Delivery of the Nutrition Supplementation Programme in the Cape Town metropolitan area from the perspective of mothers of under-5s: A qualitative study

Abstract

Background . Child malnutrition is a major problem in South Africa despite implementation of various policies and programmes. Ideally 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 to help underweight children gain weight and empower parents to tackle malnutrition. Objective . To study mothers’ experience with the NSP, and assess this in relation to South Africa’s emphasis on human rights. Subjects and methods . Seven focus group discussions were conducted with a total of 28 mothers of under-5s included in the NSP. The methodology used is particularly suitable for disclosing unexplored and unexpected issues. Results . Most mothers expressed satisfaction with receiving the supplements, which they perceived to be nutritious. However, they had received little or no education and lacked knowledge and skills regarding how to help 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 were real for mothers and 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 . Even though small studies are relatively prone to bias, this qualitative study is informative. More focus on the education part of the NSP would enable mothers to manage their children’s nutrition better. Measures to improve health workers’ knowledge of how to work within a human rights paradigm are necessary in order to strengthen accountability of the health authorities and improve children’s health.