Background An understanding of the association between adolescent nutrition, adolescent pregnancy and their quest for healthcare services may elucidate a basis for intervention and formulation of programs that enhance post-partum and increase the lifespan of the newborn, improve the quality of life and bridge morbidity, mortality and healthcare-associated cost. However, the nutritional needs of pregnant and lactating adolescent girls aged below 10 years resident in Trans Mara East Sub-County, Kenya remained unestablished. The objective of this study was to assess the nutritional needs of pregnant and lactating adolescent girls (under 19) when accessing and utilizing nutritional advice and services in Trans-Mara East Sub-County, Narok County. Methods The study adopted a cross-sectional approach that employed mixed methods with both quantitative and qualitative research approaches. Cochran formula was applied to arrive at a minimum of 291 households. Probability proportionate to size sampling techniques using cluster and simple random methods were used to practically access adolescents who are pregnant or lactating. Data was collected using questionnaires, in-depth interview and Focus Group Discussion. Quantitative data was analyzed descriptively using frequencies and inferentially using odds ratio and z-test. Framework analysis was employed to analyze qualitative data. p ≤ 0.05 was considered statistically significant. Results The study revealed that access of pieces of nutritional-related advice represented by 67.8% was significantly higher than expected frequency of 50%. Nutrition supplementation, food fortification or blending and complementary feeding were significantly below the expectant frequency ( p < 0.01) of 50%. Nutrition service areas such as provision and collection of vitamin A and IFAS were significantly lower than expected frequency ( p < 0.01). Conclusions The most widely utilized were nutrition services that falls within the preventive-focused services followed by curative-focused services. Nutritionist and nurse more likely to increase overall utilization of nutrition services. Electronic supplementary material The online version of this article (10.1186/s12884-019-2391-7) contains supplementary material, which is available to authorized users.

There appears to be increasing evidence of the relationship between infant feeding practices and growth during infancy. Effective complementary feeding has demonstrated an observable positive effect on the linear growth of a child within the first 24 months of life. It appears that improved complementary feeding is directly proportional to the linear growth of a child. Fortification of commonly used food vehicles provides an opportunity for increasing nutrient intake during infancy and has the potential to improve growth and development dimensions. This review scanned through 186 articles from common search engines, mainly PubMed, BioMed Central, and Google Scholar. The result based on a systematic review of articles which met the minimum selection criteria identified milk, iodine, maize meal porridge, and vegetable oils as recurring fortification vehicles in the context of complementary feeding. A significant impact of fortification on linear and cognitive growth was demonstrated recurrently across the included empirical studies. However, the review reflects outcomes that still do not demonstrate direct cause and effect relationships but rather implied meaning in the relationship matrix.

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Background: During pregnancy or lactating, adequate nutrition for adolescents becomes critical to reduce risks for both child and maternal-related morbidity and mortality. Power dynamics play a massive role in health outcomes. The main objective of this study was to examine the power dynamics in the families and communities and their impact on the pregnant and lactating adolescent girls' access and utilization of nutrition services in Trans-Mara East Sub-County, Narok County. Methods: A cross-sectional approach that employed mixed methods with both quantitative and qualitative research was adopted. Probability proportionate to size sampling techniques using cluster and simple random methods were used to practically access pregnant or lactating adolescents. Data was collected using questionnaires, in-depth interview and Focus Group Discussion. Quantitative data was analyzed descriptively using frequencies and inferentially using odds ratio and Ztest. Framework analysis was employed to analyze qualitative data. P ≤ 0.05 was considered statistically significant. Results: In the power dynamics analyses, the intrinsic capability (Intrinsic capabilities are those adolescent driven initiatives that facilitate their access to nutrition services) was more likely to decrease awareness by half (OR = 0.52, 95% CI = 0.4-0.7, P < 0.01) whereas extrinsic dependency was likely to increase utilization by 1.2 times (OR = 1.2, 95% CI = 1.0-1.5, P = 0.055). From the stakeholder power matrix, the health personnel had observable visible power to influence access and utilization of nutrition services. Additional results revealed that adolescents who draw their support from significant others were more likely to utilize nutrition services as compared to those who attempted to make their own efforts to seek these services. Furthermore, health personnel have the most influential powers in ensuring adolescents access services and thus the most important actors in the stakeholder matrix. Other actors requiring focus included parents, political figures and governments while stakeholder engagement have higher potential of increasing access and utilization of services through dialogue.

Abstract:There is a rise in prevalence of Type 2 diabetes in Kenya, and an increase in related complications, which lead to disability and death. Diet modification oriented for this group of patients includes recommendations to control blood sugar, lipid levels and pressure which are vital in lowering risk and complications development in the management of Type 2 diabetes. Studies indicate that adherence to diet therapy is weak in the midst of diet recommendations and patients' education. There seems to be limited literature in developing countries as to the most critical factors in the prediction mix of adherence. This article attempts to display the competitiveness between socio-demographic and patient education related factors in the context of adherence. Across sectional analysis of a sample of 240 eligible diabetics was used and their dietary behaviour evaluated using a pre-tested dietary habit assessment survey tool with socio-demographic and patient-focus education factors. Linear regression preceded by principle axis factoring to categories adherences was executed. The results indicated that diet characterized by control of lipid levels was influenced by diet accessible within distance from home (β=0.211, t=2.053, ρ=0.041), while diet to control blood sugar and pressure was influenced by diet accessible from the workplace (β=0.193, t=2.027, ρ=0.044), occupation status (β=0.162, t=2.051, ρ=0.042), age (β=0.178, t=2.238, ρ=0.026), marital status (β=0.208, t=2.731, ρ=0.007) and diet found in the locality or surrounding environment (β=0.277, t=3.034, ρ=0.003). In conclusion, adherence enhancement seems to draw reference to education sessions focused on challenges faced by the unmarried, age specifics, occupation, setting specifics.