How COVID‐19 affected food systems, health service delivery and maternal and infant nutrition practices: Implications for moving forward in Kenya

Abstract

This implementation research study sought to examine the impact of the COVID‐19 pandemic on maternal and infant nutrition practices, and related aspects of health and food systems in Nairobi and Uasin Gishu Counties, Kenya. The study triangulated in‐depth interviews with 16 pregnant women, 31 lactating women (including COVID‐19 positive), 10 facility health workers, 10 community health volunteers, 6 focus group discussions (FGDs) with food vendors, 4 FGDs and 15 stakeholder interviews with government and implementing partners. Trends from Kenyan Health Information System indicators (i.e., exclusive breastfeeding and initiation of breastfeeding, antenatal care) were also examined. During the COVID‐19 pandemic, a decline in attendance of antenatal care, and maternity facilities was observed, and corroborated by Kenyan Health Information System data. Lack of clarity among health workers on COVID‐19 breastfeeding guidance and fear of COVID‐19 infection early in the pandemic were key drivers of early infant formula use, mother–child separation following delivery and delayed initiation of breastfeeding. Most women exclusively breastfed due to Government of Kenya restrictions in movement. Unemployment and job loss was linked to food insecurity and worsened by increased food prices and limited social protection measures. In response, pregnant and lactating women resorted to skipping meals and reducing quantity and variety of foods consumed. Efforts to build forward from COVID‐19 in Kenya should include facility and community health education to prevent disruptions in breastfeeding and to support maternal dietary intake, and in the provision of targeted social protection measures alongside other multisectoral interventions (i.e., psychosocial support) for Kenyan pregnant and lactating women.

Perinatal care and breastfeeding education during the COVID‐19 pandemic: Perspectives from Kenyan mothers and healthcare workers

“…• Mothers with prior breastfeeding experience were less affected by the breastfeeding counselling constraints, and first-time mothers more frequently reported stress and anxiety related to breastfeeding and childcare. due to extreme lockdown measures and related economic downturn (Ahoya et al, 2022;Ali et al, 2020). As the health sector and health care workers (HCW) play a pivotal role in BF promotion, the perspectives and experiences of these stakeholders are critical to understanding how to build forward from the COVID-19 pandemic.…”

“…Sub‐Saharan African countries experienced multiple shocks from the COVID‐19 pandemic, including increases in food security, food price inflation and reduced attendance to maternal health services due to extreme lockdown measures and related economic downturn (Ahoya et al, 2022 ; Ali et al, 2020 ). As the health sector and health care workers (HCW) play a pivotal role in BF promotion, the perspectives and experiences of these stakeholders are critical to understanding how to build forward from the COVID‐19 pandemic.…”

Building forward better—An exploration of nutrition practices, food choice, and coping behaviors among Kenyan adolescents during COVID‐19: Experiences and program implications

“…Fieldwork occurred between August and September 2021, and country caseloads of COVID‐19, per available Ministry of Health data were 36,479 and 10,331 for August and September, respectively (Ministry of Health – Republic of Kenya, 2022). Data collection for adolescents was part of a larger implementation research study collecting qualitative information from pregnant and lactating women on dietary intake, access, and use of health services, while also examining perspectives from health workers, community health volunteers, and food vendors on effects on the health and food systems (Ahoya et al, 2022). While study participants were part of this larger implementation research study, adolescent boys and girls were selected as an independent sample via opportunistic purposeful sampling (Patton, 1990).…”

A qualitative comparative study: Coping strategies among food secure and insecure pregnant mothers during the COVID-19 pandemic in Serang District

“…Households should implement coping strategies to fulfill their necessities, notably food (Chaudhuri et al, 2021). Despite implementing coping, the vulnerable group, including the pregnant mother, would be more impacted amid the food crisis due to the tendency to prioritize decreasing food (quantity and variety) and the discrimination of distributed food compared to other household members (Ahoya et al, 2022). A previous study revealed the important factor in maintaining a healthy pregnancy: households should be provided with proper food both in quantity and quality (Zinga et al, 2022).…”