Household deprivation and its relationship to food intake and nutritional status of children 6-13 years in rural Queenstown, Eastern Cape, South Africa

Abstract

The study was conducted among 200 children aged six to 13 years in rural Komani, formerly known as Queenstown within the district of the Enoch Mgijima local municipality in South Africa which includes Lesseyton, Birch Farm and Machibini. Three hundred and eighty five million children worldwide lived in extremely poor households, and 19.5% of children who live in developing countries lived on less than $1.90 a day. Children who lived in extremely poor households were found mostly in developing countries. Sub-Saharan Africa had the highest rates of children that lived in extreme poverty-stricken circumstances at just below 49.0%. Poverty in children results in many adverse effects such as stunted growth, lack of education, limited access to healthcare and nutrition. Aim: This research aimed to evaluate household deprivation using the acute multidimensional poverty index (AMDPI) and its relationship to the food intake and nutritional status of children aged 6-13 years. Methods: A valid and relevant socio-economic demographic questionnaire was completed in a face-to-face interview situation with the children’s parents and caregivers to determine the socio-economic demographic background of the participants. A valid and reliable food frequency questionnaire was also completed where the parents/ caregivers and the children were asked to identify foods that the children had consumed in the last seven days to determine the dietary diversity of the participants. In addition, the participant’s average anthropometric measurements were obtained by measuring the child’s weight and height in order to determine each participant’’s height-for-age and BMI-for-age and analysed using the WHO Anthroplus. Results: It was discovered that the majority (37.0%) of the households in the three rural areas of Komani (Queenstown) were headed by the grandmothers followed by the mothers (27.5%) and the fathers (20.0%). Food insecurity was prevalent in 83.6% of the households where the parent’s/ caregivers explained that they sometimes did not have money to purchase food. The low per capita income of the households of R12 07.94 - R18 030.00 per annum, compared to South Africa’s GDP per capita of $6.100 (R107 970) income, indicated that the households lived below the poverty line. These households achieved a mean acute multi-dimensional poverty index (AMPI) score of 24.72 out of the 30.0% cut-off point set by Alkire and Santos (2010), indicating that 82.4% of the households were poor. The mean energy intake for boys and girls (six to eight years) of 5474.23kJ was inadequate compared to the recommended Estimated Energy Requirement (EER) of 7316kJ and 6896kJ, whilst both boys and girls ages nine to 13 years met their EER. In addition, all the children exceeded the Recommended Dietary Allowance (RDA) for both protein and carbohydrate. However, none of the children met the Adequate Intake (AI) for total dietary fibre. This was evident in the top 20 foods consumed by the children with the cereal group food items, namely meal, samp and beans, rice and bread all being in the top ten most consumed foods, with fat-containing food items being evident in all three age categories; indicating that the children’s diets were mainly energy-dense. Overall, the total fruit and vegetable intake of the children was substantially poor measured against the recommended goal set by the WHO of ≥400g/day, with a per capita intake per day of 60.7g (children six to eight years), 51.1g (girls nine to 13 years), and 38.3g (boys nine to 13 years). Conclusion Factors such as unemployment, lack of education and poverty all contributed to household food insecurity and poor dietary intake. This was also evident in the children’s low fruit and vegetable intake with a high intake in carbohydrate-based food items such as maize, bread, potatoes, samp and beans, indicating that the group consumed a low food variety. Although only a low prevalence of malnutrition was found in the children, many of the households were food insecure, this was further indicated by the low per capita income and low AMPI score achieved by the households, which meant that, according to the Alkire-Foster method, the households were acute multi-dimensionally poor.