A strategy to facilitate the implementation of educational nutritional guidelines for caregivers of children in selected rural communities of Vhembe District

Abstract

Despite several developed strategies, policies and guidelines, malnutrition is still an ongoing challenge. According to the District Health Information System (DHIS), 24 of 141 (17%) children in the Kutama Clinic of the Vhembe District were reported to have malnutrition between April 2018 and March 2019. Although there are several interventions in place to promote nutritional feeding practices for growth and development, there are no policies on how to implement these interventions. This study aimed to develop a strategy to implement educational nutritional guidelines for caregivers of children under the age of five years in selected rural communities of the Vhembe District in the Limpopo Province. A qualitative, exploratory and descriptive design was used in the study. The study population was caregivers of children with malnutrition under the age of five years and nurses working with child growth monitoring in two local municipalities in the Vhembe District of Limpopo Province. Non- probability purposive sampling was used to select the Vhembe District as it has a high fatality rate of severe acute malnutrition in children under five years. Non-probability convenient sampling was used to sample 38 caregivers of children with malnutrition and 13 nurses monitoring children’s growth. In conducting this research, ethical principles were considered. In-depth interviews were used to collect data from nurses, and focus group interviews were used to collect data from caregivers. Data were analysed using Tesch’s eight steps. During phase one, caregivers indicated the kind of food they give children and its contributing factors. They also revealed the type of information they provide regarding nutritional feeding practices. In addition, participants indicated the actions to be taken to facilitate the nutritional feeding practices leading to phase two of developing the strategy. The six elements of practice theory outlined by Dickoff et al., SWOT and BOEM action plan informed the development of the strategy.The study was limited to clinics in the Makhado and Musina Municipalities. The study was contextual as the focus was only on caregivers of children with malnutrition. Most of the participants were mothers; thus, minimal information was obtained from grandmothers or aunts. The study recommends that the district office reinforce the strategy in primary health facilities.