A training program for care givers of underweight children in South African schools

Abstract

A recent Report Card on Physical Activity and Health in South African Children and Youth 2010 states that at least four major factors place young children at risk: tobacco use, poor diet, lack of physical activity and facing weight challenges, this then including being overweight, underweight, obese or stunted for one’s age. One of the areas for action and intervention mentioned in the report card is training of teachers. The aim of this study was to increase knowledge, skill and competence in school teachers (care givers) when dealing with underweight in school children. A training program (train-the-trainer) was designed by the researcher. Under nutrition (underweight) is implicated in more than half of all child deaths worldwide. 25.33% of respondents in this study showed signs of underweight highlighting the importance of such training in schools. Using the above statistical data the research embarked on the development, implementation and evaluation of a training program for care givers on underweight prevalence in children in South African schools. The intervention research model of Thomas and Rothman was used in the design and development of the training program. A descriptive design with a quasi-experiment one group pre-test-post test was used in this study. A non parametric statistical test was utilized as data was measured on an ordinal scale (Wilcoxon signed rank test). The care giver training program was implemented over nine weeks consisting of one and a half hour sessions held once weekly. All Foundation Phase teachers were involved in the training (18 Care Givers). The program was implemented with grade one learners at a traditional primary school in Pretoria with a mixed demography and age groups varying between 6 and 8 years of age. Hundred and fifty learners participated in the pre and post test wherein a non probability sampling method was used. The study found that the training program for care givers had a statistically significant effect on underweight prevalence in young children. FMEA profiling in this study confirmed that enhancing care giver knowledge, skill and competence contributes significantly to the changes experienced in children’s underweight status. BMI levels changed significantly. The percentage underweight children dropped from 25.33% to 15, 33% over time. It is recommended that this intervention program be implemented and facilitated by teachers (care givers) forming part of a multi-disciplinary education approach in many South African schools. AFRIKAANS : ‘n Onlangse verslag getiteld “Report Card on Physical Activity and Health in South African Children and Youth 2010” dui aan dat daar ten minste vier hooffaktore is wat jong kinders se gesondheid aan gesondheidsrisiko’s blootstel. Die faktore sluit in rook, ongesonde eetstyl en dieet, gebrekkige deelname aan fisieke aktiwiteit en gewigsuitdagings. Gewigsuitdagings waarvoor Suid Afrikaanse jeug te staan kom sluit in oorgewigvoorkoms, ondergewigvoorkoms, obesiteit en of groeibeperking (stunting). Een van die areas wat in die verslag as voorkoming vir hierdie gewigsuitdagings voorgestel word is opleiding aan opvoeders. Die doel van die studie was dan om kennis, vaardigheid en bekwaamheidsvlakke in onderwysers te verbeter wanneer hulle met ondergewig kinders in hulle sorg werk te bewerkstellig d.m.v ‘n indiensopleidingsprogram (Train-the–trainer). Tans dra ondergewigvoorkoms by tot meer as die helfte van alle sterftes onder kinders wêrelwyd. In hierdie studie is bevind dat soveel as 25.33% van die kinders in die studie tekens van ondergewig getoon het. Dit beklemtoon die belangrikheid van ‘n opleidingsprogram aan die opvoeders van hierdie kinders. Statistiese data soos hier bo genoem is deur die navorser aangewend in die ontwikkeling, implementering en evaluering van die opleidingsprogram aan opvoeders van ondergewig kinders in die skool. Die intervensie navorsingsmodel van Thomas and Rothman is gebruik in die ontwerp en ontwikkeling van die opleidingsprogram. ‘n Beskrywende ontwerp met kwasi-eksperimente, een groep voortoets-natoets is in die studie gebruik. Nie parametriese statistiese toetsing is aangewend en data is gemeet aan die hand van ‘n ordinale skaal (Wilcoxon signed rank toets). Die opleidingsprogram aan opvoeders is oor ‘n tydperk van nege weke geïmplimenteer. Elke opleidingsessie was een en ‘n half uur lank en een maal per week aangebied. Alle grondsalgfase opvoeders was in die opleiding betrokke (n=18). Die program is getoets op graad een leerders wat skoolgaan in ‘n tradisionele laerskool in Pretoria met ‘n gemengde demografie en ouderdomsgroepe het gewissel tussen ses en agt jaar oud. Een honderd en vyftig leerders het aan die voor en natoetsing deelgeneem en ‘n nie waarskynlike metode van insluiting is gebruik. Die studie het bevind dat die opleidingsprogram aan opvoeders van ondergewig kinders in die skool ‘n beduidende invloed gehad het op die voorkoms van ondergewig. FMEA profiele gedoen in die studie het bevestig dat die verbetering van opvoeder kennis, vaardigheid en bekwaamheidsvlakke beduidend bygedra het tot die verandering in die ondergewig status van die kinders. LMI tellings het gedaal vanaf 25, 33% tot slegs 15, 33% oor verloop van tyd. Die navorser is van mening dat hierdie voorkomingsprogram in werking gestel behoort te word en deur opvoeders in die skool gefasiliteer word; om sodoende deel te word van ‘n multi-dissiplinêre onderwysbenadering in Suid Afrikaanse skole.