Public Health

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Attitudes of African males to contraception.
(1986) Luthuli, H. V.; Arbuckle, Derek Dennis.; Naidoo, K.
The attitude of the African male to contraception and the role he plays in the acceptance of contraceptives by his racial group is presented. Over a period of one month the researcher interviewed 220 African males at a primary care private practice. In this study 186 (85%) were aware of contraceptives and 34 (15%) had no knowledge of contraception; 111 (60%) were married and 75 (40%) were unmarried. The 26 - 35 year age group were the most familiar with contraception (57%). The unemployed were the least users of contraceptives (8%), whereas 69% of the professional group were using contraceptives. The average ideal family size of the group was 4 children. No significant cultural barriers to contraception were found. Religion was found to have little effect on contraceptive practice by the African male. Fifty-three percent of the Urban dwellers were using contraceptives compared with only 30% of the Rural inhabitants. Modern methods of contraception are not yet sufficiently known by the African male to be useful to him. Health workers should educate the African male in matters of contraception to achieve the desired objectives of family planning campaigns among this racial group.
Inpatient catchment populations of public sector hospitals in Natal/KwaZulu.
(1988) Emerson, P.; Arbuckle, Derek Dennis.; Naidoo, K.; Will, R. G.
The Natal/KwaZulu Health Services Liaison Committee (HSLC) has been established to co-ordinate health care delivery in Natal and KwaZulu. This body has defined eight geographical Health Planning SubRegions (HPSRs) (Annexure E) of which each is a unit for planning and prioritising health service delivery in respect of its resident population. The HSLC considered that a study of inpatient catchment populations of hospitals under the control of the statutory Health Authorities would provide information which was essential to the planning processes of those authorities. The Department of Community Health was requested by the HSLC to undertake this study. A previous study, co-ordinated by the Department of Community Health (September 1987), dealt with "Outpatient Catchment Populations of Hospitals and Clinics in Natal and KwaZulu" (E DADA). No previous similar study on inpatients has been undertaken in South Africa. The expansion and improvement of basic services - particularly health care, water supply and basic education - should be perceived as essential elements in a strategy designed to enable all residents of a region to meet basic human needs and enjoy a minimum standard of living. Thus increased efforts have to be made to utilise health care resources effectively and efficiently and to plan future facilities carefully with regard to accessibility and appropriateness . This will require careful and objective management by all Authorities responsible for delivering health care to the people of Natal and KwaZulu. Accurately predicting the utilisation of hospital inpatient facilities is critical to efficient resource allocation in Health Services management. Catchment population studies and cross boundary flow characteristics provide valuable information on the utilisation of available facilities. This information is of value in the development of existing health services and the planning of additional health facilities with regard to size, situation and service type. Studies in other areas on utilisation of health service facilities, suggest that distance strongly influences hospital choice in both rural and metropolitan areas (Inquiry 1984 21(1) : 84-95) and this could explain some of the findings of this study with regard to cross boundary flow between Magisterial districts and HPSRs. For the efficient planning of resources, particularly with regard to situation and size, knowledge of the population size and demographic composition are important, as is a knowledge of the profile of disease in a community. The objectives of this study are directed to making available this information to each of the health authorities responsible for health care delivery and thus, to facilitate the management process.
The nutritional status of pre-school children in Malukazi : a study of nutritional status using anthropometric measuments and dietary intake, and selected ecological factors which may impinge on nutritional status, in 3-6 year old children in Malukazi.
(1991) Peberdy, Carol Nicola.; Arbuckle, Derek Dennis.
Nutrition education is recognised as being of value in the prevention of malnutrition. However, in order for it to be effective, an in-depth study of the community prior to the implementation of any nutrition education programme is essential. A study of the nutritional status of pre-school children in Malukazi (an informal, unplanned Black township in the greater Durban area) together with background information on the household and the childminder was therefore undertaken, so that recommendations for a nutrition education programme in the area could be made. The relationship between nutritional status and certain ecological variables was also studied in order to determine which of these, if any, was a significant factor in the development of malnutrition. Nutritional status was assessed by using anthropometric measures (height and weight) and dietary intake (24-hour recall and food frequency). Background information obtained included socio-economic status; food purchasing, preparation and storage patterns; intrafamilial pattern of eating; food taboos; clinic attendance; and the childminder's sage, educational level, body size, nutritional knowledge and attitude towards nutrition education. Information was obtained by means of face-to-face interviews using a single, trained interviewer. The incidence of low weight-for-age was relatively low and that of low height-for-age ("stunting") considerably higher (14,2% and 47,3% below the 3rd percentile respectively), indicating that chronic malnutrition is a serious problem in this community. Information on dietary intake showed that intakes of several nutrients notably energy, calcium, vitamin A, ascorbic acid and vitamin D were low for the study population. The percentage of total energy provided by the various macronutrients was however in line with recommendations, which tends to indicate that the greatest need is for an overall increase in food intake. Of the ecological variables studied, only two were found to be significantly associated with the incidence of malnutrition. These were the number of children cared for by the childminder (p=0,04) and whether or not the household grew their own vegetables (p=0,02). The degree of malnutrition found to exist in this community, together with the unsatisfactory level of nutritional knowledge of the childminders and their apparent willingness to learn more, revealed the desirability for further nutrition education in this area. Recommendations regarding future nutrition education programmes for this community based on the findings of the study are submitted.
Primary health care needs of an urban and a rural African community.
(1986) Ngubane, B. S.; Arbuckle, Derek Dennis.
No abstract available.
A profile of children admitted to a rehydration unit.
(1988) Davies-Salter, Linda Ann.; Arbuckle, Derek Dennis.
The first twelve months operation of a five-bed rehydration unit at Osindisweni Hospital is described and data related to admissions presented. Osindisweni hospital is situated in a rural area north of Durban and has approximately 300 general beds with 60 000 outpatient attendances per year. A profile of children admitted to this unit was obtained and results are analysed according to the objectives of this study. The main findings of the study showed that 269 children were admitted to the unit during the study year and the majority of children were black African children, below three years of age, coming from rural areas. The children presented with acute diarrhoeal dehydration mostly of mild to moderate degree and were normally managed by oral rehydration therapy. Eighty-four percent of these children were successfully managed on the rehydration unit and only 13,7% received IV fluids. The majority of children requiring transfer to the ward had either persistent dehydrating diarrhoea or other complications such as malnutrition or septicaemia. No child died on the unit and no child died as a result of dehydration but 4 children died later as inpatients on the children's ward. The mortality of children admitted to the unit was therefore 1,5%. One hundred and nine patients were followed up (41,6% of questionnaires) and of these only 76 (69,7%) actually came for review the others presenting for other illnesses or else interviewed on the wards after transfer. However, most of these children had either no or minor complaints on follow up. Seventeen and a half percent of children were below the 3rd centile for age on discharge. Children with marasmus and/or kwashiorkor were not admitted to the unit. The availability of health care was poorly assessed but indicated a general lack of facilities for the rural population served. Also it was noted that the principles of G.O.B.I. had been poorly taught at Osindisweni in the past, particularly growth . charts. Mothers received health education on the unit and were found to have a good understanding of G.O.B.I. after their stay on the unit. On the whole the unit was well accepted by the mothers. It is thought that this short-stay oral rehydration unit offers a more appropriate and more cost effective alternative to previous methods of in-patient management of children with diarrhoeal dehydration and that it offers an excellent opportunity for health education.

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