Assessment of Caregivers’ Nutrition Knowledge, Attitudes and Practices on Diet Adequacy and Nutritional Status of Children 6-23 Months in Rongai Sub-County, Kenya

Abstract

Under nutrition among children is still a global concern affecting many developing countries. Lack of adequate nutrition knowledge among caregivers translates to inappropriate complementary feeding practices hence under nutrition especially among children aged 6-23 months. Caregivers’ knowledge, attitudes and practices (KAP) on infant and young child nutrition (IYCN) have been associated with child diet adequacy and nutritional status. Varied results and recommendation have been documented from studies done to investigate the association of caregivers’ KAP on IYCN and nutritional outcomes. Therefore, the aim of this study was to assess caregivers’ nutrition KAP regarding IYCN on diet adequacy and nutritional status of children aged 6-23 months in Rongai Sub-county, Nakuru County. A cross-sectional study design was conducted among 388 randomly selected caregiver and child pairs. Sociodemographic and KAP related data were collected using a researcher-administered structured questionnaire. A Qualitative 24-Hour Food Recall data was used to generate child diet diversity. Child anthropometric measurements were taken and z-scores computed. All data were analyzed using Statistical Package for Social Sciences (SPSS) version 20.0. Caregivers had low knowledge on young child feeding (83.3%), dietary diversity (98.2%), and water and sanitation (92.7%). Moreover, all caregivers (100%) attitudes on young child feeding and dietary diversity were negative. Overall, 65.6% of caregivers had poor practices on young child feeding and were significantly different (P>0.004) across the two agro-ecological zones. More than half (56.9%) of the children had minimum diet diversity (MDD) with more children from low potential areas attaining minimum meal frequency (MMF) per day compared to those from high potential area. The overall prevalence of wasting, underweight and stunting was 6.2%, 9.2% and 23.4% respectively with no difference (P>0.05) across the agro-ecological zones. Caregivers’ education level positively (P<0.05) associated with MDD in low potential area [AOR= 3.797, 95% C.I; (1.477-9.759)] and with MAD in high potential area [AOR=1.874, 95% C.I; (1.014-3.465)]. In addition, children from high potential areas whose diets met MDD [AOR=0.129, 95% C.I; (0.027±0.609)], MMF [AOR=0.244, 95% C.I; (0.076±0.785)] and MAD [AOR=5.417, 95% C.I; (1.350±21.732)] requirements were less likely to be underweight. In conclusion, caregivers’ KAP on IYCN varied across the agro-ecological zones and contributed to child diet adequacy and subsequently nutrition outcomes of children. There is need for nutrition education and interventions that target improving caregivers’ KAP on IYCN, child diet adequacy in order to improve children’s nutrition outcomes.