Diarrhoea morbidity and nutritional status among pre-school children of hawking mothers in Nairobi city markets, Nairobi county, Kenya
Karani, Lizbeth Kageni
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The under- fives mortality continues to rise globally at an annual rate of 24% despite efforts to counteract it through vertical programmes. Seven out of ten child deaths are due to diarrhea, acute respiratory infections, measles and malnutrition. Malnutrition and diarrhea morbidity continues to be a public health problem of considerable magnitude in most developing countries. Efforts to combat it focus primarily on preventive and curative health services. The main objective of this study was to assess the diarrhea morbidity and nutritional status among the pre-school children of hawking mothers in Nairobi. This was a descriptive cross-sectional survey that was carried out in Muthurwa and Toi markets in Nairobi. Simple random sampling was used in selecting the markets whereas systematic random sampling was used in respondent's selection. A sample size of350 hawking mothers was selected. Data for this study were collected using structured interviews and an observation checklist. Data were analyzed using the SPSS software, Epi info and presented in tables, graphs and charts. Chi-square was used to test for statistical associations. The study revealed reasonable literacy levels among the mothers/care giver with 68% of them having attained primary, secondary and college education. The literacy levels were positively associated with diarrhea morbidity among the children (p-value=0.047). In regard to food availability and consumption patterns the main source of food for 47.1 % households was purchasing. During food shortage 52.3% children under five years have only three meals whereas 82.3% of the mothers/caregivers gave complimentary feeds to their children before the age of six months. There was a positive association between age when complementary feeding was started and whether the child had suffered from diarrhea (P-value=0.027). Children of 53.4% of the mothers/caregivers had suffered from diarrhea in the previous two weeks before the study: mothers/caregivers whose children had suffered from diarrhea 38% had the opinion that the cause had been contaminated food and milk. Of 53.4% children who had suffered from diarrhea 50.3% displayed watery stool with 26% displaying loose stool. At least 29% of the study children are stunted; higher proportions (34%) of male children are stunted compared with 24.3% of female children. Stunting is highest (25.7%) in children age 12-23 months a similar age group that recorded higher percentages 33.7% of diarrhea cases likewise, 19.5% of the study children are underweight. The levels are lowest (3.4%) in the age group 6-11 months, the same group that had indicated lower incidences of diarrhea. Association between the Age of mother/caretaker and stunting levels was positively significant (P-value=0.01). From the study findings it can be concluded that diarrhea is a common occurrence among children of hawking mothers and the children were malnourished as indicated by cases of stunting, wasting and underweight levels. The study recommends that The Ministry of Public Health and Sanitation should plan and implement intensive health education programmes to change incorrect practices especially those related to food consumption and to educate mothers/caretakers about the role of infection in causing diarrhea. On further research, the study suggests that a national survey targeting the under five children of hawking mothers be undertaken so as to ascertain the magnitude of diarrhea and malnutrition among this group. This will help in establishing their patterns of growth.