title: Maternal nutrition in rural Kenya: health and socio-demographic determinants and its association with child nutrition.
abstract: High levels of food insecurity and human immunodeficiency virus (HIV) infection place most breastfeeding mothers in Kenya at high risk of malnutrition. We examined the role of selected socio-economic, demographic and health factors as determinants of nutritional status among HIV-infected and HIV-uninfected mothers in rural Kenya and further examined the interrelationship between maternal nutritional and child nutritional status within this population. A cross-sectional design was used to collect data from non-pregnant mothers with children ages 4-24 months in Kisumu District, Kenya. Over 80% of the mothers were breastfeeding at the time of the study. Mean maternal body mass index (BMI) (21.60 ± 3.15) and percent body fat (22.29 ± 4.86) values were lower than among lactating mothers in other Sub-Sahara African countries. Maternal HIV status was not significantly associated with any of the maternal nutritional indicators assessed in the study. Breastfeeding, recent severe illness and having multiple children below 2 years of age were negatively associated with maternal nutritional status, while higher maternal age, socio-economic status and household food security were each positively associated with maternal nutritional status. Significant positive association was reported between maternal weight, height, BMI, mid-upper arm circumference (MUAC), body fat and fat-free mass estimates, and children's height-for-age, weight-for-age, weight-for-height and MUAC-for-age z-score. This analysis identifies determinants of maternal nutritional status in rural Kenya and highlights the importance of interventions that address malnutrition in both HIV-infected and HIV-uninfected mothers in rural Kenya. Significant association between maternal and child nutritional status stresses the importance of addressing maternal and young child nutritional status as interrelated factors.
authors.affiliation: Department of Global & Community Health, College of Health & Human Services, George Mason University, Fairfax, Virginia 22030, USA. cgewa@gmu.edu
authors.forename: Constance A
authors.initials: CA
authors.lastname: Gewa
authors.forename: Monica
authors.initials: M
authors.lastname: Oguttu
authors.forename: Nanette S
authors.initials: NS
authors.lastname: Yandell
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001942:Breast Feeding; D003430:Cross-Sectional Studies; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena / Q000502:physiology*; D007630:Kenya; D007774:Lactation / Q000502:physiology*; D008297:Male; D008423:Maternal Age; D039382:Maternal Nutritional Physiological Phenomena / Q000502:physiology*; D009752:Nutritional Status; D012423:Rural Health / Q000706:statistics & numerical data; D012959:Socioeconomic Factors