Abstract:
School feeding programmes have been introduced in most of the developing countries to improve child health and reduce malnutrition. However, high levels of undernutrition still prevail in the arid and semi-arid areas of low-income countries. This study compared the dietary intake and nutritional status of preschool children (3-5 years) who were in the school feeding programme with those not in the programme in Ganze Constituency, Kilifi County, Kenya. Selection of 288 pre- school children, and their households was carried out and investigated for 33 weeks, with data collection at 11 weeks intervals. Children in the school feeding programme (Programme group) were 146 and those not in the school feeding programme (No programme group) were 142. Dietary intake and nutritional status of the children in the two groups were evaluated using Nutri-Survey 2007 and WHO Anthro 2009 programs respectively. The data from the two groups was compared using the Statistical software program SPSS Version 24 and SAS Version 9.4. Pearson’s Chi-square test was used to compare proportions; bivariate analysis was used to assess the association of sociodemographic characteristics with dietary intake and nutritional status. Independent t-test determined the difference in mean dietary intake and nutritional status between the two groups. Logistic regression was used to assess the association of the feeding programme with dietary intake and nutritional status of the feeding programme group and reported as Odds Ratio and 95% Confidence Interval. Threshold for statistical significance for all analysis was set at p<0.05. The results showed that there was poor sanitation in the households and poor access to health services, which contributed to increased child morbidity. The children in the school feeding programme had a higher Individual Dietary Diversity score (IDDS) compared to those not in the programme. Most of the children in both groups did not meet the Recommended Dietary Adequacy (RDA) for essential nutrients of health concern including zinc, iron and calcium. There was no significant reduction in stunting associated with the school feeding programme (Estimate= [OR 0.95; 95% CI 0.35–2.64; p= 0.93] neither wasting (Estimate= [OR 0.14; 95% CI 0.15–0.43; p=0.33] or underweight (Estimate= [OR 0.05; 95%CI 0.19-0.28; p=0.87]. School feeding programmes are normally associated with improved dietary intake and nutritional status among the preschool children but this study did not identify any significant difference between the children in the feeding programme and those not in the programme. The study suggests improvement of sanitation in the households and community health services outreach to promote children’s health. This would impact positively on dietary intake and nutritional status. Diversification of foods at the household level and also for the feeding programme would contribute to recommended dietary adequacy and consequently to improved nutritional status.
