Abstract
The right to adequate nutrition in children is essential for the attainment of high standards of health. The health and nutritional status of orphans and vulnerable children is important as it affects their growth, health and mental development. However, these children suffer from malnutrition as they have limited access to adequate food and proper health care. The objective of this study was to assess the effect of an integrated nutrition care intervention in improving the nutritional status of children aged 6 - 14 years orphaned and made vulnerable by HIV and AIDS in Kilifi District, Kenya. A longitudinal quasi-experimental study was carried out in selected households of two divisions of Kilifi District. Two-stage sampling was used to identify the target households. Random sampling was used to identify the study subjects. A sample of 276 children was included in the study for experimental (138) and control (138) groups drawn from 153 households. The data collected included anthropometry measurements, dietary intake and socio-demographic characteristics of the study children. The intervention measures of the study were food rations, health and nutrition education, Vitamin A supplementation and de-worming. The experimental group was put on all the intervention measures, whereas the control group was given Vitamin A supplements and de-worming tablets, given in all the three phases. Epi-Info Anthro’ software package was used to analyze anthropometry data. Nutri- survey package was used to compute the nutrient content of the children’s meals. In both study areas, 26.1% of the children were underweight and 17.8% were wasted at baseline. In the control group at baseline, underweight was 29.7% and 18.8% were wasted, whereas in the experimental group, underweight was 22.5% and wasting was 16.7%. At endline evaluation, the proportion of underweight children in the control group reduced insignificantly (p=0.203) from 29.7% to 22.6% and wasting reduced insignificantly (p=0.295) from 18.8% to 13.9%. Among the experimental group, there was significant reduction (p=0.007) of underweight children from 22.5% to 9.4%, and wasting reduced significantly (p=0.031) from 16.7% to 7.7%. There was significant reduction (p<0.05) in malnutrition among the children in the experimental group but no significant reduction (p>0.05) in the control group. There is need for food rations and nutrition education among orphans and vulnerable children to improve their nutritional status. These results can be used by policy makers to modify programmes targeting orphans and vulnerable children to assure their nutrition security and improve their quality of life.
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