The impact of household size on poverty: An analysis of various low-income townships in the Northern Free State region, South Africa

Poverty is a multi-dimensional socio-economic problem in most sub-Saharan African countries. The purpose of this study is to analyse the relationship between household size and poverty in low-income communities. The Northern Free State region in South Africa was selected as the study region. A sample of approximately 2 900 households was randomly selected within 12 poor communities in the region. A poverty line was calculated and 74% of all households were found to live below the poverty line. The Pearson’s chi-square test indicated a positive relationship between household size and poverty in eleven of the twelve low-income communities. Households below the poverty line presented larger households than those households above the poverty line. This finding is in contradiction with some findings in other African countries due to the fact that South Africa has higher levels of modernisation with less access to land for subsistence farming. Effective provision of basic needs, community facilities and access to assets such as land could assist poor households with better quality of life. Poor households also need to be granted access to economic opportunities, while also receiving adult education regarding financial management and reproductive health.

Is facility based neonatal care in low resource setting keeping pace? A glance at Uganda’s National Referral Hospital.

Objectives: To identify reasons for neonatal admission and death with the aim of determining areas needing improvement. Method: A retrospective chart review was conducted on records for neonates admitted to Mulago National Referral Hospital Special Care Baby Unit (SCBU) from 1st November 2013 to 31st January 2014. Final diagnosis was generated after analyzing sequence of clinical course by 2 paediatricians. Results: A total of 1192 neonates were admitted. Majority 83.3% were in-born. Main reasons for admissions were prematurity (37.7%) and low APGAR (27.9%).Overall mortality was 22.1% (Out-born 33.6%; in born 19.8%). Half (52%) of these deaths occurred in the first 24 hours of admission. Major contributors to mortality were prematurity with hypothermia and respiratory distress (33.7%) followed by birth asphyxia with HIE grade III (24.6%) and presumed sepsis (8.7%). Majority of stable at risk neonates 318/330 (i.e. low APGAR or prematurity without comorbidity) survived. Factors independently associated with death included gestational age <30 weeks (p 0.002), birth weight <1500g (p 0.007) and a 5 minute APGAR score of < 7 (p 0.001). Neither place of birth nor delayed and after hour admissions were independently associated with mortality. Conclusion and recommendations: Mortality rate in SCBU is high. Prematurity and its complications were major contributors to mortality. The management of hypothermia and respiratory distress needs scaling up. A step down unit for monitoring stable at risk neonates is needed in order to decongest SCBU.