2020 Onwards…

Table of Contents04 Where we come from:

The DASH Project

05 The KaziBantu Project in a Nutshell

06 Physical Activity and an Active Lifestyle

07 KaziKidz Teaching Material: A holistic educational tool

08 KaziKidz Modules

09 KaziHealth: A Workplace Health Intervention Programme

11 Blood Pressure Resultsfrom the KaziBantuBaseline Testing Phase

12 Media and Scientific Releases

13 The Way Forward –Beyond Borders

14 The KaziBantu ProjectTimeline

Where we come f rom:

The DASH Project'Education is the most powerful weapon which can be used to change the world.’Nelson Mandela (2003)

n 2014, the Nelson Mandela University,together with the University of Basel and the SwissTropical and Public Health Institute fromSwitzerland, collaborated on the Disease,Activity and Schoolchildren's Health (DASH)project. The objective was to explore theimplementation of a multi-fold, school-basedintervention, aimed at the improvement of thehealth and wellbeing of schoolchildren indisadvantaged communities of Port Elizabeth,South Africa. Important research findings and atoolkit emanated from the project.

The multi-fold intervention was applied over two10-week blocks and comprised of four elements:

1. Weekly physical activity and dancing-to-music lessons;

2. Health and hygiene education lessons;3. Nutritional supplementation; and4. Deworming.

The KaziBantu project is an expansion of the DASH project.

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KaziBantu Project

I

The KaziBantu Projectin a Nutshell

‘Sport has the power to change the world. It has the power to inspire.’Nelson Mandela (2013)

he KaziBantu Project, translated fromSwahili and Xhosa to ‘active people’, builds onthe findings and experiences of the DASHproject. It encompasses specifically tailoredschool-based intervention programmes,focusing on physical activity and fitness, dietand nutrition as well as health, hygiene andpsychosocial wellbeing. The KaziBantuproject promotes a healthy, active lifestyle inschoolchildren and teachers in disadvantagedsettings in South Africa.

Two toolkits have been developed to contributeto the health of learners and teachers:

• KaziKidz: A holistic educational and instruction tool aimed to enhance schoolchildren’s overall health.

• KaziHealth: A workplace health intervention programme designed specifically for school teachers to decrease non-communicable disease risk factors.

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Physical Activity and an Active Lifestyle

esearch over the past few decades hasprovided a greater understanding of factorsinfluencing physical activity, in people or in acommunity setting. These factors arehighlighted in the illustration above.Studies have shown that children of inactiveparents are more sedentary than children ofactive parents. Lack of physically active rolemodels in modern families may thereforecontribute significantly to inactivity andoverweightness.

With physical inactivity contributing to non-communicable diseases, including cardio-vascular diseases, strokes, diabetes andcertain types of cancer, it forms a key riskfactor for mortality globally.The United Nations General Assemblyestablished 17 global SustainableDevelopment Goals in 2015. Focusing ondecreasing non-communicable disease riskand promoting good health and wellbeingfor all ages, the KaziBantu project aims tocontribute to these goals.

Experts predict that by the year 2030, 1.3 billion people or approximately 15% of the global population, will be classified as overweight.

Beliefs

Gender

MotivationAge

Skills

Water

Air

Topography

Weather

Green Space

LandUsePatterns

Urban Design

Transport

SocialCohesionCulture

Social Support

Income

Equity

Source:Edwards, P. & Tsouros, A., 2006. Promoting Physical Activity and Active Living in Urban Environments: The Role of Local Governments (Copenhagen, WHO Regional Office for Europe).

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KaziKidz Teaching Material:A hol i s t i c educat iona l too l

aziKidz is a holistic educational and instructional tool, usedby teachers in low-resourced settings to promote healthybehaviours in primary schoolchildren.

Three content pillars are used:• Physical Education• Moving-to-Music• Health, Hygiene and Nutrition Education

The KaziKidz lessons are aligned with South Africa’sCurriculum and Assessment Policy Statement (CAPS), resultingin easy implementation and integration within schoolstructures. Schoolchildren are led through the content withgames and playful activities, partly supported by music, andultimately promoting a healthy lifestyle from childhood intoadolescence.

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KaziKidz Modules

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By implementing the KaziKidz Toolkit, teachers contribute to the overall health and wellbeing of learners.

hildren should be active for atleast 60 minutes per day, toensure health enhancingbenefits.

Through the Physical Educationcontent pillar of KaziKidz,learners’ physical activity levelsand fundamental movementliteracy skills are increased.

Low-resourced school settingsare often faced with inadequateinfrastructure, the lack of sportequipment and large class sizes.The Physical Education contentpillar was designed keepingthese challenges in mind, findingcreative ways to keepschoolchildren active.

C he Moving-to-Music contentpillar of KaziKidz was designedto support teachers to developphysical, psychological andpersonal skills in schoolchildrenthrough dancing and movementexperiences.

With the ready-made lessons,any teacher is empowered toteach Moving-to-Music dancelessons in a school setting. Eachlesson has clear instructions thatcan simply be read withaccompanying movementsongs, designed to getschoolchildren moving in a funand enjoyable manner.

Tow resourced settings facemany health challenges notprominently seen in the burdenof disease statistics of SouthAfrica.

By addressing these conditionsthrough health and hygieneeducation, the risk of infectionscan be reduced.

Furthermore, inadequate intakeof nutritional foods mayadversely affect the health andwellbeing of primaryschoolchildren. Simpleeducational material andawareness techniques are usedto empower schoolchildren tomake healthier food choices.

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KaziHealth: A Workp lace Hea l th Intervent ion Programme

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he KaziHealth workplace healthpromotion programme, designedspecifically for teachers in low-resourcedsettings, embraces a behaviour changemodel and focuses on improving lifestylebehaviours with five easy-to-follow steps(Figure 1).

The disease profile of South Africa is movingtowards a profile seen in Western countries,where more and more deaths are beingattributed to chronic, non-communicable,lifestyle- and cardiovascular diseases. Withup to 80% of these diseases preventable

with lifestyle modification, the KaziHealthprogramme focuses on increasing physicalactivity and psychosocial wellbeing bymanaging stress and sleep problems, andimproving nutrition by promoting a morebalanced diet.

The main aim of the KaziHealth workplacehealth promotion programme is to informand foster behavioural change so that eachteacher, who has completed theprogramme, will have the knowledge andskills to make better lifestyle related choicesand ultimately live healthier lives.

Step 1:Individual

Risk Assessment

Step 2:Personal

Health Risk Profile

Step 3:Lifestyle Coaching Sessions

Step 4:Self-Monitoring and Motivation

Step 5:Evaluation of Goals Achieved

Figure 1: KaziHealth Workplace Health Promotion Program Steps

KaziHealth: A Workp lace Hea l th Intervent ion Programme

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Step 1: Individual Risk Assessment

Determines current health status and includesmedical history, lifestyle habits, and variousclinical measures using the KAZICHAT platform:

• Blood pressure to determine hypertension risk

• Blood glucose through glycosylated haemoglobin

• Cholesterol levels with a full lipid profile• Free living accelerometer physical activity,

cardiorespiratory fitness and handgrip strength

• Stress, burnout, health related quality of life and sleep

• 24-hour dietary analysis

Step 2: Personal Health Risk Profile

A healthcare professional provides a personalhealth risk profile (Figure 2), using an easy tounderstand traffic light model, where a redlight signifies high health risk; an orange light,moderate risk, and a green light low healthrisk.

Figure 3: KaziHealthmobile application

Steps 3 and 4: Lifestyle Coaching Sessions, andSelf-monitoring and Motivation

Two lifestyle coaching sessions are conducted whereinformation on the intervention (physical activity,diet and nutrition and stress and sleep management)is provided by healthcare professionals in therespective fields. Participants are assisted to setpersonal goals based on their health risk results.Progress and/or barriers to the successfulimplementation of these goals, as well as solutionsare discussed in the second session.

After the lifestyle coaching sessions, ongoing self-monitoring and motivation is provided through theKaziHealth mobile application (Figure 3) to assisteach participant in achieving his/her personal healthgoals.

Step 5: Evaluation of Goal Achievement

After incorporating the intervention, the individualhealth risk assessment is repeated, to determinewhether health indicators have improved.

Figure 2: Personal health risk profile

Blood Pressure Results from the KaziBantu Baseline Testing Phase

0%

Diastolic

77.6% (n=657)

5.1% (n=43) 8.4% (n=68) 9.2% (n=78)

(N total=845)

20%

40%

60%

80%

Perc

ent

1 2 3 4

11.4% (n=96)10.4% (n=88)5.7% (n=48)

72.5% (n=613)

0%20

%40

%60

%80

%

Systolic1 2 43

Legend1. Normotensive: <90th percentile

2. Pre-hypertensive: ≥90th to <95th percentile

3. Stage 1 hypertension: ≥95th to <99th percentile

4. Stage 2 hypertension: ≥99th percentile +5 mmHG

Source:

Cut-offs and syntax were applied according to the "German Health Interview and Examination Survey for Children and Adolescents" (KIGGS) study, Robert Koch-Institute, Berlin, 2013.

Method

ach child’s blood pressure was measuredthree times, with a calibrated Omron®digital blood pressure monitor, after thechild had been seated for five minutes. Thecuff was wrapped around the left arm, sothat only a finger could fit between the cuffand arm. The bottom of the cuff was placedabout 4 cm above the elbow, with the palmfacing up while the blood pressure wastaken. A cuff size of 17-22 cm was used(Omron® CS2 Small Cuff; Hoofddorp, TheNetherlands). Since the first measurementoften results in higher values, the average of

the second and third measurements was utilized toestimate diastolic and systolic blood pressure. Toanalyse the data, children were categorized into anormotensive, pre-hypertensive or hypertensivegroup, based on percentiles, taking age, sex andheight of each child into account.

Results

or both diastolic and systolic measurements, atKaziBantu baseline testing phase, about 20% or onefifth of the children measured, were categorized aseither hypertension stage 1 or stage 2.

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Media and Science Release

“Worms partly responsible for lower academic results among children”

Newspaper article in Dispatch Live;May 10th, 2017

“A multidimensional, school-based

physical activity intervention can

reduce the increase of specific

cardiovascular risk factors.”International Journal of Environmental Research andPublic Health; January 15th, 2019

“Physical activity contributed

to the maintenance

of academic performance”

Newspaper article in The Heralds;March 18th, 2019

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The way forwardBeyond borders

ur aim is to disseminate the KaziBantu Project to 300 quintile 3 primary schools in the EasternCape, before being distributed nationally. This would be done through formal courses and teacherworkshops. Funding is sought for the dissemination and for much needed research on the health andwellbeing of children and teachers in the rural parts of South Africa.

The ultimate goal of the project is to cooperate with other local as well as internationally recognizedinstitutions and researchers from Tanzania, Ivory Coast, Namibia, Botswana, Mauritius and Europeanregions.

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Timeline of KaziBantuBeyond borders

Oct 2019 Oct 2020 Oct 2021

T3Teacher

T3Kidz

KaziKidzKaziHealth

T2Teacher

T2Kidz

T1Kidz

T1Teacher

Eastern Cape, South Africa

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Text, Editing, Design and Illustration: KaziBantu Research Team

Picture Credit: Joubert Loots Photography, Rooftop Productions and the KaziBantu Research Team

Cover Photo: Rooftop Productions, Port Elizabeth, South Africa

Printing: Nelson Mandela University, Port Elizabeth, South Africa

Copyright: Nelson Mandela University, South Africa, and the University of Basel, Switzerland

© 2019

Prof Dr Uwe Pühse, Department of Sport, Exercise and Health, Switzerland uwe.puehse@unibas.ch

Prof Dr Cheryl Walter, Nelson Mandela University, South Africacheryl.walter@mandela.ac.za

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Website: www.kazibantu.orgTwitter: www.Twitter.com/KaziBantuYouTube: KaziBantu Project South Africa