Determinants of Maternal and Child Malnutrition Among Low Income Households in Turkana County, Kenya

The purpose of this study was to determine the major factors associated with maternal and child malnutrition in Turkana County, Kenya, where 94% of the population lives in absolute poverty . The ultimate goal was to use these data to design a sustainable community based nutrition education intervention that would decrease malnutrition among women and children in Turkana. Four hundred and eight women and children were randomly selected from Nadapal and Nayainei villages in Turkana County. The participants were recruited by officials from Share International, a Faith Based Organization that works in Turkana. Weight, height and age were used to calculate BMI for women and weight for height (WHZ), weight for age (WAZ) and height for age (HAZ) Z scores for children, in order to determine their nutritional status. Food insecurity was determined using Household Food Insecurity Access score (HFIAS) questionnaire, dietary intake was determined using 24 hour recalls and food frequency questionnaires, maternal nutritional knowledge and child care practices were assessed using validated questionnaires and the results compared to WHO recommendations on infant and young child feeding practices. Results from this study showed that 53% of the women were underweight (BMI< 18.5kg/m 2 ), 24% of the children were stunted (HAZ <−2), 20.7% wasted (WHZ <−2), and 28.6% underweight (WAZ <−2). Most of the undernourished children were between the ages 2–5 years. Almost all (99%) the households were food insecure. Calories and nutrient intake in both women and children were inadequate as compared to the Estimated Average Requirements (EAR). This was especially the intake of calories (average 592 Kcal for children and 849 Kcal for women), vitamin A (9 % of EAR in children and 5.2% of EAR in women), calcium (11% of EAR in children and 6.8% of EAR in women), and zinc (68.25% of EAR in children and 34% of EAR in women). In addition, there was poor dietary diversity with most households consuming mainly cereals and tubers and less fruits, dairy products, and animal source proteins. Mothers displayed adequate knowledge on the need and importance of breastfeeding and complementary feeding; however, some did not have adequate knowledge on the recommended length of exclusive breastfeeding and the required quality of complementary foods. The most popular complementary foods were starch based, mainly maize porridge and mashed potatoes with 25% of the children being fed only tea without milk. Only 5% of the children consumed fruits on a regular basis. In addition to poor dietary intake, more than 50% of the children had suffered from diarrhea and malarial infections more than once in the 3 months preceding the study. The study concluded that malnutrition in this population was associated with the high food insecurity, poor dietary intake, low maternal nutritional knowledge and presence of infectious diseases. The recommendations from the study were to develop a nutrition education intervention that would improve dietary intake and diversity as well as reduce instances of infectious diseases though sanitation based approaches. Such an intervention, with improved food security could be successful in reducing the levels of malnutrition in women and children in this population. Support or Funding Information Schlumberger Foundation