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Theses and dissertations (Applied Sciences)

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    Development of nutrition, healthy eating and food preparation guidelines for child and youth care centres in KwaZulu-Natal, South Africa
    (2023-05) Chibe, Mumsy Evidence; Napier, Carin E.
    Background 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. Conclusion 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.
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    Menu adequacy and nutritional status of children aged 6-19 years residing in child and youth care facilities in Durban
    (2022) Mbambo, Thembelihle Jessica Sibusisiwe; Napier, Carin E.
    The primary function of Child and Youth Care Facilities (CYCFs) is to provide a safe and secure environment run by trained and capable child and youth-care workers while the parents may not be capable of taking care of their children for various reasons. For children 6 - 19 years of age, the meals should provide at least 60-100% of the daily nutritional requirements. Studies worldwide have shown that child malnutrition and lack of access to healthy foods is still one of the biggest contributors to child mortality. AIM The main objective of the study was to analyse the nutritional adequacy of the menus, the food variety and the nutritional status of 6–19 year-old children residing in child and youth care facilities in Durban. METHOD Four CYCFs were randomly selected where the sample population consisted of (n=211) children between the ages of 6-19 years. The anthropometric measurements for weight and height were collected to determine BMI-for-age and height-for-age. The researcher also collected menus and recipes for analysis using Food Finder® version 3 and also conducted plate waste studies to analyse food wastage. The sample population consisted of (n=22) Child and Youth Care Workers (CYCWs) who completed the FFQ, the sociodemographic questionnaire and the nutrition knowledge questionnaire. Trained fieldworkers assisted in the interview process and the total sample size resulted in (n=233) participants. RESULTS The anthropometric indices showed a low prevalence (9.3%; n=7) of severely stunted children and stunted (9.3%; n=7) children amongst the boys. None of the children in this study were affected by wasting; however, the study indicated that 15.3% (n=21) of the girls were overweight and 16.7% (n=23) of the girls were obese. The results reported that the children were served an average portion size of 195- 287.41g of starchy foods, and the portion sizes of vegetables were below the recommended daily requirements resulting in poor micronutrient intake. The FVS in the CYCFs indicated that the highest number of individual foods consumed was between 20-40 individual foods and this indicated a medium food variety score. The results of the socio-demographic questionnaire revealed that most of the CYCWs were mothers who were the head of their households. The majority of the CYCWs had not obtained a relevant tertiary education, 72.7% had obtained a standard 10/ matric certification and 22.7% had obtained a college/FET qualification and none of the CYCWs had received training for food preparation at the CYCFs. The nutrition knowledge questionnaires indicated that more than 50% of the CYCWs answered the questions correctly CONCLUSION Overall, the majority of the meals met 100% of the daily nutrient requirements for carbohydrates, protein and fats. The majority of the micronutrients did not meet 100% of DRIs. RECOMMENDATIONS The CYCWs needed relevant training on food preparation and food handling as well as nutrition education to improve their nutrition knowledge. More nutrition interventions should be implemented to help combat nutrition deficiencies.
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    Trans fatty acid content in used vegetable cooking oil and food safety hygiene practices of informal food vendors in Warwick Triangle, Durban
    (2023-05) Rubushe, Mthokozisi; Napier, Carin E.; Mdluli, Phumlane Selby
    Aim: The aim of the study was to determine the food safety and hygiene practices and the safety levels of cooking oil used, by the informal food vendors in the Warwick Triangle Avenue (WTA) to prepare meals to sell to consumers by determining the trans-fatty acid content of the cooking oil used. Objectives: The specific objective of the study is to investigate the oil safety, hygiene practices and food safety knowledge of informal food vendors at the WTA in eThekwini. Methods: A total number of 40 informal food vending outlets, scattered in the WTA, participated in the study. Fried food prepared by vendors in the WTA were either deep-fried or shallow-fried. Therefor the vendors were divided into two groups: 20 deep-frying and 20 shallow-frying groups. This study was descriptive with an analytical component. The data collection exercise was quantitative, using a socio-demographic questionnaire and a food handler’s questionnaire. A detailed observation sheet and a sheet for recording the results of 3MTM oil quality test strips were also used. Used cooking oil samples were collected in small glass bottles for lab analysis. Data was captured in Excel and analyzed using a statistical package for social science (SPSS) version 24 for descriptive statistics. Summary of Findings: Adequate cooking spaces was not present in 70.0% (n=14) of DF vendors and 65.0% (n=13) of SF vendors. Sixty-five percent (n=13) DF and 80.0% (n=16) of the SF vendors did not have access to safe water for food preparation. Most of the DF vendors (40.0%; n=8) kept food for less than 15 minutes and 30.0% (n=6) kept the food for more than 45 minutes. A small number of vendors (10.0%; n=2) kept the food from 30 to 45 minutes, while 20.0% (n=4) kept the food from 15 to 30 minutes. Most of the SF vendors (30.0%; n=6) kept food for more than 45 minutes and 25.0% (n=5) kept the food for less than 15 minutes, and 25.0% (n=5) kept the food between 15 – 30 minutes. A small number of vendors (20.0%; n=4) kept the food for 30 to 45 minutes. Cleaning or removal of rubbish by DF vendors took place once a day in 45.0% (n=9) of the cases, and twice a day in 6.0% (n=30) for the rest of the cases. Cleaning or removal of rubbish took place once a day in 5% (n=1) SF of the vending sites. Only 50.0% (n=10) of DF vendors and 30.0% (n=6) of SF vendors had rubbish bins with tightly fitting lids. Only 10.0% (n=2) of the DF vendors indicated that they clean their utensils during food preparation compared to 25.0% (n=5) of the SF vendors. The researcher's observation reveals that correct cleaning chemicals were not available in all the SF and DF vending sites (100.0%) such as detergent for clothes and sanitizers and dishwashing liquid. All the DF and SF vending sites were not sanitized during food preparation, and 65.0% (n=13) of the areas were not cleaned during food preparation. Forty-five percent (n=9) of the DF vendors changed oil daily, while 30.0% (n=6) changed the oil frequently, with 15.0% (n=3) changing the oil weekly and 10.0% (n=2) changing it seldom. Forty-five percent (n=9) of the DF vendors’ cooking oil was suitable for cooking, 20.0% (n=4) was probably suitable and 20.0% (n=4) was probably not safe depending on the quality of food and 15.0% (n=3) was not safe and had to be discarded. Gas chromatography further revealed that a value of 4.62% for methyl palmate (sample A1) was obtained implying an increase in viscosity, acid value as well as the saturation process. The highest saturation point was observed for samples A11 and A12. This effect implies an increase from C17: 1 (monosaturated) fatty acid to C17: 2 (diunsaturated) fatty acid chains. Additionally, the results obtained indicate that fats and oils experience different degrees of proportionality in saturation during frying or cooking use, with the magnitude of these changes varying from sample to sample. It was observed that most of the DF food handlers did not wash their hands before serving (90.0%; n=18), as 50.0% (n=10) of the DF vending sites did not have water available for food handlers to wash their hands. Conclusion: It was observed that there was no evidence of monitoring of policies and procedures for all SF vending sites (100.0%; n=20) and for the majority (95.0%; n=19) of the DF sites. A high degree of composition is observed in the used frying oil samples. The results indicate high consistency (or repeatability) of used cooking or frying oil from the sampling points of WTA.
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    Food safety practices, nutrition knowledge and menu adequacy at non-registered Early Childhood Development (ECD) centres in the Ntuzuma Area, Durban, South Africa
    (2023-05) Shabangu, Gugu Bongiwe; Grobbelaar, Heleen; Napier, Carin; Ijabadeniyi, Oluwatosin Ademola
    Globally, millions of children are deprived of their right to good nutrition which contributes to child development and nurturing while eliminating preventable diseases that could affect them at their early age. According to the World Health Organisation (WHO), food safety has become a health priority over the years with more than 95% of deaths reported globally due to diarrhoea and dehydration and 40% of these being young children. Food safety is the responsibility of every person who is involved in food handling. In general, food handlers’ mistakes include serving contaminated food, inadequate cooking, heating or reheating of food and allowing the consumption of food from unsafe sources. Children spend more than 50% of their day at an Early Childhood Development (ECD) centre therefore centres need to provide adequate meals and snacks in order to provide for the basic nutritional needs of these children. Nutrition remains an essential element of a child’s health care and nutrients are important for optimum growth, which is why regular small healthy meals for young children should include fruit and vegetables, whole grain and cereals, meat and meat alternatives (fish, legumes). The aim of this study was to investigate the food safety and hygiene practices, and evaluate the current nutrition knowledge of food handlers and also assess the nutritional adequacy of the menus at nonregistered ECD centres. This study also aimed to observe the food handling and hygiene practices of the food handlers and also determine the menu adequacy of meals served to the young children in these non-registered ECD centres. The designing of the research is one of the important steps in conducting a research as it helps structure research questions and objectives that have been outlined to provide a solution. This cross sectional study was of a quantitative nature and data was collected through structured research measuring tools that have been tested for their validity and reliability, and ensuring accuracy in measurements. A list of non-registered ECD centres (n=10) based in the Ntuzuma area was provided to the researcher by the Department of Social Development’s (DSD) Durban office. It must be stated that this list consisted of ECD centres that were not registered with DSD at the time of the study but were in the process of complying with the regulations and requirements stated by DSD, to assist in the sampling process. All ten of the centres were approached by the researcher and they all agreed to participate. Questionnaires and the observation checklist were then piloted in a sample group to establish suitability and adapted if necessary in one ECD centre while the remaining ECD centres formed part of the study (n=9). Eleven participants in total, two of whom were food handlers who assisted the managers when they were not available and nine who were both managers and food handlers formed part of the study. The researcher also conducted a plate waste study to determine the consumption patterns during meal times. Food finder version 2019 software was used to analyse the menu adequacy in each ECD centre by comparing it to the DRIs for children younger than five years old. Data collected from this study showed that food handlers were more knowledgeable on certain aspects of food safety as the majority of the food handlers knew that raw and cooked food needed to be placed separately during storage to prevent cross contamination. The vast majority of the centres had adequate space and utensils for cooking but insufficient chopping boards. Furthermore, simple hygiene practices such as washing of hands after a visit to the toilet and before food preparation were demonstrated by most of the food handlers. However, there was no antibacterial soap available for hand washing and no designated hand washing stations. Knowledge on temperature control was poorly demonstrated as all cooked foods should be kept very hot before serving; however, the food handlers kept their food warm by leaving it in pots on the stove with the lid tightly secured during the holding stage. The data gathered from this study was that food handlers at all the non-registered ECD centres needed to attend intensive formal training on food safety and hygiene practices on all the different aspects of food safety Nutrition knowledge questionnaire showed that majority of the FHs were able to correctly answer most of the questions relating to the South African Food Based Dietary Guidelines. However, it was disappointing that most of the food handlers were not aware that an average of 8 glasses of water a day are recommended to be drunk. The dietary analysis indicated that there was a low consumption of fruits and vegetables and dairy products as most meals lacked essential macro and micronutrients, contributing to the poor nutritional status of the young children. The microbial analysis revealed that the occurrence of Staphylococcus aureus and Escherichia coli was visible on the hands of the food handlers, the chopping boards and the preparation surface areas in each centre before washing but no growth was observed after washing, indicating that the cleaning process was effective. The overall observation assessment suggested that food safety compliance was not implemented. This indicates that thorough food safety and hygiene training is urgently needed. This study aimed to determine the food safety, hygiene practices and nutrition knowledge of all the food handlers, while analysing and assessing the nutrition adequacy of the menus offered to the children in these non-registered ECD centres, and lastly, to observe the food safety practices of food handlers and analyse the food workspaces for bacterial count. More research at non-registered ECD centres in other provinces is crucial in order to compare the results to the results obtained in this study. It is also recommended that other government stakeholders such as the Department of Social Development and the Department of Health be engaged in order to supplement existing knowledge and implement further practical improvements.