A dairy hub intervention was associated with increased milk intakes among reproductive age women in rural Tanzania Open Access

Mishkin, Kathryn Emily (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/8c97kq758?locale=en


Objectives: Animal milk serves as an animal source food that contributes to women's dietary diversity, especially among pastoral communities. Despite this, there is limited literature describing how women's milk consumption is associated with environmental and social influences. The objective of this study was to describe the factors associated with women's milk consumption behavior in four districts in rural Tanzania.

Methods: This study utilized data from two surveys conducted in the Morogoro and Tanga regions of Tanzania in 2015. Data from 232 pastoral and agro-pastoral women participating in both surveys were used. Chi-square and Cochran-Mantel-Haenszel analyses were conducted to identify factors associated with whether milk was consumed in a 24-hour period. ANOVA analyses were performed to identify factors associated with frequency of milk consumption. Logistic regression was performed to quantify the independent effect key variables.

Results: Of the total sample of women, 76% reported drinking milk in a 24-hour period. The proportion reporting milk consumption in the previous 24 hours was greater among residents of Morogoro (p<0.01), self-identifying as Masaai (p<0.01), self-identifying as non-Seventh Day Adventist Christians (non-SDA, p<0.01), women residing in pastoral households (p<0.01), women residing in food insecure households (p=0.02), women in the experiment group (p=0.01), and women who were breastfeeding (p=0.01). The odds of consumption of milk were 16.1 times greater for Masaai than other tribes, adjusting for insecurity status, religion, marital status, presence in the control group, breastfeeding status (95% CI 1.72- 150.44). The odds of consumption among non-Masaai tribe members was 3.45 times greater for those in the experiment, compared to those who were in the control, adjusting for religion, food insecurity status, marital status, relationship to the household head (95% CI 1.07- 11.05). The odds of Masaai consuming milk 3-4 times a day compared to 1-2 times was 9.96 times greater if they were in the experiment group compared to the control, adjusting for breastfeeding, livelihood strategy, food insecurity, marital status, and religion (95% CI 1.03 - 96.09). No factors were associated with increased milk consumption among women who were not Masaai. No factors were associated with maternal underweight or morbidity. Food and milk inadequacy occurred throughout the year, and results showed that severity of milk inadequacy occurred at different times for Masaai and non-Masaai.

Conclusions: Milk consumption was greatest among Maasai and those communities with active dairy interventions. Additional longitudinal research with larger and more representative samples should be conducted to verify impacts of the dairy interventions and articulate the factors associated with milk consumption among Masaai and other tribal groups.

Table of Contents

Table of Contents 6

Chapter 1 8

Introduction and rationale 8

Milk for women's health 9

Milk intake moderated by sociodemographic factors 9

Problem statement 10

Purpose statement 10

Research question 10

Significance 10

Definition of terms 12

Chapter 2: Literature Review 13

Health of women and children dependent upon nutrition 13

Importance of micro and macronutrients 14

Dietary Diversity 14

Milk as essential component of good nutrition 15

Milk for women's health 15

Milk and disease prevention 15

Maternal consumption of animal milk for child health 16

Maternal consumption of animal milk for mother health 17

Pastoralist culture and milk 18

Variation in life quality as livelihoods shift 19

Health outcomes per livelihood strategy 19

Socioeconomic status per livelihood strategy 20

Gender norms per livelihood strategy 20

Impact of female-headed families on nutrition 21

Milk cooperatives and women's empowerment 22

Malnutrition and milk in Tanzania 23

Chapter 3: Manuscript 25

Chapter 4: Conclusion and Recommendations 43

References 47

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