MODELING KEY DRIVERS OF UNDER-FIVE CHILD MALNUTRITION IN MARSABIT COUNTY, KENYA USING GENERALIZED LINEAR MODELS

Abstract

Malnutrition remains one of the major problems in developing countries affecting people of all age groups. The severity of the crisis varies among specific groups, such as children under the age of five years. In Kenya, Marsabit County suffers high rates of acute malnutrition (wasting) above recommended levels by the World Health Organization for children between the ages of 6-59 months. The main determinants of wasting include but are not limited to poor nutrition of women during pre-conception, pregnancy status and lactation; poor infant feeding; poor environmental conditions within households where children live; poor health-seeking behaviors among women in the reproductive age and poor maternal health. Therefore, this study aimed at investigating the underlying factors that affect childhood nutritional status and specifically to determine; the prevalence rates of wasting in North Horr and Laisamis study sites, the correlation between household food security status and wasting, fit a logit model to determine factors that significantly affect wasting and a mixed-effects model on factors associated with wasting with site as a random factor for children between 6-59 months in Marsabit County, Kenya and propose appropriate interventions in Marsabit County and other ASAL counties in Kenya. The study utilized retrospective data of the Standardized Monitoring and Assessment in Relief and Transition (SMART) survey collected in Marsabit County in July 2019. Results showed that 29.3 percent of the children were acutely malnourished and that there was an insignificant difference between household food security and child malnutrition status (p-value = 0.842). Factors such as the age and level of education of caregivers, household size, the gender of the child, , if the child was weighed at birth, source of income, the occupation status, and the distance to the water source remained insignificant at a multivariate level. However, factors such as full-term maternal pregnancy, the child being ill for the past two weeks, and the study site were strong significant factors affecting the status of childhood wasting. Moreover, mothers with full-term pregnancy up to the birth were 53 percent less likely to have malnourished infants when compared to their counterparts whose pregnancy was not term. Caregivers who were herders were 1.29 times more likely to have their children undernourished than their counterparts in other occupations [AOR=1.29, 95% CI=0.546-3.057]. The other important results were that mothers/caregivers who traveled more than half a kilometer were twice more likely to have their children wasted than those who had traveled less than half a kilometer [AOR=2.00, 95% CI=1.282-3.190]. Based on the findings, the study makes recommendations that the policymakers and the entire county government of Marsabit should build more social amenities that provide pregnant women with full-term maternal checkups for both antenatal and postnatal care. Moreover, the County government of Marsabit should lobby and mobilize resources for food aid or cash transfers to households with severely or moderately malnourished to curb the high rate of wasting, make water available close to households so that the women/caregivers minimize the distance to a water source and have sufficient time to be with their infants.