(P24-021-24) Factors Related to Complementary Feeding in Turkana County, Kenya: A Mixed-Methods Study

Objectives: This study examined factors related to complementary feeding indicators and community perceptions of barriers to optimal complementary feeding in Turkana County, Kenya.

Methods: A mixed methods 2-year longitudinal study of the drivers of acute malnutrition was conducted in Turkana County, Kenya. The population-based study (N=674 for children 6-23 months) represented four livelihood zones: fisher folk, urban/peri-urban, pastoral, and agropastoral. Wave 1 survey data were used to calculate timely complementary feeding initiation from 6-8 months and minimum dietary diversity (MDD) and minimum meal frequency (MMF) for children 6-23 months. The qualitative component included 20 focus group discussions and 83 in-depth interviews with mothers and fathers of children < 3 years. Audio files were transcribed and imported into NVivo for coding and thematic analysis.

Results: Overall, 71% of children 6-8 months were receiving complementary food, 4% had MDD, and 15% had MMF. All three indicators were lowest among pastoralists and mothers with no education. Timely initiation of complementary feeding and MDD were also lower in female-headed households and in households in the lowest wealth tertile, whereas MMF was lower in male-headed households. The most common food groups were grains, roots, and tubers (74%) and dairy (46%); mean number of food groups was 1.8. Poverty, resulting in the inability to afford nutritious foods, was perceived to be the main barrier to optimal complementary feeding. Other barriers were seasonal variations in food access and utilization; male decision-making about food purchases; and in urban/peri-urban and agropastoral livelihoods, alcohol use by caregivers, leading to neglect of childcare and feeding.

Conclusions: Few children received an adequate complementary feeding diet, with some variations by livelihood, maternal education, wealth, and gender of the household head. These findings have been used by the USAID Nawiri project to refine and adapt program strategies to improve child nutrition, including complementary feeding.

Funding Sources: USAID Nawiri 72DFFP19CA00003