Childhood Diseases Nutritional Status And Child Mortality Differentials In Kenya

Abstract

The study seeks to establish the linkages between childhood diseases nutritional status and childhood mortality. Childhood diseases here are represented by diarrhoea, fever (Malaria) and Acute respiratory infections (ARI). The diseases are limited to these three due to data limitations. Nutritional status in this study is used as an indicator of growth faltering and involves indices such as stunting wasting and underweight. Childhood mortality is limited to children under 2 years following assumption involved in the analysis. The study is based on data drawn from the 1998 Kenya Demographic and Health Survey (KDHS). The conceptual model was adapted from Mosley and Chen (1983) to act as a guideline to the study. Prevalence of childhood diseases was calculated using data from KDHS 1998. Cross tabulations were used to establish the association between childhood diseases and nutritional status. Bivariate logistic regression was used to establish the nature of this association and estimation of differentials in mortality by disease and nutritional status was done using direct method whereby interval risks of death were computed. The results obtained show that the prevalence of malaria is highest 42.3% among the three childhood diseases followed by ARI 19.9% and diarrhoea 16.8%. On the other hand stunting of children is the highest among indices of nutritional status in Kenya whereby 31.3% of under three children are stunted followed by underweight 21 % and wasting is quite low with only 6.9% of the under three wasted. The association between the three diseases and nutritional status was found to be positive except for acute respiratory infections which was found to be negatively associated with wasting or current nutritional status. Other indices such as stunting and underweight showed significant association at cross tabulation level with chi-square test.

The results further show that the three childhood diseases have a positive effect on childhood mortality. The computed interval risks of death are higher for children of mothers whose children had disease compared to those who had not except for diarrhoea in infancy. The relationship between nutritional status and childhood mortality is different from that of diseases with some indices showing positive relationship in infancy yet others showing it at year 2. All the same underweight is seen to be positively associated with childhood mortality at year 1 and year 2. Stunting was seen to be positively associated with childhood mortality in the first year of life while wasting was found to be positively associated with childhood mortality at the second year. This is according to the computed interval risks of death though the estimates in the second year were unstable and the differences negligible. Arising from the results of the study, several recommendations have been made. The study recommends that to improve child survival in Kenya a combined effort to tackle problems resulting from diseases and malnutrition are required. Specifically the three diseases warrant some attention on treatment and control with some focus on child nutrition. Lastly the study recommends a cohort study for establishing accurate relationship between diseases, nutritional status and mortality. This alongside surveillance and use of diagnostic data will establish the levels of morbidity and mortality. Further investigation should be to find out the determinants of nutritional status.