Maternal nutritional status in pastoral versus farming communities of West Pokot, Kenya: Differences in iron and vitamin A status and body composition

Abstract

Background. Underweight and micronutrient defi- ciencies are sequelae of the prevailing harsh living and economic conditions of women in sub-Saharan Africa. There are few data describing maternal nutritional status in these resource-poor settings. Provision of more effective modes of intervention requires that public health and nutrition policy at both the national and the multisectoral levels be based on community-specific nutritional and behavioral practices. Objective. This longitudinal study investigated mater- nal micronutrient status in two remote, semiarid, rural communities that are ethnically similar but have dis- tinctly different pastoral and farming lifestyles. We looked at differences in iron stores, vitamin A levels, and body composition of women in the third trimester of pregnancy and again at 4 months postpartum. Methods. Complete data were collected from 113 pastoral and 110 farming Pokot women. Anthropometric measurements were taken, and serum ferritin and retinol levels were measured. Infants were weighed within 7 days of birth. Results. Women from the farming community had significantly (p < .05) lower hemoglobin concentra- tions than women from the pastoral community during the third trimester of pregnancy. Pastoral women had significantly higher serum ferritin concentrations than farming women during the third trimester of pregnancy (p < .05) and at 4 months postpartum. There were no significant differences between pastoral and farming women in the percentage of women with serum retinol levels < 0.70 μmol/L during the third trimester of preg- nancy (27.9% [34/113] and 24.2% [31/110], respec- tively) and at 4 months postpartum (29.2% [33/113] and 30.9% [34/110]) In the farming community, mean infant birthweight was significantly lower (p < .01) than in the pastoral community and a significantly higher (p < .05) proportion of newborns weighed less than 2.5 kg. At 4 months postpartum, the percentage of body fat was significantly lower in pastoral women than in farm- ing women. Conclusions. Women from the farming community in West Pokot, Kenya, have lower iron stores during the third trimester of pregnancy than women in the pastoral com- munity. In addition, the mean weight of their newborn infants is lower than that of infants in the pastoral com- munity. These findings may be associated with differences in living conditions, which are usually harsher in farming than in pastoral communities.