Development of a Sesotho health literacy test in a South African context

Background: Research shows that poor health literacy (HL) can be a threat to health and health care. Health literacy is under-researched and poorly understood in developing countries, including South Africa, because of the absence of language and context-specific HL tests. Aim: The researchers aimed to develop an appropriate HL test for use among South African public health service users with Sesotho as their first language. Setting: The test was developed in the Free State Province of South Africa, for use among Sesotho speakers. Methods: Mixed methods were employed to develop the Sesotho Health Literacy Test (SHLT). The process of developing the test was carried out in distinctive methodological steps. Results: The stepwise process set out by identifying abstracts (n = 206) referring to HL tests. Sourcing of HL tests followed a tapered process resulting in the use of 17 HL tests. Elements within a conceptual framework guided HL test item selection (n = 47). Two Delphi sessions assisted in reaching consensus regarding final HL test items (n = 40). The readability testing of the SHLT tested 4.19 on the Coleman­Liau Index score. A context-suitable and comprehensive SHLT ensued from this work. Conclusion: The SHLT assessment instrument development creates a platform for HL testing among Sesotho first language speakers in South Africa. The context-sensitive methodology is entrenched in a theoretical framework, distributing HL test items between identified competencies and related skill dimensions and domains. The methodology can be applied to the development of HL tests for other languages and population groups in developing countries

Body weight, eating practices and nutritional knowledge amongst university nursing students, Eastern Cape, South Africa

Background: Health care workers need to be equipped to deal with the increasing obesity and obesity-related morbidity occurring in developing countries. Objectives: To assess weight status; eating practices and nutritional knowledge amongst nursing students at the University of Fort Hare; Eastern Cape. Method: A cross-sectional descriptive survey was conducted on 161 undergraduate (51 male and 110 female) students of the Department of Nursing Sciences at the University of Fort Hare. Body mass index; waist and hip circumferences and waist hip ratio were determined. Nutritional knowledge and eating practices were investigated by structured intervieweradministered questionnaires. Results: Statically; 49.7were overweight or obese (58.2of the females; 31.4of the males) and 65.2had waist circumferences putting them at risk for non-communicable diseases. Most did not meet the recommendations for intakes from the vegetable group (97.5ate 3 servings per day); the fruit group (42.2ate 2 servings per day); and the dairy group (92.6ate 2 servings per day); whilst 78.3ate ?4 serving per day of sugar or sweets. Most consumed margarine; oil or fat (68.3); sugar (59.0) and bread (55.9) daily; but few reported daily intakes of vegetables (12.4); fruit (23.6); fruit juice (21.2) and milk (15.6). Fewer than 50knew the recommended intakes for vegetables; fruit; dairy; starchy foods and meat or meat alternatives. Conclusions: These nursing students had a high prevalence of overweight and obesity; poor eating habits and inadequate knowledge on key nutrition issues; which may impact negatively on their efficacy as future health ambassadors to the public