Determinants of Improved Water Supply and their Influence on Dietary Intake, Nutritional Status and Morbidity Rates of Pupils Aged 6-13 years in Yatta Sub County, Kenya

Abstract

In Africa, it is estimated that 25% of the population (about 200 million people) currently experience water stress, with more countries expected to face high risks in the future. In Kenya, three and a half (3.5) million people, including children are estimated to be in need of immediate humanitarian assistance mainly due to drought. Children living in Semi Arid regions are of the most vulnerable groups at risk of malnutrition, yet there is the scarcity of data concerning their dietary intake, nutritional status and morbidity rates in relation to the availability of improved water supply in Kenya. Located on the Eastern Coast of Africa, Kenya, a generally dry country with a humid climate, experiences severe water crisis. Global warming, is a major cause of severe droughts as well as floods. The contamination of drinking water, and a lack of investment in water resources have enhanced the crisis. Despite an improved water supply intervention, the population was still limited with potable water. The situation was particularly severe in Arid and Semiarid (ASAL) regions such as Yatta Sub County. The main purpose of this study was therefore to determine the effect of improved water supply on dietary intake, nutritional status, food consumption practices and morbidity rates of pupils aged 6-13 years in day mixed public primary schools. The dietary intake, food consumption practices, and morbidity rates of pupils in the schools with improved water supply were compared to those in the schools without improved water supply. Six schools were purposively sampled from public mixed day primary schools stratum. A sample of 400 pupils, aged 6-13 years, were randomly selected from six public schools in Yatta Sub County. A semi-structured questionnaire, observations, food proximate laboratory experiment, Key Informants Interviews (KII) and Focus Group Discussions (FGDs) were used to collect data. The assessment of dietary intake, nutritional status and morbidity rates of pupils in schools with and without improved water supply was carried out. The 24-hour dietary recall and Anthropometric measurements were carried out. World Health Organization (WHO) AnthroPlus was used to calculate the Body Mass Index (BMI), height for age and weight for age Z scores. Standard procedures of Association of Official Analytical Chemists (AOAC) were used to determine the food proximate chemical composition food that pupils fed on. Data was analyzed using Statistical Package for Social Science (SPSS) 2000, to determine the contribution of water supply on dietary intake, morbidity rates and nutritional status of pupils. Anthropometrical data was transformed into nutritional indices using EPI-INFO (2000) computer software. The indices were compared to World Health 0rganization (WHO) reference growth standards. The 24-hour dietary recall results were analyzed using Nutri-survey software to establish the total amount of selected nutrients in the meals consumed per day. Independent “t” test was done to compare the results between of the two groups