A description of growth monitoring and promotion activities at primary care level in Grahamstown, Makana Sub-District, Eastern Cape.

Master of Public Health. University of KwaZulu-Natal, Durban 2017.Aim To describe growth monitoring and growth promotion (GMP) activities in children aged 0-24 months at primary healthcare facilities in Grahamstown, Makana Sub-District, Eastern Cape. Methods A cross-sectional descriptive study design was implemented. A sample of one hundred and sixty-four children from birth to twenty four months attending seven clinics in Grahamstown for well-baby visits, sick visits and growth monitoring and promotion from November 2012 to January 2014were included in this study. A Road-to-Health Booklet audit checklist and caregiver questionnaire were used to collect the data. Frequency distributions were reported for appropriate GMP activities. Appropriate GMP was defined as: correct use of weight-for-age index; growth interpreted correctly and discussed with caregiver; interventions promoted or given as indicated; and follow-up scheduled according to the relevant Department of Health policies. Results From the Road-to-Health Booklets sampled at the seven clinics and from caregiver interviews forty-seven (28.7%) of the children had evidence of appropriate GMP, although the majority of children sampled were weighed at their clinic visit. One hundred and twenty (80.0%) of the caregivers reported that their children were weighed by community health workers. The prevalence of appropriate GMP was significantly different according to the primary healthcare facility attended by the child (p=0.046 for the seven facilities using Fisher’s exact test). In the children sampled, seventeen (18.1%) had a recorded length in their Road-to-Health Booklet and for only nine (10.0%) of the children was the length for age plotted. There was no documented evidence in any of the Road-to-Health Booklets indicating that length measurements were interpreted. Discussion There is over emphasis on the technical aspects of GMP such as weighing of children, i.e. growth monitoring compared to growth promotion. Optimal GMP practice requires growth measurement, interpretation and intervention, e.g. nutritional counselling for growth promotion, with caregiver engagement in discussions about child growth. Sub-optimal GMP persists after the implementation of the new Road-to-Health Booklet, as evidenced by: inadequate interpretation of growth indices; lack of appropriate interventions for growth faltering; and poor follow-up. Length-based measurements are not used routinely in child growth assessment since their addition to the RTHB in 2010. Conclusion Implementation of quality growth monitoring and promotion activities at primary care facilities in Grahamstown remains problematic after the introduction of the revised Road-to-Health Booklet and additional growth indices

The 'causes' of teenage pregnancy: review of South African research - Part 2

This article forms the second of a two-part series in which South African research on teenage pregnancy is reviewed. Part 1 of the series dealt with the consequences of teenage pregnancy; this paper reviews the 'causes' thereof. International literature is incorporated in the discussion by way of comparison. Contributory factors which have been investigated by South African researchers include: reproductive ignorance; the earlier occurrence of menarche; risktaking behaviour; psychological problems; peer influence; co-ercive sexual relations; dysfunctional family patterns; poor health services; socio-economic status; the breakdown of cultural traditions; and the cultural value placed on children. Preston-Whyte and colleagues present a revisionist argument, stating that early pregnancy may represent a rational life choice for certain adolescent women. The article is concluded with comments on methodological problems encountered in the South African research, and a discussion on the implications in terms of policy formulation

An analysis of the emerging patterns of reproductive behaviour among rural women in South Africa : a case study of the Victoria East District of the Eastern Cape Province

Thesis (DPhil)--Stellenbosch University, 2002.ENGLISH ABSTRACT: The study describes and analyses changes in women's reproductive behaviour ID developing communities. These changes took more than hundred years to occur ID Western communities but only two to three decades in developing communities such as Taiwan and Barbados. The population of Victoria East district of the Eastern Cape province of South Afiica was chosen as a case study of these changes. Changes in the reproductive behaviour of women are described over a period of twenty-two years. The base year for the study is 1978 and data were collected up to 2001. Changes increased in particular since 1988. Statistical descriptive analyses were undertaken with regard to patterns of changes in variables such as age at the onset of births, child spacing, the mean number of births per woman, fertility regulation, and the number of children ever bom. Variations in patterns were analysed according to age cohorts, occupation and marital status. Information regarding these variables was collected from records at hospitals and clinics. Focus group interviews were held to reflect women's own descriptions and experiences regarding these variables. The research design thus combines the quantitative and qualitative approaches. The findings confirm a pattern of fertility decline that Caldwell described as the African pattern, which is different from that seen in Europe and Asia. It is characterized by a progressive delay in onset of childbearing and reductions in the mean number of childbirths that occur across all age cohorts and are associated with contraceptive accessibility. The high incidence of non-marital childbearing in the Victoria East district however sets the population studied apart from the polygamous Afiican societies on which Caldwell based the African transition. In this respect the population considered resembles the scenarios seen in Latin America, the Caribbean, Botswana and in recent years Europe. The study population shows a divergence in the patterns of marital and non-marital childbearing, with marital childbearing following the African pattem. Because of its high incidence, non-marital childbearing is dominant and the major contributor to the fertility decline that is afoot. The implications of this pattern needs much more in-depth study before comparisons with the above-mentioned communities can be made.AFRIKAANSE OPSOMMING: Die studie beskryf en ontleed veranderinge in vroue se reproduktiewe gedrag in ontwikkelende gemeenskappe. Hierdie veranderinge het in Westerse gemeenskappe meer as honderd jaar geneem om plaas te vind maar slegs twee tot drie dekades in ontwikkelende gemeenskappe soos Taiwan en Barbados. Die bevolking van die landelike Victoria-Oosdistrik: in die Oos-Kaapprovinsie is gekies as 'n gevalstudie daarvan in Suid- Afrika. Veranderinge in die reproduktiewe gedrag van vroue in hierdie gemeenskap word oor 'n periode van twee-en-twintigjaar beskryf Die basisjaar van die studie is 1978 en data is ingesamel tot en met 2001. Veranderinge het veral toegeneem vanaf 1988. Statistiese-beskrywende ontleding is gedoen ten opsigte van patrone van verandering in veranderlikes soos die ouderdom by die skenk van geboorte, geboorte-spasiëring, die gemiddelde aantal geboortes per vrou, fertiliteitsregulering en die aantal kinders ooit gebore. Variasies in patrone is ook na aanleiding van huwelikstaat en beroep bepaal. Inligting aangaande hierdie veranderlikes is verky vanaf rekords wat by hospitale en klinieke gehou word. Fokusgroeponderhoude is ook onderneem waarvolgens vroue se eie beskrywings en ervarings aangaande die genoemde veranderlikes verkry is. Groepe is saamgestel volgens verskeie ouderdomskohorte en huwelikstaat. Die navorsingsmetodologie behels dus 'n kombinasie van kwantitatiewe en kwalitatiewe benaderings. Die bevindings bevestig 'n patroon van fertiliteitsafhame wat deur Caldwell as die Afrikapatroon beskryf word en afwyk van die Europese en Asiatiese patroon. Dit word gekenmerk deur 'n progressiewe vertraging in die aanvang van geboorte-skenk, afhame in die gemiddelde aantal geboortes oor al die ouderdomskohorte en word geassosieer met kontraseptiewe toegankliheid. Die hoë voorkoms van buite-egtelike geboortes in die Victoria-Oosdistrik onderskei egter die bestudeerde bevolking van die poligame Afrika gemeenskappe waarop Caldwell die Afrika-oorgangstipe gebaseer het. In hierdie opsig vertoon die bevolking eerder ooreenkomste met ontwikkelende gemeenskappe m Suid-Amerika, die Karibbiese Eilande, Botswana en die meer onlangse Europa. Die bestudeerde bevolking vertoon uiteenlopende patrone van binne-egtelike en buite-egtelike geboortes met die binneegtelike patroon meer in ooreenstemming met die Afrika-patroon. Die hoë voorkoms van buite-egtelike geboortes domineer egter die algehele patroon en kan beskou work as die hoof bydraende faktor in the afhemende fertiliteit wat waargeneem is. Die implikasies hiervan moet egter veel dieper studie ondergaan alvorens verdere vergelykings met die bogenoemde gemeenskappe gemaak kan word

DEVELOPMENT DEBATE AND PRACTICE: A situational appraisal of demographic data utilisation in planning in the Eastern Cape province

The relationship between population and development is frequently highlighted in international debates as signifying that changes in population size, age and gender structures, settlement patterns and other population characteristics have implications for public policy planning and for developing evaluation indicators. This study explores the accessibility, quality, userfriendliness and other aspects of demographic data from a planning perspective. Planners from South Africa's Eastern Cape provincial Departments of Education and Health were interviewed and the policy documents were studied to determine how they incorporate population variables. The findings indicate dissatisfaction among planners with the quality of available demographic data at sub-national levels, particularly for the smaller geographic units - regions, districts and villages. Inadequate coordination of data compilation and evaluation is another common perception. There is consensus on the potential contribution of demographic data to improved planning, and recommendations for improving demographic data accessibility and use were made.

The historical evolution of demographic data compilation, evaluation and use in South Africa

The compilation and evaluation of demographic data in South Africa have advanced over the years, despite a variety of socio-political constraints characterised by exclusions of entire population groups, poor cooperation in data compilation by individuals and inadequate institutional capacity for the compilation of data for the black population. Data compilation proceeded unevenly for the component racial population groups, and the use of demographic data was informed by separatist ideology. Supportive legislative measures were not responded to appropriately owing to political and social realities. The advent of democracy in South Africa in 1994 opened new vistas and challenges for developments, based on a new ideological orientation and the foundations that were put in place over the years. Research and monitoring of progress in this area are now mandatory.

Development of Urban, Human, Environmental & Technological Systems: DEV 222

Development of Urban, Human, Environmental & Technological Systems: DEV 222, supplementary examination January 2010

Development of Urban, Human, Environmental & Technological Systems: DEV 222

Development of Urban, Human, Environmental & Technological Systems: DEV 222, supplementary examination January/February 2010