Primary Health Care Facility Infrastructure and Services and The Nutritional Status of Children 0 to 71 Months Old and Their Caregivers Attending These Facilities in Four Rural Districts in The Eastern Cape and Kwazulu-Natal Provinces; South Africa

ABSTRACT

Objective: To assess primary health care (PHC) facility infrastructure and services; and the nutritional status of 0 to 71-month-old children and their caregivers attending PHC facilities in the Eastern Cape (EC) and KwaZulu-Natal (KZN) provinces in South Africa. Design: Cross-sectional survey. Setting: Rural districts in the EC (OR Tambo and Alfred Nzo) and KZN (Umkhanyakude and Zululand). Subjects: PHC facilities and nurses (EC n = 20; KZN n = 20); and 0 to 71-month-old children and their caregivers (EC n = 994; KZN n = 992). Methods: Structured interviewer-administered questionnaires and anthropometric survey. Results: Of the 40 PHC facilities; 14 had been built or renovated after 1994. The PHC facilities had access to the following safe drinking water (EC 20; KZN 25); electricity (EC 45; KZN 85); flush toilets (EC 40; KZN 75); and operational telephones (EC 20; KZN 5). According to more than 80of the nurses; problems with basic resources and existing cultural practices influenced the quality of services. Home births were common (EC 41; KZN 25). Social grants were reported as a main source of income (EC 33; KZN 28). Few households reported that they had enough food at all times (EC 15; KZN 7). The reported prevalence of diarrhoea was high (EC 34; KZN 38). Undernutrition in 0 to younger than 6 month-olds was low; thereafter; however; stunting in children aged 6 to 59 months (EC 22; KZN 24) and 60 to 71 months (EC 26; KZN 31) was medium to high. Overweight and obese adults (EC 49; KZN 42) coexisted. Conclusion: Problems regarding infrastructure; basic resources and services adversely affected PHC service delivery and the well-being of rural people; and therefore need urgent attention