Constraints and opportunities for implementing nutritionspecific, agricultural and market-based approaches to improve nutrient intake adequacy among infants and young children in two regions of rural Kenya

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Date
2016Author
Hotz, Christine
Gretel, Pelto
Margaret, Armar-Klemesu
Ferguson, Elaine F.
Chege, Peter
Musinguzi, Enock
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Several types of interventions can be used to improve nutrient intake adequacy in infant and young child (IYC)
diets, including fortified foods, home fortification, nutrition education and behaviour change communication
(BCC) in addition to agricultural and market-based strategies. However, the appropriate selection of interventions
depends on the social, cultural, physical and economic context of the population. Derived from two rural Kenyan
populations, this analysis combined information from: (1) a quantitative analysis to derive a set of food-based
recommendations (FBRs) to fill nutrient intake gaps in IYC diets and identify ‘problem nutrients’ for which intake
gaps require solutions beyond currently available foods and dietary patterns, and (2) an ethnographic qualitative
analysis to identify contextual factors posing opportunities or constraints to implementing the FBRs, including
perceptions of cost, convenience, accessibility and appropriateness of the recommended foods for IYC diets and
other social or physical factors that determine accessibility of those foods. Opportunities identified included
BCC to increase the acceptability and utilisation of green leafy vegetables (GLV) and small fish and agronomic
interventions to increase the productivity of GLVand millet. Value chains for millet, beans, GLV, milk and small
fish should be studied for opportunities to increase their accessibility in local markets. Processor-level interventions,
such as partially cooked fortified dry porridge mixes or unfortified cereal mixes incorporating millet and
beans, may increase the accessibility of foods that provide increased amounts of the problem nutrients. Multisectoral
actors and community stakeholders should be engaged to assess the feasibility of implementing these
locally appropriate strategies