Challenges and strategies to implement exclusive breastfeeding in the selected Districts of Limpopo Province, South Africa: professional nurses´ perspectives.

Introduction: despite the efforts of professional nurses, exclusive breastfeeding rate is very low in South Africa. Per statistic South Africa, EBF rate is 32% with Limpopo Province being rated 8% as one of the lowest in South Africa. Implementation of exclusive breastfeeding required professional nurses´ efforts, lactating mothers, families, and community need information and support from the health care system. The purpose of this study aimed at exploring professional nurses´ challenges regarding implementation of exclusive breastfeeding in Limpopo Province. Methods: qualitative research involving phenomenological design was employed to explore professional nurses´ challenges using one on one, unstructured, in-depth interview with 30 professional nurses; 27 females and three males, working in the six birthing facilities of two selected districts; Vhembe and Waterberg, in Limpopo Province. Results: the three higher order themes emerged were challenges experienced by nurses during promotion of exclusive breastfeeding; findings revealed challenges as cultural and religious beliefs, lack of family/community and health professional support, teen and HIV positive mothers, nurses found to have challenges to implement exclusive breastfeeding. Healthcare system and services such as shortage of staff and lack of proper training on lactation management and perceived measures to promote exclusive breastfeeding suggested by health professionals, which include ongoing health education, door to door campaigns, implementation of policy by health care professionals would promote exclusive breastfeeding strategies that are in place and encourage families and community to support lactating mothers to improve their confident on breastfeeding. Conclusion: professional nurses had challenges in promoting exclusive breastfeeding. An intervention is needed to promote exclusive breastfeeding.

Salt Used for the National School Nutrition Program (NSNP) in Rural Schools of Limpopo Province, South Africa, has Adequate Levels of Iodine.

BACKGROUND: Salt iodisation is considered the most effective long-term public health intervention for achieving optimal iodine nutrition. Effective salt iodisation is a prerequisite for the sustainable elimination of iodine deficiency disorders. The aim of this study was to determine iodine concentration of salt used for the National School Nutrition Program (NSNP). METHODS: A cross-sectional study was conducted in 359 food handlers from Vhembe and Mopani districts of Limpopo Province, South Africa. The questionnaire was administered to solicit data on demographic information, general questions on salt fortification, and iodine nutrition knowledge. After the interviews, two tablespoons of salt used for the NSNP food preparation was collected from 318 schools in small zip-lock plastic bags. The salt samples were coded and stored at room temperature and protected from light and moisture until the time of analysis. Salt iodine concentrations were determined at the North-West University (NWU) in Potchefstroom by means of the iCheck test method. RESULTS: The median iodine concentration of both Mopani (31.65 ppm) and Vhembe (32.56 ppm) districts signified adequate iodine levels. Of 318 salt samples, 113 (71%) samples in Mopani and 104 (65%) in Vhembe had an iodine concentration of 15-64 ppm. A few (6%) food handlers in Mopani and almost half (45.9%) in Vhembe could correctly identify iodated salt as the main source of iodine. Almost half of the food handlers (%) in Mopani and 36.5% in Vhembe did not know which part of body needs iodine for functioning. CONCLUSION: More than 20 years after the implementation of the USI program, the result of the study shows that the international goal of 90% coverage is still far from being realised.

Recommendations for Infant Feeding Policy and Programs in Dzimauli Region, South Africa: Results From the MAL-ED Birth Cohort.

BACKGROUND: There is strong evidence that exclusive breastfeeding (EBF) in the first 6 months of life reduces the risk of diseases in infancy and in later life. OBJECTIVE: To understand the maternal reasoning that influences optimum infant feeding practices of caregivers in semirural communities of Limpopo province. METHODS: Nested qualitative study among mothers in an ongoing birth cohort study was conducted; structured and semi-structured interviews were used to collect data. Data from 234 infants after 6 months of follow-up was included for quantitative analysis. Four focus discussion groups comprising 7 to 10 caregivers were used to obtain perception of mothers on breastfeeding. A semi-structured interview guide was used to stimulate discussions. Thematic content analyses were conducted to identify the main themes that influence breastfeeding practices of caregivers. RESULTS: Over 90% of the caregivers initiated breastfeeding after delivery. However, less than 1% of mothers practiced EBF by 3 months, and none of the children were exclusively breastfed for up to 6 months. All caregivers introduced non-breast milk liquids and solids by the second month of child's life. Common reasons for introducing non-breast milk foods included insufficiency of breast milk production, going back to work or school, and influence by elderly women (mothers/mothers-in-law) and church members. CONCLUSION: Exclusive breastfeeding was not practiced in this community due to cultural and religious beliefs and misinformation. The involvement of elderly women and church members in infant feeding education and promotion programs and the dissemination of breastfeeding information through mobile phones to younger mothers are recommended.

Knowledge and practices of pre-school teachers on growth monitoring program--South Africa.

The aim of this study was to determine knowledge and practices of pre-school teachers on growth monitoring. A quasi-experimental, one-group pre- and post-test intervention study was conducted in eight conveniently selected government subsidized pre-schools in Vhembe and Mopani districts of Limpopo Province, South Africa. Fifteen pre-school teachers participated in the study. An intervention in a form of nutrition education lessons on growth monitoring was developed and implemented. Pre-school teachers completed a knowledge test questionnaire prior to the lessons. The intervention also included the following training skills: procedure to take anthropometric measurements and plotting the Road to Health Chart. About 67% teachers understood the importance of growth monitoring at baseline. The results also showed an improvement 6 months after intervention. All (100%) teachers knew that growth monitoring can be used for diagnosing undernutrition. The results also showed an improvement in skills, such as the procedure to take anthropometric measurements. Knowledge and practices of teachers on growth monitoring were improved by nutrition education 6 months after intervention.