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To assess type, nutrient profile and cost of food items sold by informal vendors to learners; and to determine nutrient content of corn-based processed snacks frequently sold.
Quintile 1 to 3 schools (n 36) randomly selected from six education districts; Eastern Cape, South Africa.
Informal food vendors (n 92) selling inside or immediately outside the school premises.
Food items sold at most schools were corn-based processed snacks (94 % of schools), sweets (89 %), lollipops (72 %) and biscuits (62 %). Based on the South African Nutrient Profiling model, none of these foods were profiled as healthy. Foods less commonly sold were fruits (28 % of schools) and animal-source foods; these foods were profiled as healthy. Mean (sd) energy cost (per 418 kJ (100 kcal)) was highest for animal-source foods (R2·95 (1·16)) and lowest for bread and vetkoek (R0·76 (0·21)), snacks (R0·76 (0·30)) and confectionery products (R0·70 (0·28)). The nutrient profiling score was inversely related to the energy cost of the food item (r = −0·562, P = 0·010). Compared with brand-name corn-based processed snacks, non-branded snacks had lower energy (2177 v. 2061 kJ; P = 0·031) content per 100 g. None of the brand-name samples contained sucrose; six of the nine non-branded samples contained sucrose, ranging from 4·4 to 6·2 g/100 g.
Foods mostly sold were unhealthy options, with the healthier food items being more expensive sources of energy.
To explore the perceptions of educators from the Western Cape Province about the feasibility of implementing South African food-based dietary guidelines (FBDG) in the national curriculum of primary schools.
Combined quantitative and qualitative methods. We report on the quantitative component.
Twelve public primary schools of different socio-economic status in three education districts of the Western Cape: Metro Central, Metro East and Cape Winelands.
Educators (n 256) participated in the self-completed questionnaire survey.
Educators assessed that FBDG were appropriate to South African schoolchildren (94%), could be used as an education tool (97%) and fill gaps in the current curriculum about healthy dietary habits (91%). Besides Life Orientation, FBDG could be taught in other learning areas from grades 3 to 7 (9–13 years old). Important barriers to implementing FBDG in the curriculum were educators’ workload (61%), insufficient time (46%), learners’ disadvantaged background (43%) and educators’ lack of knowledge (33%). Other approaches to teach children about FBDG included linking these to the National School Nutrition Programme (82%), school tuck shops (79%), parent meetings (75%), school nutrition policy (73%) and school assembly (57%). Educators in high-income schools perceived that learners’ lifestyle was significantly worse (P < 0·001) and that tuck shops and the school assembly were the best means to teach pupils about FBDG (P < 0·001 and P < 0·05).
Implementing FBDG in the national school curriculum is seen as important together with optimizing the school physical environment. Key factors required for successful implementation in the curriculum are sufficient educational materials, adequate time allocation and appropriate educator training.
To identify and describe factors associated with food shop (known as tuck shop in South Africa) and lunchbox behaviours of primary-school learners in South Africa.
Analysis of data collected in 2008 from a cross-sectional survey.
Sixteen primary schools in the Western Cape, South Africa.
A total of 717 grade 4 learners aged 10–12 years.
A 24 h recall established that 69 % of learners carried a lunchbox to school and 49 % had consumed at least one item purchased from the school food shop/vendor. Most lunchboxes contained white bread with processed meat, whereas the most frequent food shop/vendor purchase comprised chips/crisps. Learners who carried a lunchbox to school had significantly lower BMI percentiles (P = 0·002) and BMI-for-age (P = 0·034), compared with their counterparts. Moreover, they were younger, had higher standard-of-living and dietary diversity scores, consumed more meals per day, had greater self-efficacy and came from predominantly urban schools, compared with those who did not carry a lunchbox to school. Learners who ate food shop/vendor purchases had a lower standard-of-living score and higher dietary diversity and meal scores. Only 2 % of learners were underweight, whereas 19 % were stunted and 21 % were overweight/obese (BMI ≥ 25 kg/m2).
Children who carried a lunchbox to school appeared to have greater dietary diversity, consumed more regular meals, had a higher standard of living and greater nutritional self-efficacy compared with those who did not carry a lunchbox to school.
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.
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.
Duncan Village, a low socio-economic urban settlement in East London, South Africa.
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.
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.
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.
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