The Association between Nutritional Knowledge, Socio-Economic Status of Caregivers and Stunting of Children under 5 Years in Kwale County of Kenya: A Baseline Survey

A B S T R A C T

Background: In Low- and Middle-Income Countries (LMIC), including Kenya, undernutrition has been the most significant contributor to child morbidity and mortality. Knowledge and practices of mothers/caregivers have been identified as a key sustainable factor for consideration in determining the nutritional status of children. The study aim was to determine how caregiver knowledge and socio-economic status will impact on nutritional status of children under 5 years.
Methods: This study was conducted in Kwale County, Kenya, to assess baseline maternal and child parameters. Seven hundred pairs; children and their primary caregivers were sampled at baseline.
Results: A total of 681 households comprised of caregiver and index child pair participated in the survey from the sampled 700. Knowledge scores of food functions, breastfeeding and complementary feeding were combined to assess caregivers’ nutritional knowledge with a maximum score of 24. The median score was 11 (IQR: 9-12) and ranged from 0 to 24. Those with scores of 12 and above (50% plus) were 230 (33.2%). Stunting was 29.8% and the level of under-weight was 16.4%. No significant association was found between nutritional knowledge of the caregivers and nutritional indicators of children under 5 years, but there were significant differences (P= 0.002) in the Knowledge score of caregivers between the five wealth quintiles.
Conclusion: Most of the caregivers did not have any nutritional knowledge which was assessed as knowledge of food groups and sources and functions of different foods as well as knowledge in breastfeeding and complementary feeding.

Keywords

Stunting, nutritional knowledge, caregivers



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Article Info

Article Type
Research Article
Publication history
Received: Wed 03, Mar 2021
Accepted: Thu 25, Mar 2021
Published: Thu 22, Apr 2021
Copyright
© 2023 Violet Wanjihia. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JFNM.2021.01.01

Author Info

Corresponding Author
Violet Wanjihia
Centre for Public Health Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya

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References

1.     UNDP (2015) Sustainable development goals. SDG overview.

2.     UNICEF (2015) The promise of equity. For every child, a fair chance.

3.     Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M et al. (2008) For the Maternal and Child Undernutrition Study Group: Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 371: 243-260. [Crossref]

4.     Bhutta ZA, Das JK, Rizvi A, Gaffey M, Walker N et al. (2013) Evidence based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet 382: 452-477. [Crossref]

5.     KNBS (2015) Kenya demographic and health survey 2014.

6.     Levinson FJ, Barney J, Bassett L, Schultink W (2007) Utilization of positive deviance analysis in evaluating community-based nutrition programs: An application to the Dular program in Bihar, India. Food Nutr Bull 28: 259-265. [Crossref]

7.     Abubakar A, Holding P, Mwangome M, Maitland K (2011) Maternal perception of factors contributing to severe undernutrition among children. Rural Remote Heal 11: 1423. [Crossref]

8.     El Arifeen S (2008) Child health and mortality. J Heal Popul Nutr 26: 273-279. [Crossref]

9.     Talbert AW, Ngari M, Tsofa B, Mramba L, Mumbo E et al. (2016) “When you give birth you will not be without your mother” A mixed methods study of advice on breastfeeding for first-time mothers in rural coastal Kenya. Int Breastfeed J [Internet] 11: 10. [Crossref]

10.  UBOS (2012) Uganda demographic and health survey 2011.

11.  Ickes SB, Heymsfield GA, Wright TW, Baguma C (2016) “Generally the young mom suffers much:” Socio‐cultural.pdf. Matern Child Nutr 13: e12365. [Crossref]

12.  Matsuyama A, Karama M, Tanaka J, Kaneko S (2013) Perceptions of caregivers about health and nutritional problems and feeding practices of infants: A qualitative study on exclusive breast-feeding in Kwale, Kenya. BMC Public Health 13: 1-13. [Crossref]

13.  Sudfeld CR, Fawzi WW, Lahariya C (2012) Peer Support and Exclusive Breastfeeding Duration in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis. PLoS One 7: e45143. [Crossref]

14.  Kimani Murage EW, Kyobutungi C, Ezeh AC, Wekesah F, Wanjohi M et al. (2013) Effectiveness of personalised, home-based nutritional counselling on infant feeding practices, morbidity and nutritional outcomes among infants in Nairobi slums: Study protocol for a cluster randomised controlled trial. Trials 14: 445. [Crossref]

15.  Shinsugi C, Matsumura M, Karama M, Tanaka J, Changoma M et al. (2015) Factors associated with stunting among children according to the level of food insecurity in the household: a cross-sectional study in a rural community of Southeastern Kenya. BMC Public Health [Internet] 15: 441. [Crossref]

16.  Morrow AL, Guerrero ML, Shults J, Calva JJ, Lutter C et al. (1999) Efficacy of home-based peer counselling to promote exclusive breastfeeding: a randomised controlled trial. Lancet 353: 1226-1231. [Crossref]

17.  Ickes SB, Baguma C, Brahe CA, Myhre JA, Adair LS et al. (2017) Maternal participation in a nutrition education program in Uganda is associated with improved infant and young child feeding practices and feeding knowledge: A post-program comparison study. BMC Nutr 3: 32. [Crossref]

18.  Nankumbi J, Muliira JK (2015) Barriers to infant and child-feeding practices: A qualitative study of primary caregivers in rural Uganda. J Heal Popul Nutr 33: 106-116. [Crossref]

19.  Ickes S, Hurst TE, Flax VL (2015) Maternal literacy, facility birth, and education are positively associated with better infant and young child feeding practices and nutritional status among Ugandan children. J Nutr 145: 2578-2586. [Crossref]

20.  Galgamuwa LS, Iddawela D, Dharmaratne SD, Galgamuwa GLS (2017) Nutritional status and correlated socio-economic factors among preschool and school children in plantation communities, Sri Lanka. BMC Public Health 17: 377. [Crossref]

21.  WFP (2017) Comprehensive Food Security & Vulnerability Analysis Guidelines.

22.  Kaneko S, James K, Kiche I, Wanyua S, Goto K et al. (2012) Health and Demographic Surveillance System in the Western and Coastal Areas of Kenya : An Infrastructure for Epidemiologic Studies in Africa. J Epidemiol 22: 276-285. [Crossref]

23.  MOH (2016) Baby Friendly Community Initiative implementation Guidelines. Breastfeeding advocay toolkit.

24.  UNICEF (2011) Infant and young child feeding.

25.  WFP (2009) Comprehensive food security and vulnerability analysis guidelines.

26.  Kuzma J (2013) Knowledge, attitude and practice related to infant feeding among women in rural Papua New Guinea: A descriptive, mixed method study. Int Breastfeed J 8: 16. [Crossref]

27.  Sukandar D, Khomsan A, Anwar F, Riyadi H (2015) Nutrition Knowledge, Attitude, and Practice of Mothers and Children Nutritional Status Improved after Five Months Nutrition Education Intervention. IJSBAR 23.

28.  Jemide JO, Ene Obong HN, Edet EE, Udoh EE (2016) Association of maternal nutrition knowledge and child feeding practices with nutritional status of children in Calabar South Local Government Area, Cross River State, Nigeria. Int J Home Sci 2: 293-298.

29.  Imdad A, Yakoob MY, Bhutta ZA (2011) Impact of maternal education about complementary feeding and provision of complementary foods on child growth in developing countries. BMC Public Health 11: S25. [Crossref]

30.  Bégin F, Aguayo VM (2017) First foods: Why improving young children’s diets matter. Matern Child Nutr 13: e12528. [Crossref]

31.  WHO Multicentre Growth Reference Study Group (2006) WHO Child Growth Standards based on length/height, weight and age. Acta Paediatr Suppl 450: 76-85. [Crossref]

32.  Victora CG, De Onis M, Hallal PC, Blössner M, Shrimpton R (2010) Worldwide timing of growth faltering: Revisiting implications for interventions. Pediatrics 125: e473-e480. [Crossref]

33.  Emina JBO, Kandala NB, Inungu J, Ye Y (2011) Maternal education and child nutritional status in the Democratic Republic of Congo. J Public Heal Epidemiol 3: 576-592.

34.  Wekesa NM, Makokha A, Wanjihia VW, Lihana RW, Kaneko S et al. (2017) Infant feeding knowledge and practices among lactating mothers in Kwale County, Kenya. East Afr Med J 94.

35.  Peiris T, Wijesinghe D (2010) Nutritional Status of under 5 Year-Old Children and its Relationship with Maternal Nutrition Knowledge in Weeraketiya DS division of Sri Lanka. Trop Agric Res 21.

36.  Akeredolu I, Osisanya OJ, Mbah P, Okafor JC (2010) Mothers’ Nutritional Knowledge, Complementary Feeding Practices and Nutritional Status of Children in Lagos State, Nigeria. J Nutr Educ Behav 42.

37.  Kabehenda M, Mullis RM, Erhardt JG, North Clewes C, Nickols SY (2011) Nutrition education to improve dietary intake and micronutrient nutriture among children in less-resourced areas: a randomised controlled intervention in Kabarole district, western Uganda. South African J Clin Nutr 24.

38.  Negash C, Belachew T, Henry CJ, Kebebu A, Abegaz K et al. (2014) Nutrition education and introduction of broad bean-based complementary food improves knowledge and dietary practices of caregivers and nutritional status of their young children in Hula, Ethiopia. Food Nutr Bull 35: 480-486. [Crossref]