Background Kenya is faced with a triple burden of malnutrition which is multi-faceted with health and socio-economic implications. Huge geographical disparities exist, especially, in the arid and semi-arid lands exacerbated by inadequate resource allocation to the nutrition sector and challenges in multi-sectoral coordination and nutrition governance. UNICEF’s Maternal and Child Nutrition Programme is a four-year (2018–2022) resilience-building, multi-sectoral program focused on pregnant and lactating women, mothers of children under five years and children under five years. The objective of the mid-term evaluation was to establish the relevance, effectiveness, efficiency, and sustainability of the programme. Methods The field evaluation conducted between June and July 2021, adopted a concurrent mixed-methods approach, where qualitative information was gathered through 29 key informant interviews and 18 focus group discussions (6 FGDs per population group; women of reproductive age, adolescent girls and men). Quantitatively, data were obtained through desk review of secondary data from programme reports, budgets, and project outputs where descriptive analysis was undertaken using Excel software. Qualitative information was organized using Nvivo software and analyzed thematically. Results The findings provide evidence of the relevance of the Maternal and Child Nutrition Programme II to the nutrition situation in Kenya and its alignment with the Government of Kenya and donor priorities. Most planned programme targets were achieved despite operating in a COVID-19 pandemic environment. The use of innovative approaches such as family mid-upper arm circumference, integrated management of acute malnutrition surge model, Malezi bora and Logistic Management Information Management System contributed to the realization of effective outputs and outcomes. Stringent financial management strategies contributed toward programme efficiencies; however, optimal utilization of the resources needs further strengthening. The programme adopted strategies for strengthening local capacity and promoting ownership and long-term sustainability. Conclusion The programme is on track across the four evaluation criteria. However, a few suggestions are recommended to improve relevance, effectiveness, efficiency, and sustainability. A formal transition strategy needs to be developed in consultation with multi-stakeholder groups and implemented in phases. UNICEF Nutrition section should explore a more integrated programming mode of delivery through joint initiatives with other agencies under the Delivery as One UN agenda, along the more gender transformative approaches with more systematic involvement of males and females in gender-based discussions.
All tests of data quality suggest an improvement in 2014 relative to 2008 to 2009, despite the complexity implied by the larger sample. This improvement corresponds with efforts to enhance training and supervision of anthropometry, suggesting a positive effect of these enhancements.
Background: Many boys and girls in developing countries transition to adolescence undernourished, making them more vulnerable to disease and mortality. Growth during adolescence is faster than any other period of life leading to increased requirements for both macro- and micronutrient. High vulnerability to undernutrition has been expressed more on adolescent girls despite similar stage of growth for both males and females. This necessitates more information on gender influence on undernutrition and dietary practices especially in resource poor environments with rich cultural practices such as pastoral Samburu community in Kenya.Methods: The study design is cross sectional with both quantitative and qualitative components for in-depth understanding of the parameters in context of the target population that targeted 490 male and female adolescents based on probability proportionate to population size. Simple random sampling method was used to reach adolescent respondents in each cluster in Samburu Central sub-county. Questionnaires, in-depth interview, and Focus Group Discussion guides were used to collect data. Quantitative data was analyzed and presented descriptively as frequencies and percentages and inferentially as odds ratio, Chi-square and t-test. Content analysis was done on qualitative data and information triangulated with quantitative data for in-depth understanding of the context of study findings, Results: Low education level was observed among the adolescents where 21.9% dropped out of primary school while 21.9% completed primary education. There was no difference in gender distribution in both primary and secondary schools’ enrolment (χ2, p> 0.05). The married adolescents were more likely to be females than males (χ2, p<0.001). The adolescents aged 10-14 years were two times more likely to be underweight compared to 15–19-year-old (OR,2.101; CI,1.331-3.317; P=0.001). Males aged 15-19 years associated with underweight (χ2, p=0.049). Females had significantly higher Mean Dietary Diversity Score (MDDS) at 3.93±1.39 compared to 3.59±1.40 of their male counterparts (t-test, p=0.007). Male adolescents (59.9%) were more likely to consume less than 4 food groups compared to the 35.3% female counterparts (χ2, p<0.001). Conclusion: Adolescents are vulnerable to malnutrition that is associated to poor dietary practices and nutrient inadequacies that are further compromised by cultural gender roles that place the male adolescent at a higher risk. Culture sensitive strategies are recommended to reduce malnutrition and all its forms in this population group
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