Diets of infants and young children in two counties of Kenya: Key drivers and barriers to improvement

Abstract

Infant and young child feeding (IYCF) practices are influenced by many context‐specific factors related to local food systems as well as social and cultural practices. Understanding these local contextual perspectives is essential for designing effective programs and policies. This paper uses focused ethnographic study methods to examine challenges experienced by mothers related to IYCF in two counties in Kenya, a country with considerable heterogeneity in agriculture, food systems, and cultures. A two‐phase qualitative study was undertaken in each of Kilifi County and West Pokot County, entailing interviews and rating activities with mothers, health workers, and vendors. Interviews were audio‐recorded, transcribed, translated into English, coded, and analysed by topic. Results show low levels of dietary diversity in both counties; in West Pokot, the level of adequate meal frequency is also low. Core foods in young child diets included maize porridge and family foods such as ugali (stiff maize porridge), vegetables, beans, fish, and plantains. Food safety, acceptability, and acquisition ease were the main drivers of food choice. Mothers generally felt that all core foods fed to young children are healthy and safe, but there was more variability regarding child acceptance, acquisition ease, cost, and convenience. Common barriers to feeding nutrient‐dense foods to children included child illness, economic constraints, and limited knowledge of modification strategies, skills, or tools to make the foods suitable for young children. Potential actions to address these barriers include sharing information on child‐appropriate recipes; raising awareness on local, affordable nutrient‐dense foods; and improving WASH practices to reduce illness frequency.

Improving complementary feeding practices, programs and policies for optimal early childhood nutrition in Kenya: What would work?

“…The third research paper complemented findings on affordable nutrient-dense foods by identifying core foods commonly used for young children's diets in Kenya (Kimiywe et al, 2022), including maize porridge and family foods, such as ugali, vegetables, beans, fish and plantains. The paper found that although IYC aged 6-23 months were often fed family foods, they mostly received the 'brothy/soupy' portion of foods prepared (the less nutrient-dense part), as opposed to the (semi)solid portion (the more nutrientdense part).…”

A subnational affordability assessment of nutritious foods for complementary feeding in Kenya

“…subprovincially or seasonally) are not addressed by this paper and could be the subject of future research. Ethnographic research in two Kenyan counties elsewhere in this supplement (Kimiywe et al, 2022 ) indicates that a lack of strategies to modify foods that are commonly consumed but not generally given to young children, such as eggs, is one important barrier. Food handling procedures (drying, preservation, storage, transportation) are also critical for many foods, such as omena, as they impact nutritional value, palatability and safety.…”

“…Other research has explored sociocultural drivers of complementary feeding practices (Kimiywe et al, 2022 ). Previous research has also highlighted unaffordability as a major barrier to the consumption of several micronutrients among children of complementary feeding age in other countries in Eastern and Southern Africa (Ryckman, Beal, Nordhagen, Chimanya, et al, 2021 ).…”

Identifying and understanding barriers to optimal complementary feeding in Kenya

“…partners at the global level to guide the evidence-based improvement of young children's diets and feeding practices. For instance, in 2011, UNICEF launched the community Infant and Young Child Feeding counselling package, which includes detailed processes for frontline and community workers to provide counselling on complementary feeding (Rudert et al, 2020) In Kenya, in 2019-2021, UNICEF in partnership with GAIN undertook four separate but complementary analyses to identify barriers to optimal complementary feeding (Kimiywe et al, 2022;Lowe et al, 2023;Ryckman et al, 2022;Traoré et al, 2023). This research is summarized in this Special Issue.…”

“…In Kenya, in 2019–2021, UNICEF in partnership with GAIN undertook four separate but complementary analyses to identify barriers to optimal complementary feeding (Kimiywe et al, 2022 ; Lowe et al, 2023 ; Ryckman et al, 2022 ; Traoré et al, 2023 ). This research is summarized in this Special Issue.…”