Nutrition-Sensitive Intervention with Selected African Indigenous Leafy Vegetables Among School-Going Children in Machakos County, Kenya
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Date
2020-11
Authors
Wakhanu, John Akello
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
The 2014 Kenya Demographic Health Survey (KDHS) and Micronutrient Survey report showed malnutrition among children aged 5-11 years in Kenya. In particular, malnutrition in Machakos County manifested as stunting (26.3 %), wasting (6.3 %), underweight (12.7 %), marginal vitamin A deficiency (VAD) (33.9 %), anemia (16.5 %), zinc deficiency (82.5 %) and iron deficiency (9.4 %). African Indigenous Leafy Vegetables (AILVs) such as Vigna unguiculata and Amaranthus cruentus can be used to fight malnutrition in school-going children, based on their high micronutrient levels, but they need to be made more available to these children. The cultivation of AILVs as well as their consumption can be optimized through school garden establishments and the effect of the AILVs’ consumption on the children’s nutrition status accurately determined. This is to generate data to support the recommendation by 2014 KDHS that food based intervention through garden establishment can fight malnutrition. However, empirical data to support this recommendation employs determining body mass index, a limited technique as compared to deuterium dilution isotope (DDI) method that measures fat free mass (FFM) and fat mass (FM). The objective of the study was to determine the effect of consuming school garden-sourced vegetables on nutritional status of school children in Machakos County, Kenya. This was an experimental cross over design study with 4 weeks in between phases, phase I (13 weeks) and II (12 weeks). In phase I study subjects (children aged 6-10 years) who met the inclusion criteria were grouped as experimental (Kangundo, N=66) and control (Kilalani, N=46). The experimental group fed on a recipe of Vigna unguiculata and Amaranthus cruentus grown in school gardens of Kangundo and Kilalani primary, Machakos, with an accompaniment of a mixture of maize grains and beans once a day, 5 days a week per phase while the control group had only the accompaniment. The baseline information on dietary practices, morbidity, socio-demographic, economic factors and anthropometry of children were collected using a structured questionnaire. Hemoglobin (HB) was measured by a hemoglobinometer, while levels of Fe and Zn in raw and cooked recipe and in blood samples were determined using AAS procedure. The body FFM and FM was determined by DDI method and saliva analyzed by Fourier Transform Infrared (FTIR) spectroscopy, while serum retinol and BC were analyzed by HPLC. Baseline results showed poor consumption of indigenous vegetable (< 20 %), high morbidity (> 40 %), low socio-economic status of the parents/guardians (> 95.6 % who earned <Ksh.10, 000 month), the anthropometry and low HB results indicated malnutrition. The garden sourced vegetable recipe contained sufficient levels (mg/100g) of Fe 55.465 ± 0.419, Zn 3.430 ± 0.054, and BC 4.299 ± 0.010 to meet the RDA for children. At end line, the study subjects’ body composition as indicated by the FFM and FM as well as the Fe, Zn and BC levels significantly improved (p < 0.001) during both intervention phases. Further, there was a positive micronutrient impact, as shown by significantly higher levels of Fe, Zn, BC, Retinol and HB in the experimental group as compared to the control group at end line (p < 0.001) during both phase I and II. Since consumption of AILVs improves nutritional status of school going children the study recommends promotion of school gardens and consumption of school-garden sourced AILVs to improve nutrition of school going children.
Description
A Thesis Submitted in Fulfillment of The Requirements for the Award of The Degree of Doctor of Philosophy (Applied Analytical Chemistry) in The School of Pure and Applied Sciences of Kenyatta University, November, 2020
Keywords
Nutrition-Sensitive, Intervention, African Indigenous, Leafy Vegetables, School-Going Children, Machakos County, Kenya