A comparative study of the health of black preschool children living in the Umtata district of Transkei
The purpose of this study was to assess the state of child health by comparing pre-school children from three geographic zones in the Umtata district of Transkei. The study area comprised' clusters from urban, peri-urban and rural areas for comparari -e purposes. Ninety clusters of 12 pre-schoolchildren each were demarcated using a stratifie . proportional cluster sampling technique thus giving a sample size of 1080 children. Information collected included the children's anthropometric measurements [weight and height], their immunisation status, the family's socioeconomic status and the maternal/guardian's knowledge, attitudes and practices regarding the GOBI package. The child's place of birth, maternal education and paternal SUPPOl:t were also assessed. Twenty one percent of children had been born at home. Many mothers were married but few stayed with their husbands in rural areas because of migration for employment. Diarrhoea was prevalent (2 week period prevalence) in all three zones ranging from 18% in urban to 25% in peri-urban areas. But while 72%mothers/carers knew about ORT and 56% had used it to treat diarrhoea, only 3% knew how to prepare the solution properly. Breastfeeding was practised early in life but by O'1eyear of age 7S% of mothers had stopped with 55% starting supplementary feeds at one month of age. Ninety percent of all children were on supplementary feeds by 4 months of age, Rural mothers generally breastfed longer than others. Regarding malnutrition, 10% of children were underweight [ranging from 8% in urban to 10% ill peri-urban], 26% were stunted [ranging from 14% in urban to 34% in rural areas] and 4% had acute PEM [wasting). Nutritional status was based on Waterlow's classification. Regarding socioeconomic status, the monthly per capita food expenditure [MPCFE] was used and the lognormal distribution showed that 50% of all children came from homes spending R21.00 or less per person on food per month. The socioeconomic impact associated with urbanisation and rural-urban migration for employment is discussed. Reasons for poor child health were examined and possible practical interventional recommendations are made to promote child health in the face of rapid urbanisation.
A dissertation submitted to the Faculty of Medicine, University of the Witwatersrand, in fulfilment of the requirements for degree of Master of Science in Medicine. Johannesburg 1994.