Given Hapunda

212 Ethical consideration Ethical clearance for this study was obtained from the University of Witwatersrand Medical Ethics Committee for Research on Human Beings (R14/49). The protocol was submitted in accordance with the guidelines of the South African Medical Research Council (MRC) as well as the guidelines of the Helsinki agreement (World Medical Organisation, 1996; Colantuno, 2009). Before the commencement of the study, stakeholders (caregivers/parents, pre-school principals, and teachers, and Early Child Development (ECD) governing bodies) were informed about the feeding programme, thereafter caregivers/parents gave informed consent by signing the forms indicating that they understood the purpose of the study and what was required of them and that they were willing to participate (Mukherji & Albon, 2010). Parents/caregivers were informed that participation was voluntary and they were allowed to withdraw any time during the study period. The numbers system was used, whereby children were allocated numbers to ensure confidentiality of information and identity. The master list with names and contact details of the participants was kept by the principal researcher. Other ethical issues were considered, such as making sure that all parents were competent to make decisions. It was made clear that no harm would be done to the children, and that the study would adhere to the ethical principle of beneficence and would conform to a scientific principle, and the programme would be carried out by scientifically-qualified researchers under the supervision of a competent clinician. Assessments of risks and benefits were conducted, hazards weighed, and finally; the interest of the participants always took precedence over the interest of science and society. Results Socio-demographic baseline results The socio-demographic results indicate that the majority of the caregivers were the mothers, with 84%, 74% and 66% from Evaton West, Soshanguve, and Vaal region, respectively, and of these women the majority (84% in Evaton West, 86% in Soshanguve and 71% in the Vaal region) ranged from 20 to 40 years of age. The results showed that of the all caregivers in all the groups, the majority were unemployed (73% in Evaton West, 84% in Soshanguve and 85% in the Vaal region). Majority of the parents/caregivers had secondary school education, with 50%, 48% and 37% in Evaton West, Soshanguve, and the Vaal region respectively holding a matriculation certificate. Most of the households had a maximum monthly income of less than R1500 in the Vaal region (57%), compared with a minority of households in Evaton West (42%)