Soweto communities have identified lack of stable income, lack of social farming and high rate of food waste as the underlying causes of malnutrition in SA's biggest township.
This is according to a three-year study by the South African Medical Research Council (SAMRC) and a group of social scientists at the University of the Witwatersrand which focused on improving nutrition for mothers and children from the perspective of communities.
One of the researchers, Agnes Erzse, said the study focused on improving nutrition from the perspective of communities, rather than scientists or health workers, as decisions are left to policymakers and there’s little input from people on the ground.
“We engaged both men and women in group exercises (54 in total) from the community, focusing on selecting programmes to improve nutrition. The exercise, called CHAT, involved collective decision-making, where participants received a budget to buy interventions from a list of options. It offers a practical way to involve the public in making healthcare decisions,” explained Erzse.
"Five programmes were 'nutrition-specific' (directly influenced the immediate causes of malnutrition) and delivered through the healthcare system (pregnancy supplements), whilst nine programmes were 'nutrition-sensitive' (addressed the underlying causes of nutrition) and accessed in non-health sectors (extended paid maternity leave)," Erzse added.
She said the respondents proposed providing school breakfast, paid maternity leave, improved food safety and establishing community gardens and clubs as a solution to fight malnutrition.
She said poor maternal and child nutrition is a major cause of ill health and poor human development. She added that the study was designed to put communities into the shoes of policymakers when it comes to decision-making on limited health budgets.
"Malnutrition effects such as stunted growth and obese babies affect children under the age of five and more mothers than the national average, suggests the need for additional services programmes.
"Additionally, they prioritised reducing the price of healthy food and ensuring that food sold in their surroundings was safe and hygienic. These factors were influenced by daycare, creches, schools and the food environment in Soweto,” said Erzse.
She said the research was aimed at investigating potential issues and gaps in current nutrition strategies.
“It took really long, we started in 2019 with discussions with groups of men and women in Soweto, identifying barriers to ensuring mothers and children's well-being in their communities and brainstorming possible solutions to these nutritional gaps.
"Then discussions led to the development of programme options and evidence that these programmes could work in real life. Policymakers were consulted to ensure feasibility for these solutions," explained Erzse.
She added that after developing a list of potential programmes, they designed materials for a board game exercise, CHAT.
“The final step involved putting communities in the shoes of policymakers and asking them how to allocate limited resources. The exercise aimed to understand if communities had more say in how to allocate public funds, as per South Africa's Constitution, in what ways would they use these resources. This exercise aimed on focusing on how they perceive nutrition in their communities being improved,” said Erzse.
Erzse mentioned that other studies done by Wits have shown that extending child support grants during pregnancy can save lives and prevent complications from unhealthy food choices.
“However, it is not enough to protect individuals from poor and unhealthy food and beverages. Advertisements often give false images of nutritious food, convincing people to rely on quick, convenient, sugary alternatives,” she said.
Erzse said the success of the research solely depended on them listening to the communities.
“The value of listening to communities is crucial, as they are at the end of services and know what works and what doesn't. Some services are not working as well as they should be, and policymakers should be aware of these gaps,” said Erzse.
Residents reveal malnutrition causes in Soweto
Study seeks to find solutions for lack of healthy food
Image: Chayakorn Lot/123rf.com
Soweto communities have identified lack of stable income, lack of social farming and high rate of food waste as the underlying causes of malnutrition in SA's biggest township.
This is according to a three-year study by the South African Medical Research Council (SAMRC) and a group of social scientists at the University of the Witwatersrand which focused on improving nutrition for mothers and children from the perspective of communities.
One of the researchers, Agnes Erzse, said the study focused on improving nutrition from the perspective of communities, rather than scientists or health workers, as decisions are left to policymakers and there’s little input from people on the ground.
“We engaged both men and women in group exercises (54 in total) from the community, focusing on selecting programmes to improve nutrition. The exercise, called CHAT, involved collective decision-making, where participants received a budget to buy interventions from a list of options. It offers a practical way to involve the public in making healthcare decisions,” explained Erzse.
"Five programmes were 'nutrition-specific' (directly influenced the immediate causes of malnutrition) and delivered through the healthcare system (pregnancy supplements), whilst nine programmes were 'nutrition-sensitive' (addressed the underlying causes of nutrition) and accessed in non-health sectors (extended paid maternity leave)," Erzse added.
She said the respondents proposed providing school breakfast, paid maternity leave, improved food safety and establishing community gardens and clubs as a solution to fight malnutrition.
She said poor maternal and child nutrition is a major cause of ill health and poor human development. She added that the study was designed to put communities into the shoes of policymakers when it comes to decision-making on limited health budgets.
"Malnutrition effects such as stunted growth and obese babies affect children under the age of five and more mothers than the national average, suggests the need for additional services programmes.
"Additionally, they prioritised reducing the price of healthy food and ensuring that food sold in their surroundings was safe and hygienic. These factors were influenced by daycare, creches, schools and the food environment in Soweto,” said Erzse.
She said the research was aimed at investigating potential issues and gaps in current nutrition strategies.
“It took really long, we started in 2019 with discussions with groups of men and women in Soweto, identifying barriers to ensuring mothers and children's well-being in their communities and brainstorming possible solutions to these nutritional gaps.
"Then discussions led to the development of programme options and evidence that these programmes could work in real life. Policymakers were consulted to ensure feasibility for these solutions," explained Erzse.
She added that after developing a list of potential programmes, they designed materials for a board game exercise, CHAT.
“The final step involved putting communities in the shoes of policymakers and asking them how to allocate limited resources. The exercise aimed to understand if communities had more say in how to allocate public funds, as per South Africa's Constitution, in what ways would they use these resources. This exercise aimed on focusing on how they perceive nutrition in their communities being improved,” said Erzse.
Erzse mentioned that other studies done by Wits have shown that extending child support grants during pregnancy can save lives and prevent complications from unhealthy food choices.
“However, it is not enough to protect individuals from poor and unhealthy food and beverages. Advertisements often give false images of nutritious food, convincing people to rely on quick, convenient, sugary alternatives,” she said.
Erzse said the success of the research solely depended on them listening to the communities.
“The value of listening to communities is crucial, as they are at the end of services and know what works and what doesn't. Some services are not working as well as they should be, and policymakers should be aware of these gaps,” said Erzse.
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