Barrier Analysis of Diet Diversity and Milk Consumption of Infants and Young Children in Rural Kenya Open Access

Abstract

Context: Among rural Kenyan children, only 30% meet global indicators for minimum

dietary diversity. For infants and young children 6-24 months old, diet diversity is an

indicator of nutritional adequacy and is inversely associated with malnutrition and

stunting. The International Livestock Research Institute (ILRI) is a non-profit organization

that works in rural communities in Kenya to improve child nutrition through dairy

programs. To inform their programming, ILRI conducted formative research among

mothers, fathers, and grandmothers of infants and young children to understand the

perceived barriers and facilitators of diet diversity and milk feeding practices. This

study’s objectives are to identify the key determinants of behavior that drive diet diversity

and milk consumption behaviors in rural communities in Kenya.

Methods: Data were collected in 2017 in Busia, Kitui, Siaya, Taita Taveta, and Vihiga

counties. A barrier analysis survey was conducted among 100 mothers of infants and

young children 6-24 months old and 15 focus groups were conducted among mothers,

fathers, and grandmothers. Survey participants were categorized as “doers” or “nondoers”

of two desired behaviors of diet diversity and milk consumption and analyzed with chisquare

tests. Focus group discussion data were used to triangulate findings from the

surveys.

Results: 41% of all mothers had fed their child from at least four food groups in the

previous day and 66% of mothers of children 12-24 months fed their child at least one

serving of milk per day (doer status). Significant differences between doers and nondoers

for the diet diversity analysis included action-efficacy and perceived advantages. Milk

serving doers tended to have more self-efficacy compared to nondoers and cited livestock

ownership more often as a facilitator.

Discussion: To successfully change behavior, ILRI’s programming should focus on

improving mothers’ knowledge of how diet diversity can prevent malnutrition in infants

and young children. Milk’s acceptability for children in the community was confirmed but

there were differences in perceptions of access. Household livestock ownership and milk

production may play an important role in improving mothers’ opportunity to feed their

children more milk. Further analyses should examine doer and nondoer behavior by

region.

Table of Contents

Introduction ........................................................................................................................... 1

Literature Review .................................................................................................................. 3

Methodology ......................................................................................................................... 9

Results ................................................................................................................................. 14

Discussion ........................................................................................................................... 27

Public Health Implications .................................................................................................. 31

References ........................................................................................................................... 34

Appendix: Tables ................................................................................................................ 40

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Diet diversity Complementary feeding Barrier analysis Kenya
Committee Chair / Thesis Advisor	Amy Webb Girard, Emory University

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