Seasonality of associations between production of indigenous foods and food security status of mother-child dyads in Kisumu County, Kenya.

BACKGROUND: Food insecurity is a major predicament for rural populations, especially mothers and children, whose livelihoods are often dependent on rain-fed agriculture. Indigenous foods have the potential of mitigating food insecurity as they can thrive in poor agro-ecological conditions. However, the associations between indigenous food production and food security status of mothers and children drawn from rural contexts has not been expansively assessed. Food insecurity evident by high food poverty rates remain high in Kisumu County due to over-reliance on food imports from other counties. The objective of the study was to assess seasonality in associations between production of selected indigenous foods (kidney beans, soya beans, millet, cassava, sweet potatoes, groundnuts, green grams, cow peas, amaranth leaves, spider plant leaves, black night shade leaves, mangoes, guavas, lime, and tamarind) and food security status of mothers and children during planting and harvesting seasons. METHODS: We used a longitudinal study design adopting both quantitative and qualitative data collection methods. A structured questionnaire assessed production of selected indigenous foods in the sampled households, Household Food Insecurity Access Scale for mother's food security status and Prevalence of Underweight for children's food security status. Ordinal logistic regression was used to derive odds ratio (OR), which assessed strength of associations between dependent variables (mother's and children's food security status) and independent variables (production of selected indigenous foods). Significance was determined at α ≤ 0.05. RESULTS: Results demonstrated that during planting season, production of kidney beans decreased the odds of mothers being severely food insecure by 53% (OR = 0.469, 95% CI = 0.228-0.964, p = 0.039). In the same season, sorghum production demonstrated 3.5 times increase in odds of children being severely food insecure (OR = 3.498, 95% CI = 1.454-8.418, p = 0.005). During harvesting season, production of kidney beans was associated with a 62% reduction in the odds of children being severely food insecure (OR = 0.379, 95% CI = 0.190-0.754, p = 0.006). CONCLUSIONS: Production of some of the selected indigenous foods demonstrated significant odds of predicting mother's and children's food security status across both study seasons. An intervention-based study approach that would best establish causal associations of indigenous food production and food security status is recommended.

Food price perception, food and beverage marketing and the nutritional status of children 6-24 months in Obunga slums, Kisumu Kenya: a cross-sectional study.

BACKGROUND: Malnutrition is a significant problem in Africa. In Kenya, 26% of under-fives are stunted; slums are the hardest hit. Obunga slum has the highest prevalence at 40%. METHODS: A cross-sectional study was adopted; simple random sampling techniques were used to identify 189 eligible households in the Obunga slum with children between 6-24 months. An interviewer-administered questionnaire collected data on food price perceptions and food and beverage marketing. An anthropometric data collection form gathered information on the children's height, weight and age. Scores for stunting, wasting and underweight were generated based on WHO Z-Score cut-off points. Binary logistic regression identified the relationship between food price perceptions, food and beverage marketing and the nutritional status of children between 6-24 months in Obunga slums. RESULTS: Prevalence of wasting was 3.2%, stunting was 27.0%, underweight was at 7.4%, while overweight was at 13%. Food price perceptions: An increase in fruits prices was significantly associated with wasting (Adjusted O.R. = 10. 82, C.I. = 1.10-106.77, P < 0.05) and underweight (Adjusted O.R. = 5.44, C.I. = 1.35-21.61, P < 0.05). Food & Beverage Marketing: Feeding children on commercially produced complementary food products and commercially produced food was significantly associated with wasting at an (Adjusted O.R. = 7.82, C.I. = 1.29-47.46, p < 0.05, and adjusted O.R. = 5.96, C.I. = 1.06-33.60, p < 0.05) respectively. Stunting was significantly associated with listening/reading or watching advertisements on commercial food products (Crude O.R. = 0.49, C.I. = 0.24-0.998, p < 0.05.). Watching food-related adverts on television (Adjusted O.R. = 0.38 C.I. = 0.146- 0.10) and watching marketing on commercial foods (Adjusted O.R. = 0.21, C.I. = 0.07-0.61) and watching television (Adjusted O.R. = 9.30, C.I. = 2.31-37.40). While watching food-related adverts on television was associated with being underweight (Adjusted O.R. = 18.68 and at C.I. = 1.22-286.89). CONCLUSION: The price perceptions of fruits, feeding children commercially produced food products and complementary foods, and Watching food-related adverts on television; had an impact on the nutritional status of children. Thus, a longitudinal study would be needed to understand the long-term effect of food prices and food and beverage marketing on nutritional status.

Food Environment in and around Primary School Children's Schools and Neighborhoods in Two Urban Settings in Kenya.

We conducted a cross-sectional study to provide an overview primary school children food environment in two urban settings in Kenya. Six schools, catering to children from low-, medium- and high-income households in the cities of Nairobi and Kisumu in Kenya, participated in the study. Data on types of food places and foods offered were collected and healthy and unhealthy food availability scores calculated for each place. We utilized prevalence ratio analysis to examine associations between food availability, food place characteristics and neighborhood income levels. Altogether, 508 food places, located within 1 km of the schools and the school children's neighborhoods were observed. Open-air market sellers and kiosks were most common. The proportion of food places with high healthy food availability was 2.2 times greater among food places in Nairobi compared to Kisumu, 1.9 times greater in food places with multiple cashpoints, 1.7 times greater in medium/large sized food places and 1.4 times greater in food places located in high income neighborhoods. These findings highlight differences in availability of healthy foods and unhealthy foods across types of food places and neighborhood income levels and inform public health interventions aimed at promoting healthy food environments in Kenya.

Mothers' beliefs about indigenous and traditional food affordability, availability and taste are significant predictors of indigenous and traditional food consumption among mothers and young children in rural Kenya.

OBJECTIVE: To examine mothers' and young children's consumption of indigenous and traditional foods (ITF), assess mothers' perception of factors that influence ITF consumption, and examine the relationship between perceived factors and ITF consumption. DESIGN: Longitudinal study design across two agricultural seasons. Seven-day FFQ utilized to assess dietary intake. Mothers interviewed to assess their beliefs about amounts of ITF that they or their young children consumed and on factors that influence ITF consumption levels. SETTING: Seme sub-County, Kenya. PARTICIPANTS: Mothers with young children. RESULTS: Less than 60 % of mothers and children consumed ITF at time of assessment. Over 50 % of the mothers reported that their ITF consumption amounts and those of their children were below levels that mothers would have liked for themselves or for their young children. High cost, non-availability and poor taste were top three reasons for low ITF consumption levels. Mothers who identified high cost or non-availability as a reason for low levels of ITF consumption had significantly lower odds of consuming all ITF except amaranth leaves. Mothers who identified poor taste had significantly lower odds of consuming all ITF except green grams and groundnuts. Similar relationships were noted for young children's ITF consumption levels. CONCLUSIONS: A majority of the mothers reported that they and their children did not consume as much ITF as the mothers would have liked. Further studies should examine strategies to improve availability and affordability of ITF, as well as develop recipes that are acceptable to mothers and children.

Assessing Nutrient Intake and Nutrient Status of HIV Seropositive Patients Attending Clinic at Chulaimbo Sub-District Hospital, Kenya.

Background. Nutritional status is an important determinant of HIV outcomes. Objective. To assess the nutrient intake and nutrient status of HIV seropositive patients attending an AIDS outpatient clinic, to improve the nutritional management of HIV-infected patients. Design. Prospective cohort study. Setting. Comprehensive care clinic in Chulaimbo Sub-District Hospital, Kenya. Subjects. 497 HIV sero-positive adults attending the clinic. Main Outcome Measures. Evaluation of nutrient intake using 24-hour recall, food frequency checklist, and nutrient status using biochemical assessment indicators (haemoglobin, creatinine, serum glutamate pyruvate (SGPT) and mean corpuscular volume (MCV)). Results. Among the 497 patients recruited (M : F sex ratio: 1.4, mean age: 39 years ± 10.5 y), Generally there was inadequate nutrient intake reported among the HIV patients, except iron (10.49 ± 3.49 mg). All the biochemical assessment indicators were within normal range except for haemoglobin 11.2 g/dL (11.4 ± 2.60 male and 11.2 ± 4.25 female). Conclusions. Given its high frequency, malnutrition should be prevented, detected, monitored, and treated from the early stages of HIV infection among patients attending AIDS clinics in order to improve survival and quality of life.

Food consumption patterns, diversity of food nutrients and mean nutrient intake in relation to HIV/AIDS status in Kisumu district Kenya.

As the causes and consequences of the AIDS epidemic become clearer, so does the fundamental importance of food and nutritional security for HIV-affected individuals. Even as food insecurity remains a major problem in poor households, its effects are worsened in disease states like HIV infection. Food deficiency and nutritional inadequacy compromise an individual's physical status and work capacity, and may also diminish their resource base and household provisioning. The prevalence of HIV and AIDS in Kenya threatens food production systems, which intensifies poverty, increases the nutritional implications for HIV-infected individuals, accelerates the rate of orphanhood beyond what existing social networks can cope with, and basically affects all indicators of socio-economic development in the country. This cross-sectional study sought to assess food and nutrient intake in HIV-affected versus non-HIV-affected households. Purposive sampling was used to select 160 households (77 HIV-affected households and 83 non-HIV-affected households) in Kisumu district, a lowland area along Lake Victoria. A consolidated questionnaire that included a food-frequency checklist and personal 24-hour dietary recall was used to gather information from 40 households. The data were analysed quantitatively; descriptive statistics were mainly measures of central tendency, and inferential statistics involved chi-square tests and independent t-test samples. A table depicting food composition was used to compute the nutrient intake of each household. The findings reveal a significant relationship between a household's HIV/AIDS status and nutrient intake.