Influence of Dietary Intakes, ‘WASH’ and Diarrhoeal Morbidity on Stunting mong Children below Five Years in Kaptembwo and Milimani, Nakuru County

Abstract

Stunting is a form of undernutrition in which affected children are too short for their age. Stunting affects 21.3 % of children under five years globally. The prevalence of stunting in sub-Saharan Africa in 2019 was 34%, while Kenya’s national average is 26%. The prevalence of stunting in Nakuru County is 28%, in which 9% are severely stunted. The high prevalence of stunting in Nakuru prompted this cross-sectional study with an analytical design in Kaptembwo and Milimani estate. The study aimed at establishing the contribution of water, sanitation and hygiene towards episodes of diarrhea and if these factors have influence on stunting. Objectives of the study were to determine the socioeconomic status, to evaluate the dietary intakes of children below five years, to determine the water, sanitation and hygiene practices, to determine the diarrheal morbidity of children below 5 years, and to determine the level of stunting of children below 5 years. The study included 314 children (0-59 months) sampled using systematic random sampling. Data was collected using questionnaires programmed in Survey CTO platform, which had been installed in mobile phones and or Tablets. Descriptive data was analyzed using SPSS version 22 software while Stata was used for regression analysis. Other statistical tests such as t-test and chi-square test were also used. The mean age of sampled children was 24.5months while their mean height was 81.82cm. The mean maternal age was 28.5 years. 19.1% of the mothers were single while 80.89% were married. 32.69% of mothers had at least secondary education. 10.81% of mothers in Milimani had university degree compared to 1.01% of mothers in Kaptembwo. The dietary intakes, dietary diversity and food frequencies of children sampled in the two study areas was not any significant P>0.05. The mean dietary Intakes (energy (Kcal)) was within the recommended dietary intake (RDI). Diarrhoea morbidity was high in Kaptembwo (38.61%) than in Milimani (16.96%). High diarrhoea episodes were associated with eating vended foods e.g. (Nuts; Coef. = -1.313667, Githeri; Coef. = 0.4715581). Low diarrhoea episodes were associated with deworming within 3 months (coef. = 0.8902153) and use of ORS (coefficient. 1.000825). However, the level of stunting was high in Kaptembwo than Milimani. Stunting levels for children were measured and classified based on z-score cut-off less than -2 SD of height for age (HAZ). Among the 314 children, 162 (51.59%) were male and 152 (48%) were female. Of the 202 children sampled in Kaptembwo, 25% were stunted, while of the 112 children sampled in Milimani, only 3.33% were stunted. The percentage of boys stunted in Milimani was (5%) while the percentage for boys stunted in Kaptembwo was 30%. The percentage of girls stunted in Milimani was 1.67% compared to 20% in Kaptembwo. Of the stunted children, boys accounted for a higher percentage (35%) than girls (26.67%). However, the Average stunting percentage was 14.17%. Results further showed that the risk of stunting increased with gender, age, and decreased with increase in hand washing. Maternal age, Education level, marital status did to influence stunting, P=0.097, P=0.016 and P=0.0285 respectively. Dietary intake did not have significant influence on stunting of children of all ages. Diarrhoea had very significant influence on stunting between 21-27 months P=0.004 and a general influence across all age groups P=0.050. Government at both levels should make deliberate efforts towards making basic utilities such as safe drinking water and good sewerage systems available for the people and further carry out public education on good sanitation and hygiene practices.