IMPROVING THE NUTRITIONAL STATUS OF INFANTS AND MOTHERS LIVING IN INFORMAL SETTLEMENT IN NAIROBI, KENYA

Abstract

The major obstacles to child survival in the developing world include infections, parasitic diseases, malnutrition and the risks associated with low birth weight and high fertility. A serious problem exists in the informal settlements in Nairobi, as result of children dying from common illness and infections that are attributed to poor nutrition. In Nairobi slums, mortality rates for children under five years old are double the city’s average and greater than for rural areas, according to UN Habitat, the U.N. agency for human settlements. Studies have indicated that children living in slums are more likely to die from pneumonia, diarrhoea, malaria, measles or HIV/AAIDS than those from wealthier parts of the same city and rural areas. Establishment of a community-based mothers’ and infant’s centre would beneficial to these informal settlements with the hope of expanding to other areas as well. Such a project would remain in the forefront of the efforts of the Government of Kenya to achieve the child nutrition related Millennium Development Goal (MDG1). This centre would focus on providing nutritional education and counselling for mothers, especially those from the extremely low-income areas. It is expected that through the provision of information to the mothers, it would be possible to have a direct and positive effect on the well being of the young children of the community. The objectives of the study were: 1. To reduce the degree of malnutrition among young children byproviding mothers in slums with relevant information regarding health and nutrition;assisting mothers in Nairobi slums in learning how to effectively apply health and nutrition information in helping their young children to be healthier; and teaching mothers in slums how to evaluate changes in the health of their young children. 2.To effectively use volunteers as a major factor in helping people to learn by recruiting a group of undergraduate students in local Kenyan Universities to become volunteers; providing a 4 week training program for the volunteers that covers basic nutritional information for mothers and information on adult teaching methods, placing the students in the centre to offer tutoring services to local mothers.  Cross Sectional Survey was done in villages where KEMRI/CDC conducts population-based surveillance for infectious disease syndromes. All enrolled households that had at least a child under five were included in the survey wheredata collected using structured questionnaire and anthropometric measurements.Data was analyzed using WHO Anthro software and SAS.  During the study 1476 children were recruited from 1100 households aged between 0 and 59 months. Anthropometric measurements obtained for 1310 children 6-59 months, results were available for 1245 children from 929 households where 635 households had each one child aged 6-59 months and 294 households had more than one child aged 6-59 months. Majority (90.0%) of respondents experienced food shortage. They dealt with this situation by reducing the quantity of meals consumed and eating less expensive foods. Majority (92.7%) of the respondents bought municipal water from salespersons. Almost half (47.1%) of the respondents did not treat their drinking water. A test of association was performed to check for any association of wasting with the following factors; gender, number of meals eaten, feeding in illness, number of children under five in household, ages of the children and morbidity of children two weeks prior the survey. Therefore Malnutrition among children under five in Nairobi Slums is a sustained problem and the predominance of malnutrition in older childrenindicates failure to catch up on growth during the firsttwo years of life.Promotion and protection of optimal infant and toddler feeding practices are urgently needed within urban slums.