Comparison of Complementary Feeding and Nutrition Status between Children in Households with and those without Kitchen Gardens in Kakamega County, Kenya

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Date
2024-03
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Kenyatta University
Abstract
Sub-optimal feeding and nutrition among infants and young children less than 59 months old are leading causes of under nutrition in least developed countries. Recent agri nutrition interventions, focused on kitchen gardening in developing countries revealed its impact on children’s complementary feeding and nutrition status, despite insufficient empirical evidence. This study aimed at comparing nutrition status and complementary feeding of 64 children aged between 6 and 23 months in households with and 64 others without kitchen gardens in Lurambi Sub-County, Kakamega County. The study used a comparative cross-sectional and analytical research design. The findings on nutritional status were compared with WHO, 2006 Child Growth Standards. Researcher administered interviews for selected study participants households, key informants and focus group discussions. Data on IYCF, nutrition assessment and kitchen gardening was elicited and analyzed using SPSS comparing variables from households across the groups. Mothers or caregivers socio-economic, and demographic characteristics with children 6 to 23 months, revealed a significant correlation between owning kitchen garden and crops grown, all (p-values<0.05). Crop production per year, Length for Age Z-scores (LAZ), amount consumed and sold were not normally distributed as was assessed by Shapiro Wilk test and were summarized into median and inter-quartile range (IQR). Logistic regression was used to compute Odds ratios for crops grown, with kitchen gardening households being four times more likely to grow kales (OR=4.058) and three times more likely to grow both jute mallow (OR=2.524) and cow peas (OR=3.246). Their utilization was compared across the two groups. Most households without kitchen gardens did not grow micronutrient rich vegetables. ENA for SMART software was used to generate Z scores from children’s anthropometric measurements. This was interpreted using WHO (2006) Child Growth Reference, with ˂-2 and ˃+2 z-scores as cut off points for under nourished and over-nourished children respectively. Severe stunting of Length for Age Z scores (LAZ) < -3 Z score among children was higher, n=64 (20.3%) than the other n=64 (6.3%) in those without than those with kitchen gardens respectively, with statistically significant difference in stunting levels (LAZ) across the groups (Mann-Whitney Z-test; p-value= 0.011).Minimum dietary diversity was the only index that was statistically significantly different across the groups, (p-value=0.013); with 71.9% and 53.1% meeting MDD in kitchen and non-kitchen gardening households respectively. Diet among children in households without kitchen gardens was mainly consisting of cereals (maize), obtained from their farms. Socio-economic characteristics of mothers and caregivers did not determine the adoption of kitchen gardening technologies. All households should be encouraged to practice kitchen gardening. Common crops grown in kitchen gardens were kales, cowpeas and yams that were mainly utilized as food in households. It was critical to sensitize the later households to practice crop diversification both for subsistence and nutritional implications. Majority of kitchen gardening households had a high crop diversity grown, which resulted in attaining a higher children proportion having MDD. This may mean that despite households accessing arable land, mothers and caregivers need education on the health implications of feeding their children on a less diverse diet. Stunting levels of children with kitchen gardens had lower stunting levels than their counterparts. The null hypotheses that there is no significant relationship between kitchen gardening and dietary diversity as well as no significant relationship between kitchen gardening and nutrition status of index children were therefore rejected. It is recommended that non-kitchen gardening households grow bio diverse, nutrient rich crops that contribute to optimal IYCF. Organizations implementing agricultural programs should collaborate with the Ministry of Health, focus on improving household nutrition, health and food security through agri- nutrition. A longitudinal study ought to be carried out to establish how optimal complementary feeding can be achieved among the children between 6 and 23 months old using nutrition sensitive agricultural programs
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A Research Thesis Submitted in Partial Fulfillment for the Degree of Master of Science (Food, Nutrition and Dietetics) in the School of Health Sciences of Kenyatta University March, 2024 Supervisors: 1. Sophie Ochola 2. Irene Ogada
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