Pastoralists’ Perception of Poverty: A Case of the Somali and Turkana of Northern Kenya

Poverty is a complex phenomenon, without a single definition or standard methods of reducing it. Income based methods of assessing poverty have been shown to have limitations that undermine their application in measuring and attacking poverty among pastoral households. Stages of progress method of poverty assessment was used to assess poverty among pastoral households in Turkana and Mandera Counties of Northern Kenya. Three hundred and three hundred and fifty-four households in Mandera and Turkana Counties respectively were sampled across three different livelihood zones: pastoral, agro-pastoral and off-farm. Accumulation of livestock was regarded as a key indicator of wealth among pastoral households. The two pastoral communities used different pathways to escape poverty, meaning that no single blanket poverty reduction approach may be applied across different pastoral communities

Gender Differences In The Household-Headship And Nutritional Status Of Pre-School Children

Background: In genera self declared female headed-households in most developing countries tend to be poorer, own less and have less access to job opportunities.Objective: To assess the nutritional status of pre-schoolers by gender differentiation of heads of households.Design: A cross-sectional descriptive study carried out in February 2003.Setting: Four beneficiary villages registered under the Ethio-Danish joint community development programme in North Ethiopia.Subjects: A total of 144 heads of random systematically selected households regrouped as male-headed (n=96) and female-headed households (n=48) with their respective preschoolers.Main outcome measures: Nutritional status of two groups of children categorised by gender of the head of household.Results: The number of pre-schoolers from male-headed households was 1.54 as opposed to the female-headed households (1.08). The proportion of stunted and underweight pre-schoolers was significantly higher in female headed-households than in the male-headed households while the prevalence of wasting was practically similar. The proportion of vaccinated and breastfed children, although not statistically significant, was higher in male headed households while the practice of colostrumsfeeding, giving water and butter, vitamin A and appropriate weaning was better in female headed households. The difference noted in prevalence of feeding colostrums was significant. The energy, protein and vitamin A intake in almost all of the households was below the recommended daily allowances; showing a nutrient adequacy ratio of 50.2%, 48.8% and 17.9% respectively whereas iron intake exceeded 100%. The energy,protein, vitamin A and iron intake was better in the male-headed households than in female-headed households. The difference, however, was statistically significant for energy only.Conclusion: This study delineated that chronic child under-nutrition is not only higher among female children but also in female headed households and hence the implication of gender biased violation of the right to nutrition security. Other important implication of this study is that apart from gender issues alternative livelihood options that promote healthy behaviours, such as, improving the provision of health servicesand curbing the harmful traditional practices that may have a dual impact on the well being of mothers and children is recommended

A comparative study on the nutritional status of children (6-59 months) in a world vision project area and a non-project area in Kathonzweni division, Makueni District, Kenya

A cross-sectional survey was conducted in Kathonzweni division, Makueni district to assess and compare the nutritional status of children (6-59 months) drawn from households participating in a World Vision project vis-à-vis non-project area. The purpose of the study was to provide region specific data on the nutrition situation in the World Vision Project area and establish whether there is any significant  difference from the non-operational area. A total of 320 households, of which 160 were from the World Vision project area each with at least a child aged between 6-59 months were randomly selected. In households with more than one child at this age category, only one child was selected. Structured questionnaires were administered to mothers or to alternative caretakers while anthropometric  measurements were taken for all the children in the study households. Statistical package for Social Scientists (SPSS/PC+) computer package was used for data entry and analysis. Indices of nutritional status that is weight-for-age, height-for-age and weight-for-height were computed using the Epi-Info programme. The prevalence of stunting in the project area (46.5%) was slightly higher than among the non-project area (42.1%). A significant relationship was found between the children's age and their nutritional status based on the prevalence of wasting and ofunderweight (p<0.01) while nutritional status, based on stunting, was significantlyassociated with birth order. Overall, there was no significant difference in  prevalence of stunting, wasting and underweight between the world vision project area and nonproject area. However, the prevalence of stunting and underweight was higher than the national levels. It is, therefore, concluded that chronic malnutrition is a problem in the study area and age is an important determining factor. Even though World Vision Kenya has been involved in development projects in the area, there is still need for more targeted nutrition interventions by the organization.Key Words: Under-fives, Nutritional status, Wasting, Stunting, UnderweightUne étude transversale a été menée dans la Division de Kathonzweni, District de  Makueni, au Kenya, en vue d’évaluer et comparer l’état alimentaire d'enfants (qui ont entre 6 et 59 mois) pris de ménages participant à un projet de World Vision par rapport à une région en dehors de ce projet. Le but de l'étude était de fournir des données spécifiques à des régions sur la situation de la nutrition dans la région couverte par le projet de World Vision et établir s'il y a une différence significative par rapport à la zone non couverte par ce projet. Un total de 320 ménages, dont 160 étaient de la région couverte par le projet de World Vision, ayant chacun au moins un enfant âgé de 6-59 mois, ont été sélectionnés au hasard. Dans des ménages ayant plus d’un enfant se trouvant dans cette catégorie d'âge, un enfant seulement a été retenu pendant la sélection. Des questionnaires structurés ontété administrés aux mères ou à d’autres responsables d’enfants tandis que des mesures anthropométriques ont été prises pour tous les enfants dans les ménages faisant l’objet de l’étude. Le logiciel informatique Statistical package for Social Scientists (SPSS/PC+) a été utilisé pour le stockage et l'analyse des données. Les indices de l’état alimentaire qui est mesuré par le poids par rapport à l’âge, la  taille/hauteur par rapport à l’âge et le poids par rapport à la taille/hauteur étaient calculés en utilisant le programme Epi-Info. La fréquence du retard de croissance dans la région couverte par le projet (46.5%) était légèrement plus élevée que dans la région non couverte par le projet (42.1%). Un rapport significatif a été trouvé entre l'âge des enfants et leur état alimentaire en se basant sur la fréquence de la perte de poids et de la maigreur (p<0.01) tandis que l’état alimentaire, basé sur le retard de croissance, était considérablement associé avec l'ordre de naissance.Dans l‘ensemble, il n’y avait aucune différence significative dans la fréquence de retard de croissance, la perte de poids et la maigreur entre la région couverte par le projet de World Vision et la région non couverte par le projet. Cependant, la  fréquence du retard de croissance et de la maigreur était plus élevée que les niveaux nationaux. Il est donc conclu que la malnutrition chronique est un problème dans la région étudiée et que l’âge est un facteur déterminant important. Bien que World Vision Kenya ait été impliqué dans des projets de développement dans cette région, il faut que cette organisation oriente ses interventions davantage sur la nutrition.Mots-clés: Les enfants de moins de cinq ans, l’état de l’alimentation, la perte de poids, le retard de croissance, la maigreur.

Nutrients and antinutrients composition of raw, cooked and sun-dried sweet potato leaves

Traditional indigenous vegetables are the most economically efficient source of micronutrients in terms of both land required and production costs per unit. Promotion of production and consumption of such micronutrient-rich foods will improve intakes, the overall diet, and health status. This study aimed to determine nutrient (iron, calcium, vitamin A and ascorbic acid) and anti-nutrient (oxalates and polyphenols) contents in raw, cooked and dried sweet potato leaves Two varieties of sweet potatoes, which were identified as commonly grown for leaves consumption were analyzed at Department of Food Technology, Sokoine University of Agriculture and at the Government Chief Chemist Laboratory Tanzania. The analysis included proximate, nutrient (ascorbic acid, carotenoids, iron and calcium) and anti-nutrient (oxalate and polyphenols) composition. The purple midrib sweet potato leaves were further analyzed for nutrient and anti-nutrient retention after cooking (with and without lemon) and open sun-drying (with and without salting). There was no significant difference (P>0.05) between the two varieties in crude protein, crude lipid and moisture content. The purple midrib sweet potato leaves had significantly (P<0.05) higher ash, crude fibre, carotenoids, calcium and iron contents while the green midrib sweet potato leaves had significantly (P<0.05) higher ascorbic acid content. The polyphenols were about 4 times higher in the purple midrib sweet potato leaves (22.16%) as compared to that of the green ones (5.28%), which had significantly higher oxalate levels (3730 mg/100g). Drying with salt and cooking with lemon reduced polyphenols significantly (p<0.05), with retention of 42% and 56% respectively; while cooking with lemon lowered significantly the oxalate levels. The traditional methods of cooking SPL with addition of lemon is advantageous because it reduces polyphenols while retaining higher levels of minerals, β carotene and vitamin C. Drying with salt results in a nutritionally and organoleptically good product, hence, drying with salt and cooking with addition of lemon is encouraged. Since the sweet potato leaves are harvested more than once before the plant is uprooted, further studies are recommended to assess whether there is variation in nutrient and anti-nutrient contents in consecutive harvests.Key words: Sweet potato leaves, nutrients, antinutrient

Leucine supplementation in the management of protein energy malnutrition: A review

Background: Wasting accounts for 4.7% of all deaths of children under five years of age globally. Currently there is no standard for treatment of moderate wasting in children resulting in high variability of treatment methods and low predictability  if recovery  outcomes. Leucine, a branched chain amino acid,has recently received significant attention as a therapeutic agent for the  treatment of numerous muscle wasting conditions. This is attributed to its ability to accelerate protein synthesis and reduces protein breakdown in the muscles.Objective: To establish if leucine could be used as a therapeutic agent in the treatment of protein energy malnutrition.Study selection: Based on defined key words a search was carried out on Pubmed to retrieve all publications on leucine  supplementation and muscle protein synthesis. Only studies that met the search criteria were retrieved and the required data obtained.Data synthesis: Eightunique studies obtained from 8 articles that met the study criteria were included. The publications were  analysed to establish whether leucine supplementation had any effect on muscle protein synthesis and protein break down. Dosage levels used in the studies if available were also duly noted.Results: The articles reviewed indicated that leucine supplementation either led to enhanced pr otein synthesis or reduced  muscle mass loss in both healthy participants and participants with wasting conditionsConclusion: Leucine supplementation is a safe and effective way to enhance muscle protein synthesis and reduce loss of lean mass in catabolic conditions. Given the low effectiveness of current therapeutic feeds used in the management of moderate malnutrition, leucine supplementation should be given significant consideration as a potential strategy for treating the condition

Diversity and immune boosting claims of some African indigenous leafy vegetables in western Kenya

A survey was carried out to document the diversity and immune boosting claims of African indigenous leafy vegetables (AILVs) in Western Kenya. Both qualitative and quantitative methods of data collection were used. The results showed that there is diversity of AILVs in the study area with nine popular and frequently consumed, but cassava leaves, stinging nettle and russian comfry are not popular. Seven of these are cultivated but two, stinging nettle (Urtica massaica) and vine spinach (Basella alba) grow wildly. The AILVs are cultivated at subsistence level on home gardens withminimal inputs and only excess of this is sold. The religion one belonged to was significant (p<0.05) in determining consumption or not of some of the vegetables. The vegetables are rain fed and the process of harvesting is by first uprooting during thinning followed by breaking the main stem and finally plucking off the leaves with maturity. Vegetable preparation in most households was mainly by women. The elderly women were keen in this process and spent more time in preparing the vegetables which were believed to be ‘nutritious’. There was no processing and preservation of the AILVs for use during the dry season. The communities rely on wild weeds during such seasons. The AILVs though consumed for good nutrition are also associated with various medicinal and immune boosting claims. Out of the nine, five are known for various health benefits, African  nightshade and spider plant for good nutrition by 31.8% and 25.1% of the respondents, respectively, slender leaf for healing power by 34%, cowpea leaves and slender leaf for anti-aging by 50% and 43.8%, respectively, and cowpea leaves (43.6%) and amaranthus (53%) for smooth skin and adding blood, respectively. Chi square analysis indicated that African nightshade, spider plant and amaranthus are statistically significant (p<0.05) incontributing to good nutrition, healthy functioning of the body and immune boosting. Further analysis showed that spider plant and amaranthus are significant (p<0.05) for immune boosting.Key words: indigenous vegetables, diversity, immune boostin

Development and packaging of a leucine-rich composite flour for treatment of moderate wasting in children aged 6 – 24 months

Wasting, categorized as either severe or moderate, is a form of child malnutrition that manifests with a low weight-for-height Z-score. Previous treatment methods for moderate wasting, which affects approximately 300,000 children in Kenya, were ineffective as they lacked a mechanism to replace the accelerated loss of lean tissue.  Supplementation with leucine, may be a safe and effective method for treating moderate wasting. At a high dosage, leucine activates the mammalian target of rapamycin within the muscles which enhances gain of lean tissue. Leucine supplements are currently inaccessible to populations affected by moderate wasting in Kenya. The objective of this study was, therefore, to formulate a leucine-rich composite flour (TheraPEM) from locally available foods for treatment of moderate wasting. Six composite flours were prepared using combinations of beans (Phaseolus vulgaris), groundnuts (Voandzeia subterranea), and foxtail millet (Setaria italica) selected for their high leucine content, local availability and relatively low cost. Nutrient composition analysis and sensory evaluation were conducted on each of the six flours. The three preferred flours in terms of sensory attributes were subjected to accelerated shelf-life evaluation to determine changes in peroxide value, fat acidity, moisture content and total viable count. Kraft paper, gunny bags and plastic containers were the packaging materials used. All six flours met the Codex Alimentarius food standards for minimum energy density (80 kcal/100g) and maximum fat content (27 %) in processed cereal-based foods used for complementary feeding of infants and young children. They all also met the required >1050 mg leucine per 100 grams of flour. Formulations 2, 3 and 5 had the most preferred sensory attributes and were thus subjected to accelerated shelf-life evaluation. At the fifth month, fat acidity was least in the flours packaged in plastic containers. There was no peroxide formation in any of the three samples during the storage period. The study generated six formulations that meet the minimum requirement for leucine in treatment of moderate wasting but formulation 3, had the most preferred sensory attributes. It is recommended that formulation three be subjected to a study to further validate its effectiveness in the treatment of moderate wasting prior to release for up-scaled use.&nbsp

Magnitude and determinants of stunting in children underfive years of age in food surplus region of Ethiopia: The case of West Gojam Zone

Background: Child malnutrition is a major public health problem in Ethiopia. Surprisingly, the highest level of stunting is found in food surplus areas of the country. Objective: To identify the determinants of stunting in food surplus areas of West Gojam Zone. Method: A community based cross-sectional survey was conducted on 622 mother-child pairs of 0-59 month old children in Mecha and Wenberma Woredas of West Gojam Zone, Northern Ethiopia between May and June 2006. The study investigated the differential impact of demographic and socio-economic factors, health related factors and dietary factors on stunting among under-five children. Both bivariate analysis and multivariate analysis (logistic regression model) were used to identify the determinants of under-five stunting. Results: The analyses revealed that 43.2 (12.0-17.6) 95% CI percent of the children under age five were suffering from chronic malnutrition, 14.8 (39.3-47.1) 95% CI percent were acutely malnourished and 49.2 (45.3-53.1) 95% CI percent were found to be under-weight. The main contributing factors for under-five stunting were found to be sex of the child, child’s age, diarrhea episode, deprivation of colostrum, duration of breastfeeding, pre-lacteal feeds, type of food, age of introduction of complementary feeding and method of feeding. Conclusion: The findings of this study led to the realization that inappropriate feeding practice is the principal risk factor which brought about nutritional deprivation among under-five children in food surplus areas of Ethiopia. Thus, the importance of appropriate feeding during infancy and childhood cannot be overstated even in food surplus areas. The high prevalence of malnutrition in the study area points out the need to revisit the impression held by many people that malnutrition is not a problem in food surplus areas. Development and implementation of preventive policies aimed at addressing child malnutrition should also consider food surplus areas of the country. [Ethiop. J. Health Dev. 2009;23(2):98-106

Dietary intake and cognitive development among children in Kisumu County, Kenya

Varied nutrient-dense and high-quality diet are key to ideal growth and cognitive function in the early years of life. Nutrient deficiency can lead to negative functional effects of the brain and poor cognitive function. High rates of poverty in developing countries predispose children to malnutrition. This study aimed at exploring factors associated with dietary intake and cognitive development among children in Kisumu County, Kenya. This was a cross-sectional study survey that recruited 192 children aged less than 24 months. Food frequency questionnaire and Bayleys Scale for Infant Development kit was used to collect data. It was revealed that a total of 51% were girls with 30% aged below 6 months. Only 12% had cognitive scores above average. Child cognitive scores were linked with age (p= 0.022), carbohydrate (p=0.021), fat (p=0.011) and iron (p=0.022) intake. Only 34% and 32% of children consumed diets adequate in proteins and iron, respectively. Of children aged above 18 months, only 13% consumed diet adequate in iron. Factors associated with carbohydrate intake included: mother's marital status (p=0.036) and her level of income (p=0.028) while protein intake related to the type of housing (p=0.013). Fat intake was linked with the mother's marital status (p=0.009) and her level of income (p=0.001) while the iron intake was linked to the mother's level of income (p=<0.001) and her educational level (p< 0.001). Vitamin A intake was linked to the ability to pay rent by the household (p=0.016). Further analysis revealed that children whose fathers were earning more than Kenya shillings 3000.00 per month had 0.2 times lower risk of being above average on cognitive scores compared to those whose fathers were earning less than Kenya shillings 3000.00 per month, while those with an inadequate intake of carbohydrate had 8 times more risk of having cognitive scores above average compared to those whose diets were adequate. In conclusion, majority of children consumed diets inadequate in protein and iron while 12% of children had cognitive scores above average. Mother’s marital status, eduation and income influenced child’s dietary intake while their age groups and father’s income were associated with child's cognitive outcomes. Policies to enhance parental education and income level should be formulated to improve child's dietary and cognitive outcomes. Key words: Dietary intake, Cognitive development, Children, Bayleys Scale for Infant Development, Malnutritio

Childcare practices and nutritional status of children aged 6-36 months among short and long term beneficiaries of the Child Survival Protection and Development Programmes (The case of Morogoro, Tanzania)

A comparative cross-sectional study was carried out to compare childcare practices and nutritional status of children aged 6–36 months in Mwembesongo and Mjimpya wards that had long and short experiences respectively with the Child Survival, Protection and Development (CSPD) programme. The purpose of the study was to establish whether the long-term implementation of the CSPD programme had an impact compared to that of a short-term programme. The findings showed that the children from Mwembesongo were exclusively breast-fed for a significantly longer period (50 days) than those in the Mjimpya ward (32 days) and that significantly more mothers (95.7%) in Mwembesongo than in Mjimpya (84.5%) attended growth monitoring programmes. On the other hand, significantly more mothers in Mjimpya (71.5%) compared to those in Mwembesongo (51.8%) breast-fed immediately (less than one hour) after birth. The study revealed that there was no significant difference in children's nutritional status (wasting and underweight) between the two wards, except for stunting. More children in Mwembesongo (39.7%) than in Mjimpya (27.5%) were stunted. The findings have demonstrated that financial capacity to support children's food and care requirements forms a springboard from which to launch additional efforts for improved nutritional status. SAJCN Vol. 21 (1) 2008: pp. 16-2