| dc.description.abstract | In Kenya, weight of under five year old children is taken monthly as routine growth monitoring
procedures. Linear growth of the children is however not monitored unless under special
circumstances yet the early stage of life is a period when growth is very critical and if retarded, it
may never be reversed in lifetime. World Health Organisation has recommended that Weight for-
Height be also monitored in well baby clinics but this is yet to be implemented fully in
Kenya. In fact the indicator of stunting, that is, height-for-age z-score has not been used in well
baby clinics. Furthermore, no efforts have been focused on children who may be stunted and
overweight at the same time. Currently, only malnourished children in paedriatics wards are
assessed for stunting but the well babies are assessed for weight only. This study was therefore
endowed to assess the prevalence of stunted-overweight and feeding practices among children
attending the well baby clinic in Kenyatta National Hospital.
A cross sectional survey employing both descriptive and analytical methods was conducted at
Kenyatta National Hospital. A pretested structured questionnaire was used to collect both
qualitative and quantitative data from a sample of 330 mothers/guardians with infants and young
children aged 6-59 months attending the well baby clinic at the hospital. Information was sought
on demographic and social-economic characteristics of the household, child feeding practices
and health, morbidity experience and immunization status. Anthropometric measurement
included the weight and height of the children.
Qualitative data on feeding practices 'were collected through the Key Informant Interviews (KII),
Focus Group Discussion (FGD) and observations. Key informant interviews were used to obtain
information from health service providers while a focus group discussion was used to collect
information from the mothers/caregivers.
Data analysis was done using Statistical Package for Social Sciences (SPSS) and EPI-INFO
programs. Univariate analysis was used to assess the association between nutritional status and
feeding practices. The WHO reference Z-scores-for-age was used to assess the Body Mass Index
-for-age (BMI) of the children.
A significantly high proportion of the study children were males as compared to females (x2 p-value<.
000,95%: CI =1.39 - 1.5).
The number of children attending the clinic drastically decreased with age from 81.4 % at
infancy to 1.5 % at 36-59 months old.
Most of the children (92.7%) fell in the "window of opportunity" category, (the period < 24
months of age).
Overall, 15% of the children were stunted and 12% were at risk of being stunted. There was no
significant difference in stunting between boys and girls.
The prevalence of overweight and obese children was 11.8 % while the prevalence of stunted overweight
was 3%.Those underweight but also stunted were 4.9%, while 7.1% were stunted but
with normal weight. There was a highly significant correlation between stunting and the body
mass index of the children (p= 0.000). However, there was no significant relationship between
stunted-overweight and feeding practices among the children.
It was estimated that only weight but not length of the children was routinely assessed and a total
of 328 (99.4%) children did not have their length recorded at birth. The assessment of stunted overweight
using weight-for-age showed that 9.4% of the children had normal weight-for-age
but were stunted. Those who were stunted overweight and stunted-underweight using weight-forage
were 2.7% and 2.9% respectively. The ratio for the undernourished (14.3%) and over nourish
(14%) was 1:1 when the weight for age was used.
In conclusion, there is some coexistence of stunting and overweight (3%) among children 6-59
months of age in the well baby clinic at Kenyatta National Hospital. This could possibly be
higher if a higher sample were obtained from the age group of 24-59 months, as this age group
was not well represented among the children attending the well baby clinic. Feeding practices are
not significantly associated with stunted-overweight probably because of the small number of
stunted overweight children obtained.
There is need to conduct a comprehensive community-based growth monitoring research to
provide for more explanation on prevalence of stunted-overweight and its determinants. We
recommend for routine monitoring of linear growth among under fives alongside weight
monitoring. | en |
