Dietary diversity interventions and its impact on iron status of preschool children 36-59 months in Emali, Kenya

Abstract

Background: Dietary diversity is considered crucial in ensuring adequate micronutrient intake, especially among children since they have increased nutrient requirements. Iron deficiency is the most common nutrient deficiency in the world and a major public health risk particularly in the developing countries. This study assessed the impact of dietary diversity interventions on iron status of preschool children in Emali Kenya. Methods: A non-randomized pre-post intervention trial involving 495 pre-school children aged 36-59 months in Early Childhood Development (ECD) schools was conducted. Dietary diversity of the children was enhanced by establishing school gardens in the early-childhood education centers and innovative home-gardening techniques in the homes of selected children’s caregivers. Poultry houses for rearing chicken were also constructed at the ECD centers to provide the children with good sources of protein and minerals. Structured nutrition education on appropriate child feeding was also offered to the children’s caregivers. Children were clustered in two communities the Kamba and Maasai to represent the different ecological settings. Results: Dietary diversity score improved significantly in the Kamba community which recorded a high uptake of the dietary diversity intervention programs. Only 9.1% of the children did not meet the minimum acceptable dietary diversity after the intervention from the 48.1% pre-intervention. The intake of iron-rich foods also improved considerably (77.5%) after the intervention with the prevalence of anemia reducing to 3.4%. Prevalence of anemia among the Maasai children remained high (58.3%) due to low intake of iron-rich foods such as green leafy vegetables (34.6%) and meat (21.8%). Conclusion: Anemia is a matter of public health concern among preschool children. Dietary diversity interventions such us; kitchen gardening, nutrition education (enhancement of food nutritional value through better food preparation methods) and implementation of other nutrition-sensitive agriculture interventions can significantly enhance dietary diversity score and iron status of children.