MST-Department of Foods, Nutrition & Dietetics

Permanent URI for this collection

https://repository.ku.ac.ke/handle/123456789/373

Browse

Now showing 1 - 20 of 159

Relationship between Intake of Energy-Dense Diets and Nutritional Status of Adolescents in Primary Schools in Nairobi City County, Kenya
(Kenyatta University, 2024-06) Muinga, Evelyne Ndunge
Energy-dense diets are of low nutrient quality but high energy content and this may have adverse health outcomes. There is limited information regarding the relationship between the intake of energy-dense foods and adolescents' nutritional status. The study aimed to establish how the intake of energy-dense diets relates to the nutritional status of adolescents in Nairobi County. The study was a mixed-method research design combining qualitative and quantitative techniques of data collection. Cluster sampling was utilized to select schools in Embakasi South Sub-County. Simple random sampling was utilized to select adolescents in classes 5, 6 and 7; and 161 adolescents (87 females and 74 males) aged 10-14 years participated in the study. Structured questionnaires, 24-hour recall, and food frequency questionnaires were used to collect quantitative data. Anthropometric measurements were taken using calibrated standometers, weighing balance and MUAC tape to determine the nutritional status of the adolescents. The key informant interviews were conducted with 7 headteachers/ class teachers to collect qualitative data. Analysis of quantitative data was done using SPSS software version 23.0. Dietary and anthropometric data were analyzed using Nutrisurvey and ENA for SMART software. Pearson correlation was utilized to determine the relationship between the nutritional status and intake of energy-dense foods. The school heads consented on behalf of the parents of the adolescent. The study established a burden of malnutrition among adolescents in Nairobi County (13%) who are underweight, (5.7%) overweight, (4.3%) severely underweight, and (2.5%) obese. The average energy taken was 1610.4±686.4 kcal. The energy-dense foods which had a significant relationship with the nutritional status of the adolescents were: potato chips (r=0.044, p=0.045), doughnuts (r= -0.02, p = <0.001), pancakes (r= -0.001, p= 0.762), cheese (r= -0.107, p-value= 0.660), and Regular soft drink (r= - 0.147, p= 0.101). Qualitative findings indicated that doughnuts were frequently brought to school as snacks. In conclusion, a quarter of the adolescents interviewed were malnourished. The adolescents' nutritional status was influenced by the intake of some energy-dense diets and sociodemographic characteristics. There is a need to have nutrition education forums in schools and communities on the importance of nutrition to adolescents for better health.
Comparison of Complementary Feeding and Nutrition Status between Children in Households with and those without Kitchen Gardens in Kakamega County, Kenya
(Kenyatta University, 2024-03) Naandi, Bilha
Sub-optimal feeding and nutrition among infants and young children less than 59 months old are leading causes of under nutrition in least developed countries. Recent agri nutrition interventions, focused on kitchen gardening in developing countries revealed its impact on children’s complementary feeding and nutrition status, despite insufficient empirical evidence. This study aimed at comparing nutrition status and complementary feeding of 64 children aged between 6 and 23 months in households with and 64 others without kitchen gardens in Lurambi Sub-County, Kakamega County. The study used a comparative cross-sectional and analytical research design. The findings on nutritional status were compared with WHO, 2006 Child Growth Standards. Researcher administered interviews for selected study participants households, key informants and focus group discussions. Data on IYCF, nutrition assessment and kitchen gardening was elicited and analyzed using SPSS comparing variables from households across the groups. Mothers or caregivers socio-economic, and demographic characteristics with children 6 to 23 months, revealed a significant correlation between owning kitchen garden and crops grown, all (p-values<0.05). Crop production per year, Length for Age Z-scores (LAZ), amount consumed and sold were not normally distributed as was assessed by Shapiro Wilk test and were summarized into median and inter-quartile range (IQR). Logistic regression was used to compute Odds ratios for crops grown, with kitchen gardening households being four times more likely to grow kales (OR=4.058) and three times more likely to grow both jute mallow (OR=2.524) and cow peas (OR=3.246). Their utilization was compared across the two groups. Most households without kitchen gardens did not grow micronutrient rich vegetables. ENA for SMART software was used to generate Z scores from children’s anthropometric measurements. This was interpreted using WHO (2006) Child Growth Reference, with ˂-2 and ˃+2 z-scores as cut off points for under nourished and over-nourished children respectively. Severe stunting of Length for Age Z scores (LAZ) < -3 Z score among children was higher, n=64 (20.3%) than the other n=64 (6.3%) in those without than those with kitchen gardens respectively, with statistically significant difference in stunting levels (LAZ) across the groups (Mann-Whitney Z-test; p-value= 0.011).Minimum dietary diversity was the only index that was statistically significantly different across the groups, (p-value=0.013); with 71.9% and 53.1% meeting MDD in kitchen and non-kitchen gardening households respectively. Diet among children in households without kitchen gardens was mainly consisting of cereals (maize), obtained from their farms. Socio-economic characteristics of mothers and caregivers did not determine the adoption of kitchen gardening technologies. All households should be encouraged to practice kitchen gardening. Common crops grown in kitchen gardens were kales, cowpeas and yams that were mainly utilized as food in households. It was critical to sensitize the later households to practice crop diversification both for subsistence and nutritional implications. Majority of kitchen gardening households had a high crop diversity grown, which resulted in attaining a higher children proportion having MDD. This may mean that despite households accessing arable land, mothers and caregivers need education on the health implications of feeding their children on a less diverse diet. Stunting levels of children with kitchen gardens had lower stunting levels than their counterparts. The null hypotheses that there is no significant relationship between kitchen gardening and dietary diversity as well as no significant relationship between kitchen gardening and nutrition status of index children were therefore rejected. It is recommended that non-kitchen gardening households grow bio diverse, nutrient rich crops that contribute to optimal IYCF. Organizations implementing agricultural programs should collaborate with the Ministry of Health, focus on improving household nutrition, health and food security through agri- nutrition. A longitudinal study ought to be carried out to establish how optimal complementary feeding can be achieved among the children between 6 and 23 months old using nutrition sensitive agricultural programs
Assessment of Infant and Young Child Feeding and Nutritional Status of Children 0-23 Months among Ilchamus Pastoralists in Baringo County, Kenya
(Kenyatta University, 2024-04) Rotich, Joyline J.
World Health Organization defines feeding practices of infants and young children as breastfeeding instantly after delivery and continuing exclusively for six months. Complementary feeding gradually from seven months with breastmilk till two years. Caregivers adhere to adequate infant and young child feeding practices to minimize child undernutrition. However, this is not always the case among the Ilchamus pastoralist community who live in the arid and semi-arid regions of Baringo County, facing challenges such as food insecurity and cattle theft. High prevalence of stunting (28.1%) and underweight (4.7%) have been reported among the community despite efforts to alleviate malnutrition in the area. Unfortunately, there is limited research on the feeding practices of children aged zero to twenty-three months in this community, resulting in a scarcity of information. Consequently, this study investigated the feeding patterns and nutritional status of children zero to twenty-three months among the Ilchamus pastoralists of Baringo County, Kenya. The researcher involved 206 caregivers with children zero to twenty-three months. A cross-sectional analytical study design was adopted. A multi-stage selection strategy was used to arrive at the study sample. Wards and locations were purposively selected. While proportionate selection for villages and households. The study was accomplished in Mukutani and Ilchamus Wards, Baringo County, Kenya. A structured questionnaire was utilized to gather descriptive data. The Statistical Packages for Social Sciences (SPSS) version 22 aided in data analysis. Nutritional status was determined by the mid-upper arm circumference, Weight-for-height, and Weight-for-age Z-score based on World Health Organization cut-offs. Descriptive statistics of infant and childcare characteristics were done using percentages and frequencies while association shown by chi-square and spearman’s correlation significant at p<0.05. Most caregivers had a primary level of education, 154(60.2%), and only seven (2.7%) had tertiary training. About 150(58.6%) were unemployed, and the majority, 142(55.5%), had an income of Ksh 5000- 10,000. About 207(80.9%) were married while 46(16.0%) were single. The prevalence of exclusive breastfeeding was 180 (70.3%), with 181(70.7%) initiating breasting within an hour after birth. About 35(13.7%) introduced other foods before age six. Minimum dietary diversity was at 3.8% for ages 6-8 months, 4.9% for 9-11 months, 8.2% for ages 12-17 months, and 9.2% among ages 18-23 months, and minimum meal frequency was three times a day. Prevalence of Wasting was at 35.6%, stunting (41.6%), and underweight (35.2%). The number of household members and household income are significantly associated with wasting (p<0.05). IYCF practices indicated a significant association with wasting (p<0.05). Stunting also showed a significant link between household members showed a significant association with stunting (p<0.05). In addition, household head, number of people in the household, and occupation of the household head showed a significant statistical association with underweight (p<0.05). Low uptake of optimal children's feeding practices contributes to their poor health and Nutritional status. The findings provide evidence of the importance of ensuring adequate feeding practices among Infants and young children to alleviate malnutrition. Thus, Baringo County and the National Government Ministry of Health in Kenya should enhance programs to improve nutrition education to advance maternal and child health.
Adherence to Dietary Recommendations in the Management of Type 2 Diabetic Patients Attending Diabetic Clinic at Nyahururu County Referral Hospital, Kenya
(Kenyatta University, 2024-02) Muketha, Maureen Karimi
Type 2 Diabetes is among the biggest contributors of deaths and morbidity worldwide. It’s also increasing steadily, and if not controlled, it will soon become an epidemic due to an increase in the ageing population and the number of obesity cases worldwide. This aggravates the existing burden on health systems especially in developing nations. Screening and diagnosis are based on clinical guidelines that encompass both clinical and laboratory parameters. There is presently no cure for the disease. However, adherence to dietary recommendations as advised by health care workers has proven to be a game changer in its management. Hence, the current study sets to unravel adherence to dietary recommendations in the management of Type 2 diabetic patients at Nyahururu County Referral Hospital. Blood glucose level was used in order to determine if the patient has adhered to dietary recommendations. The study was conducted between November 2022 and January 2023; and it adopted a cross sectional analytical design using the Perceived Dietary Adherence Questionnaire to collect information on the socio-demographic characteristics, behavioural characteristics, dietary diversity, adherence to dietary recommendations and the level of dietary awareness. The study also utilised Focus Group Discussions (FGDs) and Key Informant interviews (KIIs) to collect complementary qualitative data. Systematic random sampling was applied in the 152 participants; who attended the diabetic clinic at Nyahururu County Referral Hospital. The information and data collected was entered into SPSS Version 21.0 and analysed. Qualitative data was transcribed coded and analysed to bring out the emerging themes. The study found that the social demographic factors, behavioural characteristics and awareness influenced adherence to dietary recommendation among the diabetics’ patients attending Nyahururu diabetic clinic at Nyahururu County Referral Hospital. Analysis of the respondent BMI was classified under 4 categories of underweight, normal, overweight and obese. Most of the respondents had a normal BMI (55.3%), overweight (28.4%), obese (7.4%) while (9.2%) were underweight. It was also observed 91.5% of the respondents had fasting blood glucose of more than 7.0mmol/l or higher glucose levels at the time of this study. This means that most of the respondents had high and uncontrolled blood sugar levels. The mean energy intake per day was 2291.4±125.6 kcal for men and 2193.7±164.3 kcal for female. The patients’ demographic characteristics influenced the level of adherence to dietary recommendation among the diabetics’ patients attending Nyahururu diabetic clinic at Nyahururu County Referral Hospital. There existed a statistically important association between gender, income, level of education, marital status and the level of awareness with the diabetic patients’ adherence to dietary recommendations at α=0.05. On the other side, age was not found to have insignificant influence on the participants’ adherence to dietary recommendations at α=0.05. There also existed a statistically significant association between Physical exercise, smoking as well as presence of other disease and diabetic patients’ adherence to dietary recommendations at α=0.05. Taking alcohol, family diabetics history, duration lived with diabetes and self- care did not significantly influence participants’ adherence to dietary recommendations at α=0.05. The intervention should be based on gender, education status, marital status and income; the average sugar level in mean was higher than the sugar level in women thus implies that men had low observance of recommended dietary than female. The study recommends emphasis on the observations of physical exercise, smoking and presence of other disease. The Ministry of Health and stakeholders should emphasize regular community sensitization of communities on the dietary recommendations for diabetic patients through continuous nutrition advocacy.
Parental Use of Reward and Punishment on Children’s Food Choices, Dietary Diversity and Nutritional Status in Kiambu County, Kenya
(Kenyatta University, 2024-06) Mutuura, Caroline H. K.
Determinants of food choices are many and include socio-cultural, socio-economic and environmental conditioning. The Kenyan population is made up of 47,564, 296 people of whom 1.4 % are the school going children aged 6-years- old in Juja Sub-County. Parental use of reward and punishment is a key to reinforcement or deterrence of food choices among children an aspect that affects nutritional status throughout. The purpose of this study was to establish the relationship between parental use of reward and punishment, on 6-year-old children and food choices, dietary diversity and nutritional status in Kiambu County, Kenya. A cross-sectional analytical research design was adopted on 384 parent-child pairs who were disproportionately sampled in Juja sub-county. A researcher administered questionnaire was used to collect data on demographics and socio-economic characteristics of the parents and children, parental use of reward and punishment on the study population, food choices and dietary diversity of the study children. Anthropometry was used to establish nutritional status of the study children. SРSS software version 26.0 and excel were used to analyze the data after coding. Anthropometric data was analyzed using WHO Anthro-Plus Survey Analyzer and compared to reference cut-off points for BMI-for-age (BAZ), weight-for-age (WAZ) and height-for-age (HAZ) Scores for the target age. Pearson’s correlation (r) was used to establish association of ratio data where a value of p< 0.05 or lower was significant and chi square (x2 ) used to establish association of categorical variables where the higher the score, the more likely the association between the variables. The boys were 48.0% while the girls were 52.0% with a mean age of 6.4± 0.1. Almost a half of the index children (45.1%) were born first. Mean household size was 5.0± 1.66 with maternal mean age at 34± 4.9 years and that of the fathers at 39± 4.8 years. Majority of the mothers (73.0%) and fathers (76.1%) had tertiary level of education with more fathers than mothers in the formal sector of employment and with a higher income. All (100%) of the children reported being rewarded by receiving incentives like praise words and special permissions (60.1%), favorite snacks (6.3%) and while majority of them (92.0%) reported being punished in multiple ways by the mothers when they refused to feed while a third of the fathers (61.0%) reported praising and gifting the study child to feed. Prevalence of stunting (6.9%), underweight (7.1%), wasting (7.2%), overweight (16.4%) and obesity (11.7%) was observed in the study population. A positive strong significant relationship (P≤0.05, x 2 =5.2) between age of the mothers and punishment was noted and also between married mothers and shouting threats, grounding, inflicting pain & withdrawal of privileges (P≤0.05, x 2 =9.6). More parents with tertiary education (74.6%) and higher incomes (40.5%) gifted and gave special permissions. Gift, praise & special permissions had a stronger positive relationship to food choices (P≤0.06, x 2 =4.33) and nutritional status (P≤0.04, x 2 =5.9). Food choices had a strong positive relationship to nutritional status (P≤0.05) and so did dietary diversity (P≤0.6). Sensitization of parents on the use of parental reward and punishment on children’s food choice and nutritional status came out as an area of interest. The findings of the study will contribute to the achievement of the third sustainable development goal.
Weight Loss Methods among Overweight and Obese Bank Staff in Selected Commercial Banks in Nairobi City: County, Kenya
(Kenyatta University, 2023-05) Macharia, Jacqueline; Peter Chege; Ann Munyaka
Abstract
Determination of Vitamin Concentration in Fresh, Sun and Oven Dried Selected Edible Insects Collected From Siaya County, Kenya
(Kenyatta University, 2023-02) Muya, Virginia Wambui; Hudson Nyambaka; Chrysantus Mbi Tanga
Abststract
Antioxidant Retention Acceptability in Solar-Dried Mushrooms and Acceptability of Mushroom Millet Porridge Blend among HIV Patients in Nakuru County Referral Hospital, Kenya
(Kenyatta University, 2023-11) Masiko, Bosire Miriam; Ann Munyuka; Juliana Kiio
Th_e rolg of mushrooms in preventing and treating illness and promoting quality of life has gained increased awareness especially due to their high antioxidant content. Antioxidants are necessary for body protection against oxidative stress especially among people with lowered immune system, such as People Living with HIV/AIDS (PLWHAs). There are limited options ot: nutritional therapeutic foods available for use by PLWHAs. Millet is an Under}mllze.d indigenous crop in Kenya whose nutrient profile can be improved through blt_ndm.g with other foods. The purpose of this study was to establish the antioxidant (Vltamm E, Vitamin C, B-carotene and Total Phenolic Content) concentration and retention in fresh' .and solar-dried oyster mushrooms (Pleurotus ostreatus) and assess the acceptability of finger millet (Eleusine Coracana) porridge enriched with oyster mushroom among PLWHASs. The study adopted an experimental design with fresh mushrooms and pure millet flour as the control samples and mushroom enriched millet flour as the experimental samples. Fresh mushrooms were purchased in Juja sub-county, Kenya, transported using cool boxes and refrigerated at 4°C in the Kenyatta University food chemistry laboratory. Millet samples were purchased from markets within Nairobi County, Kenya and transported and stored in hermetic bags. B-carotene and Total Phenolic Content of mushrooms and millet were analyzed using UV-VIS spectrophotometry at 450nm and 765nm respectively. Vitamin C and Vitamin E content were analyzed using reverse-phase high Pressure liquid chromatography (HPLC). Sensory acceptability of mushroom-millet porridge was determined using a S-point hedonic scale questionnaire administered to 30 randomly selected participants (PLWHAs) from Nakuru County Referral Hospital. Independent T-tests and Analysis of Variance (ANOVA) were used to analyze nutrient content and sensory scores. The antioxidant nutrient content of fresh and solar dried mushrooms were: B-carotene- 13.73 + 0.02 mg/100g dw, 1.21 + 0.00 mg/100g dw ; Vitamin E- 23.23 + 2.12 mg/100g dw, 0.96 + 1.18 mg/100g dw; Vitamin C 37.25 + 0.32 mg/100g dw, 5.60 + 0.12 mg/100g dw and TPC 36.48 + 1.50 mg/100g dw, 21.55 + 0.24 mg/100g dw respectively. Blanching the mushrooms before solar drying increased the retention rate of the nutrient antioxidants in the solar dried mushrooms. There was a significant difference in the antioxidant content of fresh mushroom and solar dried mushrooms in all the tested nutrients (p < 0.05). Enriching millet flour with mushroom powder significantly increased p-carotene, Vitamin C and TPC concentrations (p < 0.05). There were significant differences between control porridge and mushroom enriched millet porridges on all sensory attributes apart from color (p < 0.05). The unblanched mushroom: millet porridge (60:40) blend was rated the poorest (2.97 + 1.47) in all the sensory attributes. This study’s findings demonstrate that oyster mushrooms are rich in antioxidants. However, solar drying the mushrooms without blanching significantly lowers the levels of the antioxidants. This study established that porridge made from millet flour enriched with mushroom is rich in -carotene, Vitamin C and TPC; and is acceptable among PLWHAs. The consumption of porridge made from millet-mushroom blended flour should be promoted among PLWHAs not only because of protein content but also because of antioxidant content. Findings from this study are relevant to nutritionists, farmers, and policy makers as it shows the potential of mushrooms in enhancing diets, promoting health and income generation.
Socio-Economic and Demographic Determinants of Dietary Practices among Young Adults (19-24 Years) Attending Commercial Colleges in Nairobi’s Central Business District, Kenya
(kenyatta university, 2023-09) Mwanthi, Florence Mwende; Irene Ogada; Zandile Mchiza; Sophie Ochola
Attending a college or university is an experience that is stressful to many young adults as they get introduced to an unfamiliar food environment full of economic constraints. As a result, they may develop poor dietary practices as a way of coping with this stressful environment. Evidence suggests that college students consume sub-optimal diets, hence, they tend to present with the triple burden of malnutrition. There is minimal data on the dietary practices of students attending commercial colleges in Kenya. The purpose of this study was to explore the socio economic and demographic factors related to dietary practices as well as health and nutrition status of commercial college students 19-24 years of age. A sample of 385 students was selected using proportionate stratified sampling coming from 10 purposively picked colleges in Nairobi's Central Business District (NCBD). Data was collected using a pre-tested researcher-administered semi-structured questionnaire that consisted of socio-demographic variables, a 24-hour dietary recall and a food frequency questionnaire. Key informant interview guides and observation checklists were also used to collect information on the food frequently consumed by the participants, food prices and types of food outlets available in the colleges. Food-related data analyses were conducted using the South African Medical Research Council (SA-MRC) Food Finder 111 (2016) package while the general data was analysed using the SPSS version 24 (2017) package. Statistical significance was set at p <0.05. Overall, the mean energy, protein, fat, carbohydrate, added sugar, dietary fibre and sodium intake were respectively 5347kJ±, 138±132g, 138g±132g, 57g±50g, 172g±203g, 16g±15g, 12g±15g and 1244mg±1551mg. Females had higher BMI indices than males (22.67kg/m2 versus 21.48kg/m2, p=0.010). They also had significant waist-to-height ratios (WTHRs) when compared to males (0.49 versus 0.47 p=0.005). Males on the other hand had significant waist–to-hip ratios (WHRs) than females (0.85 versus 0.81, p<0.001). In this case, being male decreased the likelihood of the students having BMI ≥ 25kg/m2 (r= 0.203, p<0.001); while having 2 children or more and attending college for 2 years or more increased the likelihood of the students having BMI ≥ 25kg/m2 (r=7.682, p=0.002 and r= 1.710, p=0.044). The socio-economic determinants of dietary intake were; being a food decision maker, source of water and type of cooking fuel while socio-economic determinants of nutritional status were the source of income and monthly food expenditure. Furthermore, the demographic determinants of dietary intake were the tribe students belonged to, their year of study and the number of children and family size the students had while the socio-demographic determinants of nutritional status were age, sex, and religion. No dietary intake factors were significantly associated with the BMI ≥ 25kg/m2. The food outlets were found to be selling mostly high fat and sugary foods and snacks. The commercial colleges did not have guidelines on the type and nutritional quality of food that should be sold. We therefore recommend that the colleges liaise with food outlets to encourage the sales of healthy food and consult nutrition experts to facilitate provision of information to the students regarding healthy food. The information from this research will therefore be useful to tertiary institutions and stakeholders such as the Ministry of Higher Education, Science and Technology, Ministry of Health, colleges in the Nairobi Central Business District and relevant Non-Governmental Organisations on the current dietary intake and nutritional status of students in Nairobi CBD.
In Vitro Bio-Accessibility and Consumer Acceptability of Zinc Bio-Fortified Mushroom-Heat and Moisture Treated Millet Complementary Porridge in Vihiga County, Kenya
(Kenyatta University, 2023-10) Karenya, Susan; Ann Munyaka; Fredrick Musieba
Zinc is a crucial micronutrient for human physiological processes like infant growth, reproductive health, immune system function, and vision. Zinc deficiency can lead to poor growth, intellectual impairment, prenatal complications, and increased morbidity and mortality. Zinc supplementation or food fortification is recommended to decrease the severity and incidence of severe childhood infectious diseases in populations at risk for zinc deficiency. Given their nutrient density, vital mineral content, and human-promoting compounds, edible mushrooms in this case have great potential for improving the nutritional value of usually carbohydrate-rich diets. There is limited information on the bio-accessibility of zinc from bio-fortified mushrooms when added to heat and moisture treated finger millet porridge. This study was conducted to determine whether heat- and moisture-treated finger millet combined with biofortified mushroom powder effectively increased zinc bio-accessibility and its acceptability. This study adopted a completely randomized experimental design. The study evaluated the effect of zinc supplementation on the zinc content of oyster mushroom fruit-bodies grown on straws with varying concentrations of zinc sulfate. The mushrooms were harvested, dried, and milled into fine powder and those with the highest zinc were mixed with HMT finger millet in different ratios of 100:0 (control), 95:5, 90:10, 85:15, and 80:20. The total zinc content of biofortified mushroom and zinc bio-accessibility in millet-mushroom flour blends were determined using atomic absorption spectrometry and a simulation method of gastro intestinal digestion, respectively. In addition, 25 semi-trained panelists, including mothers and caregivers aged 18-45, evaluated porridges made from HMT finger millet-mushroom composite flours at a postnatal clinic. Adding zinc to growth substrates had a significant (p˂0.05) effect on zinc content in mushroom. Zinc levels. Substrates without ZnSO4 produced mushrooms containing 8.9 mg Zinc, which increased by 30.9% when 600 mg ZnSO4 was added. Furthermore, HMT finger millet porridge without mushrooms had a Phytic acid: zinc molar ratio of 60.3, which decreased to 34 when 20% (w/w) mushroom powder proportions were added. Despite having the highest bio-accessible zinc with the least effect on texture and appearance, a 20% mushroom proportion in HMT finger millet porridge considerably compromised the taste, aroma and general consumer acceptability. Bio-accessibility of zinc was increased from 16.57% to 21.653% when blended with 20% mushroom powder. Blending HMT finger millet flour with mushroom powder improved zinc bio-accessibility of the porridge. However, when added beyond a certain limit, mushroom reduced organoleptic qualities of the porridge, which affected overall consumer acceptance. The study recommends, therefore, that mushroom powder be added to finger millet flour in the appropriate proportions to enhance nutritional and health benefits of porridge while minimizing possible negative impacts on sensory properties.
Lifestyle Habits and Nutritional Status of Undergraduate Students at Kenyatta University, Nairobi City County, Kenya
(Kenyatta University, 2023-09) Ndung’u, Joseph Mburu; Judith Waudo; Joseph Kobia
Since 1975, the prevalence of obesity has nearly tripled. About 39% of adults worldwide (1.9 billion) were overweight and obese by the year 2016. Lifestyle habits such as eating habits, physical activity, smoking, alcohol intake and sleep duration have been associated with obesity. The transition from secondary to tertiary education comes with increased liberty and choices in lifestyle habits. The study’s purpose was to establish a relationship between demographic, socio-economic status, and lifestyle habits on the nutritional status of undergraduate students at Kenyatta University in Nairobi County, Kenya. The study design was cross-sectional analytical while the study location was Kenyatta University. The sample population was 260 students drawn from 17 schools. Data was collected using a researcher-administered questionnaire. Data analysis was conducted using SPSS version 24.0. About 249 respondents participated in the study. About 79.9%, 8%, and 12% had neutral eating habits, unhealthy eating habits and healthy eating habits. Just under a quarter (24.1%) of the respondents were physically active while 75.9% were physically inactive. A low prevalence of tobacco smoking was reported. All smokers were light smokers. The average sleep duration was 7.88 ± 1.308 hours per day. About, 56.6%, 28.1% and 15.3% reported they sleep between 7-8 hours, ≥9 hours and <7 hours of sleep per day. Close to a third (31.3%) reported alcohol intake. Based on drinks per occasion, 73.1 and 26.9% of the alcohol users were moderate and binge alcohol users respectively. Based on Body Mass Index, 8.4%, 67.5%, 16.5% and 7.6% of the respondents were underweight, normal, overweight and obese respectively. However, based on Waist Circumference, 21.7% had abdominal obesity while 78.3% had no abdominal obesity. There was a significant relationship between residential status and eating habits. Only sex and age showed a significant relationship with smoking status. Significant associations between demographic and socio-economic characteristics were reported. Advanced age, fourth year of study and source of meals were significantly associated with BMI. Only sex, year of study and residence status were significantly associated with Waist Circumference. Associations between lifestyle habits and nutritional status, consumption of fast foods was significantly associated with Furthermore, mean eating habits scores had a significant association with waist circumference. The study findings showed that more males than females engaged in harmful alcohol intake and smoked tobacco while more females than males were physically inactive and reported higher BMI and waist circumference. These findings can be used to inform gender- specific strategies and interventions to prevent smoking, harmful alcohol intake, physical inactivity, overweight, obesity and abdominal obesity. Studies on physical activity and nutritional status using objective methods of assessing physical activities should be conducted.
Dietary Intake, Comorbidities and Nutrition Status of Maintenance Hemodialysis Patients Attending Renal Unit Kenyatta National Hospital, Kenya
(Kenyatta University, 2023-10) Maina, Rachael Muthoni; Judith Waudo; Regina Kamuhu
Chronic Kidney Disease globally has been worrying as it has risen to being the 17th leading cause of mortality in 2015. It is approximated that in Kenya 4% are affected which may not be the true burden as the country lacks national registries. Diabetes and hypertension, the major etiologies of kidney failure are epidemic in Kenya. Although there are good guidelines by the Kidney Disease Outcome Quality Initiative on the recommended dietary energy and protein intake, hemodialysis patients are unable to meet the targets because of the dietary restrictions to prevent mineral imbalances, low socioeconomic status and presence of comorbidities. Protein Energy Wasting, an indication of low nutrition status of patients is seen in 18-75% of hemodialysis patients. This called the need to evaluate, do the hemodialysis patients in Kenya meet the required dietary intake, what the comorbidities are affecting them and what is their nutrition status? Therefore, the objective of the present study was to know the dietary intake, comorbidities and nutrition status of hemodialysis patients. A cross-sectional analytical study was conducted among 84 respondents undergoing hemodialysis present during the month of November 2021 at Kenyatta National Hospital renal unit. They were selected using consecutive purposive sampling. Data collection was done using a digitalized questionnaire for the socio-demographic and economic factors, presence of comorbidities, a 7-point subjective global assessment scale to assess the nutrition status, two 24hr dietary recalls both on non-dialysis and dialysis days, Individual dietary diversity score from the average 24hr recall, a 7-day food frequency questionnaire and nutrition supplement consumption to evaluate the nutrient intake. The researcher also conducted a focus group discussion with 12 dialysis patients and caregivers to know the factors that caused proper and poor adherence to diet. Quantitative data were analyzed using SPSS version 25 and Updated Nutri-survey 2018 while qualitative content, hand-coding and presented in form of themes. The mean age was 42.24±16.6 years with 41% being male. About a third 38.1% were employed and a majority 66.7% relied on family for financial support. Diabetes Mellitus (20.2%), present or past malignancy (4.8%) and cardiovascular illness (4.8%) were comorbidities present. The average energy intake was 14.738±8.46 kcals/ kg body weight/ day lower than endorsed 30-35kcal/kg/day. There was no significant difference (t=.990, p-value=0.325) in energy intake on dialysis and non-dialysis day. The mean protein intake was 0.43g/kg/day way lower than advocated 1.2g/kg/day. The mean daily micronutrients intake was as follows: sodium, 904.54±805.27mg; potassium 973.57±595.2mg; phosphorus, 549.835±401.91mg, calcium, 203.78±127.325mg; zinc 4.92±4.02mg; vitamin C, 42.83±31.58mg; and vitamin B6, 0.815±0.685mg. The average 7-point Subjective Global Assessment score was 4.95±0.963 with 70% having protein-energy wasting (score ≤ 5). Employment (P =.007) and education level (P= .035) were found to be significantly associated with nutrition status. There was no significant relationship noted between average energy intake (P=0.446), average protein intake (P=0.16) and nutrition status. Comorbidities had no significant association with nutrition status(P=.221). Fear of respiratory distress and hope for better health caused adhere to nutrition counselling. NHIF cover not inclusive of nutrition service charges, low purchasing power and constant delays due to machine breakdown and water issues caused poor dietary adherence. This study reveals that there was low dietary intake and moderate protein energy wasting. It can be curbed by proper and continuous nutrition counseling by the renal nutritionist. Ministry of Health, National and County Hospital heads to ensure full NHIF medical cover inclusive of laboratory biochemical tests and nutrition services for continuous nutrition status review.
Knowledge, Attitude and Acceptability of Human Breast Milk Banking among Lactating Mothers at Pumwani Maternity Hospital, Nairobi City County, Kenya
(kenyatta university, 2023) Mati, Christine Mwende; Peter Chege; Joseph Kobia
Human breast milk is the most critical feeding option for newborns and infants. The World Health Organization recommends infant exclusive breast feeding for the initial six months of life. In the instance that breastfeeding cannot be seamlessly achieved or initiated; the WHO recommends the donation and use of human breast milk as the best of other replacement feeding options. In Kenya, the first human milk bank was started up in 2019 at Pumwani Maternity Hospital in Nairobi City County, with the aim of filling this gap in breastfeeding practices for the benefit of infants. The purpose of this study was to establish the knowledge, attitude and acceptability of human breast milk banking among lactating mothers at Pumwani Maternity Hospital, Nairobi City County, Kenya. A cross-sectional descriptive study design approach was utilized for the study, with systematic sampling and sample random sampling methods applied to gain 403 lactating mothers as the study respondents. A structured and consolidated, researcher-administered questionnaire, key informant interviews and focus group discussions were used to collect the data. The collected qualitative data was analyzed using the Statistical Package for Social Sciences (SPSS) version 21.0. Chi-Square tests were used to determine association and the Fisher’s Exact test was applied to assess the null hypotheses for variables where the frequencies were less than five. Results with p-values less than 0.05 were said to be statistically significant. For qualitative data, content analysis was conducted. The results indicated that the mean age of lactating mothers visiting Pumwani Maternity Hospital was 30.8 ± 6.9 years. A majority (51.7%) of the lactating mothers had adequate knowledge on human donor breast milk banking with 48% of them having a basic knowledge on the concept of human breast milk donation. A majority (57.1%) of the lactating mothers reported positive attitudes towards human breast milk donation and banking. However, human breast milk donation and banking was only acceptable to 36.4% of the lactating mothers, and was unacceptable to 24.8% of them. 32.7% of the participants were uncertain about their acceptability of donor human breast milk banking. A significant relationship (χ2==55.9671; p-value<0.00001) was found to exist between the lactating mothers’ age and their acceptability of donor human breast milk banking. Their acceptability of donor human breast milk banking was also significantly associated with their marital status (χ2 =43.3383; df 2); and their level of education (χ2=11.78; df 2; p-value=.019046). However, it was found that there was no significant relationship between the lactating mothers’ acceptability of donor human breast milk banking and their employment status or occupation ((χ2=1.1567, p=.5608]). The researcher concluded that knowledge and attitudes of lactating mothers are co-dependent in influencing their acceptability of human breast milk donation and banking. It is recommended that efforts to improve knowledge levels of lactating women on the concept and availability of human breast milk donation and banking facilities be employed within Pumwani Maternity Hospital and Nairobi City County. The findings of this study may therefore be useful to stakeholders within the Nairobi City County, and the Human Breast Milk Banking coordinators at Pumwani Maternity Hospital, in the effort of strengthening gaps in infant feeding.
Antioxidant Retention in Solar-Dried Mushrooms and Acceptability of Mushroom Millet Porridge Blend among HIV Patients in Nakuru County Referral Hospital, Kenya
(Kenyatta University, 2023) Bosire, Miriam Masiko; Ann Munyaka; Juliana Kiio
The role of mushrooms in preventing and treating illness and promoting quality of life has gained increased awareness especially due to their high antioxidant content. Antioxidants are necessary for body protection against oxidative stress especially among people with lowered immune system, such as People Living with HIV/AIDS (PLWHAs). There are limited options of nutritional therapeutic foods available for use by PLWHAs. Millet is an underutilized indigenous crop in Kenya whose nutrient profile can be improved through blending with other foods. The purpose of this study was to establish the antioxidant (Vitamin E, Vitamin C, β-carotene and Total Phenolic Content) concentration and retention in fresh and solar-dried oyster mushrooms (Pleurotus ostreatus) and assess the acceptability of finger millet (Eleusine Coracana) porridge enriched with oyster mushroom among PLWHAs. The study adopted an experimental design with fresh mushrooms and pure millet flour as the control samples and mushroom enriched millet flour as the experimental samples. Fresh mushrooms were purchased in Juja sub-county, Kenya, transported using cool boxes and refrigerated at 4ºC in the Kenyatta University food chemistry laboratory. Millet samples were purchased from markets within Nairobi County, Kenya and transported and stored in hermetic bags. β-carotene and Total Phenolic Content of mushrooms and millet were analyzed using UV-VIS spectrophotometry at 450nm and 765nm respectively. Vitamin C and Vitamin E content were analyzed using reverse-phase high Pressure liquid chromatography (HPLC). Sensory acceptability of mushroom-millet porridge was determined using a 5-point hedonic scale questionnaire administered to 30 randomly selected participants (PLWHAs) from Nakuru County Referral Hospital. Independent T-tests and Analysis of Variance (ANOVA) were used to analyze nutrient content and sensory scores. The antioxidant nutrient content of fresh and solar dried mushrooms were: β-carotene- 13.73 ± 0.02 mg/100g dw, 1.21 ± 0.00 mg/100g dw ; Vitamin E- 23.23 ± 2.12 mg/100g dw, 0.96 ± 1.18 mg/100g dw; Vitamin C 37.25 ± 0.32 mg/100g dw, 5.60 ± 0.12 mg/100g dw and TPC 36.48 ± 1.50 mg/100g dw, 21.55 ± 0.24 mg/100g dw respectively. Blanching the mushrooms before solar drying increased the retention rate of the nutrient antioxidants in the solar dried mushrooms. There was a significant difference in the antioxidant content of fresh mushroom and solar dried mushrooms in all the tested nutrients (p ≤ 0.05). Enriching millet flour with mushroom powder significantly increased β-carotene, Vitamin C and TPC concentrations (p ≤ 0.05). There were significant differences between control porridge and mushroom enriched millet porridges on all sensory attributes apart from color (p ≤ 0.05). The unblanched mushroom: millet porridge (60:40) blend was rated the poorest (2.97 ± 1.47) in all the sensory attributes. This study’s findings demonstrate that oyster mushrooms are rich in antioxidants. However, solar drying the mushrooms without blanching significantly lowers the levels of the antioxidants. This study established that porridge made from millet flour enriched with mushroom is rich in β-carotene, Vitamin C and TPC; and is acceptable among PLWHAs. The consumption of porridge made from millet-mushroom blended flour should be promoted among PLWHAs not only because of protein content but also because of antioxidant content. Findings from this study are relevant to nutritionists, farmers, and policy makers as it shows the potential of mushrooms in enhancing diets, promoting health and income generation.
Women’s Participation in Household Decision-Making, Dietary Diversity and Nutritional Status of Children in Smallholder Farming Households in Kakamega County, Kenya
(Kenyatta University, 2023-08) Musau, Kelvin; Elizabeth Kuria; Ann Munyaka
Addressing malnutrition in under-five children remains a global priority due to its association with long-term adverse health and economic implications at all levels in society. While huge disparities in progress towards nutrition targets for SDGs exist across the globe, sub-Saharan Africa particularly lags despite the intensity of nutrition and health programmes ongoing in the region. There is a need to explore new paradigms in the etiology and epidemiology of child malnutrition paying attention to the socio-economic and cultural dynamics associated with unique contexts. Evidence shows that allocation of resources towards a child's health and nutrition inputs like child feeding and treatment hung on household decision-making patterns. However, there is limited evidence on the level of women’s participation in household decision-making and its implication on the nutritional and health outcomes in children. This study adopted a cross-sectional analytical design to determine women’s participation in household decision-making and its influence on nutritional status of children aged 6-59 months of age in rural smallholder farmer households in Kakamega County. Lugari Sub-County was purposively chosen based on the high prevalence of malnutrition and large population of smallholder farmers. Simple random sampling method was used to select Chevaywa out of the 6 Wards making up Lugari Sub-County while 330 households randomly selected from a sampling frame of smallholder farming households with children 6-59 months old from the 3 Sub–locations in the ward participated. A researcher-administered questionnaire was used to collect data on demographic and socio-economic characteristics of the participants, household decision-making patterns, child dietary diversity and nutrition status. Data collected was coded and analyzed using STATA version 15.1 and presented using measures of central tendency, frequency tables and graphs. Regression analysis was used to model the relationship between predictor variables (socio-economic characteristics, level of women’s participation in household decision making, child dietary diversity) and the outcome variable (nutritional status). Significance was tested at α=0.05, 95% confidence interval. The findings show that in majority (90%) of the households, decisions were predominantly made jointly by the women and their spouses. The prevalence of wasting, stunting and underweight was 4.5%, 20.6% and 6.4%, respectively. Women who made fewer unilateral household decisions (<=50%), were more likely to have wasted (odds ratio=1.38, p=0.003), stunted (=odds ratio= 1.77, p=0.010), and underweight (= odds ratio =1.11, p=0.044) children compared to those who made > 50% unilateral decisions. Based on the study findings, participation of women in household decision-making is critical to the realization of optimal nutritional outcomes in under-five children in rural smallholder farming contexts as it enhances dietary diversity and nutritional status of children aged 6-59 months. Cognizant of the importance of women in decision making, policies should that seek to empower women socio-economically should be promoted at all levels in the society. Similarly, nutrition programmes implementers should integrate social behavior change and communication interventions in their projects to address culturally propagated and encouraged gender stereotypes and biases that deny women the decisional space at the household level.
Feeding practices, morbidity, and nutrition status of adolescent street children 10-17 years in Nairobi city county, Kenya
(Kenyatta University, 2023-11) Machocho, Jomo Sofia
UNICEF approximates that there are millions of street children globally, and a majority of them live in low- and middle-income countries. According to the 2018 National Census of Street Families, 15,347 adolescents are street inhabitants, and approximately 5,046 of live in the streets of Nairobi. Despite this high population, research on the feeding practices, morbidity, and nutrition status of adolescent street children is very limited. The purpose of this study was to determine the feeding practices, morbidity, and nutrition status of adolescent street children 10-17 years in Nairobi City County. Analytical cross-sectional design was used for this study. The study had 248 study participants (89 females and 159 males). The sampling was done by cluster sampling. Five clusters were randomly selected; Jeevanjee Gardens, Uhuru Park, Toi Market, Muthurwa Market, and Gikomba Market. Everyone who met the inclusion criteria in the randomly selected clusters took part in the study. Data was collected using anthropometric tools, interviewer-administered questionnaires, and focus group discussions. Anthropometric data was analysed using WHO AnthroPlus software, quantitative data was analysed using the 25th version of Statistical Package for Social Science (SPSS) software, and qualitative data was analysed using NVivo 1.0 software. A majority (40.3%) of the study participants had two meals per day. The participants lacked dietary diversity. Majority (75.8%) of the respondents had been sick in the past two weeks prior to the data collection. Over half (54.8%) of the respondents had experienced gastrointestinal (GIT) infection. A few of the respondents were malnourished as 3.2% had severe thinness, 8.1% had thinness, 4.8% were overweight, 7.7% were stunted, and 2.8% were severely stunted. The rate of thinness in the respondents was more than the acceptable levels of wasting recommended by WHO in developing countries (<2%). The cases of under-nutrition were more in adolescent street males than adolescent street females. The study showed that there is a significant relationship between feeding practices and nutrition status of adolescent street children 10-17 years in Nairobi City. The study also showed that there is a significant relationship between morbidity and nutrition status of adolescent street children 10-17 years in Nairobi City County. The findings revealed that the nutrition status of street children is influenced by their feeding practices and morbidity. The county government is planning to construct a rehabilitation centre and develop a policy with programmes for the street children. While waiting for the street children to be rehabilitated, the county government should strengthen the implementation of programmes aimed at improving the feeding practices and health status of street children. Specific feeding and treatment programmes for street children should also be included in the proposed street children rehabilitation policy. To determine effective strategies that can be used to improve the nutrition status of adolescent street children, a longitudinal intervention study should be done.
Agricultural Commercialization of Staple Foods, Household Food Security and Nutrition Status of Children Aged 6-59 Months in Tharaka-Nithi County, Kenya
(Kenyatta University, 2022) Gitari, Janice Gatakaa; Peter Chege; Ann Munyaka
Globally, the number of undernourished people rose to above820 million in 2018. Kenya ranked 125th out of 157 countries in progress toward meeting the Sustainable Development Goals in 2017. Among the thirteen counties in the eastern and central regions of Kenya, Tharaka-Nithi County ranked second on stunting levels at 32%. Studies have shown large variations in food security implications caused by commercialization of agriculture hence need for further research to generate conclusive results. Thus, this study sought to assess the effect of agricultural commercialization of staples and household food security on nutrition status of children aged 6-59 months in Tharaka-Nithi County. The study adopted a cross-sectional analytical study design. Purposive sampling was used to select Mukothima ward. Proportionate to sizes sampling was used to select the number of households while systematic sampling was used to select the households with under-fives in each of the sub-locations to generate 374 children-caregiver pairs. Researcher administered structured questionnaires, key informant interview and focus group discussion guides were used to collect data. Data was entered into SPSS version 20.0 for analysis. Nutri-Survey and ENA for SMART were used to analyse 24-hour recall and anthropometric data respectively. Chi-square tests were run to test associations among categorical data variables. Qualitative data was organized into themes for analysis. The mean household size was 4.28 ± 1.404 with 85.2 %, of the households being headed by youthful men. 52.5% of the subjects relied on food crops’ sale as their main income source with65.3% being high level participants of agricultural commercialization. The mean Household Dietary Diversity Score was 5.32± 1.06. Based on Household Food Insecurity Access Score, 35.51% of the households were food secure. The mean number of meals eaten by the households in the day preceding the study was 2.94 ±0.926 with the main food source being purchases. Further, the mean energy and selected nutrient intakes of the under-fives in the study were adequate except for Zinc and Vitamin A. The prevalence of underweight based on WAZ-scores was 17.2 % while the GAM based on WHZ-scores was at 5.4 %. 33.6 % of the under-fives in the study were stunted. Significant positive associations were observed between: agricultural commercialization and income (Chi-square=23; P value =0.021); agricultural commercialization and occupation (Chi-square=23; P value =0.007); Income and HDDS (r=0.71; P value =0.035); agricultural commercialization and HDDS (P value =0.001); agricultural commercialization and nutrition status of the under-fives (P value =0.0041) and HDDS and nutrition status of the under-fives (r=0.78; P value =0.003). This study demonstrated that households which practice Agricultural Commercialization to a larger extent generated income which enabled them to purchase various foods in addition to their own produce thus achieving adequate nutrient intakes resulting to better nutrition outcomes. Thus, Tharaka-Nithi County Government should domesticate the Food Crops Act of 2013 which regulates food crop production activities. The County Government of Tharaka-Nithi and other partners should intensify adoption of sustainable nutrition interventions that will address the high levels of stunting among under-fives as revealed by the study results. A longitudinal study is recommended to further explore the relationships between agricultural commercialization and food security given their multi-dimensional nature.
Competency of Community Health Volunteers on Complementary Feeding Strategies of Children 6-23 Months in Masinga, Machakos County, Kenya
(Kenyatta University, 2022) Kivaya, Susan Katunge; Eunice Njogu; Juliana Kiio
Sub-optimal complementary feeding practices are a major cause of malnutrition among children aged 6-23 months in developing world. In Kenya, only 39% of children are fed according to the recommended optimal infant and young child nutrition practices with only 54% achieving adequate dietary diversity. Machakos County has a high prevalence of stunting (26.5%), wasting (6.5%) and underweight (8.1%) among children. Community Health Volunteers (CHVs) can help in reducing malnutrition and child mortality through advocacy of the recommended complementary feeding (CF) practices. However, CHVs’ face myriad challenges including, low levels of education and inadequate training as their curriculum is limited on CF information. There is scarcity of information on the level of training and competence of CHVs in the area of CF. This study therefore aimed at assessing the competency (knowledge, skills and practices) of CHVs on CF in Masinga Sub-County of Machakos County. A cross-sectional analytical study design was adopted. A semi-structured questionnaire was administered to 168 CHVs randomly selected from 10 Community Units (CUs). An observation checklist was used to assess skills of CHVs. Four Focus Group Discussions (FGD) were used to gather qualitative information from CHVs on knowledge, practices and challenges faced. Key Informant Interviews (KII) were administered to nutritionists, nurses and public health officers and solicited information on knowledge and challenges faced by CHVs on CF. Data was analyzed using SPSS version 24 and a p value of <0.05 was used as the statistical significance. An overall knowledge score categorized as low (<40%), moderate (41-69%) and high ((≥70%) was used to establish CHVs’ knowledge on CF. Majority (73.8%) of the CHVs, were female. The mean age of the CHVs was 46.64 ± 10.9 years. Majority (56.5%) had attained primary education as their highest level of education and farming was their main source of income. The findings further showed that 23.2%, 66.1%, and 10.7% of the participants had high, moderate and low CF knowledge score respectively. About 83.9% of the CHVs had fair counselling skills while the rest (16.1%) had unsatisfactory skills. Majority (83.5%) of the participants used nutrition counselling as their strategy to pass CF information to caregivers. Nearly half (43.5%) met the MOH requirements of visiting households at least once in a month. Overall, only 8.3% of the CHVs met the minimum expected competence threshold based on a combined knowledge, skills and practice score. Statistically significant associations were observed between the CHVs’ CF nutrition knowledge level and their occupation (AOR = 1.63 C.I; 1.23-8.25), education level (AOR = 3.36 C.I; 1.07-10.59) and source of income (AOR = 3.50 CI; 0.91-13.40). Moreover, occupation (AOR = 3.50 CI; 0.27–16.05) and education level (AOR = 12.1 CI; 5.48–21.95) were also associated with the CHVs skills. The number of topics covered during nutrition counselling by the CHVs were also associated with the CHVs CF nutrition knowledge (AOR = 3.80 C.I; 1.24-11.63). The CHVs’ skills were also associated with their practice of nutrition counseling (AOR = 45.43 C I; 20.47-89.54). MOH and other stakeholders should enhance training and capacity building of CHVs and the training curriculum should also be reviewed to strengthen the CF aspects
Household Food Security and Nutrition Status of Children 6-59 Months among Smallholder Tea Farmers in Vihiga County, Kenya
(Kenyatta University, 2022) Onchwari, Callen Kerubo; Peter M. Chege; Regina W. Kamuhu
Childhood malnutrition remains a major public health problem in developing countries. Appropriate, Infant and young child feeding practices at this stage is thus very critical for the growth, development, and survival of children. Household food insecurity which has strongly been associated with poor health of both adults and children remain prevalent in developing countries. This is so because food insecurity could affect the quantity and quality of food consumed by the household member. In children, Inappropriate care and feeding which could be influenced by household food insecurity are recognized as some of the underlying causes of under nutrition. Tea farming is common in Kenya and most of it is produced by smallholder farmers. Further, there is very minimal data currently on the food security status and nutrition status of under five children of small-scale tea farmers in Kenya. This study investigated the food security status and under-five nutrition status of smallholder tea farmers in Vihiga County, Kenya. The study will adopt a cross-sectional analytical study. A Multistage sampling technique was employed in this study and a sample of 310 was considered. In the first stage, Vihiga County was purposively selected while the respondents were randomly selected. Descriptive statistics such as frequencies and means, were used to describe the data while Inferential statistics such as Chi-Square, Correlations. Logistic regression was used to determine the predictors of the household food security and child nutrition status. Majority of people had 3 acres of land (45.5%) while (3.1%) had more than 6 acres of land. Cash crop took the highest portion of their land. Most children (49.0%) consumed four different food groups per day. The DDS was low (4.5 ± 2.1) with only about 15% meeting the minimum requirements for dietary diversity, meal frequency and acceptable diet while most households >90% took cereals, pulses, vegetables, sugar and fat. Most of the children are suffering from wasting. The GAM rate for stunting was 35.6% with 2.4% being severe while in wasting 8.6% were wasted with 0.7 being severely wasted and 16.8% were underweight with 0.7 being severe. Morbidity status indicate majority of the sick children having malaria (42.1%), followed by Cold (26.3%) and then diarrhea (21.1%). The production from tea was low (104.3 ± 24.7 kg while the income from tea was not reliable with a kg being paid at 18 KES, however most of the tea-based income was not used on accessing food. Most of the tea-based income was not used on accessing food. The production from tea was low (104.3 ± 24.7 kg while the income from tea was not reliable. Men controlled the tea income, and any other income, with a few drinking the proceeds. Consumption of cereals, pulses, vegetables and chicken were okay. However, the consumption of the others was low. The study recommends empowerment of women so that they make decisions on food production, income and use and further the review on tea pay policy to ensure payment that commensurate with input as well as more sensitization of mothers on more allocations of funds to food use of the available funds for a diversified health diet.
Maternal Perception on use of Edible insects for Complementary Feeding and Nutrition Status of Children in Kakamega and Siaya Counties, Kenya
(Kenyatta University, 2022) Rhoda, Nakhosi Nabuloobi; Judith Kimiywe; Ann Munyaka
Edible insects are a good source of lipids (α- linoleic and linolenic essential fatty acids), carbohydrates, vitamins, high quality protein and minerals. Malnutrition occurs mostly in children 6-24 months old and is often caused by initial introduction of complementary feeding to children below six months, diets with low protein and diseases. The aim of this study was to investigate the maternal perception on use of edible insects for complementary feeding and nutrition status of children in Kakamega and Siaya Counties in Kenya. The study adopted a cross-sectional analytical design which was used on a sample of 592 mother-child pairs (aged 6-23 months) in three wards namely; Kisa North, West Yimbo and West Ugenya in Kakamega and Siaya Counties respectively in Western Kenya. The study sites were purposively selected. Actual measurements of foods consumed were done. A structured questionnaire with different sections was used to obtain information about the socio-economic and socio-demographics, frequency of food consumption, 24-hour dietary recall, anthropometry, household insect consumption and data on maternal perception on use of edible insects for complementary feeding. Data on maternal perceptions was collected using a Likert scale of 1(strongly disagree) to 5(strongly agree). Nutrition status data was analyzed using ENA for SMART software while Nutri-survey was used to analyse data for complementary feeding practices. SPSS software version 25 was used to analyze data. Data from Focus Group Discussions and Key Informant Interviews were coded and analyzed based on the content of the study. Majority of the mothers were in the childbearing age group of 15-49 years and were married. More than half of the household heads were males and were aged between 20-49 years in nearly all (97.7%, 98.3% and 99.0%) the households in Kisa North, West Ugenya and West Yimbo respectively. Generally, among the three wards, slightly more than a half (50.9% and 54.2%) of the household heads in Kisa North and West Ugenya respectively and 48.8% in West Yimbo had attained primary education. More than half of the mothers (57.9% in Kisa North, 65.7% in West Ugenya and 64.6% in West Yimbo) had attained primary education. Almost half (49.5%) of the mothers in Kisa North and 38.9% of the mothers in West Ugenya practiced farming while 35.3% of those in West Yimbo were small scale business women. Almost half of the household heads in West Ugenya were farmers, in Kisa North they were casual labourers while in West Yimbo they engaged in fishing. The mean household income was Ksh 6002±8486, 9352.7±10434 and 4928.3±6514.9 for Kisa North, West Ugenya and West Yimbo respectively. The average household size was 5, 6 and 5 for Kisa North, West Ugenya and West Yimbo respectively. More than a third (42.1%, 33.7% and 39.3%) of the mothers in Kisa North, West Ugenya and West Yimbo respectively disagreed about the use of edible insects for complementary feeding. On average the number of meals consumed per day was 4 among the three wards. More than half (65.3%, 56.6% and 61.7%) of the children in Kisa North, West Ugenya and West Yimbo respectively in the study attained the Minimum Dietary Diversity. More than half (58.9% and 55.8%) of the children in West Yimbo and West Ugenya respectively attained the Minimum Acceptable Diet. More than half (70.3%) did not attain the Minimum Acceptable Diet in Kisa North. In terms of nutrition status of the children, there were high prevalence rates of wasting (6.3% in West Ugenya, 7.0% in West Yimbo and 6.0% in Kisa North) among the study children and low stunting (19.5% in West Ugenya and an equal proportion of 19.9% in West Yimbo and Kisa North) and underweight rates (9.2% in West Ugenya, 9.0% in West Yimbo and 8.8% in Kisa North). There was a significant relationship between the ward of residence (ꭓ²=16.86, p value=0.030), marital status of the mother (ꭓ²=11.14, p value=0.025), main source of income for the household head (ꭓ²=33.35, p value=0.007), the education level of the household head (ꭓ²=48.67, p value=0.009) and the maternal perception on use of edible insects for complementary feeding. This study recommends the use of edible insects that are locally available to improve the nutrient intake of the children. This information will be useful to the MOH through the division of nutrition for inclusion in the MIYCN policy the use of edible insects as a complementary food and to food industries as a basis for developing affordable and nutritious insect based complementary foods.

Browse

Recent Submissions