Dietary Diversity, Nutrient Intake and Nutrition Status of Children 6-23 Months in Busia County, Kenya

Abstract

Globally, 17 million children suffer from severe acute malnutrition with an estimated mortality rate of 1 to 2 million in Sub-Saharan Africa. In sub-Saharan African Countries, diets of children aged under-five years are commonly based on the calorie dense foods with minimal or no animal products and rarely do they have adequate intake of vegetables and fruits. According to Kenya Demographic Health Survey (2015), 34% of children under five of age in the western region of Kenya, where Busia County is situated were stunted while 15% were underweight. Micronutrient deficiencies such as vitamin A and iron are widespread in the area. This study therefore sought to fill this gap by assessing diet diversity, nutrient intake and its influence on their nutrition status. A cross-sectional analytical study was adopted with the aim of finding out the influence of dietary diversity and nutrient intake on the nutrition status of children aged 6-23 months from rural households of Nambale Sub-County, Busia County, Kenya. Nambale Sub-County was chosen purposively based on the high prevalence of malnutrition in the area. Random sampling using table of random numbers was used to select Nambale North / Walatsi ward and Nambale Township Ward from the 4 wards in Nambale Sub County. Nambale North had 59 villages while Nambale Township had 27 villages. Using simple random sampling, a table of random numbers using MS Excel was prepared for the villages and 40 villages were picked randomly from Nambale North / Walatsi and 15 Villages from Nambale North, respectively. Simple random sampling was used to select study households until the desired sample size of 326 participants was achieved. Dietary intake assessment was done by conducting a 24-hour dietary recall of the foods eaten by children and dietary diversity was evaluated using the WHO infant and young child feeding guidelines for that age group. Nutrient intake was determined by computing the foods consumed in terms of kilocalories and classifying them as adequate or inadequate. Anthropometric measurements were done on the children to determine their nutrition status. SPSS version 20 was used to manage and analyze the data. WHO Anthro version 3.2.2 was used to compute nutrition indices of WAZ, HAZ and WHZ and the findings were categorized according to World Health Organization, 2009 cut-off points. Descriptive statistics were used to describe quantitative data while inferential statistics, Chi square was used to show associations between categorical variables; dietary diversity, intake and nutrition status. Spearman’s correlation was used to determine the strength of association between socio-economic characteristics, dietary diversity and nutrition status. Almost half, (48.9%) of the caregivers had attained only primary school education and 73.8% indicated to practice subsistence farming. The mean age of the children was 17 months. The children had been fully immunized and de-wormed. Findings indicated that of the children consumed calorie dense foods (cereals) with few taking adequate protein rich foods. On dietary diversity score, n=243 (81.5%) had low dietary diversity of 3.25± 0.89 food groups. About 27.5% of the children were stunted with 2.7% being severe. About 96.7% had normal weight-for-height Z scores. There was a significant relationship between socio economic status and dietary diversity score with a (p-value≤0.001). Consequently, the results showed a significant relationship between dietary diversity and nutrition status Chi square (p-value≥0.002). Conclusively, the nutrition status indicated existence of under nutrition in the study area and this study recommends interventions such as nutrition education integrated with kitchen gardening for improved dietary diversity.