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.
