Abstract:
Most of the nutritional surveys that have been carried out in Kenya have concentrated on children aged five years and below who are under the care of their parent(s). On the other hand, HIV/ AIDS, conflicts, natural disasters, endemic diseases such as malaria and tuberculosis, and rising poverty have claimed the health and lives of millions of productive adults, leaving their children orphaned and vulnerable. This has led to the mushrooming of orphanages to take care of these orphans and vulnerable children in Kenya. The main objective of this study therefore was to compare the nutrition status and associated risk factors of primary school children living in orphanages and those not living in orphanages in selected primary schools in Dagoretti Division, Nairobi. In this comparative and descriptive study purposive sampling was used to select the four schools that the children from the three orphanages attended which were within Dagoretti Division. Chi-square was used to compare the frequency of food consumption and hygiene practice among the children. t-Test for proportions was used to compare the differences in proportions of children who were malnourished among non orphanage and children in the orphanages. Pearson product moment was used test the relationships of risk factors and the dependent factors. The children in orphanages had a significantly higher rate of stunting and underweight (p< 0.05) than the non-orphanage children. This was an indication that chronic malnutrition was more prevalent among the children in orphanages. However there was no significant difference in wasting among the two groups (p> 0.05). The children in orphanages had also a significantly higher rate of morbidity (p<0.05) than the non-orphanage children.
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Children in orphanages were more likely to be stunted and underweight and this was associated with high levels of diarrhea and colds/cough. There was significantly (p<0.05) lower rate of vaccination among the children in orphanages (69%) than among non-orphanage children (92%). There was a significantly (p<0.05) higher proportion of non orphanage children who reported washing hands with soap at critical times compared with the children in the orphanages. The total mean energy intake among the non-orphanage children was significantly higher (p<0.05) than among the children in orphanages. The non-orphanage children had more diversity of foods than the children in orphanages. In this study, the prevalence of stunting was significantly higher (p<0.05) among boys in orphanages in comparison to non-orphanage boys.
Stunting and underweight among the children in orphanages was also associated with longer duration of stay in the orphanage. In conclusion chronic malnutrition and personal hygiene situations were worse among children in orphanages in comparison with non orphanage children. The morbidity state was also higher among the children in orphanages in Dagoretti Division. The results of this study can therefore be used to formulate and/or strengthen strategies that address the needs of children in orphanages in Kenya and other developing countries.
