Factors Affecting the Differential Nutrition Status of Children Aged 6-59 Months in Karamoja Ethnic Groups: a Case Study of Pokot of Amudat and Pian of Nakapiripirit Districts

Abstract

Background:

In Uganda, Amudat and Nakapiripirit districts are among the districts that have persistently registered the highest rates of acute malnutrition in different forms among children aged under-five years. Poverty, low parental education, lack of sanitation, low food intake, diarrhea and other infections, poor feeding practices, family size, short birth intervals, maternal time availability and child raising practices are identified as the major causes of malnutrition in these districts. For over a decade, various interventions have been implemented to curb the rising malnutrition rates but little or no change has been achieved. Therefore, an in-depth understanding of determinants of child growth in relation to nutrition is required in order to identify the most feasible intervention to curb the persistent malnutrition.

Objective:

To find out factors affecting nutrition status differentials among children aged 6-59 months in the Pokot of Amudat and Pian of Nakapiripirit districts in Karamoja. Methods: A cross sectional study was conducted in two study groups Pokot of Amudat and Pian of Nakapiripirit in which household were the primary sampling units. A total of 270 households were sampled with 135 per study group. Three anthropometric measures; stunting (Height/length for age), wasting (weight for Height/length) and underweight (weight for age) were used as indicators for child Undernutrition. Nutritional status indicators, socio-economic and cultural factors were additionally investigated as interactive factors that could influence undernutrition. Proportions of these indicators were compared using chi square to determine their association with ethnicity.

Results:

The study shows that child under nutrition situation in Pian is higher than that of Pokot; stunting (34.1%), wasting (11.1%) and (28.9%) underweight in comparison 25.9%, 8.9% and 18.5% for Pokot respectively. A number of factors at various levels were associated with underweight. At child level, IYCF practices; breast feeding initiation within 1 hour after birth were protective of underweight while exclusive breast feeding for more than 6 months associated. Male sex, infectious diseases increased the risk of under nutrition. Maternal factors; education level and inadequate nutritional knowledge were positive associates of underweight among the study groups. At household level; underweight was lower among households with smaller than average household size in both groups with more effect in the Pian than Pokot.

Conclusion:

The study results show that there are substantial underlying differences that exist between Pokot and Pian that has led to higher rates of malnutrition among the groups. The study further revealed that lack of knowledge about recommended infant and child feeding practices among Pian and Pokot, is one of the major causes of the high rates of Malnutrition. Therefore child malnutrition among Pokot and Pian still a complex public health problem, which requires a multi-sectoral, a multidisciplinary and multi-level action to be solved. The findings of this study should guide the design of appropriate interventions aimed at reduction of malnutrition within both communities.

Key words: stunting, wasting, underweight, children 6-59 months, Pokok and Pian.