A nutrition education intervention on maternal and child nutrition and care practices among the Turkana people in Kenya
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The purpose of this study was twofold. 1) To assess maternal and child nutritional status, food security, maternal nutritional knowledge and child care practices of the Turkana community and 2) to design a sustainable nutritional education intervention project aimed at reducing maternal and child malnutrition in Turkana County Kenya. The study was carried out in three phases, baseline, intervention, and follow-up. At baseline, 408 women and children were randomly selected from Nadapal and Nayainei villages in Turkana County. Maternal and child nutritional status, food security, dietary intake, maternal nutritional knowledge and child care practices were all assessed using validated questionnaires and anthropometric measurements. The intervention involved training women on breastfeeding, complementary feeding, hygiene and sanitation. Training was carried out for two, three hour sessions every day for five days. During the intervention, 72 women and four female community leaders were trained through lectures, demonstrations, and hands on activities. Six months after the intervention, a follow-up was done to assess the effect of the intervention on maternal knowledge, dietary intake, and nutritional status. Data was analyzed using descriptive statistics (means, median, and percentages), paired t tests, and Mcnemar tests. Results of this study showed that 53% of the women were underweight (BMI< 18.5kg/m2), 24% of the children were stunted, 20.7% wasted, and 28.6% underweight. Almost all (99%) the households were food insecure. Calories and nutrient intake was inadequate, especially the intake of vitamin A, calcium, and zinc. In addition, there was poor dietary diversity with most households consuming mainly cereals and tubers and less fruits, dairy products, and animal source proteins. Mothers displayed adequate knowledge on the need and importance of breastfeeding and complementary feeding; however, some did not have adequate knowledge on the recommended length of exclusive breastfeeding and the required quality of complementary foods. The intervention showed improved knowledge on exclusive breastfeeding and complementary feeding. There was also an increase in dietary diversity after the intervention, especially in the fruits and dairy products. There was no significant changes in nutritional status in both women and children after the intervention. In conclusion, this study found high maternal and child malnutrition in Turkana County. Malnutrition in this population was associated with the high food insecurity, poor dietary intake, low maternal nutritional knowledge and presence of infectious diseases. It was also concluded that an intense and comprehensive nutrition education program was able to improve maternal nutritional knowledge and dietary diversity. Findings from this study imply that there is need for intervention programs that target both acute and chronic malnutrition as well as inclusion of nutrition education in such programs.