Publication: Dietary intake of vitamin a, household food security and Prevalence of undernutrition among lactating Mothers in Sinai Slum, Nairobi County, Kenya
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2021
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Moi University Research Funds
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Moi University
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Abstract
Background Vitamin A deficiency is a problem of public health significance among all thefamily members including the lactating mothers. In Africa, about 20% of the women ofchild bearing age are undernourished. In Kenya, 12% of the women 15-49 years areconsidered thin with a body mass index (BMI) of < 18.5. During the period of lactation,nutrient needs of the lactating mother increase to cater for her needs and the breastfeedingchild. Low dietary intake of vitamin A during lactation has been found to result ininadequate concentration in breast. Due to this, undernutrition is common among lactatingmothers.Objectives: The objective of this study was to determine the adequacy of dietary intake ofvitamin A, prevalence of undernutrition and household food security among lactatingmothers aged 16-45 years in Sinai slum, Nairobi County, Kenya. The specific objectiveswere to determine i) adequacy of dietary intake of vitamin A ii) prevalence ofundernutrition iii) Household food security.Methods: A cross sectional study method was employed with participants identifiedthrough consecutive sampling. A total of 384 lactating mothers from Sinai slum attendingLunga Lunga health centre participated in the study from March to April 2011. A 24-hourdietary recall and a Food Frequency Questionnaire (FFQ) were used to assess dietaryadequacy of vitamin A intake. Prevalence of undernutrition was determined throughanthropometric measurements; Body Mass Index and Mid Upper Arm Circumference(MUAC). Household food security was determined using food insecurity access scale anddietary diversity questionnaires. Statistical analysis was done using Microsoft excel andSPSS Version 23.0. Descriptive analysis was used to display participant characteristicwhile Chi-square test was used to test for associations between inadequate intake of vitaminA, maternal undernutrition, household food security, and sociodemographic factors.Logistic regression was used to determine actual predictors of adequate dietary intake ofvitamin A, maternal undernutrition and household food security.Results: A total of 225 (58.6%) lactating mothers had inadequate dietary intake of vitaminA while 120 (31.3%) had low MUAC<220mm and 53(13.8%) had low Body Mass Index(BMI). Low protein intakes correlated with inadequate vitamin A intakes and low MUAC(p=0.043, p=0.035). Energy intake had a statistically significant association with dietaryintake of vitamin A and low MUAC (p<0.001). Food insecurity had a statisticallysignificant association with inadequate dietary intakes of Vitamin A, low MUAC and lowBMI. Food insecure households were 2 times more likely to have inadequate Vitamin Aintakes (p<0.001), low MUAC (p=0.002 and low BMI (p=0.042). The Household DietaryDiversity Score HDDS score was 5.2(SD=2.15). Dietary diversity correlated withinadequate Vitamin A intakes (p=0.003). Length of breastfeeding also correlated with lowMUAC (p=0.027).Conclusion: Lactating women in Sinai slums have low dietary intake of vitamin A.Additionally, they are under nourished with characteristic low protein and energy intakesas well as BMI and MUAC. Food insecurity alongside limited purchasing powercompromise positive nutritional outcomes for the mothers hence at risk of these multiplemicronutrient deficiencies.Recommendations: There is need for well-designed nutrition intervention programsfocusing on nutrient intake of affordable foods to increase dietary diversity and food varietyof lactating women in this low socio-economic setting. Concurrent nutrition sensitization,distribution of nutritional supplements and empowerment programs through incomegenerating activities, developing policies and comprehensive approaches, integrating foodbasedstrategies by the government to address the high prevalence of undernutrition amonglactating mothers. Such interventions would improve their nutritional status as wellultimately reduce vitamin A deficiencies.vi
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: Vitamin A, Nutritional status, Slum, dietary diversity, Food Frequency