Health System Factors and Morbidity Profiles as Determinants of Nutritional Status of Under 5 Orphans and Vulnerable Children in Isiolo County, Kenya

الملخص

Malnutrition is the single most important threat facing those under 5 years with alarming associated morbidity and mortality. Whereas the assessment of malnutrition under 5 in the general population is commonly done, little is known about the nutritional quagmire facing Orphans and vulnerable children in the country. The study was a cross-sectional analytical study design administered at the community level. Data were collected from 394 OVCs and their caregivers. Simple random sampling was used to sample individual sample respondents from each of the 3 wards of Garbatulla Sub-County of Isiolo County. Both structured and semi-structured questionnaires were used to collect data. Data was then cleaned and analysed using SPSS version 26.0. Level one analysis involved the use of descriptive statistics whereas level 2 analysis entailed both bivariate and multivariate regression analysis. Acute malnutrition affected a third 127(32.9%) of under 5 OVC residing in Garbatulla sub county whereas 48(12.5%) were stunted. Underweight was noted to be 20(5.2%). Negative attitudes towards health workers increased the odds of malnutrition by 3.51 times with COR 3.51 (95% CI 1.74, 7.46). In addition, the lack of medicines and vaccines in the health facility increased the odds of malnutrition by 3.66 times: COR 3.66(95 CI 1.60, 9.14). Lastly, sickness in the previous month increased the chance of malnutrition in OVC by 58% COR 1.58 (95 CI 1.01, 2.50). The age group affected most is aged 2 to 5 years. In conclusion, negative attitudes towards healthcare workers, lack of basic medicines and immunization services and sickness in the previous 1 month increase the chance of malnutrition. Provision of basic preventive and curative services at health facilities, teaching the community about the role of healthcare work in community health and prompt treatment of common ailments are recommended to mitigate the effect of malnutrition on those under 5 OVC