The impact of urbanization on the health of black pre-school children in the Umtata district, Transkei, 1990.

The impact of rapid urbanisation on some aspects of child health in Transkei was assessed. The study area comprised clusters from urban, peri-urban and rural areas, giving a sample size of 1,080 children. Information collected included anthropometric measurements (weight and height), immunisation status, family socio-economic status, and practices regarding preventive health. The child's place of birth, maternal education and paternal support were also assessed. In the sample, 20.6% of children were born at home. Diarrhoea prevalence ranged from 18.3% in urban to 24.9% in peri-urban areas; 70.2% of mothers/carers knew about oral rehydration therapy and 56.3% had used it to treat diarrhoea, only 2.5% knew how to prepare the solution properly. Breast-feeding was practised early in life but by 1 year 74.6% of mothers had stopped; 54.9% started supplementary feeds by 1 month of age and by 4 months 89.6% of all children were on supplementary feeds. Of the children, 9.5% were underweight, 25.5% were stunted and 3.8% had acute protein energy malnutrition (wasting). Monthly per capita food expenditure was used to assess socio-economic status and 50% of all children came from homes spending R21,000 per person on food per month. Reasons for poor child health were examined and recommendations are made for promoting child health in the face of rapid urbanisation.