Browsing by Author "Kimiywe, J."

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    Assessment of Scope and Quality of Nutrition Services in Patient Management in Selected Health Facilities in Tanzania
    (East African Journal of Science, Technology and Innovation, 2024-12-13) Mkumbo, A. E.; Kimiywe, J.; Haikael, M. D.
    Inadequate nutrition services remain a critical barrier to optimal patient care in many low- and middle-income countries, including Tanzania. Comprehensive assessments and specialized interventions are often underutilized in clinical practice. This study evaluates the scope and quality of nutrition service delivery across Tanzanian health facilities, involving 46 participants, including nutritionists, dietitians, and healthcare providers from 28 facilities. Data were analyzed using SPSS version 29.0. The findings demonstrate that basic nutritional assessments (e.g., weight, height, and mid-upper arm circumference) are performed in over 70% of cases, yet advanced assessments like body composition analysis (body fat, muscle mass, and visceral fat) are significantly underused, occurring in less than 30% of cases. Nutrition Diagnostic accuracy was also suboptimal, with only 11% of participants correctly completing the Nutrition Diagnosis using the PES (Problem, Etiology, Symptoms) statement. While over 90% of participants delivered nutrition education and counseling, more advanced interventions such as enteral and parenteral nutrition were available in fewer than 40% of cases. Alarmingly, a severe shortage of clinical nutrition staff was identified, with one nutritionist covering more than 200 hospital beds. Participants with more than four years of experience, especially those with bachelor’s or postgraduate degrees, were significantly more effective in delivering quality nutrition services (p = 0.019). It is recommended that targeted efforts to increase human resource allocation, integrate nutrition into broader healthcare quality initiatives, and enhance nutrition continuous professional development. Expanding and fostering evidence-based research are vital to strengthening nutrition services and improving patient outcomes in Tanzania’s healthcare system.
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    Bioaccessibility of provitamin A carotenoids in bananas (Musa spp.) and derived dishes in African countries
    (2012-09-24) Ekesa, B.N.; Poulaert, M.; Davey, M.; Kimiywe, J.; Inge, V.; Blomme, G.; Dhuique-Mayer, C.
    Bananas and plantains (Musa spp.) constitute an important component of the diet in Africa. Substantial levels of provitamin A carotenoids (pVACs) in Musa fruit have been reported, but the bioaccessibility of these pVACs remains unknown. In this study, we used an in vitro digestion model to assess the bioaccessibility (i.e. the transfer into micelles) of pVACs from boiled bananas and derived dishes using the Eastern Democratic Republic of Congo as a study context. In particular, the effect of different food ingredients added to boiled bananas on pVAC’s bioaccessibility was studied. The bioaccessibility of all-trans β-carotene ranged from 10% to 32%, depending on the food recipes, and was modified, particularly when pVACs-rich ingredients (palm oil/amaranth) were added. Efficiency of micellarization of all-trans β-carotene was similar to that of all-trans α-carotene and depended on the cultivar (Musilongo, plantain type, 16%; Vulambya, East African cooking type, 28%), while that of the 13-cis isomer was higher (21–33.5%). Taking into account bioaccessibility, the estimated vitamin A activity was significantly different across the different Musa-based dishes tested. Results are discussed in terms of recommendations to help reduce vitamin A deficiency in Musa-dependent African communities.
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    Complementary feeding practices and nutritional status of children 6-23 months in Kitui County, Kenya
    (2014-10) Kimiywe, J.; Chege, P.M.
    Objectives: Inappropriate complementary feeding practices among children aged 6-23 months is major cause of under nutrition. There is scarce information on the relationship between complementary feeding practices and nutritional status. This study aimed to determine the factors contributing to the complementary feeding practices and the nutritional status of children aged 6 -23 months. Methodology and Results: A randomly selected sample of 201 children aged 6-23 months was investigated using a cross sectional analytical design in four randomly selected sub-counties in Kitui County. Data were analyzed using ENA for SMART for nutrition status, Nutri-survey for dietary intake and SPSS. Results showed that most caregivers (70.6%) had attained primary level education. Majority of respondents (69.2%) had low levels of income. The average number of meals consumed per day was 4.1 ± 0.01. The main foods consumed were carbohydrates with little consumption of fruits and vegetables. The levels of wasting, stunting and underweight were 7.0%, 22.9% and 10.9%, respectively. Conclusions and application of findings: The complementary feeding practices were inadequate to meet the macronutrient and micronutrients needs of the children. The foods lacked variety, children took fewer meals per day and key foods were consumed less frequently than expected. The low food production in the semi- arid area coupled with low income could be associated with the food insecurity and consequently to the quality, quantity and diversity of the foods consumed by the children. The levels of malnutrition were relatively high for these children aged 6-23 months and this could be attributed to food insecurity indicated by low dietary diversity. The study noted a significant relationship between complementary feeding practices and nutritional status. The study recommends use of locally available, affordable and variety of foods to improve nutrient content of complementary foods. The study recommends agricultural interventions to enhance the nutritional content of complementary foods. Nutrition education on appropriate Infant and Young Child Feeding among mothers is essential. Key words: Complementary feeding practices, Nutritional status, children under 6-23 months
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    Enhancing Agricultural Production Potential Through Nutrition and Good Health Practice: The Case of Suba District in Kenya
    (Springer Netherlands, 2011-06-06) Kimiywe, J.; Were, G.; Kamau, J.; Hongo, T.; Ohiokpehai, O.; King’olla, B.; Mbithe, D.; Oteba, L.; Mbagaya, G.; Owuor, O.
    Several studies have shown that HIV and nutrition operate in tandem. Moreover, it has been shown that the two greatly affect agricultural production due to reduced energy to work, inability to purchase agricultural inputs, low labor, and eventual death. The link between agricultural productivity, malnutrition, and HIV can therefore not be overlooked. People who are inadequately nourished are more susceptible to diseases and poor health. In an attempt to achieve optimal nutrition and good health among vulnerable groups, various intervention programs have used food supplementation and especially the plant-based food products to achieve this. Such programs have proved to be effective in restoring the nutrition and health status of the people. However, much more value would be achieved if such programs were complemented with basic health services such as deworming, water, sanitation, malaria control, hygiene. This chapter explores the benefits of research on nutrition as the basis for improving threatened rural communities’ nutria-health and potential economic performance. The premise is that good nutrition and preventive measures will reverse some of the human health problems associated with HIV, hunger, and/or malnutrition. Emphasis is placed on food preservation, processing, nutrition intervention, and education. Micronutrients through agronomic fortification/fertilization is recommended as an intervention with the benefit of improving the nutritive quality of food and thereby providing essential elements needed by the human body to combat malnutrition and poor health. The conclusion is that better nutrition will contribute to better health and increase productivity and production on the farm.
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    Food and nutrition security: challenges of post-harvest handling in Kenya
    (Nutrition Society, 2015) Kimiywe, J.
    Presently, close to 1 billion people suffer from hunger and food insecurity. Statistics in Kenya indicates that over 10 million people suffer from chronic food insecurity and poor nutrition, 2–4 million people require emergency food assistance at any given time with nearly 30 % of Kenya’s children being undernourished, 35 % stunted while micro-nutrient deficiency is wide spread. Key among the challenges contributing to inadequate foods include lack of certified seeds, seasonal production (rain-fed), high post-harvest losses and wastages, poor transportation, low value additions which reduce their market competitiveness. The present paper examines some of the underlying causes for high food wastage experience in Kenya and the associated challenges in addressing these problems. The paper also provides an overview of some of the basic solutions that have been recommended by various stakeholders. However, in spite of the recent efforts made to mitigate food wastage, there is still an urgent need to address these gaps through participatory, innovative community based interventions that will create resilience to climate change and enhance livelihoods of smallholder farmers in diverse ecosystems.
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    Zinc, iron and calcium are major limiting nutrients in the complementary diets of rural Kenyan children
    (JohnWiley & Sons Ltd, 2016) Ferguson, E.; Chege, P.; Kimiywe, J.; Wiesmann, D.; Hotz, C.
    Poor quality infant and young child (IYC) diets contribute to chronic under-nutrition. To design effective IYC nutrition interventions, an understanding of the extent to which realistic food-based strategies can improve dietary adequacy is required. We collected 24-h dietary recalls from children 6–23months of age (n=401) in two rural agro-ecological zones of Kenya to assess the nutrient adequacy of their diets. Linear programming analysis (LPA) was used to identify realistic food-based recommendations (FBRs) and to determine the extent to which they could ensure intake adequacy for 12 nutrients. Mean nutrient densities of the IYC diets were belowthe desired level for four to nine of the 10 nutrients analysed, depending on the age group.Mean dietary diversity scores ranged from 2.1 ± 1.0 among children 6–8months old in KituiCounty to 3.7± 1.1 food groups among children 12–23months old in Vihiga County. LPA confirmed that dietary adequacy for iron, zinc and calcium will be difficult to ensure using only local foods as consumed. FBRs for breastfed children that promote the daily consumption of cows’/goats’ milk (added to porridges), fortified cereals, green leafy vegetables, legumes, and meat, fish or eggs, 3–5 times per week can ensure dietary adequacy for nine and seven of 12 nutrients for children 6–11 and 12–23months old, respectively. For these rural Kenyan children, even though dietary adequacy could be improved via realistic changes in habitual food consumption practices, alternative interventions are needed to ensure dietary adequacy at the population level.