Dietary Diversity and Nutrient Adequacy of Children Aged 6-23 Months among Pastoralist and Agro-Pastoralist Communities in Loima, Turkana County-Kenya

Abstract

Malnutrition is a public health concern in many arid and semi-arid lands (ASALs) areas. Literature shows that Africa is the continent experiencing the highest number of food emergencies particularly in the ASALs. In Kenya, high cases of malnourished children among the pastoralist communities have typically increased. Despite the large herd of cattle and camels among the pastoralists community of Turkana, there are high rates of poor physical growth in children, impaired cognition, high morbidity and mortality. Global acute malnutrition (GAM) rate remains at 20.2 percent, while the prevalence of underweight and stunting rates remain at 31.2 and 25.3 percent respectively. Food-based strategies such as agro-pastoralism had been recommended as the first priority to meet micronutrient needs in Loima Sub-county by Ministry of Devolution and Planning in 2015. However, the contribution of this intervention to dietary diversity and nutrient adequacy of children (6-23 months) in these households had not been determined. This study analyzed and compared the dietary diversity and nutrient adequacy of pastoralists and agro-pastoralist communities in Loima Sub-County in Turkana County. The study adopted cross-sectional analytical study design that expedited collection of quantitative and qualitative data and enabled documentation of differences between the two communities and additionally determined associations between the dependent and independent variables of the study. A sample size of 248 children was selected to participate in the study. The study tools were 24-hour Recall to collect the information on foods consumed 24 hours preceding the interview, dietary diversity questionnaires were used to gather information on foods consumed by the children seven days preceding the interview and structured questionnaires used to collect data on social demographic characteristics. Data was analyzed using SPSS version 21.0. Socio-demographic attributes such as education, marital status, household size, and age were analyzed by descriptive statistics such as frequency, percentages, median and mode. Nutrient adequacy of macronutrient (Energy, carbohydrate, lipids, protein, fiber and water) and micronutrients (iodine, iron, and vitamin A) were analyzed using Lucille Program. T-test was used to determine differences between continuous variables in the two study groups. Chi-square was used to test for associations between the variables. A p≤0.05 level of significance applied. Study results showed that 95.0% of the participants both in pastoral and agro-pastoral communities were married. Household size was established at 7.0 in both pastoral and agro-pastoral zones. About 90.9% of children both from pastoral and agro-pastoral communities had drawn energy from grains, white roots and tubers and plantains in form of Ugali. Mean Dietary Diversity score among agro-pastoral children was 4.19 ±1.043 compared to pastoral 3.79 ±1.249. Only (30.8%) of children from pastoral and agro-pastoral communities had attained a Mean Dietary Diversity Score of more than five with breast milk as food group. About a quarter, (26.0%) of breastfeeding children aged 6-8.9 months from the two communities had met a minimum meal frequency of 4 meals a day. Only a third (29.4%) of breastfed children across the two zones had met required Minimum Acceptable Diet. There was a positive correlation between the consumption of energy, carbohydrates, Proteins, Vitamins A, Riboflavin, Vitamin C and other nutrients with Individual Dietary Diversity Score for Children, with p=≤0.001. The result also showed positive correlation between the age of the mothers and Iron consumed by the children, r =0.191, p =0.004. The study recommends that future research should assess dietary patterns in other seasons of the year and compare the dietary score of children during those seasons since this study was conducted during dry season.