Accelerating progress for complementary feeding in Kenya: Key government actions and the way forward

Abstract

Optimal complementary feeding practices, a critical component of infant and young child feeding, has been demonstrated to prevent micronutrient deficiencies, stunting, overweight, and obesity. In Kenya, while impressive gains have been made in exclusive breastfeeding, progress in complementary feeding has been slow, and the country has failed to meet targets. Recent 2014 Kenya Demographic and Health Survey reveal that only 22% of Kenyan children, 6–23 months, met criteria for a minimum acceptable diet. This case study describes key actions for complementary feeding put in place by the Kenya Ministry of Health as well as approaches for improving and monitoring complementary feeding within existing health platforms. Experience from USAID's Maternal and Child Survival Program and Ministry of Health on development of 23 complementary feeding recipes through application of a national guide for recipe development and Trials of Improved Practices is described. Challenges in how to prepare, modify, and cook foods, including meat, for young children 6–23 months of age was relayed by mothers. Addressing cultural beliefs around complementary feeding meant providing reassurance to mothers that young children are developmentally able to digest fruit and vegetables and ready to consume animal‐source protein. Through the Baby Friendly Community Initiative platform, cooking demonstrations and key hygiene actions were integrated with complementary feeding messages. Future programming for complementary feeding should consider development of context specific counselling messages on consumption of animal source foods, strengthen production and use of local foods through agriculture‐nutrition linkages, and include complementary indicators through routine health monitoring systems to track progress.

Using formative research to design context‐specific animal source food and multiple micronutrient powder interventions to improve the consumption of micronutrients by infants and young children in Tanzania, Kenya, Bangladesh and Pakistan

“…Recognizing the challenge for caregivers to adequately prepare and incorporate these foods into the child's meal lent to recommending specific, doable practices, a facilitator for behaviour change echoed by other studies. For example, in western Kenya, Ahoya, Kavle, Straubinger, and Gathi (2019) (Iannotti, Lutter, Bunn, & Stewart, 2014;Lutter et al, 2018;White et al, 2017). Iannotti et al (2014) and Lutter et al (2018) draw attention to the varying cultural beliefs around eggs that may limit feeding them to IYC, especially younger IYC, but suggest that these barriers are not insurmountable, and our findings agree.…”

“…Recognizing the challenge for caregivers to adequately prepare and incorporate these foods into the child's meal lent to recommending specific, doable practices, a facilitator for behaviour change echoed by other studies. For example, in western Kenya, Ahoya, Kavle, Straubinger, and Gathi (2019) describe cooking demonstration interventions that included teaching preparation techniques such as mashing, dicing and shredding foods to encourage improved dietary diversity and ASF consumption. In Peru, food grinders were tested as a low technology solution to prepare meat and fish for IYC and allay caregiver concerns about food texture (Creed‐Kanashiro, Wasser, Bartolini, Goya, & Bentley, 2018).…”

Subnational estimates of factors associated with under-five mortality in Kenya: a spatio-temporal analysis, 1993–2014

“…33 Government-led campaigns such as the school feeding, Malezi Bora (good upbringing), baby-friendly initiatives at the hospital and community levels (Baby-Friendly Community/Hospital Initiative (BFCI and BFHI)) have addressed poor breastfeeding practices and improved nutrition among children. [34][35][36] Initiatives to fight malaria targeted to children and mothers were intensified from 2000 through expanded, free delivery of insecticidetreated nets (ITNs), 37 38 replacing failing malaria drugs with efficacious therapeutics, 39 40 targeted indoor residual spraying (IRS) and intermittent preventive treatment in pregnancy (IPTp). 22 38 Beginning 2000, there was an expansion of HIV prevention interventions including an increase in facilities offering prevention of mother-tochild transmission (PMTCT) interventions and increased uptake of antiretrovirals (ARVs) drugs.…”

Community-based nutrition-sensitive approach to address short-term hunger and undernutrition among primary school children in rural areas in a developing country setting: lessons from North and North-Eastern Uganda

“…The use of locally available food resources to formulate nutritious food products is believed to be a potential strategy for addressing undernutrition challenges in resource-constrained localities in developing countries [ 4 ]. Indeed, substantial information on community-level research that used locally available food resources to develop elite nutritious composite products for complementary feeding of children in such localities in developing countries exists [ 10 – 12 ]. However, information is scarce on how a similar approach can be used to address short-term hunger and undernutrition experienced by primary school children in similar localities.…”