Knowledge, Attitude and Practices (KAP) that Contribute to Low Vitamin A Coverage among Caregivers of Children 6-59 Months: Results from the KAP Survey done in Kenya.

Objectives: The uptake of VAS for children 6-59 months in Kenya is low with only 30% receiving the recommended two doses of VAS yearly. The KAP survey was done to determine socio-cultural enablers and barriers of coverage and uptake of two dose VAS and thus inform the design of responsive behavior change and communication (BCC) strategies. Methods: KAP involved 3842 caregiver interviews,48 In-depth Interviews (IDIs),69 key informant interviews (KIIs) and 48 focus group discussions (FGDs) in 12 counties. Results: The KAP identified facility health workers (FHWs), community health workers (CHWs), and Early childhood and development centers (ECD) teachers as the key influencers to VAS uptake and coverage. Barriers to uptake and coverage include: 1) Restrictive policy that only allows trained health workers to deliver VAS 2) Low knowledge on correct and benefits of VAS 3) Inadequate reporting tools and poor recording and reporting 4) Low demand/uptake of VAS by caregivers post immunization 5) Frequent stock-outs especially for 100,000 IUs capsules. Enablers to uptake and coverage include: 1) Integration of VAS into other child survival services2)Delivery of VAS through ECD centers3) Consistent stocks availability. Conclusions: The KAP results will be used to identify key barriers for the target population and their potential for influencing VAS uptake and coverage. The KAP results will be used to inform the VAS strategy and also the development of a BCC strategy that responds to the socio-cultural beliefs and roles of the targeted population thereby creating an enabling environment for VAS uptake and coverage among children 6-59 months.

Myths and Perceptions on Diarrhea and Use of ORS/Zinc among Mothers and Caregivers of under Five Years Old Children among a Nomadic Community in Kenya.

Objectives: Diarrheal disease is the second leading cause of death in children aged below five years in Kenya. Community and individual myths, perceptions and attitudes toward diarrhea does influence caregiver decisions and practices in the diarrhea prevention and management. This paper explores these myths and perceptions among mothers and caregivers the under five year old children in a nomadic Maasai community in Kenya. Methods: Qualitative data was collected from 42 Key informants including chiefs, laibons, village elders, religious leaders and 12 focus group discussions, comprising of 86 caregivers of children under 5 years. Transcriptions were entered into MAXQDA version 11 qualitative analysis programme to retrieve segments under each thematic area including myths and perceptions related to causation, prevention and treatment of diarrhea among under five years. Results: The reported myths and perceptions related to causation of diarrhea include: when child is teething, breast feeding while mother is pregnant, and having too much sex while child is still breast feeding. The use of special herbs and deworming tablets were reported to protect children from diarrhea. In addition, it was widely believed that herbs mixed with either blood or alcohol work better than modern drugs used in diarrhea management. The laibons and traditional birth attendants were the main sources of the herbal medicines in the community. Some respondents showed a strong lack of faith in the use of ORS for diarrhea management. Conclusions: There are serious myths and perceptions that can compromise prevention and management of diarrhoea in this community which need to be addressed.