Comparative Analysis of Diarrhoeal Morbidity and Complementary Feeding Practices Among Children 6-59 Months In Rice Growing Regions of Kirinyaga, Kisumu and Kwale County

Abstract

Globally, diarrhea remains a significant public health concern, affecting an estimated 2.5 billion children under five annually and contributed to 10% mortality in 2015. In Africa, approximately 696 million under-fives contract diarrhea each year, with Kenya experiencing a high burden, as 25% of deaths in this age group are attributed to diarrhea, in 2011, deaths of under-fives due to diarrhea was 38,822 .Proper complementary feeding is essential for child’s health, inadequate practices can lead to malnutrition and disease. This study aimed to investigate the prevalence of infectious diarrhea and complementary feeding practices among children aged 6-59 months in rice-growing regions of Kirinyaga, Kisumu, and Kwale. Objectives included assessing morbidity rates of infectious diarrhea, evaluating complementary feeding practices, gathering demographic and socioeconomic data from caregivers, and analyzing sanitation and food hygiene practices. Method: Cross-sectional descriptive study design was used. Fichers formular was used to get the sample size which was 384 for each region, Kisumu, Kwale and Kirinyaga respectively. Simple random sampling was used to obtain 30 households with child under five years who were interviewed in each cluster. Semi-structured questionnaire was the tool used for data collection which was administered to the caregiver. Ethical consideration was followed where informed consent was obtained from caregivers before the interview. Data entry and analysis was done using SPSS version 26. Information on diet diversification was collected using a 24-hr recall questionnaire as well as a 1-week food frequency interview questions, these were analyzed by calculating diet diversity score. Descriptive statistic was used to analyze general questionnaire. Chi square was used to compare the findings between the three counties. Results: 60.2% of household head in all the three counties had primary level as the highest education level attained,33.8% were farmers while 24.0% were casual labors, the two making most occupations of the household heads.61.7% earning monthly income less than ksh 10,000. 42.9% of mothers from Kwale and 36.1% from Kisumu County introduce complementary feeding late after 6 months, compared to Kirinyaga where 36.9% of mothers, start complementary feeding starts at 6 months. Caregivers from Kwale county feeds children once a day at (66.7%) and also twice a day at (56.4%) compared to Kirinyaga and Kisumu where feeding was done more than twice a day at 42.1% and 38.9% respectively, boiling was the predominant method used in preparation of complementary foods across the three counties. On the aspect of diarrhea morbidity, in the last two weeks Kwale County recorded the highest cases of diarrhea in children at 42.5% compared to Kirinyaga (31.8%) and Kisumu (27.5%) and most of this cases did not seek treatment (42.9%) for kwale. A cross the three counties high number of children feed less than normal when they are having diarrhea (59.5%) and they lost weight (62.3%). Tap water was majorly the source of water both during wet and dry season across the three counties at 33.3% and 31.1% respectively. A cross the three counties 45.9% of the households did not have a place for hand washing. When asked about hand washing at the five critical times, 64.6% of the respondent from Kwale county did not wash hands after visiting toilet,40.5%, did not wash hands before handling foods, 41.1%,did not wash hands before feeding children and 48.5%did not wash hands after handling dirts. 95% of the households in Kwale County do open defecation indicating why their diarrhea cases were high. Conclusion: .The practice on complementary feeding was fair, most of the basic criteria of complementary feeding were adhered to, timely introduction, frequency and amount of feeding. Kwale County reported high cases of diarrhea and was doing very poorly in terms of water and sanitation. The study recommends more health education to be given to pregnant and lactating mothers across the three counties on recommended infant young child feeding and Kwale County to be more sensitized on good hygiene and sanitation practice.