Prevalence and Determinants of Malnutrition Among Primary School Children in Kilifi District, Kenya

Abstract

Childhood malnutrition remains a major public health problem in developing countries and a major contributor to global disease burden. Hunger and malnutrition among children in developing countries continue to impair health, quality of life, and survival. Under nutrition in school children is an underlying factor in low school enrolment, school absenteeism, poor performance and early school dropout. Children stunted at school-age are likely to have been exposed to poor nutrition since early childhood and that the degree of stunting tends to increase throughout the school-age years. However, children can exhibit catch-up growth if their environment improves. Healthy and well nourished children perform better in school, which translates to increased productivity as adults and eventually economic growth of a nation. To achieve the first Millennium Development Goal to “eradicate extreme poverty and hunger,” nutrition action needs to be intensified. Objectives: To determine the prevalence of malnutrition among school children aged six to twelve years in Kilifi District using anthropometric methods and to evaluate association between moderate to severe malnutrition and socio-demographic factors. Methods: This was a descriptive cross-sectional study conducted in public primary schools in Kilifi District. Multi-stage sampling method was used to select the schools and the participants in class one to four in the selected schools were randomly selected. A total of 338 children were seen and interviewed and anthropometric measurements taken. Data was computed using Epiinfo software 2002 to convert it to nutritional indicators of weight for height, height for age and weight for age. Using Z scores and cut off of -2SD, children were grouped into different categories of nutritional status. Results: The overall prevalence of malnutrition was 27.5% with the most common form being stunting at 16.6%, while wasting and underweight were 2.7% and 8.3% respectively. Age was

ix the only socio-demographic factor strongly associated with stunting (p=0.016) but not with wasting and underweight. Both males and females were equally affected in all forms of malnutrition. Presence of school feeding programme in a school did not have any significant association with the current nutritional status of the children as the food supply was not regular and children were expected to buy but were not able to afford it. Conclusion: The prevalence of malnutrition among school children in this area is significantly high and stunting like in other studies is the most common form of malnutrition in this age group. Recommendation: Nutritional surveillance programs need to be established in order to detect early the children at risk of malnutrition and intervene promptly. Effective school feeding intervention should be supported. Further studies are required to determine the long term implications of linear growth retardation in school children in this area.