The acceptability of dietary tools to improve maternal and child nutrition in Western Kenya

• Type of Material: Article
• Authors: Nidal Kram, Emory University; Sarah Melgen, Emory University; Ellah Kedera, Aphia Plus Western; Deborah Kortso Collison, Emory University; Jonathan Colton, Georgia Institute of Technology; Wendy Blount, Georgia Institute of Technology; Frederick Grant, International Potato Center, Nairobi, Kenya; Amy Girard, Emory University
• Language: English
• Date: 2016-07-01
• Publisher: CAMBRIDGE UNIV PRESS
• Publication Version: Final Published Version
• Copyright Statement: © The Authors 2015
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1017/S1368980015003213
• Title of Journal or Parent Work: PUBLIC HEALTH NUTRITION
• Volume: 19
• Issue: 10
• Start Page: 1823
• End Page: 1833
• Grant/Funding Information: This project was funded by Grand Challenges Explorations (grant number OPP1058623), the Bill and Melinda Gates Foundation. N.K. was sponsored by the Emory Global Health Institute Individual Field Scholars Program. The funders had no role in the design, analysis or writing of this article. Conflict of interest: None
• Keywords: INFANT; Western Kenya; Maternal feeding practices; Science & Technology; FOOD INSECURITY; TABOOS; Nutrition & Dietetics; UNDERNUTRITION; Dietary tools; HEALTH; Cues to action; EFFICACY; INTERVENTIONS; BANGLADESH; Public, Environmental & Occupational Health; WOMEN; FEEDING PRACTICES; Life Sciences & Biomedicine; Complementary feeding practices
• Research Categories: Engineering, Mechanical; Health Sciences, Public Health

Abstract

Objective Dietary practices in Kenya often fail to provide adequate nutrition during the first 1000 days of life, from conception to 2 years of age. We developed and qualitatively assessed the acceptability of easy-to-use dietary tools consisting of a marked bowl, slotted spoon and illustrated counselling card to support appropriate dietary practices during pregnancy, exclusive breast-feeding and complementary feeding of children aged 6-24 months. Design We conducted qualitative research to assess community acceptability and obtain feedback on the design of the dietary tools. Setting This research took place in urban and rural communities in Western Kenya. Subjects We conducted twelve focus group discussions with community members (mothers, husbands, mothers-in-law, community leaders) and five interviews with government nutritionists to assess acceptability and obtain recommendations on design and delivery of the tools. We conducted 24-28 d of user testing with fourteen pregnant women, fourteen breast-feeding women and thirty-two mothers with infants aged 6-18 months. Results Tools were positively received by communities. Mothers perceived improvements in their own and their children's food intakes including quantity, frequency, consistency and diversity. Many attributed perceived own and child's weight gain and/or increased energy to tool use. A minority reported using the bowl for other activities (n 9) or not using the bowl due to food insecurity (n 5). Conclusions Results suggest that such tools have the potential to positively impact maternal and child dietary practices. Future work should quantitatively assess the impact on diet and nutrition outcomes and the underlying behavioural domains associated with changes.