Household food security and nutritional status of children aged 6-59 months in Mwea-Tebere rice irrigation scheme, Kenya
Freedom from hunger is the most fundamental human right that can be obtained if an individual is food secure. Nearly 1.02 billion people are food insecure and one-third of pre-school children in developing countries are malnourished. It's assumed that increasing household income and/or agricultural production would consequently improve food security and nutritional status yet malnutrition in irrigation schemes have consistently remained high since the 1960's. Factors influencing food security and nutritional status in Mwea- Tebere Irrigation Scheme have received little attention. The objective of this study was to assess household food security and nutrition situation and associated factors in Mwea-Tebere Irrigation Scheme. A cross-sectional study was conducted in 200 households with a child aged 6-59 months. Data was collected through qualitative and quantitative approaches using pretested structured, semi-structured questionnaires and focused group discussion guides. Household food security indicators included food production, socio-economic status, household three-day food record (food availability), household dietary diversity and food coping strategies while underweight, stunting and wasting for children aged 6-59 months were used to assess nutri tional status. Random sampling and improved EPr method were used to sample households. Nutritional status was analyzed using weight-far-age, weight-for-height ami height-forage z-scores of WHO (2006) and mid-upper ann circumference. Food coping strategies and socio-economic status were analyzed using weighted scoring index developed o through focused group discussions. Energy and protein availability was assessed through adult equivalents at household level. Results were analyzed by descriptive statistics, ANOVA, bivariate and partial correlations and regression analysis. SPSS v. 16, Excel 2007, Nutrisurvey 2007, ENA for SMART 2008 softwares were used for data analysis. The mean household size was 4.5± 1.6 with male to female ratio of 0.9. Male-headed households were 80%. The main source of household income was casual labour and 75% of that income was spent on food. About 72% or households Lived below one dollar per capita income per day. The mean household dietary diversity score was 6.2(SD=0.9) with 98% of households consuming more than 4 food groups. Global and severe acute malnutrition prevalence were 5.1 % (Cl: 2.3-10.8) and 0.5% (Cl: 0.1-4.9) respectively. Underweight and stunting prevalence were 14.2% (Cl: 9.1-21.5) and 32.5% (Cl: 21.7- 45.7) respectively. Majority of the households used unsafe water. Children were more likely to experience diarrhoea for drinking untreated water (Odds ratio: 1.13,0.53-2.41). Morbidity experiences were high (64%) with acute respiratory infections being most prevalent followed by febrile illness and diarrhoea. A sick child was more likely to be wasted than a well child (Odds ratio: 1.75, CI: 0.46-6.7). Household income and proportion of income spent on food positively correlated with household caloric and protein availability (1'2=0.056, p<0.05) but not with nutritional status of children under five years old. Increase in income was associated with increase in household dietary diversity (p<0.05) as well as household protein (p<O.Ol) and energy (p<0.05) availability per consumer unit. Larger households were more food insecure than smaller households (p<O.Ol). Household dietary diversity correlated with nutrient intake of household members (r2=0.033, p=O.O1). No individual measure suffices to capture all dimensions of food security and a suite or indicators are used to cover the different dimensions of food security. Although the dietary diversity in Mwea-Tebere Irrigation Scheme is high, it does not translate into adequate nutrient intake in the households probably because the amounts are inadequate. Thus the cosmopolitan nature of the area contributes to high dietary diversity that does not necessarily result into adequate dietary intake. Hence, household dietary diversity is not a good measure of food security in monocropping communities. Using 3-day food record, majority or the households are food insecure while acute and chronic malnutrition is at alert and serious levels respectively. There is no direct relationship between food security and nutritional status. Furthermore, food security and economic growth do not. necessarily translate to improved nutrition. Therefore, a multi sectoral approach that will address household dynamics, health and sanitation is necessary to improve nutritional status in Mwea- Tebere rice irrigation scheme and in other monocropping agricultural projects.