Abstract:
Many of the world’s children, particularly those living in developing countries, subsist on diets that seldom vary and often do not allow for an adequate intake of the complete range of nutrients required for healthy living. Of concern is the absence of regular consumption of fresh vegetables and fruit that provide vitamin A which, if deficient, impairs children’s growth and development. In South Africa about 21% of children under the age of six years attend crèche facilities on a daily basis. The nutritional state of meals provided to children at many crèches tends to lack micronutrients, particularly vitamin A. Vitamin A deficiency is the main nutritional problem facing crèche children in South Africa today. Underlying causes are unsatisfactory diets restricted in variety and minimal knowledge of optimal dietary practices, a situation exacerbated by a high incidence of food insecurity. Limpopo is a province seriously affected by vitamin A deficiency. A South African study, based on a quantitative research paradigm, was undertaken (April-September 2007) in Thulamela municipality with the aim of developing and implementing nutrition strategies to improve crèche children’s consumption of vitamin A-rich vegetables and fruit, as advocated by an officially recognised food-based dietary guideline. Through convenience sampling, 100 caregivers from 20 crèches in the study area responded to questionnaires and participated in a game. Ongoing observation continued. Information about the participants, their nutrition knowledge and the meals provided was collected following the triple-A cycle approach (assessment, analysis and action). The research process was structured in three phases. Phase one involved a situational assessment and analysis that provided baseline information. Limitations contributing to the problem under investigation were identified and data showed that the children’s intake of vitamin A from vegetables and fruit at crèches was low. This was found to be due to a lack of knowledge and information about vitamin A, coupled with the unavailability and inaccessibility of food primarily due to non-production and affordability. Food preparation, storage and preservation also posed challenges to caregivers. Using evidence from documented studies and the findings from phase one, nutrition strategies were developed and implemented in phase two. Caregivers were shown how to increase the availability and use of foods rich in vitamin A and were encouraged to grow, and use, both cultivated and non-cultivated vitamin A-rich vegetables and fruit. Furthermore, the concept of the food-based dietary guideline “eat plenty of vegetables and fruits everyday” was introduced to the caregivers and became part of the developed nutrition strategies. Follow-up data collected in phase three showed substantial advancement in caregivers’ knowledge and skills. Access, availability and utilisation of vitamin A-rich vegetables and fruit had improved markedly. Flourishing vegetable gardens, planned menus and well prepared meals were concrete evidence, and vegetables and fruit were more frequently served to children. Implementation of the developed nutrition strategies epitomised the envisaged outcome of this study. Based on the research results, important recommendations are made to enhance the appropriate consumption of vegetables and fruit rich in vitamin A, leading to a reduction in disease and death caused by vitamin A deficiency among children.
