Nutritional service needs of pregnant and lactating adolescent girls in Trans-Mara East Sub-County, Narok County: focus on access and utilization of nutritional advice and services

Abstract

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.

Power dynamics as a determinant of access and utilization of nutrition services by pregnant and lactating adolescent girls in Trans-Mara East Sub-County, Narok County, Kenya

“…We initially determined sample size using the Cochran formula [12], which allowed for calculation of an ideal sample size given a desired level of precision, desired confidence level, and the estimated proportion of the attribute present in the population. A total sample size of 292 was applied as previously reported in our work [13]. Proportionate distribution was done across 25 clusters equivalent to villages and by adolescent status (i.e.…”

Socio-demographic and facility-based determinants of perceived quality of nutrition Services of Pregnant and Lactating Adolescent Girls in Trans-Mara east Sub-County, Narok County, Kenya

“…Trans Mara East Sub-County was purposively selected since it is the smallest in size (275.4 km 2 ), among the four sub-counties in Narok County and had the highest prevalence of teenage pregnancies [9]. To achieve the objectives of this formative study, a cross-sectional study employing concurrent nested quantitative priority mixed methods approaches with both quantitative and qualitative research techniques was applied as previously reported in our work [10]. In this case, quantitative data were given priority while qualitative data were applied to triangulate some relevant quantitative components.…”

“…Sample size was determined using the Cochran formula [11], which allowed for calculation of an ideal sample size given a desired level of precision, desired confidence level, and the estimated proportion of the attribute present in the population. A total sample size of 292 was applied as previously reported in our work [10]. As previously indicated, proportionate distribution was done across 25 clusters equivalent to villages and by adolescent status (i.e.…”

“…Given the nature of the questionnaire where 90% of key variable measures were based on 5 point-Likert scale, descriptive test for sample size adequacy was performed using Kaiser-Mayor Olkin and Batt-test of sphericity as previously described [10].…”

“…Sampling was carried out as described in our work [10]. In brief, probability sampling techniques using cluster and simple random methods was used to practically access pregnant and lactating adolescents.…”