Community-Driven Nutrition Interventions in Arid Lands: Integrating Knowledge, Practices, and Capacity Building in Turkana County

Abstract

Malnutrition remains a critical public health challenge in arid and semi-arid lands (ASALs), where environmental shocks, socio-economic constraints, and limited dietary diversity exacerbate food insecurity. Turkana County, Kenya, exemplifies these challenges, with a poverty rate of 79.4% and the second-highest malnutrition burden in the country. Despite existing nutrition interventions, gaps persist in translating knowledge into practice due to cultural barriers, seasonal food shortages, and structural limitations. This study aimed to implement and evaluate community-driven nutrition interventions in Turkana County by integrating local knowledge, dietary practices, and capacity-building approaches to improve nutrition outcomes in arid land settings. It was conducted from October through December 2020 and used a descriptive cross-sectional design and focused on Loima and Turkana South sub-counties.  A mixed-methods approach was employed by combining quantitative surveys (n=356) and qualitative focus group discussions (FGDs) across 10 community units. The study population included community health volunteers (CHVs) and long-term residents (>5 years), sampled through a multistage random sampling approach. Quantitative data were collected via semi-structured questionnaires, while FGDs explored perceptions of food security, dietary diversity, and coping strategies. Additionally, community participatory workshops were conducted to assess knowledge, attitudes, and practices on nutrition and develop action plans. Key findings revealed strong awareness of dietary diversity (72%) but limited practical application due to unemployment (45.8%), seasonal food scarcity (68%), and cultural barriers (e.g., 41% avoided eggs in pregnancy). Women showed a deeper understanding than men. Diets relied heavily on maize (89%), with low intake of animal protein (19%) and fruits/vegetables (23%). Though 9 indigenous fruits were valued, 78% faced preparation challenges. Post-workshop, participants demonstrated improved knowledge on dietary diversity and initiated home gardens and self-help groups. However, persistent barriers included a lack of seeds, irrigation, and financial resources. Post-intervention, 55% adopted home gardens and 38% joined self-help groups, but 63% lacked seeds and 58% lacked water access. While knowledge retention improved by 42%, resource gaps limited wider impact. Cultural taboos, such as avoiding eggs during pregnancy, further restricted dietary practices. Environmental challenges, drought, floods, and insecurity disrupted food production and market access. This study highlighted the critical need for integrated interventions combining nutrition education, climate-resilient agriculture, and economic empowerment to bridge the knowledge-practice gap. Therefore, there is a need to prioritise community-driven approaches in order to leverage local leadership and participatory learning for sustainable impact in ASALs.