Evaluation of a Nutrition Unit in Winterveld, South Africa: Part I

Abstract

We report on an evaluation of a Nutrition Rehabilitation Unit ( NRU ) at the request of Medecin du Monde (South Africa) on behalf of the St Peter's Health Centre (SPHC) in Winterveld. Winterveld is a sprawling squatter camp north of Pretoria, the capital of South Africa, with huge socio-economic and environmental problems. Malnutrition is a common clinical problem at the SPHC. For this reason a NRU was initiated in 1989. The evaluation had two main components: an unstructured interview with health workers at SPHC and the NRU and an analysis of all the records of patients admitted to the Unit since it opened till April 1991. The major conclusions are that the malnourished children admitted to the NRU come from a background of severe poverty, poor environmental conditions, high rate of infections and inadequate attendance of well baby care . Patient management at the NRU seems inappropriate with poor record keeping, high rates of failure to gain weight, of infections and of tilling to complete treatment. In our recommendations we provide leads to guide discussion rather that dogmatic prescriptions on what needs to be clone. The major recommendation is that the problem of malnutrition should not be addressed as the problem of the NRU. It is a community problem that needs to be addressed comprehensively by community structures and all levels of health workers. The NRU should be seen as a last resort.