The acceptability of dietary tools to improve maternal and child nutrition in Western Kenya

Abstract

Objective: Dietary practices in Kenya often fail to provide adequate nutrition during the first 1000 days of life, from conception to 2 years of age. We developed and qualitatively assessed the acceptability of easy-to-use dietary tools consisting of a marked bowl, slotted spoon and illustrated counselling card to support appropriate dietary practices during pregnancy, exclusive breast-feeding and complementary feeding of children aged 6-24 months. Design: We conducted qualitative research to assess community acceptability and obtain feedback on the design of the dietary tools. Setting: This research took place in urban and rural communities in Western Kenya. Subjects: We conducted twelve focus group discussions with community members (mothers, husbands, mothers-in-law, community leaders) and five interviews with government nutritionists to assess acceptability and obtain recommendations on design and delivery of the tools. We conducted 24-28 d of user testing with fourteen pregnant women, fourteen breast-feeding women and thirty-two mothers with infants aged 6-18 months. Results: Tools were positively received by communities. Mothers perceived improvements in their own and their children's food intakes including quantity, frequency, consistency and diversity. Many attributed perceived own and child's weight gain and/or increased energy to tool use. A minority reported using the bowl for other activities (n 9) or not using the bowl due to food insecurity (n 5). Conclusions: Results suggest that such tools have the potential to positively impact maternal and child dietary practices. Future work should quantitatively assess the impact on diet and nutrition outcomes and the underlying behavioural domains associated with changes.

Maternal and paternal involvement in complementary feeding in Kaduna State, Nigeria: The continuum of gender roles in urban and rural settings

“…There were some themes from the fathers FGDs about the roles of fathers limited to the provision of resources for their households and supervising mothers with limited involvement in the 'hands-on' activities that support complementary feeding. This is in line with social role theory and consistent with previous research findings in Nigeria, Malawi, Kenya and South Africa, which show that mothers continue to be defined by their caregiving roles, while fathers are seen as providers and decision makers with respect to complementary feeding (Bezner Kerr, 2005Eagly & Wood, 2012;Ejuu, 2016;Ene-Obong et al, 2017;Erzse et al, 2021;Kram et al, 2016;Lamb, 2000;Rakotomanana et al, 2021;Thuita et al, 2015).…”

Impact of a demand-side integrated WASH and nutrition community-based care group intervention on behavioural change: a randomised controlled trial in western Kenya

“…44 Participants were also provided with minimal inputs to enable behavioural change, including information, education and communication materials (pledge cards, food hygiene card, dietary diversity tracking calendar, dietary diversity food wheel, clean compound storybook, feeding counseling card), and hardware (washbasin, pitcher and soap for handwashing stations, mesh food covers, demarcated bowl and spoon). 47 There were two trainings to introduce…”

Mothers’ knowledge and practices on breastfeeding and complementary feeding in an urban slum area and rural area in Kenya: A cross-sectional interview study

“…Reasons for not giving these usually include a lack of knowledge on how to prepare such foods, and a prevailing fear of suffocating (Bazzano et al, 2017; Kram et al, 2016). Consequently, mothers might not give these foods to their children until the age of 12–24 months (Bazzano et al, 2017; Kram et al, 2016). Foods of animal origin can also be considered unsuitable for small children, believed to taste bad to a child, or may be regarded as luxury food (Haileselassie et al, 2020).…”

“…Foods of animal origin can also be considered unsuitable for small children, believed to taste bad to a child, or may be regarded as luxury food (Haileselassie et al, 2020). In some cultures, eggs are believed to slow down speech development and are consequently not given to a child under 1 year (Kram et al, 2016). This is regrettable, as animal products provide a number of nutrients needed by small children; an association between height gain and the consumption of milk and eggs was found in Western Kenya (Mosites et al, 2017).…”