Determinants of Nutritional Status of Children Aged 6-59 Months in Kajiado Central Sub-County, Kenya

Abstract

Abstract Optimal nutritional status in children aged 6–59 months remains a global challenge, with 149 million stunted, 45 million wasted, and 37 million overweight. In Kenya, 18% of under-fives are stunted, 5% wasted, 10% underweight, and 5% overweight, reflecting a double burden of malnutrition. Despite national programs, children in Kajiado Central continue to experience both under nutrition and overweight. This study examined determinants of nutritional status among children aged 6–59 months in the sub-county. An analytical cross-sectional study was conducted among 198 children from nine village units in both urban and rural settings, using a multistage random sampling approach. Data on socio-demographics, caregiver nutrition knowledge, dietary and hygiene practices were collected via semi-structured questionnaires, with anthropometric measurements analyzed using WHO Anthro software. SPSS v26 was used for descriptive, chi-square, Pearson correlation, and logistic regression analyses. Ethical clearance and permits were obtained from Kabarak University Scientific Research Ethics Committee and National Commission for Science, Technology and Innovation, as well as informed consent secured. Caregivers averaged 28.6 years; most were mothers (89.9%), married (78.3%), unemployed (61.1%), and 48% had at least secondary education. Nearly 81% had high nutrition knowledge, yet feeding practices were poor: only 17.7% of children 6–23 months met minimum meal frequency, 4.5% achieved minimum acceptable diet, and 19.4% attained dietary diversity. Continued breastfeeding declined from 86% at one year to 56% at two years. Diets were dominated by cereals (97%) and dairy (62%), while 38.4% of households did not treat drinking water. Prevalence of malnutrition was 21.3% stunting, 7.0% underweight, 5.5% wasting, 4.5% overweight, and 2.5% obesity. Urban residence reduced the risk of being underweight (p=0.005; AOR=0.03), while caregiver employment increased the risk of over nutrition (AOR=22.18, p<0.05). Meal frequency correlated positively with HAZ (p=0.013) and WAZ (p=0.003). Treated water reduced the odds of stunting by 69% (OR=0.31, p=0.039), with chlorine treatment reducing odds by 77% (OR=0.23, p<0.001). In conclusion, although caregiver nutrition knowledge was high, feeding practices remain poor. Children in Kajiado Central face a double burden of malnutrition. Key protective factors include urban residence and household water treatment, while caregiver employment increases the likelihood of child over nutrition. The study recommends expanding drinking water treatment, promoting dietary diversity through local foods, strengthening community feeding programs, and adopting multi-sectoral strategies addressing socio-economic and hygiene factors.