Dietary Practice and Nutrition Status of Under-5-Year-Old Orphans and Vulnerable Children in Isiolo County, Kenya

Abstract

Despite global advancements in child health, malnutrition is still the principal etiological factor underlying the elevated morbidity and mortality observed in children under five years of age, with orphans and vulnerable children (OVCs) constituting a demographically distinct cohort exhibiting heightened susceptibility. This community-based analytical cross-sectional investigation, undertaken within Isiolo County, Kenya, sought to quantitatively evaluate the nexus between specific dietary practices and the resultant nutritional status among this vulnerable subpopulation. Quantitative data were collected from OVCs and caregivers using semi-structured, researcher-administered questionnaires, while qualitative data were gathered through key informant interviews with child-care and administrative experts. Simple random sampling was used to select participants from three wards in Garbatulla. Data cleaning and analysis were conducted using SPSS version 29.0. Descriptive statistics were used for Level 1 analysis, while inferential statistics, including bivariate and multivariate regression analyses, were applied in Level 2 analysis. A p-value of < 0.05 was considered statistically significant. Qualitative data were analysed thematically to identify emerging patterns, complementing the quantitative findings. Anthropometric assessment, analysed against WHO growth standards, revealed a pronounced malnutrition prevalence of 40.2% (n=155/386), with pathologies distributed as wasting (32.9%, n=127), stunting (12.5%, n=48), and underweight (5.2%, n=20). Multivariate logistic regression modelling elucidated a statistically significant association between malnutrition and several modifiable dietary determinants: sufficient feeding frequency (Adjusted Odds Ratio [AOR] = 0.45; 95% CI: 0.24-0.81; p = 0.01), good dietary diversity score (AOR = 0.48; 95% CI:; 0.28–0.82 p = 0.032), and non-attainment of the minimum acceptable diet (AOR = 1.89; 95% CI:1.54-4.61; p=0.041), while a crude odds ratio indicated a 3.36-fold increased risk (95% CI: 1.59-4.41) for children exceeding 24 months of age. Consequently, these empirical findings necessitate the formulation of targeted nutritional interventions predicated on the promotion of dietary diversification, the implementation of responsive feeding protocols, and the structural reinforcement of support systems for at-risk households to ameliorate the disproportionate burden of malnutrition identified within this paediatric cohort.