Maternal Compliance with Recommended Dietary Diversity in Prevention of Malnutrition among Children Aged 6-23 Months in Kwale County, Kenya
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Date
2024
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Publisher
Kenyatta University
Abstract
Dietary Diversity (DD) is a crucial element of Infant and Young Child Nutrition
(IYCN). WHO and UNICEF recommends feeding of diverse diets to children aged 6-
23 months as a public health measure in curbing malnutrition. In feeding of young
children, caregivers (mostly mothers) play a central role. Mothers make vital decision
pertaining breastfeeding and complementary feeding. Kenyan government has input
lots of resources in fighting malnutrition however, children aged 6 to 23 months still
have below-average levels of mother adherence with recommended dietary diversity
with only 37% countrywide meeting the minimum dietary diversity. This study was
conducted in Kwale County, where persistent chronic malnutrition has been noted. The
main aim was to assess level of maternal compliance with recommended DD among
children aged 6-23 months. Study’s objectives included: determining mothers’ socio demographic and economic characteristics, mother’s nutritional knowledge and other
factors associated with compliance or non-compliance with recommended DD. The
study utilized a mixed methods study approach, randomly selecting 244 mother-child
pairings with children between the ages of 6 and 23 months. In order to gather
information on the socio-demographics, financial status, and nutrition education of
mothers, a pre-tested, moderately structured questionnaires were employed. A
qualitative 24-Hour recall and DD questionnaires were also administered.
Complementary information was collected through five subsequent Focus Group
Discussions (FGDs). All respondents (244) were females aged 17- 68 years with a mean
of 29.3 ±9.6 years. By educational levels, 29.5% of the respondents did not have any
formal education, 10.2% had lower primary education (class 1 – 4), 53.3% had upper
primary education (class 5- 8), and 5.3% had secondary education while only 1.2% had
post-secondary education. Most (54.1%) of the respondents were housewives. A
computed wealth index classified 20.5% in the first quintile (poorest) and 21.3% in the
wealthiest quintile (5th quintile). Nutritional knowledge levels of the caregivers were
generally very low with more than half (57.4%) of the mothers scoring zero (0) and
only 3.3% having a high score of more than 9 out of 12 of the questions asked.
Children’s DD scores ranged from 1 to 6 with a mean of 2.63 ± 0.9. Only 5.5 % of the
children met the minimum dietary diversity (MDD) of 5 food groups or more in a day.
A bivariate regression analysis to determine factors associated with children’s dietary
diversity scores showed significant positive with caregiver’s educational level
(r=0.186, P<.000, α=.01), household wealth index (r=0.163, P<.011, α=.05) but not
with the caregiver’s nutritional knowledge (r=0.024, P>.05) and attitude score
(r=0.098, P>.05). In conclusion, diets fed to children in the study area was poor in
diversity. The socioeconomic situation of the household and low maternal education
level was statistically significantly associated with this. Low maternal nutrition
awareness and discrepancies in attitudes about providing children with a variety of
foods exist. Other factors contributing to low DD were: poverty, environmental
conditions, low educational levels and unfavorable cultural practices. The study
therefore recommends a multisectoral approach in identification of interventions to
address the identified issues.
Description
A Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master Of Public Health (Epidemiology And Disease Control) in the School of Health Sciences of Kenyatta University August, 2024
Supervisor:
1. Justus O. S Osero
2. Violet Wanjihia