Nutritional status and its determinants among children aged 1-59 months accompanying their mothers in prisons in Kenya
Omukhweso, Sammy Osore
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Adequate information regarding the nutritional status of children accompanying their mothers in prisons in Kenya is scanty. Children in prisons ought to be considered as children under difficult circumstances in need of assistance (UN, 1989), but they have never been classified as such by any international organization or agency. In Kenya, 4,053 and 3,348 children under the age of 4 years spent some time in prisons in the year 2005 and 2009 respectively (Kenya Prisons Service, 2005; 2009). A cross sectional survey was conducted among children aged 1-59 months who accompanied their incarcerated mothers into prisons in Kenya between May and June, 2007. The study aimed at establishing factors that influenced the nutritional outcome of these children in prison. The target population included the children aged 1-59 months, their mothers and the officers-incharge of the prisons as key informants. Data was collected using a structured questionnaire, focus group discussions (FGD) checklist and key informant interviews guidelines. The quantitative data obtained was processed and analyzed using Statistical Package for Social Scientist (SPSS) 16.0 and World Health Organization (WHO)-Anthro computer application software. The WHO-Anthro was used to calculate the nutritional indices of weight-for-height, height-for-age and weight-for-age Zscores for each child while SPSS 16.0 was used to calculate measures of central tendency and univariate analyses. The qualitative data was analyzed by categorizing and organizing into themes before generalizations could be made. The study found that about 8.9% of the study children suffered from acute malnutrition and were wasted ﾫ-2 z-scores). The most at risk age group was the 6-11 months old where 17.4% of them were reportedly wasted. The boys (14%) were also found to be more wasted than girls (5%). About 14% of all the children were underweight. The most affected age-group was of children aged 6-11 months with a prevalence of 32%. More male children (17%) were underweight than their female counterparts (12%). The prevalence of stunting ﾫ-2 z-scores) among children in prison was 18.8%. The most vulnerable children to stunting were aged 6-11 months with 26% found to be stunted. The prevalence of stunting among male children (25%) was much higher than among the female children (14%). It was noted that the levels of malnutrition among children within Kenyan prisons was nevertheless well below the national levels for all the nutritional status indicators used in this study. Various factors were examined to establish their effect on the nutritional ~atus of the children. The following factors were established in this study as determinants of nutritional status of children in prisons: morbidity, timing of complementary feeding, immunization status, age and sex of the child. It is recommended that Parliament should review Chapter 90 of the laws of Kenya with a view to introduce special children units within prisons where expectant mothers and mothers accompanied by children could be accommodated. The special units, if established, should accord a home environment with proper nutrition in terms of quality and quantity, comprehensive medical care, clean and safe water. The Director of Prison Health Services should ensure that each prison dispensary is staffed with adequate medical staffs, well stocked with effective drugs and other necessary medical equipments. The Policy on infant and young child feeding (IYCF) practices should be incorporated in the Prisons Act, adopted and integrated in child care in all prisons. It is also recommended that a study on the dietary intake of children and their mothers in prisons should be conducted to determine its effect on their nutritional status.