An assessment of the impact of food access on children on the nutrition supplementation programme to combat protein-energy malnutrition.

Abstract

There is an increasing prevalence of food insecurity in South African households, especially in poverty stricken communities. Evidence suggests that children living in households that are food insecure will be subject to undesirable consequences, including poor quality diets and poor health outcomes, resulting in protein-energy malnutrition. Food insecurity, which is often perceived to be the same as food insufficiency, is one of the many underlying causes of malnutrition. Nevertheless, food and nutritional security seem to be a challenge not only in South Africa but in the world at large. The challenge is further exacerbated by the absence of proper tools to measure food insecurity and food insufficiency. In trying to address the two situations, the government developed a Nutrition Supplementation Programme (NSP). The impact of food access (food security) on children registered in the NSP was investigated together with the relationship between nutrition and food security. A mixed methodology was used to collect data including a questionnaire, focus group discussions, anthropometry and key informant interviews. The questionnaire included demographic information, child food insecurity access scale (CFIAS), household food insecurity access scale (HFIAS), household dietary diversity score (HDDS), months of adequate household food provisioning (MAHFP) and a 24-hour recall. The majority (71%) of children and households (52%) were food secure. Energy foods were the main type of food consumed by children compared to other types of food. The top five most consumed food types in the households were cereals (98%), fats and oil (91%), sugar (89%), vegetables (86%) and (86%) spices. The findings showed that more children in the age group from 7-24 months were severely wasted than in any of the other age groups but this age group also contained the highest number of children that had normal weight-for-height. Sixty three percent of children had normal weight-for-height, 29% were severely wasted and 8% were overweight and/or obese. It was found that the NSP is only partially effective in that it only addresses acute malnutrition (wasting) and does not have strategies in place to prevent its recipient’s from relapsing after their six month period on the programme. The programme has more threats, weaknesses, and challenges than opportunities and strengths. It managed to correct the nutritional status of 63% (n= 86) of children who were part of this study. The findings of this study further prove that there is no association between food access (FA) and nutritional security (NS), meaning that food security does not automatically translate to nutritional security. The study also showed that using multiple tools in combination with measuring FS and NS was advantageous as it counterbalanced the deficiencies of a single tool, thereby allowing multiple perspectives to be extracted from the results. The study therefore recommends that the drivers, risks and the interventions put in place to alleviate food and nutritional security should be carefully investigated. To gain a better understanding of food and nutritional security and their complexities will require further research. Linkages with other government departments such as; Department of Social Development, Department of Home Affairs and Department of Agriculture should be revived and strengthened since there are a variety of causes of malnutrition. Finally, there is an opportunity to develop new and improved measurements of food security. When researchers develop new or improve existing tools, they need to consider the fact that food security is complex with many factors influencing it.