PhD Theses

Nutritional status of children (6 To 13 Years) in Tubu and Shorobe molapo farming households, Ngamiland, Botswana

Wed, 01 Jan 2020 00:00:00 GMT

Nutritional status of children (6 To 13 Years) in Tubu and Shorobe molapo farming households, Ngamiland, Botswana Ramolefhe-Mutumwa, Tshepiso Galase Background: The size of floods in the Okavango Delta (OD), Botswana varies annually and seasonally over long periods (decadal). This influences crop production, food security, health and nutritional status of dependent farming households and especially of vulnerable populations such as children. Unlike the under-fives, school age children (SAC) and especially those living in rural, farming and resource poor households have been neglected in health research and not much is known about their nutritional status. Objective: To determine the nutritional status of children (6 to 13 years) in farming households of Tubu and Shorobe villages over the lean and plenty seasons. Methods: Using a cross sectional study design, samples of 84 and 134 children (6 to 13 years) were assessed during the lean and plenty seasons for nutritional status indicators of growth (stunting, underweight, thinness and overweight and obesity), meal patterns, serum iron and zinc status, prevalence of soil transmitted helminthes (STH), relationship between STH and iron status, household food security status and factors influencing nutritional status. Results: Double burden of malnutrition was evident in the study children. Prevalence of underweight, stunting, thinness and overweight/obesity during the lean season was 12.3%, 6%, 11.9% and 4.8% respectively, whereas in the plenty season they were 6.3%, 5.2%, 7.4% and 4.4% respectively. Regardless of season, age, and/or farming system, the bulk (>60%) of the children’s diets were predominately starchy foods such as cereals (>91%), sugar/honey (>84%), miscellaneous foodstuffs (condiments, beverages such as tea and coffee) (>78%) and meat/poultry/offal (>61%). Overall, no more than 27% of all children had representation of roots and tubers, vegetables, fruits, eggs, fish and seafood and pulses/legumes/nuts in their diets in the previous day. Unexpectedly, there was a higher prevalence of anemia at 34% (n=18/53) during the plenty season compared to 17.4% (n=4/23) in the lean season. One girl child, aged 6 years and from a molapo farming household was zinc deficient, with levels below 9.9umol/L. There was a low (0.75%) prevalence of STH but increased intestinal polyparasitism (lean: 7.1%; plenty: 11.2%) associated with poor food handling and preparation- as well as hygiene and sanitation practices. Food insecurity was common amongst households in both lean (95.7%) and plenty (88.7%) seasons. Over 67% of households in both seasons experienced worry over food supply for the previous month, and consumed food of low quality and quantity. Significant differences were only observed when comparing mean WAZ by season (lean: 0.8±0.9 and plenty: 0.5±1.0, t (133) = -2.144, p<0.05) and mean BAZ by age (6 to 9 years: 0.8±0.8 and 10 to 13 years: 1.0±0.9, t (208) = 2.341, p<0.05). Child age significantly influenced thinness. Household income, the plenty season and Tubu village were negatively associated with meal patterns (dietary diversity). On the contrary, farming system was positively associated with dietary diversity. Household income negatively influenced household food security. Conclusion: Although the study SAC seemed to have poor nutritional status, generally, they fared better than the under-fives in the nation. Nonetheless, significant health concerns that must be quickly addressed in the studied communities included undernutrition (underweight and thinness), limited dietary diversity, poor food handling and preparation practices and poor hygiene and sanitation practices, and pervasive household food insecurity. Nutritional status of SAC deteriorated more during the plenty season. Loss of crops to floods, which is an indicator of climate change majorly affected SAC nutritional status, household food security and dietary diversity. Molapo farming is a promising system towards improving dietary diversity. A dissertation submitted to the Dept. of Family and Consumer Sciences, Faculty of Education, University of Botswana in partial fulfillment of the requirement of the degree of Doctor of Philosophy in Food Nutrition. Citation: Ramolefhe-Mutumwa, T. G. (2020) Nutritional status of children (6 To 13 Years) in Tubu and Shorobe molapo farming households, Ngamiland, Botswana, University of Botswana.

Adoption stakeholders’ perceptions of sharing adoption information with adoptees: the case of Nigeria

Mon, 01 Jun 2020 00:00:00 GMT

Adoption stakeholders’ perceptions of sharing adoption information with adoptees: the case of Nigeria Okike, Juliana Kofoworola Child adoption is about the provision of families for children who cannot be cared for within the families into which they were born. It is also about experiencing parenting in which people legally assume the role of parents in respect of a person who is not their biological child. The current adoption practice in Nigeria is closed adoption, and as such, concealment of adoption information from the child is the norm. Concealing adoption information from adoptees is a practice that has generated many problems in adoptive families that negatively affects both the adoptee and the adoptive parents, leading to disruption of the adoption process, particularly in Nigeria. These problems present a challenge to adoptive parents, and hence, the need to address the issue of communicating adoption information to adoptees in a normative and timeous manner that should lead to a more successful adoption. The objectives of this study were: to examine perceived factors contributing to concealment of adoption information by adoptive parents from their adopted children; to identify the perceived possible implications of concealing adoption information from adoptees; to explore possible methods of sharing adoption information with adoptees; and to examine the perceived challenges of sharing adoption information with adoptees. The study was based on two theoretical frameworks: social constructionism and ecological system theories. The study adopted a qualitative approach in the primary data collection using interviews, focus group discussions, and documentary analysis. Secondary data were collected from relevant existing documents, periodicals, and internet and bibliographic data base sources. A total of 35 participants, consisting of fifteen (15) interviewees, and twenty (20) other participants who formed 2 focus group discussions participated in the study. The study setting was South Western Nigeria, using Lagos and Oyo states. These states were selected using a purposive sampling approach. Both states were considered central to the study in terms of access to relevant information, stakeholders, institutions and ethnic diversities. Specifically, the narratives and opinions of respondents helped to explain why people conceal adoption information from their adopted children and the effects of concealment and sharing adoption related information. The data were coded under themes based on the objectives of the study. Findings of this study revealed that people concealed adoption information from their adopted children due to societal perceptions towards adoption, cultural values relating to rearing of adopted children, cultural beliefs on communal values, individual fears and misconceptions, scarcity of information on adoption from adoption agencies, and confidentiality factors. The possible implications of concealment included emotional problems such as adoptees getting depressed, being demoralized, being devastated, being traumatized and manifesting violent behaviours on hearing about their adoption status from third parties. There were also, social implications including withdrawal syndrome, and loss of self-esteem. It emerged from findings that the possibility of sharing adoption information depended on societal views. There were more views in support of the need to share adoption information with adoptees than those who said the information should not be shared. The views that adoption information be shared were anchored on the fact that it could help the emotional stability and early adjustment of adoptees which could cement the adoption, and minimize the problems which could arise from concealing the information. The views that adoption information should be concealed were based on the fear that it might create instability in the child’s relationship with adoptive parents. Sharing the information is the foundation of love and care and a good relationship between the parents and the child. This could make the child more appreciative of the parents than becoming violent on hearing about his/her adoption. Thus, love, care and a good relationship between the parents and the child should be the foundation for the sharing of adoption information. The study findings provide enough evidence of the need to share positive adoption information with the adoptee, as well as the need for a policy statement on the issue. In addition, far reaching policy recommendations are made including: government involvement through comprehensive adoption policy; government and non-government backed public enlightenment adoption campaign; and recommendations for social work practice and professionals. Lastly, a framework for sharing adoption information with adoptees is proposed in this study. A dissertation submitted to the Dept. of Social Work, Faculty of Social Sciences, University of Botswana in partial fulfillment of the requirement of the degree of Doctor of Philosophy in Social Work. Citation: Okike, J. K. (2020) Adoption stakeholders’ perceptions of sharing adoption information with adoptees: the case of Nigeria, University of Botswana.

Socioeconomic inequalities in health: chronic disease prevalence, health care utilization, health expenditure and life course perspective in Botswana

Tue, 01 Jan 2019 00:00:00 GMT

Socioeconomic inequalities in health: chronic disease prevalence, health care utilization, health expenditure and life course perspective in Botswana Keetile, Mpho The debate on socioeconomic inequalities in health is currently dominating the research and policy agenda in many countries. In Botswana, empirical evidence on the socioeconomic inequalities linked to prevalence of NCDs, health care utilization, health expenditure and life course factors is extremely deficient and largely unknown. The main objective of this study was to explore and stir debate on socioeconomic inequalities in health in the face of the emerging burden of NCDs. Data used in this study was derived from the large sample survey on Chronic Non-Communicable Diseases in Botswana: A study on Prevalence, Health Care Utilization, Health Expenditure and Life Course (NCDs study, 2016). The NCDs study adopted a representative cross-sectional descriptive study design. Using a multi-stage probability sampling design, the survey was carried in selected urban and rural areas of Botswana, among males and females aged 15 years and over. The total sample was 1178. Evidence in this thesis indicates an increase in the prevalence of NCDs and associated risk factors. The most prevalent NCD in the study population was hypertension. Socioeconomic inequalities in health were measured by using the odd ratios and concentration index (CI). Overall, the study showed mixed findings on the association between socioeconomic status (SES) and health. The study noted that poor people were more likely to be exposed to NCD risk factors than the non-poor. For instance, they were found to have significantly higher odds of smoking, poor physical activity, and poor fruit and vegetable consumption. The poor were also found to be more likely to report multiple NCD risk factors than the non-poor. Meanwhile alcohol consumption was found to be high among the non-poor. Overweight/obesity did not show any variation by wealth status suggesting that both the poor and non-poor were overweight/obese. Though NCD risk factors are greater among the poor, the likelihood of reported morbidity for diabetes and hypertension was high among the non-poor. Educational and wealth status inequalities have been observed to exist for health care utilization outcomes. People with low education and wealth status were found to be less likely to have needed health care in the last one year, less likely to have gotten health care when they needed it, and to have sought health care for NCDs than for other disease conditions. As for the type of health facility utilized, less educated and poor people were found more likely to have visited public health facilities when they felt sick or needed to consult anyone about their health. The study established that wealth status was significantly associated with out-of-pocket health expenditure. This was evidenced by the non-poor more likely to report out-of-pocket expenditure for health care and medical insurance coverage than the poor. The findings of this study confirmed the notion that childhood SES influence adult health. It was noted that people who had poor childhood SES status were more likely to report smoking, alcohol consumption and poor fruit and vegetable consumption but were less likely to be overweight/obese. People with poor childhood SES were also found to be more likely to report hypertension, diabetes, single and multiple NCD conditions. Decomposition of inequalities analysis was done for hypertension and NCD risk factors. Overall, CI estimates were positive for poor physical activity, alcohol consumption and overweight/obesity indicating that these three NCD risk factors were more concentrated among the non-poor. Meanwhile negative CI estimates were observed for daily smoking and poor fruit and vegetable consumption. This suggests that the two risk factors were more concentrated among the poor. Decomposition of the concentration index revealed that wealth status itself was the leading contributor to socioeconomic inequality for four risk factors; daily smoking, poor FV consumption, overweight/obesity and poor physical activity. Education on the other hand, was the leading contributor to socioeconomic inequality for alcohol consumption. CI estimates for hypertension in the study population and population 50+ years were positive. Thus, the dominant factors to this inequality were education and wealth status, respectively. Mixed findings on the relationship between SES and various health outcomes shown in this study indicate the need for further research into understanding and explaining of such inequalities. This is because eliminating socioeconomic differences in health requires new knowledge about the determinants of disease. These inequalities might be reduced by improving educational opportunities, wealth distribution, health-related behavior, or access to health care. A dissertation submitted to the Dept. of Population Studies, Faculty of Social Sciences, University of Botswana in partial fulfilment of the requirement of the degree of Doctor of Philosophy in Population Studies. Citation: Keetile, M. (2019) Socioeconomic inequalities in health: chronic disease prevalence, health care utilization, health expenditure and life course perspective in Botswana, University of Botswana.

Waking up to the power crisis: the importance of securitising energy in Botswana

Fri, 01 May 2015 00:00:00 GMT

Waking up to the power crisis: the importance of securitising energy in Botswana Makombo, Uyapo Despite the vast research conducted on energy security, how can a country with a sound economy and an abundance of energy resources like Botswana end up sitting in the dark? Botswana experienced a depressing electricity power crisis at the wake of 2008 that left the nation with a sense of panic and guessing what the future holds. The purpose of this research is to identify flaws that may be in the country’s security management approach and generate knowledge on the role energy plays in the national security. Forum (2006) informs us that energy security is an umbrella term that covers many concerns linking energy, economic growth and political power. Haluzan (2013) further highlighted that without energy there is no economy, and without economy there is no progress of society in general. Using the example of the Botswana power crisis situation, this paper demonstrates that energy, especially electricity, plays a pivotal role to the security of any nation. This paper therefore argues that even with a stable political environment and a robust economic growth, if energy is not securitised, the national security of any country can be compromised. The paper further highlights that historical experiences and the securitization of energy policy play an important role to the welfare of the nation and not only economic interests. A dissertation submitted to the Dept. of Political and Administration Studies, Faculty of Social Sciences, University of Botswana in partial fulfilment of the requirement of the degree of Masters in Defence and Strategic Management. Citation: Makombo, U. (2015) Wakiing up to the power crisis: the importance of securitising energy in Botswana, University of Botswana.