When one thinks of Nakuru County, which is 150km west of capital Nairobi, images of fresh produce and plenty of food come to mind. Beneath these images however, there is a huge disparity between those with sufficient food and the ones who lack leading to extreme cases of stunted growth and obesity.
This situation has led to high cases of stunted children in the county, with one in every four children affected, says Dr Ombeva Malande, a paediatric lecturer at the School of Health Sciences at Egerton University.
A 2017 study by Egerton University nutritionists, Agrobiodiversity and Dietary Diversity for Improved Nutritional Status for Mothers and Children, show that 28 per cent stunted children’s mothers were either teenagers or single mothers. A number of them wean their babies much earlier than the recommended six months. Notably, the researchers found, the mothers fed their babies on starch. Proteins, the major foods required for the physical and mental development of children, were not part of the diet.
Dr Malande says stunting is the impaired development and growth that occurs due to poor nutrition, lack of adequate exposure to the sun that leads to rickets, and in many cases leads to delayed mental development and learning difficulties. Stunting is measured using the height and age index that assesses the linear growth.
He says mothers’ ignorance contributes greatly to this problem. Besides poor diet, mothers generally lock up their infants in the house and do not expose them to the sun for Vitamin D. This ultimately leads to the development of rickets.
“Mothers in this county are superstitious and strongly believe that babies should be locked inside for proper growth, inadvertently, it denies the growing infants sunrays which provide vitamin D,” explained Dr Malande.
In addition, says the doctor, when they carry the children to the clinics they overdress and cover them with heavy shawls, which prevents the penetration of the sun rays.
Apart from the mothers’ beliefs and ignorance, which could easily be changed through information and education, food insecurity in their households is the biggest challenge and beyond their control. The soil is acidic and the little produce smallholder farmers get they sell to take care of other needs at the expense of their growing children.
The study also showed that children brought up in peri-urban areas in the county took the least amount of milk, despite their parents owning at least two dairy cows, however they sold the milk to urban families. That means extreme poverty and economic hardship contribute to the rural parents toiling and improving the health of urban children and not their own.
Best harvest is for market
Dr Maureen Cheserek, a nutritionist at Egerton University, said in rural Kenya, where 80 per cent of families earn their livelihood from farming, the best harvest is selected for sale in the market, while the poor produce, such as beans with weevils are fed to the children.
“Poverty, poor nutrition, and stunted growth are like Siamese twins; to tackle this problem the national and county governments have to implement sound policies to improve children’s health and urgent reduction of poverty,” says Dr Cheserek.
However, Dr Malande said paediatricians in the country have identified the gaps which lead to children being stunted, and they have agreed that mothers should be taught about nutrition and be discouraged from locking their infants inside the houses as a first step.
Poverty, poor nutrition, and stunted growth are like Siamese twins
Since 80 per cent of these mothers attend antenatal clinics, this will be the best place to start the training. Indeed it will help to encourage most of them to deliver in hospitals as records show that despite attending the clinics only 60 per cent deliver in hospitals and just 50 per cent take their babies to the postnatal clinics.
Dr Malande says full adherence to clinic attendance from antenatal to six years when immunisation for children was completed is the best assurance for good health for mother and child and this drastically reduces stunted growth.
According to the Kenya Demographic Survey (KNBS) 2014 report, 26 per cent of children aged between six months and two and half years are stunted, and that compromises their immunity.
Stunted growth and coronavirus
‘Little George’, a 13-year-old boy from Kimunya village on the outskirts of Nakuru town was recently admitted to Nakuru Level Five Hospital for over two months for tuberculosis. However, he got infected with Covid-19 at the hospital and medics are convinced that it was due to his stunted growth and impaired immunity.
Dr Malande says so far the virus has been kind to children and less than 10 percent have been infected in the country.
‘Little George’ is among the few infected by the virus and the doctor attributes it to George’s impaired immunity due to his stunted growth.