Is Responsive Feeding Difficult? A Case Study in Teso South Sub-County, Kenya.

Responsive infant and young child feeding as a reciprocal relationship between the child and his or her caregiver is recommended by the WHO but has received less attention than dietary diversity or meal frequency up to now. The current study assessed common (non)responsive child feeding practices and factors that facilitate or hinder caregivers to improve feeding practices in rural Teso South Sub-County, Western Kenya. The qualitative study used focus group discussion (n = 93) and Trials of Improved Practices (TIPs) (n = 48) to identify challenges and opportunities in household food distribution and feeding practices. Overall, the implementation of responsive feeding practices was feasible for the caregivers. Parents reported mainly positive experiences in terms of the child's feeding behavior and effects on child health. Traditional beliefs, practices, and cultural norms hindered some households to change intrahousehold food distribution. Households who manage to implement responsive feeding even in food insecure regions should be consulted to (a) improve existing nutrition education messages that acknowledge these cultural norms, (b) to include more responsive feeding information in nutrition education material, and (c) to address gender norms to create awareness of the importance of responsive feeding practices and the need for adequate time allocation for infant and young child feeding.

Determinants of Children's Fruit Intake in Teso South Sub-County, Kenya-A Multi-Phase Mixed Methods Study among Households with Children 0-8 Years of Age.

Fruits are micronutrient-rich sources which are often underrepresented in children's diets. More insights into the determinants of children's fruit consumption are needed to improve nutrition education in Teso South Sub-County, Kenya. A multiphase mixed method study was applied among 48 farm households with children 0-8 years of age. A market survey together with focus group discussions were used to design a formative research approach including qualitative and quantitative data collection methods. The unavailability of fruits and the inability to plant fruit trees in the homesteads were the main challenges to improve fruit consumption behaviour, although a number of different fruit species were available on the market or in households. Perceived shortage of fruits, financial constraints to purchase fruits and taste were important barriers. Fruits as snacks given between meals was perceived as helpful to satisfy children. The mean number of fruit trees in the homesteads was positively associated with fruit consumption. Field trials are needed to test how best fruit trees within home gardens and on farms can be included, acknowledging limited space and constraints of households with young children. This should be combined with nutrition education programs addressing perceptions about the social and nutrient value of fruits for children.