RESUMO
Background: Dietary Diversity (DD) is an important component of Infant and Young Child Nutrition (IYCN). Globally, it is recommended that children aged 6-23 months be fed on diverse diets as a public health measure in curbing malnutrition. In Kenya, stunting rates among children below the age of five years is 26% and diversifying of diets is still sub-optimal. The study sought to assess maternal factors associated with dietary diversity scores among children aged 6-23 months in Kwale County, where stunting stands at 29%. Methods: A cross sectional study design was adopted and a random sample of 244 mothers with children aged 6-23 months, residing in locations under Health and Demographic System Surveillance (HDSS) program participated in the study. Results: Mothers aged 17-68 years were interviewed. Children's DD scores ranged from 0 to 5 with a mean of 2.2±0.9, only 8.2% of the children met the Minimum Dietary Diversity score (MDDs) of 4 food groups or more in a day. A bivariate regression analysis to determine factors associated with children's dietary diversity scores showed significant positive relationship with mother's educational level (r=0.186, P<.000, α=.01), household wealth index (r=0.163, P<.000, α=.01) and the child's age (r=0.396, P<.004, α=.01). Conclusion: The study concludes that mothers' level of education, households' wealth index and child's age are factors associated with dietary diversity scores of children. Higher dietary diverse scores were observed among older children in the study age categories, from wealthy families and under care of mothers with higher education levels. In the study area however, only 8.2% of children met the minimum dietary diversity score necessitating targeted nutrition education of mothers and implementation of economic development initiatives to boost availability and consumption of diverse diets. A consideration of child age specific interventions will also address nutritional needs and preferences at different stages.
RESUMO
Community-based nutritional intervention to improve the practice of dietary diversity and child nutrition by community health workers (CHWs) involving Nyumba Kumi as small neighborhood units (SNUs) in communities has not yet been explored. This study was conducted in two villages in rural Kenya between 2018 and 2019. In total, 662 participants (control vs. intervention: n = 339 vs. n = 323) were recruited. The intervention group received education on maternal and child nutrition and follow-up consultations. The custom-tailored educational guidelines were made based on Infant and Young Child Feeding and the mother and child health booklet. The educational effects on household caregivers' feeding practice attitude and child nutritional status were analyzed using multiple linear regression. After the intervention, a total of 368 household caregivers (187 vs. 181) and 180 children (113 vs. 67) were analyzed separately. Between the groups, no significant difference was found in their background characteristics. This study successfully improved the dietary diversity score (ß = 0.54; p < 0.01) and attitude score (ß = 0.29; p < 0.01). The results revealed that the interventions using CHWs and SNUs were useful to improve dietary diversity and caregivers' attitudes toward recommended feeding. This research has the potential to be successfully applied in other regions where child undernutrition remains.