Nutrition Status of Children Under Five Years (During Corona- 19 Pandemic) in Kibera Informal Settlement in Nairobi, Kenya

Abstract

Introduction: The emergence of Coronavirus Disease 2019 pandemic in 2019 disrupted societal norms and had profound implications for various determinants of health. One significant concern was the potential exacerbation of malnutrition among vulnerable populations, including children (Committee on World Food Security, 2020). Purpose: This study aimed to assess the prevalence of undernutrition among children in the age group of 6 to 59 months in Kibera informal settlement, Nairobi County, Kenya, during the corona virus disease pandemic in 2019. Methodology: A cross-sectional assessment was carried out between June 28th and July 5th, 2022, involving 411 children aged 6-59 months residing in the Kibera Informal settlement. Study participants were identified through a three-stage cluster sampling method and were then administered structured questionnaires. Anthropometric measures, including weight for height, weight for age, and height for age standard scores, were calculated using the Emergency Nutrition Assessment (ENA) 2020 software. Additionally, socio-demographic, Household and child feeding practices were analyzed using STATA version 14. To assess the correlation between the predictors and the nutrition status of the children, multivariable logistic regression was utilized. Results: The study revealed a global acute malnutrition prevalence of 3.9% (95% CI: 2.0-7.6), with no cases of severe malnutrition based on z-scores. Underweight affected 3.6% (95% CI: 2.4-5.6), including 0.2% (95% CI: 0.0-1.9) severe cases. Stunting was observed in 14.1% (95% CI: 9.9-19.8), with 2.9% (95% CI: 1.6-5.2) being severely stunted. Average age of the children in the study was 28.0 months (SD 16.2 months), about 64.2% were married and majority of the respondents, 30.4%, were earning a monthly income range of Kshs 5000– 10000. Early breastfeeding practices were positive, with 71.1% initiating within the first hour, and 96.8% were ever breastfed within the first two years, 82.4% continuing for the full two years. Dietary diversity was achieved by 55.6%, minimum meal frequency by 29.0%, and the minimum acceptable diet by only 16.3%. Associations were found between caregiver marital status, occupation, household income, handwashing practices, and child nutritional status (caregiver occupation: aOR=5.14, 95% CI=1.05-25.13, p=0.0 Marital status: aOR = 0.118; 95% CI = 0.013–1.039; household income: aOR=0.08, 95% CI=0.01-0.62, p=0.015; handwashing practices: aOR=0.21, 95% CI=0.05-0.94, p=0.041). xv Conclusion: While severe acute malnutrition remained low in Kibera Informal Settlement during Covid-19 pandemic, concerns arose from elevated rates of stunting in children aged 6-59 months. Despite a prevalent breastfeeding culture, challenges persist in achieving optimal dietary variety, meal frequency, and acceptable diets. To address these issues, the study recommends promotion of diverse food consumption, reducing reliance on cereals; implement targeted nutrition education for parents and caregivers to enhance infant feeding practices; emphasize the timely introduction of nutrient-dense complementary foods and sustained meal frequency to combat stunting; and establish a robust monitoring and evaluation system for community nutrition status