Household food (in)security and nutritional status of urban poor children aged 6 to 23 months in Kenya

Abstract

BackgroundMillions of people in low and low middle income countries suffer from extreme hunger and malnutrition. Research on the effect of food insecurity on child nutrition is concentrated in high income settings and has produced mixed results. Moreover, the existing evidence on food security and nutrition in children in low and middle income countries is either cross-sectional and/or is based primarily on rural populations. In this paper, we examine the effect of household food security status and its interaction with household wealth status on stunting among children aged between 6 and 23 months in resource-poor urban setting in Kenya.MethodsWe use longitudinal data collected between 2006 and 2012 from two informal settlements in Nairobi, Kenya. Mothers and their new-borns were recruited into the study at birth and followed prospectively. The analytical sample comprised 6858 children from 6552 households. Household food security was measured as a latent variable derived from a set of questions capturing the main domains of access, availability and affordability. A composite measure of wealth was calculated using asset ownership and amenities. Nutritional status was measured using Height-for-Age (HFA) z-scores. Children whose HFA z-scores were below −2 standard deviation were categorized as stunted. We used Cox regression to analyse the data.ResultsThe prevalence of stunting was 49 %. The risk of stunting increased by 12 % among children from food insecure households. When the joint effect of food security and wealth status was assessed, the risk of stunting increased significantly by 19 and 22 % among children from moderately food insecure and severely food insecure households and ranked in the middle poor wealth status. Among the poorest and least poor households, food security was not statistically associated with stunting.ConclusionOur results shed light on the joint effect of food security and wealth status on stunting. Study findings underscore the need for social protection policies to reduce the high rates of child malnutrition in the urban informal settlements.

Using the Uganda National Panel Survey to analyze the effect of staple food consumption on undernourishment in Ugandan children

“…This is consistent with the work that shows how household wealth affects stunting [15–17]. The FANTA 2 report states that low levels of zinc, common in these staple foods, are associated with stunting.…”

“…Earlier work focused more on socioeconomic factors shows that socioeconomic background explains child body size differences better than ethnicity, and that child malnutrition is a function of socioeconomic inequality [13, 14]. More recently, low household wealth has been shown to affect stunting in Kenya, eastern Uganda, and Cambodia [15–17]. …”

Malnutrition status and associated factors among HIV-positive patients enrolled in ART clinics in Zimbabwe

“…Lower CD4 cell counts have been found to be associated with severe and moderate malnutrition [14,29] and these are also associated with increased mortality [35]. Similar to other studies, household food insecurity which affects the frequency of meals and dietary diversity of meals consumed in a household has been commonly reported as a predictor of poor nutritional status [36]. There were no differences in levels of undernutrition between PLHIV in rural and urban residences and this could be explained by our findings that show that study participants were generally from poor households given that the majority had household incomes below the national poverty datum line and food poverty line.…”

“…Table 1 shows the socio-demographic characteristics of the 1,242 HIV-positive adults who were enrolled in this study. There were 849 (68%) females and the overall median age of all participants was 41 years (IQR, [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49]. Slightly more study participants resided in the rural areas (n = 699, 56%) compared to urban areas (n = 543, 44%).…”

Association of household food security with toddler stunting in the Sleman Regency Indonesia

“…21 In addition, food security was not associated with stunting in toddlers who came from very poor families due to food availability are more stable with food production activities (farming or livestock) carried out independently. 22 The process of stunting in toddlers in poor region is started from the age of 6 months and appears mainly two to three years early in life and continues until 18 years. 23 Some studies suggest that growth failure in infants and toddlers started from the aged of 7 months when breast milk and complementary food were inadequate so nutrition needs of infants and toddlers could not be fulfilled.…”