Socio-cultural determinants of Malnutrition among children aged below 5 years in Garissa Sub County, Kenya

Abstract

Malnutrition is a serious condition that occurs when a person’s diet doesn't contain the right amount of nutrients. It is a chronic public health problem among under-five children in the developing world. In Kenya it is also the single greatest contributor to child mortality yet information on contributing socio-cultural factors has not been well documented. The main objective of this study was to investigate the socio-cultural factors that contribute to under nutrition among children below five years in Garissa sub county, Kenya. A cross-sectional study was employed where mixed methods were used. A sample of 365 children under five years was selected from households using the systematic sampling method. Pre-tested questionnaire and FGDs were the instruments employed to collect data. Pearson’s chi-square test and odds ratio with corresponding 95% confidence interval were used to establish the association between the dependent variable (Nutritional status) and independent variables. The level of statistical significance was set at P-value <0.05. Binary logistic regression analysis was performed to determine the independent factors associated with malnutrition. The findings of the study reveal that 38.1% of the children were found to be stunted, 31% underweight and 26% wasted. The factors that were independently associated with occurrence of stunting at multivariate analysis included: child’s age (13-24 months) [AOR=2.71; 95%CI=1.50-4.87; P<0.001] and (25-36 months) [AOR=2.37; 95%CI=1.27-4.42; P<0.007], weaning within two months of age [AOR=3.12; 95%CI=1.87-5.23; P<0.001], cost of preparing food for the child[AOR=2.07; 95%CI=1.31-3.27; P<0.002]. Similarly factors that were independently associated with occurrence of underweight after multivariate analysis were: low birth weight (<2.5kgs) [AOR=3.16; 95%CI=1.90- 5.27; P<0.001]; child’s gender (female) [AOR=1.86; 95%CI=1.12-3.08; P<0.017]; recent illness [AOR=1.76; 95%CI=1.07- 2.91; P<0.027] and households income [AOR=3.11; 95%CI=1.19-8.12; P<0.021]. The factors that were independently associated with occurrence of wasting after multivariate analysis were: child’s age (37-54 months) [AOR=3.07; 95%CI=1.47-6.39; P<0.003], recent illness [AOR=2.54; 95%CI=1.52- 4.25; P<0.001]; mothers who didn’t attend ANC [AOR=2.06; 95%CI=1.18-3.62; P<0.012] and mothers/guardians age [OR=4.52; 95%CI=1.57-13.01; P<0.005] The prevalence of child malnutrition among the under five children was high, indicating that the nutrition situation in study area is very critical. Therefore, malnutrition still remains a major public health problem thus program planners and policy makers in the Ministry of Health and stakeholders should consider and strengthen collaboration and coordination of nutritional programs that aim to alleviate nutritional deficiencies by addressing the above significant factors.