Competency of Community Health Volunteers on Complementary Feeding Strategies of Children 6-23 Months in Masinga, Machakos County, Kenya
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Date
2022
Authors
Kivaya, Susan Katunge
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyatta University
Abstract
Sub-optimal complementary feeding practices are a major cause of malnutrition among children aged 6-23 months in developing world. In Kenya, only 39% of children are fed according to the recommended optimal infant and young child nutrition practices with only 54% achieving adequate dietary diversity. Machakos County has a high prevalence of stunting (26.5%), wasting (6.5%) and underweight (8.1%) among children. Community Health Volunteers (CHVs) can help in reducing malnutrition and child mortality through advocacy of the recommended complementary feeding (CF) practices. However, CHVs’ face myriad challenges including, low levels of education and inadequate training as their curriculum is limited on CF information. There is scarcity of information on the level of training and competence of CHVs in the area of CF. This study therefore aimed at assessing the competency (knowledge, skills and practices) of CHVs on CF in Masinga Sub-County of Machakos County. A cross-sectional analytical study design was adopted. A semi-structured questionnaire was administered to 168 CHVs randomly selected from 10 Community Units (CUs). An observation checklist was used to assess skills of CHVs. Four Focus Group Discussions (FGD) were used to gather qualitative information from CHVs on knowledge, practices and challenges faced. Key Informant Interviews (KII) were administered to nutritionists, nurses and public health officers and solicited information on knowledge and challenges faced by CHVs on CF. Data was analyzed using SPSS version 24 and a p value of <0.05 was used as the statistical significance. An overall knowledge score categorized as low (<40%), moderate (41-69%) and high ((≥70%) was used to establish CHVs’ knowledge on CF. Majority (73.8%) of the CHVs, were female. The mean age of the CHVs was 46.64 ± 10.9 years. Majority (56.5%) had attained primary education as their highest level of education and farming was their main source of income. The findings further showed that 23.2%, 66.1%, and 10.7% of the participants had high, moderate and low CF knowledge score respectively. About 83.9% of the CHVs had fair counselling skills while the rest (16.1%) had unsatisfactory skills. Majority (83.5%) of the participants used nutrition counselling as their strategy to pass CF information to caregivers. Nearly half (43.5%) met the MOH requirements of visiting households at least once in a month. Overall, only 8.3% of the CHVs met the minimum expected competence threshold based on a combined knowledge, skills and practice score. Statistically significant associations were observed between the CHVs’ CF nutrition knowledge level and their occupation (AOR = 1.63 C.I; 1.23-8.25), education level (AOR = 3.36 C.I; 1.07-10.59) and source of income (AOR = 3.50 CI; 0.91-13.40). Moreover, occupation (AOR = 3.50 CI; 0.27–16.05) and education level (AOR = 12.1 CI; 5.48–21.95) were also associated with the CHVs skills. The number of topics covered during nutrition counselling by the CHVs were also associated with the CHVs CF nutrition knowledge (AOR = 3.80 C.I; 1.24-11.63). The CHVs’ skills were also associated with their practice of nutrition counseling (AOR = 45.43 C I; 20.47-89.54). MOH and other stakeholders should enhance training and capacity building of CHVs and the training curriculum should also be reviewed to strengthen the CF aspects
Description
Thesis Submitted in Partial Fulfillment of the Requirements for the Award of Master of Science in Food, Nutrition and Dietetics, School of Health Sciences, Kenyatta University, November, 2022
Keywords
Competency of Community Health Volunteers, Complementary Feeding Strategies, Children 6-23 Months, Masinga, Machakos County, Kenya