Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-17T14:43:28.529Z Has data issue: false hasContentIssue false
  • English
  • Français

Association between household food security and infant feeding practices in urban informal settlements in Nairobi, Kenya

Part of: DOHaD on International Women's Day 2020 Advancing the DOHaD Agenda in Africa

Published online by Cambridge University Press:  18 January 2018

T. N. Macharia ,
S. Ochola ,
M. K. Mutua  and
E. W. Kimani-Murage
T. N. Macharia*
Affiliation:
African Population and Health Research Center, Nairobi, Kenya Kenyatta University, Nairobi, Kenya
S. Ochola
Affiliation:
Kenyatta University, Nairobi, Kenya
M. K. Mutua
Affiliation:
African Population and Health Research Center, Nairobi, Kenya
E. W. Kimani-Murage
Affiliation:
African Population and Health Research Center, Nairobi, Kenya Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, Mostertsdrift, Stellenbosch, South Africa International Health Institute, Brown University, Providence, RI, USA College of Medical, Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
*
*Address for correspondence: T.N. Macharia, African Population and Health Research Center, P.O. Box 10787, 00100, Nairobi, Kenya. (Email tmacharia@aphrc.org)
Get access Rights & Permissions [Opens in a new window]

Abstract

Studies in urban informal settlements show widespread inappropriate infant and young child feeding (IYCF) practices and high rates of food insecurity. This study assessed the association between household food security and IYCF practices in two urban informal settlements in Nairobi, Kenya. The study adopted a longitudinal design that involved a census sample of 1110 children less than 12 months of age and their mothers aged between 12 and 49 years. A questionnaire was used to collect information on: IYCF practices and household food security. Logistic regression was used to determine the association between food insecurity and IYFC practices. The findings showed high household food insecurity; only 19.5% of the households were food secure based on Household Insecurity Access Score. Infant feeding practices were inappropriate: 76% attained minimum meal frequency; 41% of the children attained a minimum dietary diversity; and 27% attained minimum acceptable diet. With the exception of the minimum meal frequency, infants living in food secure households were significantly more likely to achieve appropriate infant feeding practices than those in food insecure households: minimum meal frequency (adjusted odds ratio (AOR)=1.26, P=0.530); minimum dietary diversity (AOR=1.84, P=0.046) and minimum acceptable diet (AOR=2.35, P=0.008). The study adds to the existing body of knowledge by demonstrating an association between household food security and infant feeding practices in low-income settings. The findings imply that interventions aimed at improving infant feeding practices and ultimately nutritional status need to also focus on improving household food security.

Keywords

complementary feedinghousehold food securityinfant feeding practicesurban informal settlements
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 9 , Issue 1: Themed Issue: DOHaD AFRICA , February 2018 , pp. 20 - 29
Check for updates
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. United Nations Standing Committee on Nutrition. United Nations Standing Committee on Nutrition (SACN) 2010; Sixth report on the world nutrition situation: progress in nutrition. Retrieved 4 August 2015 from https://www.unscn.org/files/Publications/RWNS6/report/SCN_report.pdf.Google Scholar
2. National Bureau of Statistics-Kenya, ICF International 2014; KDHS key findings. Rockville, Maryland, USA: KNBS and ICF International; 2015. Retrieved 11 August 2015 from https://www.dhsprogram.com/pubs/pdf/SR227/SR227.pdf.Google Scholar
3. Olack, B, Burke, H, Cosmas, L, et al. Nutritional status of under-five children living in an informal urban settlement in Nairobi, Kenya. J Health Popul Nutr. 2011; 29, 357.Google Scholar
4. Kimani-Murage, E, Muthuri, SK, Oti, SO, et al. Evidence of a double burden of malnutrition in urban poor settings in Nairobi, Kenya. PLoS One. 2015;10. Retrieved 11 August 2015 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476587/.CrossRefGoogle Scholar
5. Saha, KK, Frongillo, EA, Alam, DS, et al. Household food security is associated with infant feeding practices in rural Bangladesh. J Nutr. 2008; 138, 1383–1390.Google Scholar
6. Mberu, BU, Haregu, TN, Kyobutungi, C, Ezeh, AC. Health and health-related indicators in slum, rural, and urban communities: a comparative analysis. Glob Health Action. 2016; 9, 33163.Google Scholar
7. Kramer, MS, Kakuma, R. The Optimal Duration of Exclusive Breastfeeding. In Protecting Infants through Human Milk. Advances in Experimental Medicine and Biology (eds. Pickering LK, Morrow AL, Ruiz-Palacios GM, Schanler RJ), 2004; Springer, Boston, MA.Google Scholar
8. Onyango, AW, Esrey, SA, Kramer, MS. Continued breastfeeding and child growth in the second year of life: a prospective cohort study in western Kenya. Lancet. 1999; 354, 2041–2045.Google Scholar
9. Owais, A, Kleinbaum, D, Suchdev, P, et al. Household food security and infant feeding practices in rural Bangladesh (378.1). FASEB J. 2014; 28(Suppl. 1), 378–381.Google Scholar
10. WHO. Nutrition – WHO|Regional Office for Africa. 2015. Retrieved 13 August 2015 from http://www.afro.who.int/en/clusters-a-programmes/hpr/food-safety-and-nutrition-fan/programme-components/nutrition.html.Google Scholar
11. Black, RE, Victora, CG, Walker, SP, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet (London, England). 2013; 382, 427–451.CrossRefGoogle ScholarPubMed
12. WHO. Indicators for assessing infant and young child feeding practices: conclusions of a consensus meeting held 6–8 November 2007. 2007. Retrieved 27 July 2016 from http://apps.who.int/iris/bitstream/10665/43895/1/9789241596664_eng.pdf.Google Scholar
13. Kenya National Bureau of Statistics, Ministry of Health, National AIDS Control Council, Kenya Medical Research Institute, National Council for Population and Development. Kenya demographic and health survey: key indicators report 2014. 2015. Retrieved 11 August 2015 from http://dhsprogram.com/pubs/pdf/PR55/PR55.pdf.Google Scholar
14. Fotso, JC, Madise, N, Baschieri, A, et al. Child growth in urban deprived settings: Does household poverty status matter? At which stage of child development? Health Place. 2012; 18, 375–384.Google Scholar
15. Korir, JK. Determinants of complementary feeding practices and nutritional status of children 6–23 months old in Korogocho slum, Nairobi County, Kenya. 2013. Retrieved 11 August 2015 from http://etd-library.ku.ac.ke/handle/123456789/9419.Google Scholar
16. Kimani-Murage, E, Madise, NJ, Fotso, J-C, et al. Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya. BMC Public Health. 2011; 11, 396.CrossRefGoogle ScholarPubMed
17. Kimani-Murage, E, Wekesah, F, Wanjohi, M, et al. Factors affecting actualisation of the WHO breastfeeding recommendations in urban poor settings in Kenya: breastfeeding challenges in urban poor settings. Matern Child Nutr. 2014; 11, 314–332.Google Scholar
18. Ochola, SA, Evaluation of two counseling strategies improving exclusive breastfeeding among HIV-negative mothers in Kibera Slum, Nairobi, Kenya: a randomized controlled trial [Internet]. Stellenbosch: Stellenbosch University; 2008 Retrieved 1 November 2017 from http://scholar.sun.ac.za/handle/10019.1/1460.Google Scholar
19. FAO, WFP, IFAD 2012 The State of Food Insecurity in the World. FAO: ROME.Google Scholar
20. Agricultural Sector Coordination Unit (ASCU). National Food and Nutrition security policy. 2011. Agricultural Sector Coordination Unit (ASCU): Nairobi.Google Scholar
21. Faye, O, Baschieri, A, Falkingham, J, Muindi, K. Hunger and food insecurity in Nairobi’s slums: an assessment using IRT models. J Urban Heal. 2011; 88, 235–255.Google Scholar
22. Kimani-Murage, E, Schofield, L, Wekesah, F, et al. Vulnerability to food insecurity in urban slums: experiences from Nairobi, Kenya. J Urban Heal. 2014; 91, 1098–1113.CrossRefGoogle ScholarPubMed
23. Agbadi, P, Urke, HB, Mittelmark, MB. Household food security and adequacy of child diet in the food insecure region north in Ghana. PLoS One. 2017; 12, e0177377.Google Scholar
24. Garvelink, W., Wedding, K. Nutrition and food security in the city|Center for Strategic and International Studies. 2013. Retrieved 2 August 2015 from http://csis.org/publication/nutrition-and-food-security-city.Google Scholar
25. Lamba, D. The forgotten half; environmental health in Nairobi’s poverty areas. Environ Urban. 1994; 6, 164–173.Google Scholar
26. African Population and Health Research Center. Population and Health Dynamics in Nairobi’s Informal Settlements: report of the Nairobi cross-sectional slums survey (NCSS) 2012. APHRC; 2014.Google Scholar
27. African Population and Health Research Center. Population and health dynamics in Nairobi’s informal settlements: report of the Nairobi cross-sectional slums survey (NCSS) 2000. 2002. Retrieved 4 October 2017 from http://aphrc.org/wp-content/uploads/2014/08/Population-and-Health-Dynamics-in-Nairobi%E2%80%99s-Informal-Settlements.pdf.Google Scholar
28. Kimani-Murage, E, Kyobutungi, C, Ezeh, AC, et al. Effectiveness of personalised, home-based nutritional counselling on infant feeding practices, morbidity and nutritional outcomes among infants in Nairobi slums: study protocol for a cluster randomised controlled trial. Trials. 2013; 14, 445.Google Scholar
29. Beguy, D, Elung’ata, P, Mberu, B, et al. Health & demographic surveillance system profile: the Nairobi Urban Health and Demographic Surveillance System (NUHDSS). Int J Epidemiol. 2015; 44, 462–471.Google Scholar
30. Emina, J, Beguy, D, Zulu, EM, et al. Monitoring of health and demographic outcomes in poor urban settlements: evidence from the nairobi urban health and demographic surveillance system. J Urban Health. 2011; 88(Suppl. 2), 200–218.Google Scholar
31. Coates, J, Swindale, A, Bilinsky, P. Household Food Insecurity Access Scale (HFIAS) for measurement of food access: indicator guide. Food Nutr Tech Assist Proj Acad Educ Dev. 2007. http://www.fao.org/fileadmin/user_upload/eufao-fsi4dm/doc-training/hfias.pdf.Google Scholar
32. Agarwal, S, Sethi, V, Gupta, P, et al. Experiential household food insecurity in an urban underserved slum of North India. Food Secur. 2009; 1, 239–250.Google Scholar
33. Maitra, C, Rao, DP. Poverty–food security Nexus: evidence from a survey of urban slum dwellers in Kolkata. World Dev. 2015; 72, 308–325.Google Scholar
34. WHO. WHO|Early Initiation of Breastfeeding. 2016. WHO. Retrieved 22 November 2016 from http://www.who.int/elena/titles/early_breastfeeding/en/.Google Scholar
35. WHO. Indicators for assessing infant and young child feeding practices. Young. 2007; 2007, 1–19.Google Scholar
36. Ergib, M, Ashenafi, S, Semaw, F, Fisaha, H. Magnitude and factors associated with appropriate complementary feeding among mothers having children 6-23 months-of-age in Northern Ethiopia; A Community-Based Cross-Sectional Study. Journal of Food and Nutrition Sciences. 2014; 2, 36–42.Google Scholar
37. Rao, S, Swathi, P, Unnikrishnan, B. Hegde, A. Study of complementary feeding practices among mothers of children aged six months to two years -- a study from coastal south India. The Australasian Medical Journal. 2011; 4, 252–257.Google Scholar
38. Amendah, DD, Buigut, S, Mohamed, S. Coping strategies among urban poor: evidence from Nairobi, Kenya. PLoS One. 2014; 9, e83428.Google Scholar
39. Joshi, N, Agho, KE, Dibley, MJ, Senarath, U, Tiwari, K. Determinants of inappropriate complementary feeding practices in young children in Nepal: secondary data analysis of Demographic and Health Survey 2006. Matern Child Nutr. 2012; 8(Suppl. 1), 45–59.Google Scholar
40. Kenya National Bureau of Statistics (KNBS); ICF Macro. Kenya Demographic and Health Survey 2014. Heal (San Francisco). 2014; 1–314.Google Scholar
41. Concern Worldwide Kenya. Integrated health and nutrition baseline survey in the Nairobi slums Nairobi County. 2014. Retrieved 15 May 2017 from http://www.nutritionhealth.or.ke/wp-content/uploads/Downloads/Nairobi Slums MNCH KPC Final Report.pdf.Google Scholar