Determinant factors of Anaemia among the preschool Children and Women of child bearing age in Garrissa District, Kenya
A cross sectional study with an analytical component was conducted at Garrissa district to identify the effect of some important determinant factors of anaemia on Garrissa population. A sample of 384 households was used in three randomly selected villages in Garrissa town. A questionnaire was administered to gather information on demographic characteristics, socio economic status, physiological status (pregnancy, breastfeeding), water sanitation and hygiene, morbidity, and. food consumption patterns. Blood samples for haemoglobin concentration analyses and for malaria parasite and stool sample for Helminth and other intestinal parasites were also taken to determine the effect of parasitic infestation on the anaemia status. A majority of the people in Garrissa (89.1%) live in abject poverty and live below poverty line i.e. they earn < 1 dollar per household per day. The prevalence of anaemia in Garrissa district (63 to 86% from moderate to severe) proved to be the highest in the whole country. The households live below poverty had higher prevalence of anaemia. The stated hypothesis that socio- economic status has no effect on anaemia status has been rejected. Literacy level of the mothers, defined as those who can read and write showed no effect on the anaemia status of the studied population. In fact the study -, showed that literate women had higher prevalence of anaemia compared to the illiterates. Higher consumption of fruits and vegetables did not significantly increase Hb level and subsequently anaemia status. In fact only vitamin A had significantly correlated with Haemoglobin-(Hb) level. VI Vitamin A, Fibre, and zinc from the daily micronutrient intake showed to correlate with Hb level. Pregnant and breastfeeding women showed no difference in Hb level and anaemia status and therefore physiological status has no immediate effect on the anaemia situation of this community. Malaria had significant effect on the anaemia status of the population. Stool parasite infestation of the women of childbearing age showed to be significantly correlated with Hb levels. Unlike women, children morbidity two weeks prior to the study showed to be significantly correlated with Hb level and hence anaemia status. The pregnant mothers who had the habit of practicing pica manifested higher anaemic prevalence than those who did not practice and as such the hypothesis that there is no significant difference in haemoglobin level between those who do practice pica and those who do not is rejected. Zinc is an important micronutrient and correlation was found between Zinc and Hb level among the studied population. Though the iron consumption was adequate among the study population this has not helped in reducing the anaemia status. The consumed iron nutrient was mainly non heam iron from cereal characterised low bioavailability. For effective primary prevention, there is need to increase bioavailability of micronutrients particularly vitamin A, and pro-vitamin A. Also mineral-releasing processes such as fermentation should be re-examined and promoted appropriately. Health and nutrition education should be given in Barazas (chiefs) and should rigorously discourage pica practice. In addition, sanitation should be encouraged within these forums. To prevent malaria and parasitic infestation, improving community awareness should also be emphasized within the existing health facility programs (MCHs) in the district. De-worming programs should also be emphasized in order to reduce parasitic loading. NGOs and Ministry of Health (MOH) should implement a mosquito (malaria) control programs along the bank of Tana River with community participation. Distribution of treated bed nets should be widened in the area other than provisions only to those attend MCH (who are given as an incentive to visit MCH clinic). Given the high level of poverty and its effect on the wellbeing of the community income generation program aiming at empowering women to improve their economic status should be introduced to improve the overall nutritional status including the anaemia situation considering the strong Somali social network. This is because Somali women are less likely to divert household resources to other non essential expenditure like Miraa and related expenses at the expense of household welfare.