Older slum kids, teens most undernourished

At least 85 per cent of urban slum dwellers suffer poor nutrition, especially under-fives and adolescents.

A study by the African Population and Health Research Centre (APHRC)  said children aged between five and nine years were perceived to have better health and nutrition than younger children and adolescents.

Better nutrition was attributed to school feeding programmes.

School meals were  the main source of food for some children. Consequently, children limited their food intake in school so they could take food back home to their siblings.

“In some cases, children were not offered extra meals at home because their caregivers assumed that they had eaten at school," the report released last month said.

The study in Korogocho slums discovered most children and adolescents showed common forms of malnutrition.

Most children under five years, especially among those born to adolescent mothers, were underweight or had stunted growth. Infectious diseases such as diarrhoea, were also reported.

“Poverty was associated with poor access to food due to unemployment or low income and this is a barrier to exclusive breastfeeding. Young children were also offered family meals regardless of their ability to consume these foods,” the report reads.

The report said young mothers interviewed engage in prostitution.

One of the 32 people interviewed said “many children are left at home without food or with just a cup of porridge for the whole day."

Adolescents also reported engaging in child labour in exchange for either food or money to buy food.

Maternal employment and unemployment also cause under-nutrition and poor infant and young child feeding practices and they introduced complementary foods early.

However, most of them are poor , forcing them to consume less nutritious foods as they prioritised satiety over diet diversity.

“Participants opted for ready-made street foods, which they considered to be cheap and convenient, as less time is spent on shopping and cooking. This translated into more time to seek gainful employment,” the report read.

Parents also gave more attention to infants and young children than adolescents who were considered to be adults and therefore expected to be self-reliant.

Daycare centres  are a a common source of alternative child care. Although some provided meals, they tended to be monotonous due to the lack of funds.

Health workers reported most of the children who presented with malnutrition in the health facilities were taken to daycare centres.
Some mothers give food to their children.

In other day care centres, not all parents provide food for their children.

“As the parent feeds her child, she can be observing her child. It is not the same with women you have left to take care of your child," one respondent said.

“That woman has been left with about five or 10 children and maybe you have given your good food and those others have not carried food so maybe your child’s food is given to the others.”

In public schools though, pupils, are given githeri for lunch which despite being monotonous, was balanced. Teachers understood that some did not have food back home and would pack the leftovers from school to give to their siblings.

The under-five children reported having relatively good access to health facilities attributed to community health volunteers who conduct outreach programmes that create demand for health services.

In contrast, schoolchildren and adolescents, boys especially, were reported to have poor access; they only accessed health facilities for curative services.

There is only one public health facility in Korogocho which offers services for free. Most residents reported that they preferred to use the public health facility, which has limited staff numbers.

Consequently, the health facility is usually very busy and has long queues and waiting times.

Adolescent girls also accessed health facilities for family planning services. Poor utilisation of health care services was attributed to fear of being tested for HIV,  long queues, lack of privacy, lack of drugs, and poor interactions with health staff.

High cost and lack of drugs were factors that limited access to health facilities by both adolescents and caregivers of children less than five years.

Even though they had access to water for purchase, the quality was poor and likely to be contaminated from sewerage systems close to the main water source. Sometimes, the water is rationed.

Poor access to safe water was associated with waterborne diseases such as diarrhoea and typhoid. Poor food hygiene was also reported especially among food vendors.

Lack of toilets and poor disposal of garbage worsens the situation.

(Edited by V. Graham)