Determinants of Developmental Milestones among Children 0-23 Months at Kabale Hospital, Uganda

Background: Approximately 200 million children globally fail to fulfil their development potential due to malnutrition, poor health, and unstimulating environments. Children in Kabale, Uganda, may be at particularly high risk as the rate of malnutrition in the region is likely to impact development. The study aimed to identify possible determinants influencing developmental milestones of breastfed and non-breastfed children aged 0-23 months.Materials and Methods: The study was conducted at the young child clinic of Kabale hospital, among 250 children aged 0-23 months and their caregivers, for two months. The study adopted a comparative cross-sectional design, and systematic random sampling was used to select the respondents for the study. The socio-demographic characteristics, nutritional status, and feeding practices were assessed using structured pretested questionnaires. Developmental milestones of the children (communication, motor, fine motor, problem-solving, and social skills) were assessed using the modified ages and stages questionnaires. The data collected was tabulated, analysed statistically, and the results interpreted.Results: Developmental scores were not associated with breastfeeding and minimum meal frequency. A milestone achievement of communication skills was associated with caregiver's education, caregiver's age and length-for-age. Gross motor scores were associated with the caregiver's age, weight-for-age, and length for age. Achievement of fine motor skills was associated with caregiver's education, caregiver's age, child's age, length for age, and children who met the minimum dietary diversity score. Problem-solving scores were associated with child's age, weight for age, length for age, and children who met the minimum dietary diversity. Personal social scores were associated with lower caregiver's age and normal weight for ageConclusion: Developmental scores were not associated with breastfeeding and minimum meal frequency. Development in early childhood was mainly associated with caregiver's age, caregiver's education, child's age, weight for age, length for age, and minimum dietary diversity score. Children under the care of younger caregivers and those who attained normal nutrition status had significantly more developed motor and social skills compared to children with older caregivers and undernourished children, respectively. Recommendation: Meeting the minimum meal frequency is commendable; however, caregivers should also strive to meet the minimum dietary diversity, which ultimately contributes to a better nutritional status and hence development in children. Older caregivers should be educated on the importance of developmental milestones and their contribution to optimum development in children

Efficacy of nutrition counselling on energy and micronutrient intake of pregnant women in Migori County, Kenya

A large number of pregnant women in many parts of the world enter pregnancy at sub-optimal weight. More than 60% of Kenyan population suffers from food insecurity. The result is malnutrition which primarily affects pregnant women and children and significantly contributes to their morbidity and mortality. Maternal nutrition is critical for both mother and child as it lays fundamental foundation for the successful outcome of pregnancy. This study sought to assess changes in energy and selected micronutrient intakes after nutrition counselling among pregnant women in Migori County. A Prospective Cohort study design was used and simple random sampling was used to recruit a sample of 150 pregnant women who were enrolled into a nutrition counselling programme. Data was collected by 24 hour recall and food frequency and analyzed by Nutri-Survey computer package and SPSS Analysis Software. Relationships between variables were tested by t-tests. Generally, there was improved dietary intake of all nutrients after counselling although some did not meet the RDA even after counselling. 4.4% and 20.9% of the women had intakes above RDA for energy, at baseline and after counselling respectively, 62.5% and 84.3% had intakes above RDA for protein at baseline and after counselling respectively. Carbohydrate intake had 93.9% within or above RDA at baseline while all met the RDA after counselling. 61.2% and 77.4% were able to meet the RDA for vitamin A at baseline and after counselling respectively. Only 13.5% met the RDA for folic acid and iron each at baseline but after counselling all had intakes below RDA. The finding is important to central and local governments, civil society, intergovernmental agencies, research groups, business enterprises and community under study. The study fills the knowledge gap and therefore contributes to the advancement of knowledge

Utilization and Medicinal Value of Indigenous Leafy Vegetables Consumed in Urban and Peri-Urban Nairobi

Indigenous African leafy vegetables have recently been attracting researchattention not only in terms of their inherent nutrition quality but also the healing power of some of these plants. Diversification of diets through increased utilization and consumption of these vegetables would go along way in alleviating hidden hunger and malnutrition. The main objective of this survey was to determine the consumption patterns and medicinal use of indigenous African leafy vegetables by the residents of urban and peri-urban Nairobi. A descriptive cross-sectional survey was conducted and the survey subjects included populations from all socio-economic strata and income levels. Probability proportional to size stratified sampling was used to select a representative sample of 800 households (600 urban and 200 peri-urban). Data were collected through structured questionnaires, focus group discussions and an observation checklist guide. A picture guide consisting of all foods available on the Nairobi markets was prepared, and used by the researchers to help the respondents to identify the vegetables they consumed. Ethnic origin was found to greatly influence consumption of indigenous African leafy vegetables. There was no significant relationship between household income and education level and choice or use of indigenous leafy vegetables. Some of the reasons for not consuming the vegetables included prohibitive costs and not knowing how to cook them especially those from other tribes. More than 60 percent of the respondents reported that the vegetables had a medicinal value attached to it and some were said to cure more than one disease. About half of those who used them also said the vegetables were healthy. It was concluded that dietary diversity of indigenous African leafy vegetables in addition to providing essential nutrients presumably offers broad benefits to health. The findings support interventions to promote use of indigenous African leafy vegetables as a foodbased initiative towards alleviation of micronutrient deficiencies and poverty through premium value addition incentive strategies.Key words: Indigenous Leafy Vegetables, nutritional, medicinal 

Utilization and Medicinal Value of Indigenous Leafy Vegetables Consumed

ABSTRACT Indigenous African leafy vegetables have recently been attracting research attention not only in terms of their inherent nutrition quality but also the healing power of some of these plants. Diversification of diets through increased utilization and consumption of these vegetables would go along way in alleviating hidden hunger and malnutrition. The main objective of this survey was to determine the consumption patterns and medicinal use of indigenous African leafy vegetables by the residents of urban and peri-urban Nairobi. A descriptive cross-sectional survey was conducted and the survey subjects included populations from all socio-economic strata and income levels. Probability proportional to size stratified sampling was used to select a representative sample of 800 households (600 urban and 200 peri-urban). Data were collected through structured questionnaires, focus group discussions and an observation checklist guide. A picture guide consisting of all foods available on the Nairobi markets was prepared, and used by the researchers to help the respondents to identify the vegetables they consumed. Ethnic origin was found to greatly influence consumption of indigenous African leafy vegetables. There was no significant relationship between household income and education level and choice or use of indigenous leafy vegetables. Some of the reasons for not consuming the vegetables included prohibitive costs and not knowing how to cook them especially those from other tribes. More than 60 percent of the respondents reported that the vegetables had a medicinal value attached to it and some were said to cure more than one disease. About half of those who used them also said the vegetables were healthy. It was concluded that dietary diversity of indigenous African leafy vegetables in addition to providing essential nutrients presumably offers broad benefits to health. The findings support interventions to promote use of indigenous African leafy vegetables as a foodbased initiative towards alleviation of micronutrient deficiencies and poverty through premium value addition incentive strategies

Pregnant Women’s Energy Consumption and Weight Gain: The Perspective of a Rural Community at Rongo District Kenya

Women in poor rural communities often consume diets that are deficient in energy. Maternal malnutrition continues to be a global problem. Population studies indicate that kilocalorie intake is usually less than recommended and pregnant women often do not show a significant augmentation in energy intake. The prevalence of chronic malnutrition is reflected in the high incidences of maternal deaths, increased risk of disease, and lower pregnancy weight gain. Low rates of gestational weight gain increase the risk of low birth weight infants and shorter gestations and from an international health perspective, birth weight is the most readily available index of pregnancy outcomes. This study investigated women’s socio-demographic factors, energy intake, and and their influence on gestational weight gain among pregnant women attending Rongo Sub-District Hospital. Objectives of the study included determining socio-demographic factors, energy intake, assessing weight gain, and testing for relationships between energy intake, maternal variables and weight gain. The study adopted longitudinal design and comprehensive sampling was used to select a sample of 100 pregnant women. Data was collected by use of structured questionnaires, observation, 24- hour recall and food weighing techniques. Data was analyzed by SPSS and dietary data by use of Nutri-survey. Pearson’s Correlation Coefficient was used to test for significant relationships and t test for significant difference between mean of nutrients. Daily energy intake was found to be 1436.42 ± 421 Kcal/ day. Mean weight gain was 245.9±201std g/week and was higher for women with lower weight. The study found a significant relationship between energy intake and gestational weight gain (P≤ 0.05) and suggested possible confounding with certain socio-demographic factors. The pregnant women consumed fewer calories than the recommended levels. The study fills the knowledge gap, benefits future research work, government departments, NGOs, the community and pregnant women. The government and NGOs need to monitor gestational weight gain more closely in order to provide counselling as well as nutritional support to pregnant women

Zinc, iron and calcium are major limiting nutrients in the complementary diets of rural Kenyan children.

Poor quality infant and young child (IYC) diets contribute to chronic under-nutrition. To design effective IYC nutrition interventions, an understanding of the extent to which realistic food-based strategies can improve dietary adequacy is required. We collected 24-h dietary recalls from children 6-23 months of age (n = 401) in two rural agro-ecological zones of Kenya to assess the nutrient adequacy of their diets. Linear programming analysis (LPA) was used to identify realistic food-based recommendations (FBRs) and to determine the extent to which they could ensure intake adequacy for 12 nutrients. Mean nutrient densities of the IYC diets were below the desired level for four to nine of the 10 nutrients analysed, depending on the age group. Mean dietary diversity scores ranged from 2.1 ± 1.0 among children 6-8 months old in Kitui County to 3.7 ± 1.1 food groups among children 12-23 months old in Vihiga County. LPA confirmed that dietary adequacy for iron, zinc and calcium will be difficult to ensure using only local foods as consumed. FBRs for breastfed children that promote the daily consumption of cows'/goats' milk (added to porridges), fortified cereals, green leafy vegetables, legumes, and meat, fish or eggs, 3-5 times per week can ensure dietary adequacy for nine and seven of 12 nutrients for children 6-11 and 12-23 months old, respectively. For these rural Kenyan children, even though dietary adequacy could be improved via realistic changes in habitual food consumption practices, alternative interventions are needed to ensure dietary adequacy at the population level

Retention of ?- Carotene, Iron and Zinc in Solar Dried Amaranth Leaves in Kajiado County, Kenya

Amaranth is one of the underutilized vegetable with high nutritive value. Availability of amaranth leaves is seasonal and therefore preservation for use in other seasons is necessary. Solar drying is one of the recommended methods for vegetable preservation. Minimal information exists on nutrient content of amaranth leaves grown in dry areas. There is also scarce information on the effect of solar drying on the