Acceptability of community-based growth monitoring in a rural village in South Africa.

In rural areas, a lack of infrastructure often limits the promotion and implementation of community-based nutrition activities. Growth monitoring can potentially provide a platform for the promotion and implementation of community-based nutrition activities, provided that the growth-monitoring program has a high coverage. The aim of this study was to determine the acceptability of a community-based growth-monitoring project in terms of child attendance and maternal attitude. The study was done in a mountainous rural village that lacks health facilities in KwaZulu-Natal, South Africa. Attendance registers from 1996 to 2000 were used to determine the attendance ratio, coverage, adequacy of growth monitoring, and frequency distribution of the age of participating children. In 2001, focus group discussions were used for the qualitative assessment of maternal attitudes. The community-based growth-monitoring project had an estimated coverage of 90%, at least 60% of these children were covered adequately, and attendance was equally distributed over one-year-interval age categories for children aged five years and younger. Community-based growth monitoring can therefore provide a suitable platform for the promotion and implementation of community-based nutrition activities.

Home gardens focusing on the production of yellow and dark-green leafy vegetables increase the serum retinol concentrations of 2-5-y-old children in South Africa.

BACKGROUND: Production of yellow and dark-green leafy vegetables at the household level may provide economically deprived households with direct access to provitamin A-rich foods. OBJECTIVE: The aim of the study was to determine whether the dietary intake of yellow and dark-green leafy vegetables and the serum retinol concentrations of children improve with a home-gardening program. DESIGN: A home-gardening program was integrated with a community-based growth-monitoring system in a rural village. Cross-sectional data were collected at baseline and 20 mo after implementation of the program. The dietary intake, serum retinol concentrations, and growth of 2-5-y-old children and maternal knowledge regarding vitamin A were determined. A neighboring village served as a control village. RESULTS: In the experimental village, 126 home gardens were established, representing approximately one-third of the households. Serum retinol concentrations in the experimental village increased significantly (P = 0.0078), whereas those in the control village decreased significantly (P = 0.0148). At follow-up, children from the experimental village consumed yellow and dark-green leafy vegetables more often and had significantly higher (P = 0.005) serum retinol concentrations (0.81 +/- 0.22 micro mol/L; n = 110) than did children from the control village (0.73 +/- 0.19 micro mol/L; n = 111). Maternal knowledge regarding vitamin A improved significantly in the experimental village (P = 0.001). CONCLUSION: A home-gardening program that was integrated with a primary health care activity, linked to nutrition education, and focused on the production of yellow and dark-green leafy vegetables significantly improved the vitamin A status of 2-5-y-old children in a rural village in South Africa.