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Title: Development of nutrition, healthy eating and food preparation guidelines for child and youth care centres in KwaZulu-Natal, South Africa
Authors: Chibe, Mumsy Evidence 
Keywords: Child and youth care;Child and youth care centres;Child and youth care workers;Child and youth care managers;Nutrition;Malnutrition;Food-borne Illnesses;Food Safety;Food Handling and Preparation
Issue Date: May-2023
Child and youth care workers (CYCWs) are human service professionals that have constant
contact with the children and youth placed in child and youth care centres (CYCCs). Some
CYCWs work with children are uneducated and under-empowered. Childhood and
adolescence are critical stages in life when physical, social, cognitive, and behavioural
development occur.
Methodologies and Results
The development of the child nutrition, food preparation, food safety, and healthy eating
guidelines in this study was carried out in accordance with the FAO framework used for
planning, implementing, and evaluating. Situational analyses of child and youth care workers
were part of phase 1 of the project (CYCCs). Nine respondents (two child and youth care
managers (CYCMs) and seven CYCWs) from the two CYCCs were chosen. Selfadministration, one-on-one interviews with English-written interview questions that were
translated into IsiZulu, weighing food to determine plate waste, and the collection and
analysis of microbial samples for surfaces, hands, and water were all used to gather data.
Thirty respondents responded to a second survey that was given out in the same CYCCs to
determine the preferred learning materials. The outcomes of this phase improved the success
of the primary study and helped design the guidelines. The results of this phase showed that
all of the respondents had low levels of education, and some had no formal education. The
respondents had a high level of work experience, with 44.4% having more than five years of
experience in the CYCCs. Additionally, 100% of the respondents lacked training in food
safety and hygiene. The observers noticed that food for the older children and adolescents
was kept in the oven or stove for longer than 15 minutes before serving. None of the CYCCs
had appropriate guidelines or procedures in place, nor did they have written and signed
policies and procedures in place for receiving, storing, and serving food, as well as
maintaining good hygiene and adhering to administrative practises. Despite a coliform count
of 57 in the collected water samples, the CYCCs had access to water for drinking and
cleaning utensils. According to the nutrition knowledge results, 88.9% of respondents did not
understand the keys to healthy eating. When 77.9% of respondents suggested that starch
should not be consumed in most meals, this revealed limited knowledge. Respondents were also unaware of how much water they should drink each day, with 66.9%
incorrectly reporting that six or fewer glasses were sufficient. The food served to the children
and youths, which included uPhutu and beef served with potatoes, lacked the variety of
nutrients recommended by the FBDGs. Guidelines were preferred by 46.7% of respondents.
Meanwhile, a sizable proportion of respondents (83.3%) preferred the learning material with
drawings, images, photographs, and words written in isiZulu.
The guidelines were developed based on the literature and phase one findings and presented
to three subject matter experts for content validity. The experts received completed and
language-edited guidelines. The guidelines' organisation and content were subjected to expert
evaluation. They had two to three weeks to read and comment on the guidelines' content,
organisation, structure, and overall aesthetic appeal. Reviews and comments were provided
back to the researcher, who used them to update the guidelines based on advice from the
experts. The guidelines were then revised, published, and translated.
In order to collect data in the two CYCCs from 18 participants (pre-) and 14 participants
(post-) implementation in the same study site(s), the behaviour over time was assessed using
a three-step approach (pre- implementation (phase three), implementation (phase four), and
post-implementation (phase five). the participant's prior knowledge of the guidelines' subject
matter (menu planning, nutritious recipes, nutritional guidelines, food handling, and
preparation). A behavioural change technique was used in the post-implementation phase to
evaluate knowledge change over a ten-month period (the implementation process). Zoom was
used for the interviews with the CYCMs and CYCWs. The discussion for this interview was
facilitated by a video, which was also recorded with the participants' knowledge and consent.
During the 10-month implementation period, participants were reminded once a week via
phone and email to incorporate the guidelines into their day-to-day work activities and to ask
clarification questions. Data from the pre-and post-implementation phases were transcribed
and analysed using thematic analysis. Poor menu planning, failure to prepare nutritious
recipes and follow nutritional guidelines due to limited funds, limited nutrition training, and
limited knowledge of food handling, storage, and preparation were among the key findings
that emerged from the pre-implementation of the guidelines.Guidelines were reported to be useful in the post-implementation phase in terms of menu
planning, food handling and preparation taking into account all food groups, handling of
cutlery and cutlery, proper washing of hands, hair covering, and food storage. Menu
planning, the development of nutritious recipes for children and youths, following nutritional
guidelines, food handling and food preparation, sourcing of ingredients, food preparation
equipment, and personnel required to prepare the food were reported as lessons learned from
the guidelines.
Poor hygiene and food handling procedures among CYCWs were attributed to a lack of skills
training or guidelines prior to implementing the newly developed guidelines. However, there
was a positive impact from the developed guidelines' post-implementation phase, where the
respondents were discovered to have improved menu planning abilities, nutritional guidelines
awareness, and food-handling skills, and could allocate correct portion sizes. The proper
implementation of the guidelines developed in this study could reduce the rate of malnutrition
and foodborne infections caused by poor food handling and preparation.
Thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy in
Food and Nutrition at Durban University of Technology, Durban, South Africa, 2023.
Appears in Collections:Theses and dissertations (Applied Sciences)

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