Feeding practices and nutrition status among children aged 6-23 months following discharge from supplementary feeding program in isiolo county, kenya

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Date
2018-06
Authors
Macharia, Jacqueline Wairimu
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Kenyatta University
Abstract
Child under-nutrition is linked to delayed growth milestones and increased severity of otherwise common illnesses. There has been minimal significant change over the years on decline of malnutrition. Although Integrated Management of Acute Malnutrition (IMAM) had been successful in managing acute malnutrition, these children continue to be at risk of illnesses, relapse and ultimate death in the subsequent year after treatment. Children in Isiolo County are at risk of acute malnutrition relapse being prone to frequent dry spells. Still, scientific documentation on their follow-up is scanty and overlooks deteriorating nutrition and health trends. This study purposed to determine the feeding practices and nutrition status of the children aged 6-23 months, following successful discharge from Supplementary Feeding Program (SFP) in Isiolo County. The study used a cross sectional analytical study design on 204 mother-child pairs. The children were sampled purposively from SFP registers in 13 health facilities in Garbatulla sub-County with their mothers as respondents. Researcher-administered questionnaires, focused group discussion guides (FGDs) and Key Informant Interviews (KIIs) were used to collect and triangulate data. ENA for SMART 2011 and SPSS version 17.0 software packages were used to key in data for analysis. Relationship between variables was determined using Chi-square and Pearson Product Moment Correlation. Three-quarter (74%) of the mothers were aged between 25 years and 34 years while most of them were homemakers (71.1%) with an average household size of 6 members. Most of the households bought their food (90.2%) with some who also waited on food aid (23.5%) to meet the deficit. Under-nutrition by Z-scores was indicated by wasting (14.7%), stunting (33.8%) and underweight (19.1%) while the mean duration of time since the discharge was 5 months. The proportion of children who were breastfed in the 24 hours preceding the study was as follows: 95.0% of 6-11months, 76.6% of 12-17months and 40.2% of 18- 23months. Nearly all children (99.0%) attained their minimum dietary diversity with the most commonly consumed food groups being grains, roots and tubers (100%) then dairy products (80.4%). More than half (59.8%) of the children received their recommended minimum meal frequency. Barely 50.7% of all the children achieved their minimum acceptable diet whereby most of them were being breastfed (71.6%). Maternal age (r=- 0.352; p=0.03) and time since discharge (r=-0.25; p=<0.001) had a significant negative association with wasting. Dietary diversity (r=0.47; p=0.045), meal frequency (r=0.53; p=0.038) and attaining minimum acceptable diet (χ2=45.71; p=<0.001) exhibited a significant relationship with wasting. In conclusion, maternal age, age of the child, breastfeeding status and period of time since SFP discharge are important regarding the child’s nutrition status. The study recommends encouragement of caregivers to continue breastfeeding to at least 2 years with enhanced follow-up after discharge where mothers are advised to visit the clinic consistently for monitoring. Further studies on caloric dietary intake and longitudinal studies are suggested to assess dietary adequacy and determine causality of relapse.
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A research thesis submitted in partial fulfillment of the requirements for the award of the degree of master in public health (monitoring and evaluation) in the school of public health of Kenyatta University. June 2018
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