Childcare practices, morbidity status and nutrition status of preschool children (24-59 months) living in orphanages in Kwale County, Kenya
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Date
2018-03
Authors
Moyo, Burhaan Bakari
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
ABSTRACT
High adult mortality due to various causes like HIV and AIDS has led to an upward
trend of the number of orphans and vulnerable children. Extended family networks
have taken the responsibility of caring for these children but lack of adequate
resources for their care has forced the caretakers of these children to take them to
orphanages. As a consequence to the ever-increasing number of orphans, there has
been mushrooming of orphanages in the country. Appropriate childcare practices have
substantial consequences for growth, development and survival of infants and
children. However, due to lack of adequate resources, children living in institutions
are faced with practical challenges in being provided for their basic necessities
including nutritious food and clothing. Most studies that have been carried out in
Kenya have focused on children below five years who are under the care of their
parents. Studies conducted in orphanages have concentrated on children above five
years. Thus there is minimal information on childcare practices, morbidity status and
nutrition status of preschool children living in orphanages. The purpose of this study
was to determine the childcare practices, morbidity status and nutrition status of
preschool children 24-59 months of age living in orphanages in Kwale County,
Kenya. A cross-sectional analytical study was conducted on a comprehensive sample
of 162 children and 45 caregivers, drawn from a sample of 14 out of the 21
orphanages in Kwale County, Kenya. Data collection tools included; a structured
researcher-administered questionnaire for caregivers, Key informant interview (KII)
guide and observation checklist. The data collected was analysed using Statistical
Package for Social Sciences (SPSS) version 20.0 and anthropometric data of the
children analysed using ENA for SMART (2011). WHO standards (2006) were used
in interpretation of anthropometric data. More than a third (36.4%) of children were
either single or double orphans. The rest (63.6%) were not orphans. The mean (SD)
duration of stay in orphanages was 35.22+13.54 months. Majority (84.0%) of children
had favourable caregiver to child ratio while a small proportion (16.0%) had unfavourable
caregiver to child ratio. Supper provided a significant proportion (35.1%)
of daily energy intake than both lunch (34.7%) and breakfast (11.4%). In terms of
nutrition status: 15.4% of the children were stunted, 8.6% were underweight and 3.7%
were wasted. Boys were more stunted, underweight and wasted compared to the girls
(chi-square test; p < 0.05). A small proportion (6.8%) of children suffered from upper
respiratory tract infection, 10.5% suffered from malaria and 0.6% from measles.
Childcare (dietary) practices were associated with underweight (chi-square test; p <
0.001) and stunting (chi-square test; p < 0.001). Children who had been ill based on a
two week morbidity recall were likely to be stunted (chi-square test; p < 0.001),
underweight (chi-square test; p < 0.001) and wasted (chi-square test; p = 0.020).
Institutional characteristics (caregivers trained on childcare) were associated with
underweight (chi-square test; p < 0.001), wasting (chi-square test; p = 0.012) and
stunting (chi-square test; p < 0.001). Duration of stay of the children in the
orphanages was positively associated with underweight (p < 0.001) and stunting (p <
0.001). The results of this study can therefore be used to formulate and/or strengthen
strategies or systems that address the needs of children in orphanages in Kenya and
other developing countries. The government should ensure that registered orphanages
have adequate resources to take care of children in orphanages. The orphanages
should also encourage research activities to improve conditions in the orphanages.
Description
A research thesis submitted in partial fulfillment of the requirements for the award of the degree of Master of Science (food, nutrition and dietetics) in the school of appllied human sciences of Kenyatta University
March, 2018