Social/cultural challenges on vitamin A and iron status in infants and

young children (IYC) in Machakos and Makueni Counties, KenyaAudrine Makaka1*, Timothy Johns1, Zipporah Bukania2

1McGill University School of Dietetics and Human Nutrition, 2 Centre for Public Health Research, Kenya Medical Research Institute

*Corresponding auhor: Audrine Makaka (Audrine.makaka@mail.mcgill.ca)

Specific objectives and methodology:1. Understanding of cultural influences, taboos and feeding practice on gender differences and

nutrition status of Infants and Young Children (IYC)2. Assessment of effect of mothers/caregiver’s demographic characteristics and economic status on

the nutritional status of their IYC3. Assessment of relationship between Dietary Diversity Score (DDS) and micronutrients (Vitamin A

and Iron)4. Investigation of differences in DDS between boys and girls5. Investigation of differences in anthropometric indicators betweenboys and girlsStudy site and sample size

- Eastern Province of Kenya in Makueni and Machakos Counties.

- Average temperatures in the area around 20.2˚C-24˚C, with a highevaporation rate.

- Sample size (n=277) mother (15-49 years) and baby (6-36 months) pairs.

Acknowledgements: This research was made possible through the Canadian International Food Security Research Fund (#106510). The Canadian International Food Security Research Fund (CIFSRF) is a program of Canada’s International Development Research Centre (IDRC) undertaken with the financial support of the Government of Canada provided through Foreign Affairs, Trade and Development Canada (DFATD).

Discussion: High prevalence of Iron Deficiency Anemia ( IDA) in IYC is caused by low intake in foods rich in heme iron (meat ,organ meat) with high Vitamin A Deficiency (VAD) attributable to low intakes of animal sources which are rich source of preformed Vitamin A. This is a reflection of the effect traditions and beliefs have on the DDS based on qualitative data gathered from the focus group discussion.

Conclusion: The few areas still upholding cultural beliefs around diet have an overall

impact, as it lowers the DDS which in turn,causes a decrease in both macro andmicronutrient intake which is eventuallyreflected in the nutrition status of the affected group.

References:1. Oniang'o RK. Contemporary African food habits and their nutritional and health implications. Asia Pacific journal of clinical

nutrition. 20032. Ndiku M, Jaceldo Siegl K, Singh P, Sabaté J. Gender inequality in food intake and nutritional status of children under 5 years

old in rural Eastern Kenya. European journal of clinical nutrition. 20113. Osmani S, Sen A. The hidden penalties of gender inequality: fetal origins of ill-health. Economics and human biology. 20034. Shell-Duncan B, McDade T. Cultural and environmental barriers to adequate iron intake among northern Kenyan

schoolchildren. Food & Nutrition Bulletin. 20055. Dey I. Gender inequality in nutritional status among under five children in a village in Hooghly district, West Bengal. Indian

Journal of Public Health. 2008

0

25

50

Milk + milk products

Grains + tubers

ProVit A rich foods

Other fruits and veg.

Meats Eggs Pulses,nuts, legumes

Boys %

Girls %

(Food groups)

No

.of

IYC

(%

)

Consumption of major food groups from 24HR recall

Tradition/ cultural

influenceLow DDS

Micronutrient deficiency

Malnutrition

Indicator

Prevalence (%)(n=277)

IDA 35.9

VAD 60.0

Low DDS 76.6

HAZ (stunting) 35.7

WAZ (underweight) 11

WHZ (wasting) 2.1

Background: Food insecurity and traditional feeding practices (taboos, social, cultural influences) both contribute to

malnutrition. Traditional feeding practices affect the “utilization” aspect of food security. Food may be available, affordable and accessible but due to traditional beliefs, a group might be prohibited from consuming certain types of food, which eventually limits their micronutrient intake1. The effect of gender favuoritism on the nutrition of infants and young children has not been extensively studied, although in most developing countries nutrition status is influenced by social cultural and traditional feeding practices with gender biases more likely in favour of the male child2-3. These can contribute to differences in prevalence of malnutrition between boys and girls related to disparities in levels of micronutrient intake4-5.

Objective: This study examines relationships and determinants of vitamin A and iron in infants and young children), with a focus on variations and differences of micronutrient levels and dietary diversity score between female and male children (6-36 months) as influenced by culture and taboos.

Information from Focus group discussion

Type of food forbidden Reason

"Kathiliko" meat from goat stomach. Causes a lot of anger

Meat delay in speaking and stammering

animal heads, liver, eggs, honey and fats

Infant grows large causing birth

difficulties

raw animal blood For men only to cure low libido

"W,oa" a traditional vegetable at

flowering stage Causes dizziness in children

Results

View of Makueni county