Abstract:
Vitamin A deficiency is a problem of public health significance among lactating
mothers. Low dietary intake of vitamin A results in inadequate vitamin A
concentration in breastmilk, thereby putting the life of the breastfed child at risk.
Food availability is critical for quality nutrition that leads to a balanced diet. The
poor in urban areas spend most of their income on food yet do not meet their
dietary needs. This study aimed to assess the dietary intake of vitamin A rich
foods, prevalence of undernutrition and household food insecurity among lactating
mothers (15-49 years) attending Lunga Lunga Health Centre from Sinai Slum,
Nairobi, Kenya. This cross-sectional study was undertaken using systematic
random sampling for 384 lactating mothers from April to June 2017. A structured
questionnaire was used to obtain socio-demographic information. Dietary intake
was assessed using a 24-hour recall and Food Frequency Questionnaire (FFQ).
Prevalence of undernutrition was determined through anthropometric
measurements: Body Mass Index (BMI) and Mid Upper Arm Circumference
(MUAC). Household food security was determined using food insecurity access
scale and dietary diversity questionnaires. Statistical analysis was undertaken
using Microsoft excel and SPSS. Chi-square test was used to determine for
associations between inadequate intake of vitamin A, maternal undernutrition,
household food security and socio-demographics. Logistic regression analysis
determined the predictors of adequate dietary intake of vitamin A, undernutrition
and food security. The mean age of the lactating mothers was 26.5 (SD 5.6) years.
Majority (72.9%) had primary education while 57.6% were self-employed.
Inadequate dietary intake of vitamin A was reported amongst 58.6% of the
mothers, 31.3% had low MUAC<220mm while 13.8% had low BMI. Mothers who
consumed dark green leafy vegetables were 26.6% compared to those consuming
fruits like bananas (18.2%), mangoes (13.3%), pineapple (10.7%) and papaya
(8.3%). Fish formed the main source of proteins (18.8%), followed by meat (16.7%)
and eggs (14.8%). Vitamin A intake had a significant association with income
(p<0.001), energy (p<0.001), food insecurity (p<0.001) and buying food (p<0.001).
Household Dietary Diversity Score (HDDS) had a significant association with low
MUAC (χ2 = 1.694, p =0.031 and low BMI (χ2 = 3.039, p = 0.042). Lactating
mothers from Sinai slum had inadequate dietary vitamin A intake, were under
nourished and food insecure. Food security interventions: food-based strategies
and policies that include Vitamin A food fortification aimed at increasing intake of
Vitamin A rich food, campaigns for increased dietary diversity, alongside routine
nutrition education among mothers should be emphasized to enhance their
nutritional status and reduce micronutrient deficiencies.