Child undernutrition in Kenya: trend analyses from 1993 to 2008-09

Background: Research on trends in child undernutrition in Kenya has been hindered by the challenges of changing criteria for classifying undernutrition, and an emphasis in the literature on international comparisons of countries’ situations. There has been little attention to within-country trend analyses. This paper presents child undernutrition trend analyses from 1993 to 2008–09, using the 2006 WHO criteria for undernutrition. The analyses are decomposed by child’s sex and age, and by maternal education level, household Wealth Index, and province, to reveal any departures from the overall national trends. Methods: The study uses the Kenya Demographic and Health Survey data collected from women aged 15–49 years and children aged 0–35 months in 1993, 1998, 2003 and 2008–09. Logistic regression was used to test trends. Results: The prevalence of wasting for boys and girls combined remained stable at the national level but declined significantly among girls aged 0–35 months (p < 0.05). While stunting prevalence remained stagnant generally, the trend for boys aged 0–35 months significantly decreased and that for girls aged 12–23 months significantly increased (p < 0.05). The pattern for underweight in most socio-demographic groups showed a decline. Conclusion: The national trends in childhood undernutrition in Kenya showed significant declines in underweight while trends in wasting and stunting were stagnant. Analyses disaggregated by demographic and socio-economic segments revealed some significant departures from these overall trends, some improving and some worsening. These findings support the importance of conducting trend analyses at detailed levels within countries, to inform the development of better-targeted childcare and feeding interventions

Relationships between antenatal and postnatal care and post-partum modern contraceptive use: evidence from population surveys in Kenya and Zambia

<p>Abstract</p> <p>Background</p> <p>It is often assumed, with little supportive, empirical evidence, that women who use maternal health care are more likely than those who do not to use modern contraceptives. This study aims to add to the existing literature on associations between the use of antenatal (ANC) and post-natal care (PNC) and post-partum modern contraceptives.</p> <p>Methods</p> <p>Data come from the most recent Demographic and Health Surveys (DHS) in Kenya (2008–09) and Zambia (2007). Study samples include women who had a live birth within five years before the survey (3,667 in Kenya and 3,587 in Zambia). Multivariate proportional hazard models were used to examine the associations between the intensity of ANC and PNC service use and a woman’s adoption of modern contraceptives after a recent live birth.</p> <p>Results</p> <p>Tests of exogeneity confirmed that the intensity of ANC and PNC service use and post-partum modern contraceptive practice were not influenced by common unobserved factors. Cox proportional hazard models showed significant associations between the service intensity of ANC and PNC and post-partum modern contraceptive use in both countries. This relationship is largely due to ANC services; no significant associations were observed between PNC service intensity and post-partum FP practice.</p> <p>Conclusions</p> <p>While the lack of associations between PNC and post-partum FP use may be due to the limited measure of PNC service intensity, the study highlights a window of opportunity to promote the use of modern contraceptives after childbirth through ANC service delivery. Depending on the availability of data, further research should take into account community- and facility-level factors that may influence modern contraceptive use in examining associations between ANC and PNC use and post-partum FP practice.</p