Nutritional characterisation of low-income households of Nairobi: socioeconomic, livestock and gender considerations and predictors of malnutrition from a cross-sectional survey

Abstract

Background: In sub-Saharan Africa, urban informal settlements are rapidly expanding, leading to overcrowding and constituting challenging environments for food and water supplies, health and nutrition. The study objectives were to characterise and compare two low-income areas of Nairobi according to socioeconomic (including livestock and gender) indicators and the nutritional status of non-pregnant women of reproductive age and 1 to 3 year-old children; and to investigate socioeconomic predictors of malnutrition in these areas. Methods: In this cross-sectional survey 205 low-income households in deprived areas of Dagoretti and Korogocho (Nairobi) were randomly selected. Socioeconomic data were collected via an interviewer-administered questionnaire. Maternal and child dietary data were collected by a 24-h dietary recall. Maternal and child anthropometric and haemoglobin measurements were taken. Chi-square, t-test and Wilcoxon-Mann-Whitney test were used to compare groups and multivariable linear regression to assess predictors of malnutrition. Results: Dagoretti consistently showed better socioeconomic indicators including: income, education and occupation of household head, land ownership, housing quality and domestic asset ownership. Animal ownership was more than twice as high in Dagoretti as in Korogocho (53.0 % vs 22.9 % of households; p-value < 0.0001). A double burden of malnutrition existed: 41.5 % of children were stunted, and 29.0 % of women were overweight. In addition, 74.0 % of the children and 25.9 % of the women were anaemic, and were at risk of inadequate intakes for a number of micronutrients. Nutritional status and nutrient intakes were consistently better in Dagoretti than Korogocho; height-for-age (0.47 Z-scores higher; p-value = 0.004), the minimum dietary diversity (80.0 % vs 57.7 % in children, p-value = 0.001) and intakes of several nutrients were significantly higher. Positive predictors of maternal nutritional status were income, age and not having a premature delivery. Positive predictors of child nutritional status were area, household head education, mother not being married, female animal ownership and child's sex (female).

Cross-sectional study of drivers of animal-source food consumption in low-income urban areas of Nairobi, Kenya

“…A cross-sectional survey, including the sections used in this study on household ASF expenditures and stated reasons for consumption, was carried out in Dagoretti (low-income neighbourhood) and Korogocho (informal settlement 1 ), in Nairobi from December 2013 to February 2014, during the rainy season (excluding the last week of December and first week of January) [25]. The survey was conducted among 205 randomly selected households based on Global Positioning System (GPS) positions.…”

“…If the first household was not eligible, then the next one on the right was selected. Eligibility criteria were: informal housing (temporary) structures; households with low monthly income (below 20,000 Kenyan Schillings (KES), i.e., $US230) according to estimated incomes for manual workers); presence of at least one child between 1 and 3 years of age; and, a non-pregnant woman of reproductive age (15-45 years) [25].…”

“…The responses were captured electronically in Android tablets with the open-source tool Open Data Kit (ODK Collect) [25].…”

“…Anaemia was found in 74.1% of children and 26% of women. Among women, mild or moderate undernutrition was recorded for 7.3% while 29.1% were overweight, including 9.9% obese [25].…”

“…Among other the study collected data from 205 households on a) dietary intake using a 24 h recall questionnaire and nutrition outcomes, b) household expenditures on ASFs, and c) stated reasons for regularly consuming or not consuming the ASF products. Dominguez-Salas et al (2016) investigated the dietary intake data and nutrition outcomes among the children and women [25]. They found the households' diet to be consisting predominantly of starchy staples (e.g., rice, ugali (maizemeal), pulses, and vegetables (e.g., tomato, cabbage, carrot), including green leaves such as kale (more than 80% of women and children were reported to have eaten these during the previous 24 h).…”