Nutrition Status in Communities

Division of Human Nutrition

The Community Nutrition Security Project (CNSP)

Area/s of Food Security (Access, Availability, Utilization) that project/s fall under:

The CNSP addresses issues related to local availability, access and utilization of food

How does the Project fit in with the FSI Vision?

The overall focus of the CNSP is to deepen understanding of local conditions that contribute to the persistence of malnutrition, and to test policy and program innovations that create conditions for sustainable community nutrition security. The project will thus contribute to the FSI vision through knowledge building about dimensions of the food system that contribute to persistent malnutrition, through the processes it employs to engage with communities to find innovative solutions, and through generating information on what works to create new models of practice in the food system.

Goal/s of the Project

The goals of the CNSP are to understand the socio-economic conditions that contribute to persistent food and nutrition insecurity in rural and peri-urban communities and to design, implement and evaluate interventions that create conditions for sustainable community nutrition security. The project will involve establishing a community nutrition research site in the Winelands (East) and Overberg districts in the Western Cape, in conjunction with Ukwanda, the University’s Rural Health training and research platform, to enable ongoing research and action on nutrition security issues in these districts, and to inform nutrition security policy and programmes in other regions of South and Southern Africa.

Objectives of the Project/s

  • To assess the nutrition security status of selected population groups in rural and peri-urban communities
  • To identify the immediate and underlying causes of nutrition insecurity in the selected groups
  • To mobilize community leaders to address nutrition security issues
  • To design, implement, and evaluate interventions to improve nutrition security in partnership with communities and multi-sectoral partners
  • To generate policy and programme recommendations regarding sustainable community nutrition security

What will the Outcomes of the Project be?

Meeting the vision of the FSI

The project will contribute new knowledge on the local determinants of nutrition insecurity and participatory strategies to create conditions for sustainable nutrition security.

The different areas of Food Security (Access, Availability, Utilization)

The project will give particular attention to household food security, contributing to our understanding of the food choices available to households, the factors that influence their choices and the consequences for the diets and nutritional status of infants, young children, school age children and women of child bearing age. Post graduate research projects being undertaken as part of the CNSP include studies on maternal nutritional status and infant feeding practices; the quality and safety of food options provided through vendors at schools; the contribution of social safety nets such as the child grant to household nutrition security; and the micronutrient status of people living with HIV/AIDS and TB and the potential role of Vitamin D supplementation in the prevention and treatment of tuberculosis in the context of HIV/AIDS.

Publications

The project will deliver research reports and publications in peer-reviewed journals on the nutrition security situation in the communities; on the participatory process used to design and implement interventions; and on the impact of intervention on the conditions that influence community nutrition security.

Policy

The project will involve policy dialogue with local, provincial and national policy makers to disseminate findings and explore alternative policy options to ensure sustainable nutrition security in communities.

Community Impacts

The project seeks to mobilize local community leaders from the private, public and civil society sectors to develop and implement innovative solutions to identified nutrition security challenges. By establishing a research and action platform on nutrition security in the communities, the project seeks to have a long term positive impact on dietary practices and nutritional status of participating communities, to foster a greater awareness of nutrition and food issues among community leaders and in the population at large, and to build community capacity to address local food and nutrition issues.

Input to the Food Security rhetoric

By testing innovative participatory strategies to addressing locally-identified barriers to nutrition security, the project will seek to provide fresh perspectives on the food security discourse in the region.

What is the duration of the study?How many students and researchers are involved?

The initial project duration is three years, with the intention to create a long-term research and action platform in the study communities. In the initial phases, the research team consists of 11 researchers, including three PhD and four Masters students. With additional funding, there will be opportunities for additional Masters and PhD students to join the project.

What funding opportunities exist for your project?

The project team is actively engaged in pursuing funding from local and international funding sources.

The Community Nutrition Security Project (CNSP) of the Division Human Nutrition – Situational Analyses and Preliminary Results

The Community Nutrition Security Project (CNSP) of the Division Human Nutrition conducted a baseline study during 2011 to gather information regarding the nutritional status of young children (0 – 36 months) and their mothers / primary caregivers, and the household and community food security situation in two areas (Zweletemba and Avian Park) of the Breede Valley in the Western Cape in order to describe the relationships between child nutritional status and food security conditions.

During the last year our experience regarding community interaction and community based research methodology increased dramatically. Not only have we come to know both communities intimately, but the University has become well known in both areas for its work in food security. Currently the data that has been analysed and preliminary results are available.

Households from both Avian Park (211) and Zweletemba (241) were randomly selected for participation and a total number of 452 were included in the study. Avian Park is mostly a mixed coloured and African community while Zweletemba is a African community. The majority of respondents in both areas obtained a secondary education and are un-employed. Respondents living in both formal and informal housing were included. Results indicated that the majority of the households were headed by the mother/grandmothers of the children and usually have 4-5 members. In most households the mother/grandmother decides what type of food to buy, and how much money is weekly spent on food. Households have 2–3 people contributing financially and child support grants are accessed by 74.5% (Avian Park) and 67.7% (Zweletemba) of households. The average self-reported income is between R 1 001.00 – R3 000.00, with > R 400 spend weekly on food. Few households indicated that they make use of feeding schemes. Food gardens, livestock rearing and food preservation are rare activities.  It is concluded that the socio-economic situation of households in the two communities is similar and that mothers and grandmothers play an important role in food-related matters and child rearing.  Preliminary data clearly indicate that various opportunities exist to strengthen the local food system.

 

During the baseline study, an industrial engineering post graduate student (Joanita Roos) investigated the food availability and accessibility at spaza shops in these communities.  It is well known that low-income communities often struggle to obtain a nutritious diet and that they consume mainly energy-dense food with poor nutritional quality. The availability and accessibility of food in retail outlets influence dietary choices and therefore the food security status of a community. Joanita used a quantitative food store survey, semi-structured interviews and focus group discussions to collect her data. The sample included 13 spaza shops, 3 chain supermarkets, 3 street vendors, 2 butchers, 2 wholesalers, a community café and an independent supermarket which were randomly selected from the community. Food retail outlet managers and community residents were also included. Results from Joanita’s study indicated that limitations in the variety and quality of food are the main disadvantages of having to rely on the immediate food retail environment within the community.  Residents paid 11% more per month if they were not able to access the nearby town, with its higher variety of food retail outlets. Joanita’s study revealed that community food prices are not the main factor that inhibits food accessibility. The problem extends to the variety and quality of food that is made available in the informal food retail environment.

 

Another student (from the Division of Human Nutrition), Charlene Goosen, investigated the breastfeeding practices in these areas. It is well known that breastfeeding is a key strategy to promote child survival. Non-exclusive breastfeeding during the first six months of life is associated with childhood morbidity and mortality, (especially in resource-limited settings) while mixed feeding (predominant and partial breastfeeding as defined by the World Health Organization) carries the highest risk of HIV transmission. When compared to exclusive breastfeeding, predominant, partial or no breastfeeding increases the risk for pneumonia and diarrhoea related mortality. Charlene conducted a cross-sectional community-based survey with a simple random selection of households. One hundred and forty mothers participated in the study. Her results indicated that 77% (n=108) of the mothers initiated breastfeeding. At the time of the study, 6% (n=8) of the participants breastfed exclusively. Ninety-four percent (n=132) practiced sub-optimal breastfeeding practices, with 36% (n=51) breastfeeding predominantly, 27% (n=38) breastfeeding partially, and 31% (n=43) not breastfeeding at all. Furthermore, 91% (n=88) of the breastfeeding mothers had introduced water, of which 85% (n=75) had done so before the infant was one month old. Thirty-nine percent (n=38) of the breastfeeding mothers had introduced food or infant formula milk, of which 79% (n=30) had done so before the infant was three months old. Charlene concluded that although breastfeeding initiation is common, exclusive breastfeeding during the first six months of life is a rare practice in both communities. Water, infant formula milk and/or food are introduced at an early age.

Tolulope Bolagon (a Master’s degree student studying Clinical Epidemiology) investigated the nutrient consumption of young children in these areas.  Growth and development of children depends on nutrient intakes while deficiency of macro- and micronutrients results in increased morbidity and mortality. Tolulope’s study was also a quantitative cross sectional study with a representative sample of the children. Results from his study indicated that iron intake for male (26.7%) and female (37.5%) children in Avian Park were below the estimated average requirement of these children. In Zweletemba iron levels for males were 18.2% below the estimated average requirements and for females 25.8% below. In Avian Park, selenium was 3.9% above the estimated average requirements for males but 19.2% below for females, whereas in Zweletemba, it was above estimated average requirement by 5.7% for males and above by 2.5% for females. Intakes of all other nutrients were adequate, but intakes varied widely. Although the data suggest that, with the exception of iron, nutrient intakes of children in both communities was adequate, further analysis is required to explain the wide range of intakes and to identify whether intakes of specific nutrients pose a potential problem for some children. These results also needs to be cross checked in future with the individual children’s grow rates and blood markers for iron, selenium and vitamin A before any conclusions regarding the nutritional status of the children can be made.

 

Although preliminary results are available, further in-depth analysis needs to be made to describe the food system and food security situation in these areas. Furthermore, nutritional status of both caregivers and children still needs to be conducted. Qualitative data regarding food availability, access and utilisation and other food related topics also needs to be analysed to provide insight into the residents’ perspectives regarding the food system and food security in the area.

Contact details

Prof. Milla McLachlan, Director: Research and Information
Division of Human Nutrition, Faculty of Health Sciences,
Stellenbosch University, PO Box 19063
Tygerberg, 7505, South Africa
Tel: +27 21 938 9690
Fax: +27 21 933 2991
millam@sun.ac.za

Future areas of research

The team plans to extend the work to rural communities in districts in the Transkei region of the Eastern Cape. Through collaboration on Nutrition, Human Rights and Governance with the universities of Oslo and Akershus in Norway and Kyambogo and Makarere in Uganda, we intend to extend the CNSP to other African countries, by creating opportunities for post-graduate studies on issues related to nutrition security and human rights.

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