GROWTH AND NUTRITIONAL STATUS OF THE FIRST SIX MONTHS OF LIFE AMONG SELECTED HOSPITALS--NAIROBI PROVINCE.

BACKGROUND: Exclusive breastfeeding for infants is recommended for the first six months for optimal health, development and growth. However, there is limited data on infant feeding practices and nutrition status of infants in Nairobi. OBJECTIVE: To assess infant growth and nutritional status and compare with feeding practices in the first six months of life in selected hospitals, Nairobi Province. DESIGN: Prospective cohort design SETTING: Five major hospitals in Nairobi namely; The Aga Khan, Pumwani Maternity, Mater Misercordiae, St Mary's Langata and Jamaa Hospitals. SUBJECTS: A sample of 692 mother-infant pairs were recruited at birth and followed up until six months. INTERVENTION: There was no direct experimental intervention, but there was observation of infant feeding practices, weight and height measurement was recorded every four weeks and determination of nutrition status of the infants for a period of six months. MAIN OUTCOME MEASURES: Nutritional status and infant feeding practices in the first six months. RESULTS: Slightly more than half (58.8%) of the mothers were formally employed and the rest were self employed. The mean age of the mothers was 28.3 ± 4.9 years. The mean income was KES 26,360 ± 34,696. The mean birth weight of infants was 3.24 ± 0.43 kg and 53.3% of all infants were male. Above 80% of infants were within normal weight based on weight for age Z-scores (WAZ) at 6, 10, 14 and 23 weeks. The prevalence of overweight based on WAZ was 9.5%, 11.6%, 11.9% and 11% at 6, 14, 19 and 23 weeks, respectively. There were no significant (P > 0.05) differences in WAZ between infants on different feeding methods. CONCLUSIONS: There was no significant difference in weight or length gain among children that were fully breastfed in comparison to those who were given infant formula or had mixed feeding. However, there was concern over the proportion of overweight infants, as the condition may lead to long term health problems.

FACTORS INFLUENCING VITAMIN A SUPPLEMENTATION AMONG MOTHERS OF CHILDREN UNDER FIVE YEARS OLD AT MBAGATHI DISTRICT HOSPITAL, KENYA.

BACKGROUND: Vitamin A supplementation is one of the best-proven and most costeffective interventions to improve vitamin A status and save children's lives. OBJECTIVE: To assess factors affecting practices and utilisation of Vitamin A supplementation services among mothers with children below five years attending Mbagathi District Hospital. DESIGN: Cross-sectional descriptive study. SETTING: Mbagathi District Hospital (MDH) Maternal and Child Health Clinic (MCH) and Paediatric Out Patient Department (POPD). SUBJECTS: Mothers attending MDH MCH and POPD. MAIN OUTCOME MEASURES: Utilisation, Practices and Awareness of vitamin A supplementation (VAS). RESULTS: A total of one hundred and fifty eight respondents were interviewed. About a half (52%) of the respondents had their children up to date with VAS while less than a half (43%) of the mothers had received vitamin A after delivery. Three quarters of the respondents'children had missed the vitamin A capsule because they were either not aware of schedule (41%) or had stopped coming to clinic (35%). This notwithstanding, 91% of the respondents neither encountered any problems when seeking VAS services nor had negative beliefs or superstitions about vitamin A. CONCLUSION: The main factors affecting utilisation of VAS services was lack of information and awareness among both health workers and mothers. These services are averagely well utilised at MDH though still below the National 80% coverage target.

Vitamin A supplementation awareness among mothers of children under five years old at Mbagathi District Hospital, Nairobi, Kenya.

BACKGROUND: Vitamin A deficiency is one of the leading micro-nutrient deficiencies of public health importance in Kenya. Provision of vitamin A supplements every six months is an inexpensive, safe, quick and effective way to improve vitamin A status and save children's lives. OBJECTIVES: To determine vitamin A supplementation awareness, attitudes and beliefs among mothers of children under five years old attending Mbagathi District Hospital. DESIGN: Cross sectional study. SETTING: Mbagathi District Hospital (MDH) Maternal and Child Health Clinic (MCH) and Paediatric Out Patient Department (POPD). PARTICIPANTS: Mothers attending MDH MCH and POPD. DATA COLLECTION: Both quantitative and qualitative data using questionnaires, in-depth interviews and focus group discussions. SAMPLING: A systematic random sampling where every alternate client was recruited and questionnaires administered to make 158 respondents. Key informants were purposively chosen for in-depth interviews and focus group discussions. RESULTS: Ninety four percent of the respondents reported having heard about vitamin A, major source of information being the health worker (82%). While 58% of the respondents were aware that the recommended schedule for VAS for children is every 6 months, almost half (49%) of respondents were aware vitamin A was given to mothers. Most of the respondents were positive and supportive of VAS. There were no negative beliefs or attitudes mentioned. However, majority (66%) had never discussed about Vitamin A with other mothers/people. Only 18% of the respondents believed VAD was associated with eye problems/blindness. Most mothers did not believe there was a specific consequence of VAD. Majority (64%) of the respondents did not believe there were any possible hindrances to taking their children for VAS. CONCLUSION: Mothers were positive and supportive of VAS, major source of information being the health worker but there was lackof information and awareness among both health workers and mothers.