Delivery of the Nutrition Supplementation Programme in the Cape Town metropolitan area from the perspective of mothers of under-fives: A qualitative study

Abstract

Background. Child malnutrition is a major health problem in South Africa despite implementation of various policies and programmes addressing nutrition. Accordingly, these programmes should be delivered within a human rights paradigm, i.e. parents are responsible for their children’s health, while the State authority is obliged to help parents meet their responsibility. The Nutrition Supplementation Programme (NSP) aims at helping underweight children gain weight and empowering parents to tackle malnutrition.

Objective. To study mothers’ experience with the NSP, and assess this in light of South Africa’s emphasis on human rights.

Subjects and methods. Seven focus group discussions were conducted with a total of 28 mothers of under-fives included in the NSP. This methodology is particularly suitable for disclosing unexplored and unexpected issues.

Results. The mothers had received little or no education through the NSP and showed little knowledge and skills for how to make their children gain weight. In addition, many mothers had experienced poor communication with staff members as well as unfavourable comments and lack of respect. These experiences and perceptions are real from the mothers’ perspective. They therefore indicate that the way the NSP was delivered, resulted in inadequate compliance with certain principles of human rights, especially respect for human dignity, client participation and empowerment.

Conclusions. More focus on the education part of the NSP would enable the mothers to better tackle their children’s nutritional situation. The health authorities should take measures to improve the health workers’ knowledge of how to work within a human rights paradigm. This would strengthen the health authorities’ accountability in this context.