Dietar Diversity, morbidity prevalence and nutritional Status of children (6 - 23 months old) in Kibera
Miriti, Sussyann Makena
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About 150 million children under five years are malnourished with 70% being in the developing world and 27% of these children are in Africa. Dietary diversity has been associated with improved nutritional status. Presence of diseases suppresses immunity; depress the appetite inhibiting the absorption and nutrient uptake compromising nutritional status. Informal settlements are associated with limited nutritious foods, inadequate clean water and inadequate health care facilities. This study was carried out to assess the dietary diversity, morbidity prevalence and nutritional status of children in Kibera informal settlement. A cross-sectional analytical study design was used where 277 children from 273 households were randomly selected from two locations. A researcher administered questionnaire and focus group discussion guide were used for data collection. Anthropometric measurements were used to determine the nutrition status. Dietary diversity was assessed with 24-hour recall and 7-day- food frequency questionnaire. The 24 hour recall was analyzed by use of Nutri-survey computer software; ENA for SMART was used to convert anthropometric data to Z-scores. Chi-square was used for establishing the relationship for categorical variables. The average size of a household was 3.9 (range 2-8) people. The caregivers were mostly young mothers who were housewives with mainly primary school level of education. The rates of stunting, underweight and wasting were 25.3%, 8.6% and 4.0% respectively. Over two-thirds (64.1%) of the infants were reported to have been sick within the past 2 weeks and only 26.0% sought consultation within twenty four hours. Most caregivers did not seek medical assistance since 66.7% considered the illness as mild while 23.5% lacked money to pay at the facility. Minimum dietary diversity score was determined where 79.4% of the children had received food from the four food groups and above. It was 92.6% in 18-23 months old category, 12-17 months old category was 80.2% and 70.6% in 6-11 months old category. Dietary diversity increased with an increase in age of the child whereby older children consumed a high DDS. Sex and stunting had a significant relationship where more boys were stunted than girls (Chi-square test; p=0.003). Age of the child was also associated with stunting among the children (Chi-square test; p=0.009) with more among the older children. Mothers with some level of education had better nourished children (Chi-square test; p=O.OOI). Occupation of the mother was associated with underweight and stunting (Chi-square test; p=0.006 and p=0.009 respectively). There was association between education level and the DDS score, P = 0.003), household source of income and the DDS score (P=0.003); there was relationship between dietary diversity and the number of times a child is fed. Children who were ill were more likely to be stunted (Chi-square test; p= <0.001). Thus this study recommends households sensitization on consumption of cheaper proteins and vegetables to improve dietary diversity, promote awareness on health seeking behaviors for prompt treatment, adult education to improve knowledge of caregivers especially on nutrition in regard to child feeding.