Determinants of Malnutrition Among Children Aged 6-59 Months in West Pokot

ABSTRACT Malnutrition is depicted by either deficiencies or excess nutrient and/or energy intake by an individual and includes three major categories of conditions: under nutrition, micronutrient-related malnutrition or micronutrient excess, as well as overweight, obesity, and non-communicable diseases associated with diet. It is determined by the measurements of anthropometric indicators (wasting, stunting, and underweight); oedema and the colour of the conjunctiva. WHO estimates that 149 million children aged between 6 and 59 months are stunted and 45% of the fatalities in these children mostly occur in low- and middle-income countries. Within the West Pokot County, SMART showed prevalence of stunting at 42.8% , wasting at 11.9% and underweight at 30.7% KDHS reported malnutrition prevalence 46 % for children who were stunted. Malnutrition exposes children to a higher risk of dying from common ailments, increases the incidences and severity of infections. Generally, malnutrition has been shown to be influenced by social determinants of health. There is need for the determination of specific determinants for specific context like in West Pokot for targeted programming. This study therefore sought to find out the social determinants that are associated with child malnutrition in children aged between 6 and 59 months in West Pokot County. The objectives included to determine the prevalence, how family structure, cultural practices and parental education influence child malnutrition. The researcher used cross sectional study design and multistage cluster sampling. With total sample size was 420 children arrived through the Fisher’s Formula in which the respondents were the mothers or the caregivers of the selected children. Data was collected with a use of close and open ended structured questionnaire. Permission was sought from relevant t. Data was collected using KOBO collect data app, cleaned and organized and analyzed with SPSS v26 . Establishment of association between the malnutrition and social determinats was done using a Chi Square. The average age of the sampled subjects was 29.9 months, 51% being male. Prevalence of malnutrition was at 25.2%, males having higher prevalence of 29%(n=62). Having older siblings of >30 months increased the risk of malnutrition by 46.4%. Being a first wife in a polygamous household and caregiver being employed reduced the risk of malnutrition. Houses that used pit latrine had less cases (17%) of malnutrition compared to those that used either bush or open field defecation (32.3%), restrictions on some foods for children and prioritization of household head in meal serving predicted a higher occurrence of GAM among the under-fives (32%) and (30.7%; OR:2.3; 95% CI:1.5-4.4; P<0.001) . Caregivers having no formal education and primary education level had approximately 32% risky of their children developing malnutrition and those with tertiary had lower risk (5.9%). It is seen that the social determinants have a significant influence on child malnutrition. To mitigate these, there is need for community awareness on harmful cultural practices; collaboration between various stakeholders to enhance formal education attainment and government with stakeholders to make availability of water and general wealth availability to enhance improved livelihood