher-administered questionnaire and researcher-observation checklist were used to collect data. Data collected was analysed using SPSS software version 29. Results: The study was conducted in 60 registered and funded ECD centres at Sekhukhune District, Elias Motsoaledi Local Municipality, with 113 food handlers. The majority of respondents (70.8%) had completed secondary education and 17.7% had tertiary qualifications. About 72.6% of food handlers scored 80 to 100%, indicating excellent knowledge. Almost all food handlers (96.7%) washed their hands before handling food and after using the toilet, while 86.7% washed their hands with soap before eating. The majority of food handlers wear appropriate protective clothing and cover their hair when preparing food. All ECD centres had a daily menu and (91.2%) were approved by the dieticians, while (8.8%) were not approved. Most ECD centres (76.7%) had their menu displayed on the wall, but the majority of centres (68.3%) did not adhere to their daily menu. Conclusion: ECD centres should collaborate with nutrition experts during menu planning to ensure that they incorporate accessible and affordable nutritious foods into their daily meals. To enhance children's intake of essential vitamins and minerals, centres are encouraged to establish gardens where they can grow vegetables. This initiative can also help save money for other necessities.
Open Access
Nutrition knowledge and care practices of homebased caregivers in Makhado and Thulamela Municipalities of Vhembe District in Limpopo Province, South Africa
(2015-08-05) Masia, Tirhani Asnath; Mbenyane, X. G.; Mushaphi, L. F.; Mabapa, N. S.
Open Access
Nutrition knowledge of educators in primary schools in Makhuthamaga Municipality in Limpopo Province
(2019-09-20) Magoai, Matlou Martina; Mabapa, N. S.; Mbhenyane, X. G.
Introduction: Nutrition education is the change process whereby beliefs, attitudes, environmental influences, and understanding about food lead to nutrition practices that are scientifically sound, practical, and consistent with individual needs and available resources Design and Methods: The purpose of this study was to assess the nutrition knowledge of educators in Makhuduthamaga municipality, Limpopo Province. Quantitative, descriptive, and exploratory research was conducted to determine the factors that influence the nutrition knowledge of educators and explore the relationship between factors and nutrition knowledge. The simple random sampling technique was employed to select 200 educators in grades 4, 5, and 6. Data collection was done using structured questionnaires. The data was analysed using the statistical package for social science (SPSS), version 21. Results and Discussion: Of the educators who participated in the study, 66.5% were female, and 33.5% were males. Almost all (94%) of the educators were trained at a college and had teaching experience of between 21-30 years. Most of the educators (60.5%) had a diploma, while 0.5% had a master’s degree. Almost one third of educators indicated that children should eat three (3) times during the day, and 32% identified the important meals as breakfast, lunch, and supper. Most (36.5%) failed to give reasons why children should not skip meals. In terms of basic food and nutrition, majority of the educators (75%, 67%, 56%, and 55.5%) responded correctly on the importance of carbohydrates, fat, vegetables, and fruits, respectively. Only a quarter (26%) knew the importance of protein, while 75.5% knew that protein forms part of a balanced diet. Most of the educators knew the rich sources of vitamin A and fibre but did not know the rich sources of iron, iodine, and vitamin C. There was no significant difference between the level of education and nutrition knowledge (p= 0.129), and between training institution and nutrition knowledge (p= 0.534). Conclusion: The need to train educators on nutrition was one of the main recommendations that emanated from many research projects. Most educators mentioned that training and level of education were of the factors that affected their nutrition knowledge. Nutrition knowledge is becoming increasingly important in food choices and in this study educators acknowledged that training affected their nutrition knowledge.
Open Access
Nutritional composition of traditional mixed - dishes eaten by elderly women in Vhembe District
(2020-12-20) Tshidzumba, Sedzani Elsie; Mushaphi, L. F.; Mbhatsani, H. V.
Globally, one in every eight people (868 million) are malnourished and nearly two billion people suffer from some type of micronutrient deficiencies. Most traditional dishes contain exceptional capabilities to improve nutrition, bring about nutritional variety, hence, they play a significant role in reducing malnutrition, including micronutrient deficiencies sub-Saharan Africa (SSA) and South Africa in particular, where these ills still persist. The conveyance and documentation of indigenous knowledge on traditional food, which this research is aimed at, will make sure that the obtainability and consumption of these foods will be sustained. The aim of this study was to determine the nutritional composition of traditional mixed-dishes eaten by elderly women in Vhembe District. The research design was ethnographic with an analytic component; a mixed methods approach was used for data collection. The qualitative data was analysed using thematic analysis and the quantitative data was analysed using statistical methods on IMB-SPSS (version 26). Frequencies, mean, and analysis of variance (ANOVA) were used to interpret data and means were separated using Duncan’s multiple range test at p < 0.05. The study was conducted in accordance with the Declaration of Helsinki. From the results, one theme and eight sub-themes emerged from the respondents’ narratives during the in-depth interviews. Sixteen types of stiff porridge, eight types of traditional mixed-dishes and twenty-three types of indigenous leafy vegetables were documented. Boiling was the most common traditional cooking method used in food preparation by the Vhavenda and Vatsonga. The Vhavenda and Vatsonga frequently used ground peanuts in the preparation of most traditional foods. The total dietary fibre values ranged from 7.70% to 28.40% and a significantly higher total dietary fibre content was observed in tshidzimba/tihove B at p <0.05. The protein content of traditional mixed dishes varied from 11.70% to 31.50% and a relatively higher protein content was observed in bovhola/xipaswi at p <0.05. The iron content varied from 51.4 mg/100 g to 195.6 mg/100 g significantly different at (p<0.5). Thophi/tshopi had higher vitamin A (288.0 μg/100 g) and β-carotene (576.0 μg/100 g) content, respectively. Sensory evaluation showed that tshidzimba/tihove A was rated significantly higher in mouthfeel, aroma, taste and appearance and overall acceptability than tshidzimba/tihove B, thophi/tshopi and bovhola/xipaswi at p < 0.05. The conclusion is that, there is a great reliance on traditional foods by rural communities. Mixing traditional foods into composite dishes is a common practice among the Vhavenda and Vatsonga. These foods are inexpensive sources of important nutrients and their consumption must be encouraged, especially in local communities where they are readily available to prevent and lessen the burden of micronutrient deficiencies, thereby, promoting healthy lifestyle.
Open Access
The nutritional knowledge and consumption of blackjack by hypertensive patients in Vhembe District, Limpopo Province, South Africa
(2019-09-20) Gavhi, Fhatuwani; Nesamvuni, C. N.; Mbhatsani, H. V.
Hypertension remains a major public health problem that needs different comprehensive health strategies to deal with it. Indigenous vegetables, Blackjack in particular, have been shown to possess anti-hypertensive properties that are attributed to bioactive chemical substances such as phytochemicals, fiber, antioxidants as well as micronutrients that include potassium, magnesium, calcium, vitamin C, zinc, iron and copper. The use of indigenous vegetables in combination with the conventional hypertension treatment may reduce hypertensive conditions; hence, the purpose of this study was to determine Blackjack nutritional knowledge and consumption by hypertensive patients. A cross-sectional study employing both quantitative and qualitative methods was conducted on 275 hypertensive participants at Mphambo and Mutale Health Centers, Vhembe District of Limpopo Province, South Africa. A questionnaire was used to collect data on participants’ Blackjack nutritional knowledge, Blackjack availability around their households as well as their Blackjack consumption patterns and nutritional status. The Blackjack nutritional knowledge data was triangulated with focus group discussions and participants’ nutritional status was assessed by anthropometric and dietary intake methods. The body mass index (BMI) was calculated and dietary intake frequency from selected foods was determined. Blood pressure was measured using Microlife automatic blood pressure monitor. The findings indicated that most hypertensive participants had poor knowledge of the nutritional importance of Blackjack and its associated medicinal contribution on hypertension management. Participants were unable to mention different diseases that can be prevented or managed by Blackjack, which was mostly consumed once a week with porridge during the summer season. Hypertensive patients were consuming high amounts of sodium and less amounts of minerals that are known to regulate blood pressure, such as potassium and magnesium. Hypertensive patients had high prevalence of overweight and obesity and most were either in hypertension stage 1 or stage 2. Lack of Blackjack nutritional knowledge may have contributed to a decreased consumption of Blackjack by hypertensive patients. The health professionals should promote the nutritional benefits of Blackjack in rural areas, particularly to hypertensive patients to raise awareness of Blackjack’s benefits in disease prevention and management.
Open Access
Nutritional practices and health status of health care workers in Makhado Municipality of Limpopo Province, South Africa
(2022-07-15) Masala, Itani Faith; Mushaphi, L. F.; Masia, T. A.
Background: Health care workers spend 80% of their time daily at work and workplaces are sedentary settings for many workers. Energy-dense food and beverages are commonly consumed, resulting in increased overweight and obesity, which are health-risk factors, especially for non-communicable diseases. The study aimed to describe the nutritional practices and health status of health care workers in the Makhado municipality. Methodology: Cross-sectional survey design using a quantitative research method was applied. Study participants were health care workers who were registered with professional boards and working in the health facilities at the Makhado municipality. A total of 336 health care workers were randomly selected from 25 health care facilities across the municipality. Data were analysed by description and inferential statistics using version 2020 of the statistical package for social sciences. Results: The current study indicates that 62% of total participants was obese, 26% was overweight, 18.2% had body fat percentage in the overweight range and a total of 67.6% of participants had a total body fat percentage in the obese range. More than two-thirds (at 72%) of total participants had waist circumference above normal. Biochemically, there were disorders of blood glucose, total cholesterol, low-density lipoprotein and high-density lipoprotein among participants. The majority of female participants and 45% of male participants prepared their meals and they usually ate home-prepared breakfast and lunch while at work. About 60% of participants in both groups ate three meals a day, and 34% of male and 27% of female participants ate food from takeaway restaurants once a week. Above half (at 54.1%) of female participants and 39% of male participants had very good lifestyle habits. The majority of participants in both groups had fair and poor nutritional knowledge (with male = 80.7%, female = 83.6%). Conclusion: The majority of participants had acceptable nutritional practices, except 30.1% of participants who skipped meals. Health status is of high concern because very few of the total participants had normal weight. The majority of participants had abdominal obesity and there were participants with disorders in biochemical and clinical parameters.
Open Access
Nutritional status and feeding practices of children aged 0 to 36 months in Thulamela Municipality, Limpopo Province
(2022-07-15) Mugware, Anzani; Mushaphi, L. F.; Motadi, S. A.
Introduction: Globally, it is estimated that only 44% of infants are exclusively breastfed for the first 6 months of life while most children are introduced to solid, semi-solid or soft foods late or earlier than recommended. Poor breastfeeding practices, and complementary feeding accounts for nutrients deficiency, illness and infections in children that lead to malnutrition at an early age. Globally, malnutrition is accountable for one out of three deaths among children under five years (WHO, 2016). Aim: The study aimed to investigate the nutritional status and feeding practices of children aged 0 to 36 months at the Thulamela Municipality. Methodology: A cross-sectional study design was used in this study. The target population was all mothers with children aged 0 to 36 months in the Vhembe district and the accessible population was mothers with children aged 0 to 36 months in the Thulamela Municipality. Simple random sampling was used to select three clinics per cluster to make a total of 18 clinics. A total number of 250 mothers and their children were selected using a convenience sampling technique. A structured questionnaire was used to collect data on socio-demographic characteristics, breastfeeding and complementary feeding practices. Anthropometric and biochemical measurements of children were assessed using standard procedure. Anthropometric measurements were calculated using WHO Anthro version 3.2.2. The data obtained were analysed using SPSS version 26. Results: The study was carried out on 250 children aged 0 to 36 months and their mothers. The mean (± SD) age of children in months was 10.53 (8.39). The mean (± SD) age of mothers in years was 27.79 (±7.13SD). Most mothers (96%) initiated breastfeeding within one hour after birth. Exclusive breastfeeding up to six months was practised by only 7.6% of mothers. The majority (87.5%) were complementary feeding before the age of six months. The prevalence of stunting, wasting and underweight were 9.2%, 2% and 3.6% respectively. The prevalence of vitamin A among children was 21.7% (<10 μg/dl). The prevalence of anaemia (Hb <11 g/dL), and iron deficiency (serum ferritin < 12 μg/l) amongst children was 53.6% and 13.1% respectively. About 38.1% of children who received water before six months of age were more likely to be stunted as compared to those who received water at six months and above (19.9%) (p=0.001). Children who were still breastfeeding were more likely to have normal haemoglobin (73.5%) as v compared to those who were no longer breastfeed (61.5%) (p=0.45). Children who were given complementary foods one week after birth, the odds of being underweight were 9.00 times as compared to those who were given complementary foods after six months (OR=9.00; 95% CI=1.325 - 61.138). Children who were initiated on breastfeeding immediately after delivery, the odds of having low ferritin were 0.11 times as compared to those who were initiated breastfeeding a day after delivery (OR=0.111; 95% CI=0.015 - 0.812. Conclusion: Exclusively breastfeeding for the first six months was rarely practiced since the majority of infants were introduced to complementary fluids or foods before the age of six months. The prevalence of underweight, stunting and wasting among children were of low concern since the majority of children had normal anthropometric status. The prevalence of vitamin A deficiency, anaemia and iron deficiency remains prevalent among children. Health professionals should promote the use of mass media and mom-connect as the platforms that may be utilised more optimally to disseminate information on infant and young child feeding practices to young mothers.
Open Access
Nutritional status and milestone development of children aged 3 to 5 years attending early childhood development centres at Chief Albert Luthuli Municipality
(2024-09-06) Khumalo, Mthokozisi; Mushaphi, L. F.; Mahopo, T. C.; Mbhatsani, H. V.
Introduction: Nutritional status is vital for overall health and development in children. Anthropometry, reflecting health and nutritional status, predicts performance and survival. Children's development follows unique trajectories, with specific milestones achieved universally. This study explores the nutritional status and milestone development of preschoolers. Methods: A cross-sectional design was employed, clustering the Chief Albert Luthuli municipality into four circuits. Four Early Childhood Development (ECD) centers were randomly chosen from each cluster. Utilising Slovin’s formula, the sample size was determined, resulting in 353 participants. Participants were children attending ECD centers, while caregivers and ECD teachers were informants. Data were collected via a questionnaire and three 24-hour recalls assessing dietary diversity. Anthropometric measurements were taken using standard techniques, and developmental screening was conducted using the Developmental Assessment of Young Children-Second Edition (DAYC-2). Inferential statistics determined associations between nutritional status and milestone development. Results: Regarding household characteristics, the study found varying levels of access to resources such as land for food production and improved water sources. Notably, most households relied on electricity (94%) for cooking, while a portion of households still used wood (62%) as the primary cooking fuel, which has implications for indoor air quality and environmental sustainability. Across three visits, most children exhibited high dietary diversity scores (DDS) (63-77%). Commonly consumed food groups included meat and fish (72-78%), milk and dairy products (68-73%), with organ meat (5-8%) and eggs (6-13%) less frequent. The prevalence of stunting, underweight, and wasting varied, with stunting at 17.9%, underweight at 19.9%, and wasting at 23.2%. Approximately 8% showed suspected developmental delays, notably in physical fine motor skills (27%). Positive correlations were found between weight-for-height (wasting) and general development index (GDI) (p=0.00) as well as between DDS and GDI (p=0.00). Conclusion: The prevalence of malnutrition varied, with wasting being notably high. Physical fine motor skills showed lower scores in a significant proportion of children. However, most children met the expected milestones across developmental domains. Significant associations were observed between anthropometric indicators, DDS, and milestone development. These findings underscore the importance of addressing nutritional status and milestone development in preschool-aged children for their overall well-being and development.
Open Access
The nutritional status of children less than 5 years receiving child support grant in Mogalakwena Municipality, Waterberg District, Limpopo Province, South Africa
(2018-05-18) Kekana, Matipa Johannah; Mbhenyane, X. G.
Objectives: The study objectives were to determine demographic and environmental factors that can affect nutritional status of children receiving CSG, to assess the nutritional knowledge of caregivers, to determine the proportion of CSG spent on food and to determine the nutritional quality of food bought from CSG. Design: Cross-sectional descriptive with an analytical component Subjects: PCG of children under the age of 5 receiving CSG in Mogalakwena Municipality. 189 caregiver-child pairs were interviewed, in their households. Methods: Data collected by the interviewer included demographic data, Use of CSG, nutritional knowledge and the HHFI and anthropometric measurements were done by a 3rd year Nutrition student. Results: About 36.5% of participants were in the age 26-35 years, 75.7% were unmarried, 84.1% were unemployed and 72% had no matric. Mean age for children studied was 2.84±1.33, 77.8% of participants stayed in a household of more than 5 people. In terms of types of housing, 56% had formal houses, 55% had access to pit latrines and 52.9% used communal taps to access water, 41.3% used electricity for energy while 23.3% used wood to stretch the availability of electricity. Mean CSG received was R386.22 ±R208.75. Majority of participants (56.1%) indicated that CSG supports the whole family and 64.6% of the families depended solely on CSG for survival, while 27% of families had elderly people receiving pension grant which was supplementing the CSG. The CSG was used for different items, majority of families used 94.2% of the money for food at a mean of R171.55±159.25, followed by toiletry (71.6%) at a mean R61.89±69.24, then clothing (68.9%) at a mean of R70.77±97.14. Stokvel was also mentioned as one of the items contributed for by CSG, 32.3% of participants used more than R50.00 for stokvel. Different food items were purchased using CSG, 80.5 % of the money was used to purchase starchy food, mealie meal being the highest commodity at 43.7%. Offal (35.8%) was the highest protein source purchased followed by poultry at 26.4% and soya soup at 20%. Potatoes (19.6%) were mentioned as the most purchased vegetable, followed by cabbage (14.8%). There was a 53.5% of prevalence of stunting, of this 19.6% of children were severely xiii stunted, 5.3% underweight, and 32.3% of wasting. There were 22.1 % of PCG who were overweight and 12.1% were obese. The PCG BMI was negatively associated with WAZ (r= -0.48, p=0.515). There was a positive association between PCG BMI and HAZ (r=0.103, p=0.158), however when caregivers BMI was correlated to BAZ the association was strongly negatively significant (r=0.206, p=0.004). Most PCG received nutrition education from relatives, 71.1% were never educated on nutrition, 57.9% of children were fed 3X/ day. Conclusion: It is apparent from the study that malnutrition, precisely stunting is still a problem in South Africa, however this does not disregard the impact that CSG has on the lives of the poor. It affords the families to access basic needs in the household such as food, toiletry, electricity and even stokvel. The role of nutritionists/ dieticians is paramount in helping mothers to choose healthier economic food for the children in order to curb the burden of malnutrition.