Socio-demographic factors and anthropometric status of 0-71-month-old children and their caregivers in rural districts of the Eastern Cape and KwaZulu-Natal provinces of South Africa

Abstract

Objective: To determine nutritional status of 0-71-month-old children and their caregivers, as well as socio-demographics in two provinces in South Africa. Design: Cross-sectional baseline survey. Setting: O.R. Tambo and Alfred Nzo districts in the Eastern Cape (EC), and Umkhanyakude and Zululand (Nongoma and Pongola sub-districts) in KwaZulu-Natal (KZN), South Africa. Subjects: 0-71-month-old children and their caregivers (EC 1 794; KZN 1 988). Methods: Questionnaire and anthropometric survey. Results: The prevalence of childhood malnutrition doubled from the first to second year of life and reached high levels in the EC and Nongoma (KZN). Many caregivers were either overweight or obese (EC 55%; KZN 45%). Initiation of breastfeeding was universal. For infants <6 months, >80% were breastfeeding, and 50% received bottle feeds in addition to breast milk in the EC. Breastfeeding was similar in the two provinces up to the age of 18 months, but differed for 18-<24-month-old children (EC 50%; KZN 33%). Animal products and yellow/orange-fleshed vegetables were not consumed regularly by 2-5-year-old children. Immunisation coverage up till 10 weeks was approximately 90%; measles immunization coverage at 18 months was 40-43%. Toilet facilities (31-96%), tap water (9-38%), electricity (8-51%), single mothers (29-68%) and unemployed husbands (19-55%) varied among provinces. Many households relied on grants for income. In Umkhanyakude, 37% of caregivers had no formal education. Conclusion: Childhood malnutrition and maternal overweight/obesity co-existed. A large proportion of the study population did not have access to basic services. Differences within and between provinces were observed. Nutrition programmes should be flexible, taking into consideration local conditions.