Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-29T10:08:45.608Z Has data issue: false hasContentIssue false
  • English
  • Français

Nutritional well-being of young children in Duncan Village, East London, South Africa: accessibility of primary health care clinics

Published online by Cambridge University Press:  02 January 2007

Anniza de Villiers ,
Kholeka Koko-Mhlahlo  and
Marjanne Senekal
Anniza de Villiers
Affiliation:
Department of Physiological Sciences, Stellenbosch University, Private Bag X1, Matieland 7602, South Africa
Kholeka Koko-Mhlahlo
Affiliation:
Department of Social Work, Stellenbosch University, South Africa
Marjanne Senekal*
Affiliation:
Department of Physiological Sciences, Stellenbosch University, Private Bag X1, Matieland 7602, South Africa
*
*Corresponding author: Email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective

The aim was to contribute to the nutritional well-being of young children living in Duncan Village by investigating factors that influence clinic attendance of mothers and to formulate recommendations for optimisation of accessibility of primary health care (PHC) clinics in the area.

Design

PHC clinic accessibility was evaluated by assessing the experiences of mothers who attended clinics in the area as well as the experiences of health care workers (HCWs) in these clinics of service delivery and its recipients (mothers/children), using the focus group technique. The ATLAS/ti program was used to analyse the data in the following steps: preparation and importing of the data, getting to know and coding the data, retrieval and examination of codes and quotations, creation of families and creation of networks.

Setting

Duncan Village, a low socio-economic urban settlement in East London, South Africa.

Subjects

Focus group discussions (four to seven participants per group) were conducted with four groups of mothers who do not attend PHC clinics, six with mothers who do attend the clinics (including pregnant women) and four groups of HCWs.

Results

Four networks that provide a summary of all the major trends in the data were created. The results clearly indicate that mothers in Duncan Village perceive and/or experience serious problems that make it difficult for them to attend clinic and even prevent them from doing so. These problems include both the way they are treated at the clinics (especially the problem of verbal abuse) as well as the actual services delivered (no medicines, no help, disorganised, long waiting periods, being turned away). The main problem experienced by the HCWs with service delivery seems to be a heavy workload, as well as the fact that many mothers do not come for follow-up visits.

Conclusion

Efforts to increase the accessibility of PHC clinics in Duncan Village should focus on improving the relationship between mothers and HCWs and the heavy workload experienced by these workers.

Keywords

Primary health care clinicsAccessibilityNutrition educationMothersYoung children
Type
Research Article
Information
Public Health Nutrition , Volume 8 , Issue 5 , August 2005 , pp. 520 - 532
Copyright
Copyright © The Authors 2005

References

1World Health Organization (WHO). Strategic Directions for Improving the Health and Development of Children and Adolescents. Geneva: WHO, 2002.Google Scholar
2United Nations Administrative Committee on Coordination, Sub-committee on Nutrition (ACC/SCN). Fourth Report on the World Nutrition Situation . Geneva: ACC/SCN in collaboration with International Food Policy Research Institute, 2000.Google Scholar
3South African Vitamin A Consultative Group (SAVACG). Children Aged 6 to 71 months in South Africa, 1994: Their Anthropometric, Vitamin A and Iron Status. Medical Update, Vitamin Information Centre, No. 26, Parts I and II. Johannesburg: SAVACG, 1996.Google Scholar
4Labadarios, D, ed. The National Food Consumption Survey (NFCS): Children aged 1–9 years. Stellenbosch: Department of Health, 2000.Google Scholar
5Mahlalela, X, Rohde, J, Meidany, F, Hutchinson, P, Bennett, J. Primary Health Care in the Eastern Cape Province: 1997–2000. East London: Department of Health, 2001.Google Scholar
6Buffalo City Municipality. Buffalo City Municipality Primary Health Care Report. East London: Buffalo City Municipality, 2003.Google Scholar
7Bank, L, Jekwa, M, Lujabe, P, Mlomo, B. Small Business Development in Duncan Village: Towards a New Development Framework. East London: Institute of Social and Economic Research, Rhodes University, 1996.Google Scholar
8Chelala, C. Environmental Impact on Child Health. Washington, DC: Pan American Health Organization, 2000.Google Scholar
9United Nations Children's Fund (UNICEF). The State of the World's Children 1998. New York: Oxford University Press for UNICEF, 1997.Google Scholar
10De Villiers, A, Senekal, M. Determinants of growth failure in 12–24-month-old children in a high-density urban slum community in East London, South Africa. European Journal of Clinical Nutrition 2002; 56: 1231–41.CrossRefGoogle Scholar
11United Nations Children's Fund (UNICEF). UNICEF's Priorities for Children 2002–2005. New York: UNICEF, 2002.Google Scholar
12United Nations Children's Fund (UNICEF). Baby Friendly and Beyond: Integrated Care for Mother and Child. A publication of the Baby-Friendly Hospital Initiative. New York: UNICEF, April/June 2002.Google Scholar
13Allen, LH, Gillespie, SR. What Works? A Review of the Efficacy and Effectiveness of Nutrition Interventions. Geneva: United Nations Administrative Committee on Coordination, Sub-committee on Nutrition in collaboration with the Asian Development Bank, 2001.Google Scholar
14Shearley, AE. The societal value of vaccination in developing countries. Vaccine 1999; 17: S109–12.CrossRefGoogle ScholarPubMed
15United Nations Children's Fund (UNICEF). Strategy for Improved Nutrition of Children and Women in Developing Countries. Policy Review Paper E/CEF/1990/1.6. New York: UNICEF 1990; 5–36.Google Scholar
16Dickin, K, Griffiths, M, Piwoz, E. Designing by Dialogue: A Program Planners' Guide to Consultative Research for Improving Young Child Feeding. Support for Analysis and Research in Africa. Washington, DC: US Agency for International Development, Bureau for Africa, Office of Sustainable Development, 1997.Google Scholar
17Fern, EF. Advanced Focus Group Research. Thousand Oaks, CA: Sage, 2001.CrossRefGoogle Scholar
18Babbie, E, Mouton, J. The Practice of Social Research. Cape Town: Oxford University Press, 2001.Google Scholar
19Muhr, T. Atlas/ti: Short User's Manual. Berlin: Scientific Software Development, 1997.Google Scholar
20Kanani, SJ. Introducing participatory research to university and government health systems: some experiences from India. In: de Koning, K, Martin, M, eds. Participatory Research in Health: Issues and Experiences. Johannesburg: National Progressive Primary Health Care Network, 1996.Google Scholar
21De La Rocha, GM, Grinspun, A. Private adjustments: households, crisis and work. In: Grinspun, A, ed. Choices for the Poor: Lessons from National Poverty Strategies. New York: United Nations Development Programme, 2001.Google Scholar
22Leon, M. Perceptions of health care quality in Central America. International Journal for Quality in Health Care 2003; 15: 66–71.CrossRefGoogle ScholarPubMed
23Fonn, S, Xaba, M, Tint, K, Varkey, S. Maternal health services in South Africa. South African Medical Journal 1998; 88: 697–702.Google ScholarPubMed
24Haddad, S, Fournier, P, Machouf, N, Yatara, F. What does quality mean to lay people? Community perceptions of primary health care services in Guinea. Social Science & Medicine 1998; 47: 381–94.CrossRefGoogle ScholarPubMed
25Vlassoff, C, Moreno, CG. Placing gender at the centre of health programming: challenges and limitations. Social Science & Medicine 2002; 54: 1713–23.CrossRefGoogle ScholarPubMed
26Fahlberg, LL, Poulin, AM, Girdano, DA, Dusek, DE. Empowerment as an emerging approach in health education. Journal of Health Education 1991; 22: 185–93.CrossRefGoogle Scholar
27Vella, J. Learning to listen/learning to teach: training trainers in the principles and practices of popular education. Convergence 1994; 27: 5–21.Google Scholar
28Lehman, U, Sanders, D. Human resources development. In: South African Health Review. Durban: Health Systems Trust, 2002.Google Scholar