Determinations of under-nutrition among school-age children (6-12years) in Kawangware peri-urban slum, Nairobi province, Kenya
Chesire, Emmy J.
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Malnutrition is a major public health concern that largely contributes to infant and child morbidity and mortality, especially in developing countries. The nutritional status of school age children is an area where not much research has been done. The few studies that have been done in various countries show that a significant number of school age children do suffer from nutritional deficiencies, and the most prevalent type is Protein Energy Malnutrition (PEM). This was a group, therefore, that required due attention because they form a substantial fraction of the world's population estimated at 24% in developing countries and 15% in industrialized countries. Urbanization is one of the factors aggravating the situation in that the majority of the world's population now live in urban areas, thus increasing the number of the urban poor. This study was therefore carried out in Kawangware peri- urban slum setting within the city of Nairobi. The general objective of this study was to establish the determinants of under-nutrition among school age children between 6-12 years living in a low-income urban community. A cross sectional descriptive study was done to collect relevant data regarding the determinants of under-nutrition in this age group. Cluster sampling was used to identify the dwellings (villages) of the target group. Systematic sampling was used to get a sample size of 384 school age children. The study respondents were the parents, guardians or caregivers of the target population. Data was collected using a structured interview schedule, anthropometry measurements, 24-hour recall, key informant interview guide and observation checklist. The data collected were managed and analyzed using Statistical Package for Social Sciences (SPSS) software. Descriptive statistics was used to analyze continuous and categorical data using measures of central tendency. Pearson's Chi-square test and Fisher Exact test were used to determine associations. The level of significance was fixed at 0.05 (p=0.05). Child anthropometry data were analyzed using Anthro' software package. The diets were analyzed using the Nutri-survey package. The results obtained from this study for all the children, using Z-scores with cut off points of -2SD from the median of reference children, showed that, 4.5% were wasted, 14.9% underweight and 30.2% were stunted. There was strong significant association between the age of the children and their nutritional status in terms of weight for age (p=0.000) and height for age (p=0.000). Sex of the child and nutritional status also had significant association (p=0.003) based on weight for height, 29.1% female children and 18.2% male children were wasted. The male children were more stunted (65.7%) than the female (50.7%) having strong significant association (p=0.003) with the child's nutritional status. Household income and food prices were also significantly associated with the child's nutritional status. Other variables which had significant association with the child's nutritional status included morbidity trends, mode of treatment, school attendance and intake of energy giving foods. These results therefore can form a basis for planning strategic intervention programmes, which can address and alleviate malnutrition among the school age children in the target area and other similar environments.