1 Table of Contents Awareness of the rural elderly regarding their health and nutritional well-being ................................... 2 Comparative analysis of contract and non-contract broiler farmers in the Manzini Region of Swaziland ................................................................................................................................................................ 22 Conservation agriculture: Historical perspectives, challenges and opportunities ................................. 42 Conservation agriculture in an integrated crop and livestock farming system: Challenges and opportunities in Swaziland...................................................................................................................... 69 Food aid in Swaziland: Emerging lessons and alternative strategies ..................................................... 91 Fostering sustainable development through the integration of agro-biodiversity, local ..................... 115 Involvement of women in group-based water development projects in Swaziland ............................ 132 Opinions of rural community dwellers regarding gender-based violence in Swaziland ...................... 156 Public awareness and involvement in the environmental impact assessment process in Swaziland .. 181 Sustainability of rural agricultural development projects undertaken by non-governmental organizations in Swaziland .................................................................................................................... 203 SJSD Volume 1 Issue 1 2 Awareness of the rural elderly regarding their health and nutritional well-being Nishi Surana Department of Consumer Sciences, University of Swaziland, Luyengo, Swaziland Cell: +268 76232775, [email protected] and Hena Yasmin Mantech Training and Development Institute P.O.Box A744, Swazi Plaza, Mbabane, Swaziland Cell: +268 76035888 Email: [email protected] ABSTRACT The purpose of the study was to describe the awareness of rural elderly people regarding their health and nutritional well-being. The specific objectives were to: describe demographic characteristics of elderly people, identify their health problems, assess their nutritional knowledge, describe their socio-economic characteristics and identify their perceived barriers to nutritional well-being. It involved 29 purposively selected elderly people and utilized personal interviews for data collection. The findings revealed that a slight majority of the elderly were widowed, with a minority still married. The majority suffered from, at least, one chronic disease, and some visited a health facility, at least, once a month. They were within 1-3 km from rivers as sources of water which was unfit for human consumption. They normally ate local vegetables but seldom ate meat, fish, eggs and dairy products. While the majority were breadwinners, they had no formal education, no jobs, depended on quarterly grants for income and produced their own food, although some always ran short of food or sometimes lacked it. They lacked nutritional knowledge and cited poverty and ignorance as barriers to their nutritional well-being. They suggested an increase in and monthly SJSD Volume 1 Issue 1 3 disbursement of their grants, provision of food aid, provision of elderly nursing homes and mounting of nutritional education programmes in effort to address their problems. Keywords: Rural elderly, nutritional well-being, nutritional knowledge. INTRODUCTION Background Community development is a structured intervention that gives communities greater control over the conditions that affect their lives. This does not solve all the problems faced by a local community, but it does build up confidence to tackle such problems as nutrition as effectively as any local action can. Community development is a skilled process whose approach is partly based on the belief that communities cannot be helped unless they themselves agree to this process. Besides participation in community development, there is increasing evidence that good nutrition is an important lifestyle factor essential to the health, independence and quality of life of older adults and one of the major determinants of successful aging (Amarantos, Martinez and Dwyer, 2001). To create a successful multi-generation society, the goal is to extend the health span not just the lifespan. It is about keeping people healthy and productive longer. Diet, exercise, weight control and stress management, along with a sense of meaning and purpose play a significant role in determining health span (Public Agenda, 2005). At all stages of life, healthy individuals feel connected to others and relevant in a family and community. Successful aging and community attachment are strongly linked (Tabloski, 2006). SJSD Volume 1 Issue 1 4 The World Health Organization (WHO) has traditionally used the age group of 65 years and above to designate the elderly. Most households are headed by elderly people who are charged with the responsibility of ensuring that there is, at all times, adequate food for the family. However, many of elderly people exist in a nutritional twilight zone, grappling with the daily challenge of eating and often not eating well-balanced meals or any meal at all. Major health concerns are very important and there is increasing evidence that good nutrition is important to the health of an individual. Thus, nutritional deficits place individuals at higher risk for health problems. Rural elderly are mostly at high risk than urban elderly due to characteristics of the rural environment and they tend to have lower incomes, lower quality housing and poorer health, and tend to be nutritionally illiterate (Pollina and McKee, 2000). Worst of all, elderly people are left alone with their grandchildren who are mostly HIV positive. Rural households in Swaziland are vulnerable to food insecurity and health problems. Many of the diseases affecting them have either a dietary cause or could be, at least, partly alleviated by dietary change. More than two thirds of the elderly are at high risk of malnutrition (Wendland, 2003). Hope for better health in old age will come from maintaining the body in better shape, eradicating the diseases to which the ageing body is prone and replacing defective organs (Bates and Benton, 2002). The elderly suffer more from chronic illnesses than younger people, require more frequent hospitalization and remain in the hospital longer than younger people. Energy needs at this time in life are lower because of decrease in metabolic rate and physical activity. Although less consumption of food is needed to maintain body weight, it is still very important to eat a variety of foods that are nutrient dense. Foods high in SJSD Volume 1 Issue 1 5 sugar, fat, or alcohol should be used in moderation due to their low nutritional value. Because of their lower energy needs, protein-containing foods should be of high quality (WHO, 2002). Besides good nutrition, the problems of the aged are heavily focused on the necessary financial resources to meet their needs. Elderly people are deprived of many means of controlling their environment due to loss of their work role following retirement, lowered income, physical problems, departure of children and, sometimes, institutionalization. One consequence of inadequate income and poor health is that older people may feel that they lack control over their lives. According to Help Age International (HAI) (2000), the absence of economic well-being seems to have a statistical relationship with the absence of personal well- being. Suicides, arrest, mental hospitalization and death all increase in times of economic hardship. Traditional respect for older people ensures their status and role in the community (HAI, 2000). Many cultures have traditions of giving respect to elderly people, which makes them proud to belong to society. Young children are brought up to treat older people with special care and respect. In the fast changing world with shifts in economic, social, and cultural norms, elderly people can find themselves left out of community or household decisions, either deliberately or accidentally, because younger people see the ideas of the elderly as old fashioned or do not realize that older people have much to contribute. While some people may be of the view that elderly people should sit and rest and be looked after, this would imply denial of their right to take part in community and family activities, leading to isolation and deteriorating health due to lack of stimulus. The wish of most people of any age is to continue to take part in whatever is going on, and to go on making a contribution, particularly to their families (HAI, 2000). SJSD Volume 1 Issue 1 6 Purpose of the study Since most rural elderly in Swaziland are illiterate, the question that arises is whether they have adequate knowledge of the need for good health and proper nutrition for themselves. A study was, thus, conducted in Ebenezer community to establish whether rural elderly people were aware of aging well with good nutrition. The specific objectives were to: describe the demographic characteristics of elderly people in Ebenezer community, identify their health problems, establish their nutritional knowledge, describe their socio- economic characteristics, and identify their perceived barriers to the nutritional well-being of rural elderly. METHODOLOGY The study was conducted in Ebenezer community in the Shiselweni Region of Swaziland and employed a descriptive