Vermaak, Kerry.Simon, Benjamin Aye.2022-02-082022-02-0820212021https://researchspace.ukzn.ac.za/handle/10413/20173Masters Degree. University of KwaZulu-Natal, Durban.The overriding purpose of this study was to determine the impact of maternal socioeconomic and/or sociodemographic factors on both maternal and childhood nutrition and health in South Africa. This study draws on a customised theoretical model that put into account the UNICEF framework and the foetal-maternal interaction model as a probable theoretical model of maternal and neonatal nutrition and morbidities. The framework is structured around four (4) stages that result in both maternal and childhood nutritional intake and morbidity. In it, the interplay between the UNICEF and the foetal-maternal relationship frameworks highlights that maternal and childhood nutrition and health is not a simple problem with a single simple solution. A similarly intricate series of approaches – multifaceted and multisectoral – are necessary to effectively deal with it. This study adopted a non-experimental quantitative research approach for extracting the required data for this study. The researcher used a secondary data from the 2016 South Africa Demographic and Health Survey (SA-DHS), which complies with common demographic health surveys research design policy. The use of an explanatory research approach allows the researcher to provide an in-depth evaluation, investigation, understanding and insight analysis about the current state of maternal and under-fives health relative to nutrition in South Africa. Consequently, a survey research design was used to enrolled 1460 participants into the study from a total target population of 4081 – indicating that the SA-DHS is representative in nature. The SA-DHS 2016 followed a stratified sample technique by employing a two-stage stratified design with a probability proportional to size and systematic sampling of the dwelling units. The findings from this study revealed that 73.11% of the respondents met the minimum complementary feeding index relative to the 26.90% who did not. Furthermore, using the household wealth index as a proxy indicator for maternal socioeconomic status of households, the results statistically associate maternal socioeconomic status and complementary feeding practice – where (X2 = 23.56; p-value = 0.000). Suggesting that high wealth index households are more likely to meet the minimum acceptable dietary diversity relative to those with low wealth index. Similarly, after controlling for confounders, the results from the logistic regression negatively associate minimum acceptable diets with maternal education and household wealth index. Indicating lower or no education and lower wealth index were associated with not meeting the minimum acceptable diets of under-fives. On maternal BMI, the results found that the average BMI for the sample was 28.06 kg/m2, with 63.60% of the mothers either (overweight 29.85% or obese 33.75%), 33.91% regarded as having normal weight and 2.49% regarded as underweight. As a result, the results from this study statistically associated maternal employment (X2 = 18.18; p-value = 0.000), place of residence (X2 = 9.55; p-value = 0.023), and household wealth index (X2 = 33.19; p-value = 0.000) with maternal nutritional status in South Africa. Indicating that employed mothers, urban mothers and mothers who fell under high income households are associated with higher rates of obesity. On childhood nutritional status, 89.34% of the under-five children had normal weight-for-age (WAZ), while only 5.20% of the children were either severely underweight or underweight (WAZ). Regarding height-for-age Z scores (HAZ), 73.18% of the children had normal heightfor- age, 15.66% were stunted, 7.04% were severely stunted, and 4.13% were tall. On weightfor- age Z Scores (BAZ), 58.31% of the children had normal weight-for-age, 22.43% were overweight, 16.09% were obese, and 3.17% were underweight. The results further found that the level of malnutrition among under-five children were higher among unemployed mothers than employed mothers as follows: severe stunting (77.50% vs 22.50%), being underweight by WAZ (80.00% vs 20.00%), and obesity by BAZ (72.68% vs 27.32%) for unemployed and employed mothers respectively. However, except for severe stunting, the prevalence of malnutrition among under-five children were higher in urban areas than rural areas as follows: underweight by WAZ (57.14% vs 42.86%), severe stunting (48.75% vs 51.25%), and obesity by BAZ (56.28% vs 43.72%) for urban and rural areas children respectively. On the impact of maternal socioeconomic factors on childhood nutritional and health outcomes, the bivariate analyses negatively associated low maternal wealth index and stunting (HAZ) among underfives. Both the bivariate and multivariate analyses associated maternal BMI with birthweights and childhood nutritional status. Suggesting that higher maternal BMI led to higher weightfor- age as well as higher height-for-age among under-fives. In conclusion, the results from this study present a direct evaluation of the association between maternal anthropometrics characteristics and childhood nutritional status. Poor infant and young child feeding practices, on the other hand, is caused by low or poor maternal household wealth index working synergistically with other factors such as urbanity, employment and education. In summary, the findings presented in this study suggests that obesity and other maternal- and child-related nutritional and health issues is a consequence of the complex relationship among many factors including environmental (such as dietary intake), genetic (the link between maternal BMI and childhood nutritional status), and socioeconomic/sociodemographic factors (such as maternal age, parity, household wealth index, education, employment, etc) which eventually result in energy imbalance that either directly or indirectly impact on both maternal and childhood nutritional and health outcomes in South Africa.enSociodemographic factors.Childhood obesity.Complimentary feeding.Child nutrition.Stunting.Thesis