Diverging opinions of supplementation programmes between mothers of small children and staff at primary health clinics in the Western Cape Province of South Africa

Abstract

Objective: Nutritional status has remained inadequate among disadvantaged mothers and small children in South Africa. Several supplementation programmes are administered through primary health clinics (PHC). The present study examined the perceptions of mothers who attend PHC and of the PHC staff on the purpose, management and eligibility of the vitamin A and nutritional supplementation components of the Nutrition Supplementation Programme (NSP). Design: Observational study based on anthropometry and questionnaires. Setting: Random selection of ten urban and ten rural PHC from the Western Cape Province of South Africa. Subjects: Mothers (n 176) and their children (n 179) aged ,5 years, and various PHC staff categories. Results: Half (56 %) of the households were classified as food insecure and about one-third of the children were malnourished, as evidenced by stunting, wasting or underweight. A majority of mothers complained about poor information related to the programmes. More than half of the children who were eligible for NSP were not included. In contrast, the staff felt that they managed both programmes well and problems with implementation were mostly attributed to clients. Conclusions: In general, the mothers expressed more dissatisfaction and ignorance about the vitamin A programme and the NSP than was perceived by the staff. This apparent discrepancy might, at least in part, explain why these programmes do not work optimally.

Evaluation of selected aspects of the Nutrition Therapeutic Programme offered to HIV-positive women of child-bearing age in Western Cape Province, South Africa

“…1,3,4 It is clear that the challenges experienced by staff members and clients are obstructing the effective implementation of the programme. It is therefore necessary to take note of the relevant challenges mentioned in this study and strive to solve the problems that, if left unattended, could ultimately result in clients not reaping the benefits of the programme, which in turn will lead to increased government expenditure and depletion of clinic funds in support of a programme that is ineffective, as patients are not reaching the goals set out in the programme.…”

“…4 The questionnaires for both clients and staff members were available in Afrikaans, English and isiXhosa. Clients' experience with and knowledge about the NTP were collected through an intervieweradministered questionnaire containing both option-based as well as open questions.…”

“…2 However, studies have identified problems with implementing the NTP at PHCs, including insufficient financing, unclear responsibilities amongst staff, and knowledge gaps amongst the clients. 3,4,5 South Africa is severely affected by HIV. Even though antiretroviral therapy (ART) coverage increases, the government still faces challenges in combating the spread of the disease.…”

“…Original Research The present study evaluated the NTP at PHCs offering ART, with particular focus on women, as this group had previously not been addressed. 3,4,5 As the NTP relies largely on compliance of the individuals receiving the supplements, it is important to understand how well the programme is implemented at clinic level and adhered to at household level, to ensure that the maximum number of patients reap the full NTP benefits. Therefore the main aim of the study was to establish the opinions, perceptions and current practices of HIV-positive female beneficiaries of the NTP.…”

An assessment of the implementation of the National Therapeutic Programme for pregnant women within the City of Cape Town district

“…[12] It is of concern, however, that only 1 of these 6 women was registered in the NTP. This begs the question: Do nursing personnel know the entry criteria for registration of pregnant women to the NTP?…”