554 - Community perceptions of infant and young child feeding practices in Kisii, Kenya

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 554
Publication Number: 554.41

Alexandra Obremskey, University of Washington School of Medicine, Seattle, WA, United States; Chifor Theresia. Mfu, university of Nairobi, nairobi, Nairobi Area, Kenya; Edna Kabuna, University of Nairobi, Nairobi, Nyanza, Kenya; Suzinne Pak-Gorstein, University of Washington School of Medicine, Seattle, WA, United States

Presenting Author(s)

AO

Alexandra Obremskey, MD (she/her/hers)

Pediatric Resident
University of Washington School of Medicine
Seattle, Washington, United States

Background: Malnutrition remains an important global child health problem with 149 million children stunted and 45.4 million wasted as of 2021. Progress has been made in Kenya’s childhood nutrition since 2009, but the prevalence of malnutrition remains high with 22% chronic undernutrition (stunting), 11% underweight, and 4% wasting. Complementary feeding, defined as the introduction of food other than breastmilk for infants 6-24 months, has long-term impacts on growth and development. Unfortunately complementary feeding has worsened in Kenya with only 22% of children 6-24 months receiving a minimum acceptable diet, down from 39% in 2010.

Objective:
The aim of our study was to describe the community’s perspective on complementary feeding in Bomachoge Borabu Sub-County in Kisii, Kenya. Specific objectives were to elucidate the knowledge and practices of complementary feeding, explore flow of information about infant nutrition, and query community-identified barriers and solutions for healthy infant feeding.

Design/Methods:
Qualitative data was obtained in multiple community settings including 3 focus group discussions and 9 in-depth interviews. Focus groups were held with 11 caregivers, 10 community health volunteers (CHVs), and 8 traditional healers. Interviews included stakeholders from school, church, hospital, outpatient clinic, and community health settings. Thematic inductive coding and analysis was conducted.

Results: Barriers to appropriate complementary feeds were observed at 5 levels: individual (caregiver knowledge, adolescent mothers), household (lack of time for feeding, alcoholism), community (departure of local NGO resources), and social/environment (land scarcity, climate change). Key themes identified were 1) gaps between caregiver knowledge of healthy feeding with what is practiced (early food introduction despite knowing risks) 2) influence of cultural beliefs on nutrition practices (soups instead of vegetables, belief that feeding eggs cause speech delays) 3) importance of trust in information sources, 4) neglect/de-prioritization of child nutrition, 5) influence of poverty at all levels. Community solutions include empowering CHVs, expansion of kitchen gardens, and collective child care.

Conclusion(s): Current complementary feeding practices in this sub-county are unlikely to provide adequate nutrition to children 6-24 months or support exclusive breastfeeding to 6 months. Structures are in place to provide community education but effectiveness can be strengthened through community partnership, empowering trusted community sources for message delivery, and addressing cultural norms.