Assessment of dietary intake of Vitamin A-rich foods and associated factors among lactating mothers attending Lunga Lunga Health Centre, in Sinai slum, Nairobi County, Kenya

Abstract

Vitamin A deficiency is a problem of public health significance among lactating mothers. Low dietary intake of vitamin A results in inadequate vitamin A concentration in breastmilk, thereby putting the life of the breastfed child at risk. Food availability is critical for quality nutrition that leads to a balanced diet. The poor in urban areas spend most of their income on food yet do not meet their dietary needs. This study aimed to assess the dietary intake of vitamin A rich foods, prevalence of undernutrition and household food insecurity among lactating mothers (15-49 years) attending Lunga Lunga Health Centre from Sinai Slum, Nairobi, Kenya. This cross-sectional study was undertaken using systematic random sampling for 384 lactating mothers from April to June 2017. A structured questionnaire was used to obtain socio-demographic information. Dietary intake was assessed using a 24-hour recall and Food Frequency Questionnaire (FFQ). Prevalence of undernutrition was determined through anthropometric measurements: Body Mass Index (BMI) and Mid Upper Arm Circumference (MUAC). Household food security was determined using food insecurity access scale and dietary diversity questionnaires. Statistical analysis was undertaken using Microsoft excel and SPSS. Chi-square test was used to determine for associations between inadequate intake of vitamin A, maternal undernutrition, household food security and socio-demographics. Logistic regression analysis determined the predictors of adequate dietary intake of vitamin A, undernutrition and food security. The mean age of the lactating mothers was 26.5 (SD 5.6) years. Majority (72.9%) had primary education while 57.6% were self-employed. Inadequate dietary intake of vitamin A was reported amongst 58.6% of the mothers, 31.3% had low MUAC<220mm while 13.8% had low BMI. Mothers who consumed dark green leafy vegetables were 26.6% compared to those consuming fruits like bananas (18.2%), mangoes (13.3%), pineapple (10.7%) and papaya (8.3%). Fish formed the main source of proteins (18.8%), followed by meat (16.7%) and eggs (14.8%). Vitamin A intake had a significant association with income (p<0.001), energy (p<0.001), food insecurity (p<0.001) and buying food (p<0.001). Household Dietary Diversity Score (HDDS) had a significant association with low MUAC (χ2 = 1.694, p =0.031 and low BMI (χ2 = 3.039, p = 0.042). Lactating mothers from Sinai slum had inadequate dietary vitamin A intake, were under nourished and food insecure. Food security interventions: food-based strategies and policies that include Vitamin A food fortification aimed at increasing intake of Vitamin A rich food, campaigns for increased dietary diversity, alongside routine nutrition education among mothers should be emphasized to enhance their nutritional status and reduce micronutrient deficiencies. Key words: Vitamin A, Nutritional status, Slum, dietary diversity, Food Frequency