The aim of this research was to establish the attitudes, knowledge, job satisfaction and
professional development of community service dietitians because negative attitudes,
poor knowledge, low levels of job satisfaction and poor professional development would
be detrimental to the process of community service and ultimately to the provision of
Three distinct annual intakes of qualified dietitians completing compulsory community
service were the subjects of an analytical cross sectional survey conducted biannually for
the period 2003-2005. Data collection methods included telephone interviews, mail, emailed
questionnaires and focus group discussions. Individual factors: sex, population
group, language, university attended; institutional factors: organisation of community
service, mentorship rating, hospital manager support type of facility, rural allowance,
hospital location, access to resources, working and living conditions and personal safety
and other factors: attitude, community nutrition knowledge, job satisfaction and
professional development were included in the data set.
Management of data:
Data were divided into 2003 cohort (n=20) and 2004-2005 cohorts (n=26). Analysis of
the demographic details for 2003 and 2004-2005 cohorts were, respectively: mean ages
23.6 (±0.99) and 24.05(±4.96) years, 60 percent and 73 percent white, 90 percent and 96
percent female, 35 percent and 73 percent University of KwaZulu-Natal graduates and 65
percent of both cohorts were placed in rural facilities.
Community nutrition knowledge of the 2003 cohort was unacceptable but improved in
the 2004-2005 cohort. Subjects had a generally positive attitude towards community
service. Community nutrition levels of knowledge of the 2003 ranged between 60 percent
at entry and 67 percent at exit and for the 2004-2005 between 72.8 percent and 78.42
percent. The job satisfaction level of the 2003 cohort at exit was 13.65 (±3.573). In the
2004-2005 cohort job satisfaction was 15.75(±3.360) at entry and 15.75 (±3.360) at exit.
85 percent of the 2003 cohort rated their professional development positively whereas 65
percent of the 2004-2005 cohort rated theirs' positively. This decline and associated
problems were to some extent shown in the interview responses. The 2004-2005 cohort
did however show a tendency for improvement in the professional practitioner ranking
(p=0.088). The majority (95%) of the 2004-2005 cohort rated the dietetic services
Focus group discussions highlighted problems that the community service dietitian
(CSD) encountered such as lack of supervision and support, lack of basic facilities, poor
hospital administration, problems with transport, work overload and problem with their
professional role in the community and health facility.
A model showing the results of the research indicated that the objectives of the
Department of Health for improved service in rural areas were obtained but the retention
of health professionals and capacity was lost due to annual rotation of subjects.
Community service as a strategy to overcome service delivery has merit provided
identified problems are addressed.||en