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Forty-three percent of primary school learners in Gqeberha, Eastern Cape, showed a risk factor of getting one or more non-communicable diseases (NCDs).

This is based on two studies of 2 000 learners from 12 marginalised primary schools in the township and northern areas of Gqeberha. The studies are part of the PhD research of biokineticists, Dr Danielle Dolley and Dr Siphesihle Nqweniso from the Department of Human Movement Science at Nelson Mandela University. They graduated with their doctorates during the University’s autumn graduation ceremonies.
The researchers explain that NCDs include malnutrition, high blood pressure, diabetes and unhealthy cholesterol levels. “NCDs are lifestyle-related diseases or they can be inherited. They develop from eating an unhealthy diet, high in fats, sugar, salt and low in dietary fibre, as well as low physical activity levels,” says Dr Nqweniso.
“We are highly concerned about the rise of NCD risk factors among primary school learners,” adds Dr Dolley. “At their young age, these children are at higher risk of developing chronic diseases which could seriously impact their health as they grow and progress into adulthood. It also impacts the national health system, with the associated economic implications. What it emphasises is the importance of intervening at a young age when we are able to reduce the risk.”  
The highest NCD risk percentage was for children who are overweight or obese. This is linked to fast food, foods high in sugar and fat and not enough healthy foods, such as vegetables. Dr Dolley says, “We found that 19% of the group was overweight or obese, with a significantly higher number of girls as they are generally less active than boys. This is largely due to social influences, such as that sport makes you sweaty and this isn’t feminine.”
Their research is part of the KaziBantu programme in Gqeberha and one of its sister programmes, KaziAfya, which includes Tanzania and Cote d’Ivoire. Now in its 10th year, KaziBantu is a school-based intervention that focuses on NCD prevention strategies by integrating physical activity, healthy nutrition and good hygiene into the daily routine of learners in schools in marginalised communities. It also promotes teacher health. 
KaziBantu’s primary partnership is with the Department of Human Movement Science at Nelson Mandela University and the Department of Sport, Exercise and Health at the University of Basel in Switzerland. “According to the World Health Organisation, children need to be active for 60 minutes a day to reduce the NCD risk and enhance their overall physical and psych-social health, movement skills and learning ability,” says Dr Dolley. 
“While physical education is part of the South African school curriculum, teachers in many schools are not trained to teach it. They often use the time for other subjects or to catch up on admin.”
As part of the KaziAfya intervention, teachers at four of the schools attended two-day physical education workshops, aligned with the government curriculum. “We assessed the level of physical activity before this intervention and 20 weeks after, using a device called an accelerometer which the learners wore on their waists for seven consecutive days. There was a general improvement in the boy and girl learners’ physical activity and a reduction in NCD risk levels, including obesity,” says Dr Nqweniso. 
“We recommend that all teachers receive physical education training and we want to grow this throughout the Eastern Cape and other provinces, and extend it into Africa,” adds Dr Dolley.
The research also found that 13% of learners in the Gqeberha research group were underweight, due to insufficient nutrition and high rates of soil-transmitted helminth worms infections (such as hookworm, roundworm and whipworm). This is due to children living in congested areas with poor water and sanitation facilities.
“In schools where 20% or more of the children have worms, we de-worm the whole school,” Dr Nqweniso says. The Department of Health has a deworming programme for learners but it is done annually and it needs to be bi-annual where more than 50% of children have worms. “Deworming must be done in combination with good hygiene and sanitation practices such as washing their hands after going to the bathroom and keeping cooking and washroom areas clean.”
Dr Dolley adds that all the schools in the research group provide the learners with one meal a day: “Together with our Department of Dietetics, we work with the food preparers to improve the nutritional content, make sure they don’t use too much salt and that they include vegetables.”
In four of the primary schools, over the 2019 – 2021 research period, learners were given multi-micronutrient supplements that include a range of vitamins and minerals. They found an increase in cardiorespiratory fitness and a decrease in blood pressure and blood sugar levels. As part of the KaziAfya research primary school learners in Tanzania and Cote d’Ivoire were also given the supplement.
To continue this work, KaziBantu is now partnering with three NGOs, the Kolisi Foundation, United through Sport, and Ubuntu Pathways in the Siyaphakama Zwide Schools Project. They are engaging learning, physical education and nutrition interventions with six primary schools in Zwide township in Gqeberha. The mission is to help develop healthy, active, emotionally and academically stronger children.
All the activities which are designed to be fun for the learners, including dancing, can be downloaded from the KaziBantu site. KaziBantu also offers a South African Council for Educators- accredited short-learning programme for free. – ENDS
Dr Siphesihle Nqweniso                Dr Danielle Dolley 

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