Assessment of the nutrition component within the Integrated School Health Policy in the Msukaligwa sub-district, Gert Sibande District, Mpumalanga

Thesis (MNutr)--Stellenbosch University, 2018.ENGLISH SUMMARY : INTRODUCTION: The Integrated School Health Policy is a policy adopted by the national Department of Health and the Department of Basic Education. The policy was implemented in 2012. The focus of this policy is on addressing the primary health problems of learners and on implementing interventions that can improve their health and well-being. The aim of the policy is to ensure that school-going children, including those from remote rural areas, have equal access to quality health services. The Integrated School Health Policy strives to provide a healthy school environment, health education and school health services together with projects and outreach programmes that are implemented according to the policy framework. The aim of this study was to assess the implementation of Phase 1 of the policy’s nutrition component in quintile 1 and quintile 2 primary schools in Msukaligwa sub-district, Gert Sibande District, Mpumalanga province. METHOD: An observational, descriptive, cross-sectional study was conducted. The study population consisted of 112 full-time, appointed educators and nine acting headmasters from quintile 1 and quintile 2 primary schools in Msukaligwa. Data were collected through self-administered questionnaires. The outcome measures assessed were nutrition knowledge, perceptions, needs and barriers. Headmasters also completed the Care and Support for Teaching and Learning tool. RESULTS: The mean percentage knowledge score for educators was 88% (SD+/- 15.92) and for the headmasters was 89% (SD +/- 18.16). There was no statistically significant difference (p=0.2959) in the knowledge score between the educators and headmasters. Educators and headmasters perceived school-feeding programmes to increase food availability for school-going children who require adequate food. Need was expressed for the support of provincial and national stakeholders, training of educators on basic knowledge, improvement in infrastructural challenges, rotation, reliable and consistent suppliers, availability of security systems in schools and support in terms of the establishment of vegetable gardens. The study findings revealed the following as barriers that hamper the successful implementation of a comprehensive Integrated School Health Policy: theft, insufficient funds, unreliable suppliers, infrastructural challenges, and limited resources, lack of community participation and unavailability of clean and safe water. In terms of Care and Support for Teaching and Learning, few good practices exist under the health promotion component that includes infrastructure, water and sanitation, social welfare services, psychosocial support, nutrition and self-care. A foundation is already in place regarding safety, curricular support, material support, community support and availability of policies. CONCLUSION: The study provides evidence that the implementation of the Integrated School Health Policy in the Msukaligwa sub-district is inadequate and requires improvement. There is a need for allocating adequate funds and appointing reliable service providers, as well as the monitoring and evaluating the appointed service providers and the entire programme by dedicated persons.AFRIKAANSE OPSOMMING : INLEIDING: Die Geïntegreerde Skoolgesondheidsbeleid (GSGB) is 'n beleid binne die Nasionale Departement van Gesondheid en Departement van Basiese Onderwys en is in 2012 geïmplementeer. Die beleid fokus om beide die primêre gesondheidsprobleme van leerders, sowel as die implementering van intervensies wat hul gesondheid en welsyn kan verbeter aan te spreek. Die beleid het ten doel om te verseker dat skoolgaande kinders, insluitend dié van afgeleë landelike gebiede, gelyke toegang tot kwaliteit gesondheidsdienste het. Die GSGB streef daarna om 'n gesonde skoolomgewing, gesondheidsopvoeding en skoolgesondheidsdienste te voorsien, tesame met projekte en uitreikprogramme wat volgens die GSGB-raamwerk geïmplementeer word. Die doel van hierdie studie was om fase 1-implementering van die GSGB-voedingskomponent in kwintiel 1 en 2 primêre skole in die Msukaligwa subdistrik, Gert Sibande distrik, Mpumalanga provinsie, te assesseer. METODES: `n Waarnemings, beskrywende, deursnee-studie is uitgevoer. Die studiepopulasie het uit 112voltyds aangestelde opvoeders en nege skoolhoofde uit kwintiel 1 en 2 primêre skole in Msukaligwa bestaan. Data is ingesamel deur self-geadministreerde vraelyste. Die volgende uitkomste is gemeet: voedingskennis, persepsies, behoeftes en hindernisse. Die Sorg en Ondersteuning vir Onderrig en Leer instrument is addisioneel voltooi deur die skoolhoof of waarnemende skoolhoof. RESULTATE: Die gemiddelde persentasie kennis telling vir opvoeders was 88% (SD +/- 15,92) en vir die hoofde was 89% (SD +/- 18.16). Daar was geen statisties beduidende verskil (p=0.2959) tussen die kennis telling van die opvoeders en skoolhoofde. Opvoeders en skoolhoofde was van opinie dat skoolvoedingsprogramme die beskikbaarheid van voedsel vir skoolgaande kinders wat voldoende voedsel benodig verhoog. Die behoefte aan ondersteuning deur provinsiale en nasionale belanghebbendes, opleiding van opvoeders oor basiese kennis, verbetering van infrastruktuuruitdagings, rotasie, betroubare en konsekwente verskaffers, sekuriteitsisteem wat by skole beskikbaar is en ondersteuning in terme van die vestiging van groentetuine was uitgelig. Die studie bevind die volgende as struikelblokke wat die suksesvolle implementering van omvattende GSGB belemmer: diefstal, onvoldoende fondse, onbetroubare verskaffers, infrastruktuuruitdagings en beperkte hulpbronne, gebrek aan gemeenskapsdeelname en onbeskikbaarheid van skoon en veilig water. In terme van die Sorg en Ondersteuning vir Onderrig en Leer is daar min goeie praktyke onder gesondheidsbevorderingskomponent, infrastruktuur, water en sanitasie, maatskaplike welsynsdienste, psigososiale ondersteuning, voeding en selfversorging. Daar is reeds heelwat in plek onder veiligheid, kurrikulêre ondersteuning, materiële ondersteuning, gemeenskapsondersteuning en beskikbaarheid van beleide. Geen van die Sorg en Ondersteuning vir Onderrig en Leer komponente is aktief betrokke by goeie praktyke nie. AFSLUITING: Die studie het bewys dat die implementering van die GSGB in Msukaligwa subdistrik ontoereikend is en verbetering benodig. Daar is 'n behoefte aan voldoende befondsing en die toekenning van betroubare diensverskaffers, asook die monitering en evaluering van die toegewysde diensverskaffers en die hele programme deur toegewyde persone.Master