Objective: To determine the impact of a nutrition education programme, implemented using local nutrition advisors, on knowledge of nutrition and dietary practices in low-income coloured communities in the Free State and Northern Cape provinces. Study population and methods. A nutrition education and food aid programme was implemented for 2 years in one urban and three rural areas. Two rural control areas were included where food aid was given, but no nutrition education. Knowledge of nutrition and dietary practices were measured using a structured questionnaire before (608 respondents) and after intervention (672 respondents). Results: In contrast to control areas, knowledge of what to eat daily to remain healthy improved significantly by between 42.2% and 52.6% in rural intervention areas. The percentage of rural households that included three food groups (protective foods, energy foods and building foods) in their cooked meal improved by 32.6 - 38.8%. Improvements of between 7.0% and 12.9% were observed in the percentage of respondents who knew that milk is healthier to drink than non-dairy alternatives. The median percentage of household members using more than two cups of milk per day improved significantly, by between 14% and 100%. A significant improvement in vegetable and fruit intake was also observed. Conclusions: A community-based nutrition education programme can contribute to knowledge of balanced, economical nutrition and dietary practices in low-income communities.

/pdf/impact-of-a-nutrition-education-programme-on-nutrition-3tlshor5e1.pdf

Impact of a nutrition education programme on nutrition knowledge and dietary practices of lower socioeconomic communities in the Free State and Northern Cape

Our goal is to present recent progress in understanding the biological mechanisms underlying anemia from a public health perspective. We describe important advances in understanding common causes of anemia and their interactions, including iron deficiency (ID), lack of other micronutrients, infection, inflammation, and genetic conditions. ID develops if the iron circulating in the blood cannot provide the amounts required for red blood cell production and tissue needs. ID anemia develops as iron-limited red blood cell production fails to maintain the hemoglobin concentration above the threshold used to define anemia. Globally, absolute ID (absent or reduced body iron stores that do not meet the need for iron of an individual but may respond to iron supplementation) contributes to only a limited proportion of anemia. Functional ID (adequate or increased iron stores that cannot meet the need for iron because of the effects of infection or inflammation and does not respond to iron supplementation) is frequently responsible for anemia in low- and middle-income countries. Absolute and functional ID may coexist. We highlight continued improvement in understanding the roles of infections and inflammation in causing a large proportion of anemia. Deficiencies of nutrients other than iron are less common but important in some settings. The importance of genetic conditions as causes of anemia depends upon the specific inherited red blood cell abnormalities and their prevalence in the settings examined. From a public health perspective, each setting has a distinctive composition of components underlying the common causes of anemia. We emphasize the coincidence between regions with a high prevalence of anemia attributed to ID (both absolute and functional), those with endemic infections, and those with widespread genetic conditions affecting red blood cells, especially in sub-Saharan Africa and regions in Asia and Oceania. 

Biology of Anemia: A Public Health Perspective.

Assessing malnutrition with the mid-arm circumference.

Objective. To investigate infant feeding practices and socio-economic factors as possible causes of undernutrition in underweight preschool children. Design. A matched case-control study. Methods. Data on feeding practices and socioeconomic factors in matched groups of underweight children (UG) and normal-weight children (NC) were collected from their caretakers by means of personal interviews. The survey was undertaken in a semi-rural village, Monyamane, in Northern Province. Children aged between 7 and 71 months were matched according to age and sex, with 57 children in each group. Conditional logistic regression was used to investigate the relationship between the UC and NC groups for univariate and multivariate analyses. Results. Results indicated a low risk of underweight when a guardian looked after the child (0.26) and a high risk when solid foods were introduced before 5 weeks of age (9.42). There was a very high risk when the mother did not have a post-matric qualification (19.40), when the father was unemployed (7.45), and when there were more than 7 children liVing in the house (3.98). Conclusion. Specific infant feeding practices (early introduction of solids) and socio-economic factors (poor maternal education, paternal unemployment; more than seven children in the house) increased the risk of undernutrition in preschool children.

Differences between underweight and normal­ weight rural preschool children in terms of infant feeding practices and socio-economic factors

Study on Children with Reference to Malnutrition and its Effect on Haematology and Serum Total Proteins

The incidence of nutritional anaemia and of protein calorie malnutrition in 119 randomly selected Black children living in the Muldersdrift area was studied. The ecology of nutritional problems in the community was also investigated. Major problems in the area were poor educational and medical facilities, a high childhood mortality rate and poor cash incomes. An important factor which influenced nutrition was large family size. The incidence of protein calorie malnutrition was 27,6% and of nutritional anaemia 13,3%. In the second year of life the incidence of anaemia was 27,3%. The main cause of anaemia was iron deficiency.

Protein calorie malnutrition and nutritional anaemia in black pre-school children in a South African semirural community

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Protein calorie malnutrition and nutritional anaemia in black pre-school children in a South African semirural community