Dietary intake of iron, zinc and the nutritional status of children aged 6-11 years in schools with and without school feeding programmes in Kawangware, Nairobi west district
The deficiencies of iron and ZInC have recently become among the most prevalent micronutrient deficiencies of major public health concern globally. One of the most sustainable and cost effective strategies of combating iron and zinc deficiencies is fortification and/or supplementation of school meals. There is lack of adequate information on iron and zinc deficiencies in children in Kenya to assist policy makers to plan meaningful interventions such as school feeding programmes.The study was therefore designed to evaluate the effectiveness of the current school feeding programme in alleviating iron and zinc deficiencies in school children. A cross sectional study was carried out in Kawangware, Nairobi, to assess the adequacy of dietary iron and zinc intakes and nutritional status of children aged 6-11 years in schools with and without a school feeding programme (SFP). A total of 238 school children consisting of 135 from SFP schools and 103 from non-SFP schools were randomly picked and assessed in a comparative study. A semi structured questionnaire, previously pretested. was used to collect demographic and socio economic data of the children's households. Anthropometric measurements of weight and height of the children were measured using a weighing balance and a measuring tape respectively. A 24 hour dietary recall was carried out with a sub-sample of 38 children and their mothers. Food frequency and morbidity data in terms of helminths and malaria episodes were also collected. Focus group discussions and key informant interviews were conducted to corroborate the information collected. Results showed that the daily dietary intake of iron by children in the SFP schools ranged between 14.2mg and 25.3mg with a mean of 17.6mg, while the zinc intake ranged between 5.1mg and 11.2mg with a mean of 7.0mg. The daily dietary intakes of iron by children from non SFP schools ranged between 5.4mg and 18.lmg with a mean of9.9mg; while zinc intakes ranged between 4.2mg and 16.0mg with a mean of 9.2 mg. The mean intake of iron was significantly higher in SFP children than in non-SFP children. while the zinc intake was significantly higher in non-SFP children than in SFP children (P<0.05). These intakes translate into RDAs for iron ranging between 118% and 253% and between 45% and 181% for children in the SFP and non-SFP schools, respectively. The intakes for zinc translate into RDAs for zinc ranging between 55% and 149% and between 45% and 213 % for children in the SFP and non-SFP schools respectively. The malnourished children fro the SFP consisted of 5.3% stunted, 6.7% underweight and 6.8% wasted. While for non-SFP schools, the malnourished consisted of 1.0% stunted, 1.9% underweight and 7.2%wasted. The prevalence of malaria was 5.2% for children from SFP schools and 10.7% for children from non-SFP schools and the difference was not significant. The prevalence of helminths was 2.0% for SFP children and 0% for non-SFP children and the difference was significant. Results concluded that total malnutrition was 18.8% for SFP children and 10.1% for the non-SFP children. The severity of stunting and underweight was low for both categories of schools, while wasting was moderate for both categories of schools. Underweight was significantly higher (P<0.05) in SFP schools than in non-SFP schools. The study also concluded that children from the SFP schools were meeting more than the RDA for iron, while those from the non-SFP schools were meeting less than the RDAs for iron. With regard to zinc, the children from SFP schools were not meeting the RDAs for zinc while those from the non-SFP schools were.