Childcare Practices, Morbidity Status And Nutrition Status Of Preschool Children (24-59 Months) Living In Orphanages In Kwale County, Kenya

ABSTRACT

High adult mortality due to various causes like HIV and AIDS has led to an upward

trend of the number of orphans and vulnerable children. Extended family networks

have taken the responsibility of caring for these children but lack of adequate

resources for their care has forced the caretakers of these children to take them to

orphanages. As a consequence to the ever-increasing number of orphans, there has

been mushrooming of orphanages in the country. Appropriate childcare practices have

substantial consequences for growth, development and survival of infants and

children. However, due to lack of adequate resources, children living in institutions

are faced with practical challenges in being provided for their basic necessities

including nutritious food and clothing. Most studies that have been carried out in

Kenya have focused on children below five years who are under the care of their

parents. Studies conducted in orphanages have concentrated on children above five

years. Thus there is minimal information on childcare practices, morbidity status and

nutrition status of preschool children living in orphanages. The purpose of this study

was to determine the childcare practices, morbidity status and nutrition status of

preschool children 24-59 months of age living in orphanages in Kwale County,

Kenya. A cross-sectional analytical study was conducted on a comprehensive sample

of 162 children and 45 caregivers, drawn from a sample of 14 out of the 21

orphanages in Kwale County, Kenya. Data collection tools included; a structured

researcher-administered questionnaire for caregivers, Key informant interview (KII)

guide and observation checklist. The data collected was analysed using Statistical

Package for Social Sciences (SPSS) version 20.0 and anthropometric data of the

children analysed using ENA for SMART (2011). WHO standards (2006) were used

in interpretation of anthropometric data. More than a third (36.4%) of children were

either single or double orphans. The rest (63.6%) were not orphans. The mean (SD)

duration of stay in orphanages was 35.22+13.54 months. Majority (84.0%) of children

had favourable caregiver to child ratio while a small proportion (16.0%) had unfavourable

caregiver to child ratio. Supper provided a significant proportion (35.1%)

of daily energy intake than both lunch (34.7%) and breakfast (11.4%). In terms of

nutrition status: 15.4% of the children were stunted, 8.6% were underweight and 3.7%

were wasted. Boys were more stunted, underweight and wasted compared to the girls

(chi-square test; p < 0.05). A small proportion (6.8%) of children suffered from upper

respiratory tract infection, 10.5% suffered from malaria and 0.6% from measles.

Childcare (dietary) practices were associated with underweight (chi-square test; p