ROTEIN-ENERGY-malnutrition (PEM) is a major cause of morbidity and mortality in young children in Africa. In South Africa, in 1987, to help combating and preventing PEM in the rural black population, the Gold Fields Nutrition Unit was inaugu rated at the Medical University of Southern Africa. In 1987-9, 442 patients (rural/peri-urban) plus their mothers or child carers were admitted, and 406 attended as outpatients. Average age was 15.4 ± 7.6 months, weight 7.0 ± 1.6kg, stay in hospital, 12 ± 10.8 days, and daily weight gain during treatment was 31 ± 48g. Mothers mainly were young and unmarried. Primary causative factors were infections, ignorance, and insufficiency of food. Since results from rehabili tation are usually poor, mothers and carers were taught how best to prepare meals using local foodstuffs. The interventions included teaching and demonstrations of how to grow vegetables, maintain an orchard, a fowl-run, and improve kitchen and laundry facilities. In 1990, in a follow-up of 73 patients, no deaths had occurred within a 12 month period. This far better than usual outcome is being furthered by setting up satellite nutrition clinics.
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References
1.
Anonymous. (1989). South African child mortality rates. Epidemiol Comments16, 1-19.
2.
Anonymous. (1990). Challenges in vital statistics. Indian J. Paediat.57, 5-6.
3.
Bac, M. ( 1986). Evaluation of child health services at Gelukspan Community Hospital, Radithusa, Bophuthatswana, 1976-1984. S. Afr. Med. J.70, 277-280.
4.
Brown, R.E. (1978). Weaning food in developing countries. Am. J. Clin. Nutr.31, 2066-2072.
5.
Cook. R. (1971). Is hospital the place for treatment of malnourished children? J. Trop. Pediat.17, 15-25.
6.
David, C.B. & David, P.H. (1984). Bottle-feeding and malnutrition in a developing country: The 'bottle-starved' baby. J. Trop. Pediat., 30, 159-164.
7.
Director-General, World Health Organization. ( 1985). Women, Health and Development. Geneva : World Health Organization.
8.
Ebrahim, G. (1981). Paediatric Practice in Developing Countries. London: MacMillan Press.
9.
Editorial (1990). Structural adjustment and health in Africa. Lancet, 335, 885-886.
10.
Fildes, V. (1986). Breasts, Bottles and Babies. Edinburgh: University of Edinburgh Press.
11.
Forfar, J.O. (1990). Child health as a world problem. Proc. Roy. Coll. Phys. Edinburgh, 20, 296-309.
12.
Frankish. J.G. (1978). Nutrition rehabilitation in the Transkei. An evaluation . S. Afr. Med. J.53, 507-511.
13.
Franklin, R.R., Bertrand, W.E. & Mock. N.B. (1983). Feeding patterns of infants and young children in Kinshasa, Zaire. J. Trop. Pediat.29, 255-259.
14.
Glatthaar, I.I. (1985). Evaluation of a Nutritional Rehabilitation Programme for Undernourished Pre-School Children. Ph.D. Thesis. Medical University of Southern Africa.
15.
Greenwood, B.M., Bradley, A.K., Byass. P., Greenwood, A.M., Menon, A., Snow, R.W., Hayes, R.J. & Hatib-N'jie, A.B. (1990). Evaluation of a primary health care programme in The Gambia. J. Trop. Med. Hyg.93, 87-97.
16.
Hamill, P.V.V., Drizd, T.A., Johnson, C.L., Reed, P.B., Roche, A.F. & Moore, W.M. (1979). Physical growth: National Center for Health Statistics percentiles. Am. J. Clin. Nutr.32, 607-629.
17.
Jelliffe, D.B. (1968). Infant Nutrition in the Subtropics and Tropics . P48. Geneva : WHO Monograph Series No. 29.
18.
Kaul, M.L. (1985). Serving oppressed communities: The self-help approach . J. Soc. Social Med.12, 205-210.
19.
Musaiger, A.O. (1983). Food habits in Bahrain: Infants' feeding habits . J. Trop. Pediat.29, 248-251.
20.
Obi, J.O. & Osuhor, P.C. (1984). The influence of health education on breast feeding practices in Benin City, Nigeria. Publ. Health Lond.98, 84-88.
21.
Ogambi, A. (1987). Community-based health development: The Saradidi, Kenya experience. Ann. Trop. Med. Parasitiol.81, (Suppl 1), 1-147.
22.
Omololu. A. (1986). Nutritional problems in Nigeria. Voeding47, 112-113.
23.
Palmer. G. (1988). The Politics of Breastfeeding. London, UK: Pandora Press.
24.
Panikar, P.G.K. (1984). Intersectoral action for health — the Kerala case. World Health Forum, 5, 46-48.
25.
Peters, W. & Gilles. H.M. (1989). Nutritional disorders. Part VII. A Colour Atlas of Tropical Medicine & Parasitology. 3rd Ed. London: Wolfe Medical Publications, Ltd.
26.
Richter. L.M., Bac, M. & Hay. I.T. (1990). Psychological aspects of the health care of young children. S.A. Family Practice, Oct: 490-497.
27.
Special Report (1990). Does anyone care? Suffer the little children. Time. Oct 1: 42-50.
28.
Tomkins, A. (1981). Nutritional status and severity of diarrhoea among pre-school children in rural Nigeria. Lanceti, 860-862.
29.
Tumwine, J.K. & Mackenzie, S. (1990). Child survival in a rural area in Zimbabwe: Are we winning? Cent. Afr. J. Med.36, 113.
30.
Van Roosmalen-Wiebenga, M.W., Kusin, J.A. & De With, C. (1986). Nutrition rehabilitation in hospital — a waste of time and money? Evaluation of nutritional rehabilitation in a rural district of South West Tanzania. I. Short term results. J. Trop. Pediat.32, 240-243.
31.
Van Roosmalen-Wiebenga, M.W., Kuslin, J.A. & De With, C. (1987). Nutrition rehabilitation in hospital — a waste of time and money? Evaluation of nutritional rehabilitation in a rural district of South West Tanzania. II. Long term results. J. Trop. Pediat.33, 24-28.
32.
Walker, A.R.P., Fletcher, D.C., Strydom, E.S.P. & Anderson, M. (1955). Food preparations used in weaning urban Bantu infants. Br. J. Nutr.9, 38-41.
33.
Woodward. E. (1987). A Follow-up Study of Children Discharged from a Nutrition Rehabilitation Unit, Thaba'Nchu, Bophuthatswana. M.Sc. Thesis: University of Cape Town.
34.
World Health Organization (1983a). Measuring Change in Nutritional Status. Geneva: World Health Organization.
35.
WORLD HEALTH ORGANIZATION. The Division of Family Health. (1983b). The dynamics of breast feeding. WHO chronicle, 37, 6-10.
36.
World Health Organization Features. (1988a). The Road to Health. Priorities in Health Research . 1-9.
37.
World Health Organization. (1988b). Weaning from Breast Milk to Family Food: A Guide for Health and Community Workers. Geneva: WHO.
