Determinants of the nutritional status of children 6-23 months of women working in the cut-flower farms in Naivasha, Nakuru County, Kenya.

Abstract

Background: Infant and young child feeding practices are determinants of child survival and particularly during the period from birth to the age of 2 years. Mothers working in cut-flower farms in Naivasha work under difficult circumstances and are of low socio economic status. Objectives: The objectives of this study were to assess the infant feeding practices of women working in the cut-flower farms in Naivasha Sub-county, Kenya; assess the nutritional status of their children 6-23 months and identify the factors associated with nutritional status of the children. Methods: This study was a cross sectional study targeting 116 women with children aged 6-23 months, who had been employed for at least 6 months prior to the study as casual workers. The study employed purposive sampling to identify the study area. Respondents were identified through snowball sampling. Infant feeding practices were documented through interviews, 24-hour recall while anthropometric measurements determined nutritional status of the children. Descriptive statistics and bi-variate analysis (chi-square tests and odds ratio) was carried out to establish factors associated with nutritional status of the children. Findings: The women sampled had worked an average duration of 49 months and had an average income of nine thousand and eighty (Kshs. 9,080) per month. The average working hours of the mothers was found to be 9.8 hours. While 98% of the mothers initiated breastfeeding at birth, exclusive breastfeeding rate was found to be low at 16% with mean duration of exclusive breastfeeding being 17 weeks. Continued breastfeeding rate was 82%. Majority of the mothers (62%) had crèches within the workplace but only 56% utilized them. Thirty nine percent (39%) left children in informal baby cares at the community. Establishment of a crèche facility alone was not found to be sufficient to ensure positive nutritional outcome for the children. Majority (84%) of the children sampled consumed foods from 4 and above food categories but the diversity of the food fed to the children was poorly constituted, with their diet comprising mainly of milk (fed to 94% of the children) and grain foods (fed to 95% of the children). Prevalence of diarrhea was 43% and other childhood illnesses 48%. Slightly less than half of the children were found to be malnourished with 43%, 41% and 49% of children being wasted, stunted and underweight respectively. Conclusion: The factors associated with the nutritional status of children of women working in flower farms in Naivasha are food diversity, child care arrangements, availability of crèches, and incidence of childhood illnesses. Recommendation: All farms should set up crèche, educated mothers on infant feeding practices and informed them of the availability and use of child care facilities within the workplace. The Ministry of health should register all informal baby care premises and organize trainings for all caregivers on operational guidelines, health and safety practices. They should also train mothers on prevention of childhood illnesses affecting this cadre of children including diarrheal diseases, upper respiratory tract infections and rickets.