Caregiver’s practices as a risk of bidirectional diarrhea malnutrition among under-fives in the informal settlements of Kisumu County, Kenya

Abstract

Background: A child who suffers from diarrhea and later malnutrition or malnutrition then diarrhea is known to have a bidirectional  diarrhea-malnutrition condition. This state is common in informal settlements but the risk of caregiver’s practices associated with it is  poorly understood.

Objective: To determine caregiver’s practices as risks for bidirectional diarrhea - malnutrition among under-fives  living in informal settlements of Kisumu County, Kenya.

Study design: A cross-sectional research design using quantitative methods to collect data was applied.

Setting: The study sites were two referral hospitals in Kisumu County.

Participants: Children under five years  admitted with acute or chronic malnutrition and diarrhea with signs of dehydration.

Data analysis: Descriptive and inferential statistics  were used to analyze data.

Results: Out of 105 cases with malnutrition and diarrhea 31.43% had bi-directional diarrhea-malnutrition.  Caregivers with a primary level of education comprised 57.58% and 63.64% earned less than USD 92.34 monthly. Also, 60.0% of the  children were on a family diet, however, 36.5% had bi-directional diarrhea-malnutrition. Caregivers practices that were risk for bi- directional diarrhea-malnutrition are disposal of child’s feces in open yard (OR=7.48 (1.71-32.78) p = 0.008, not treating water (OR=3.60  (1.15-11.25) p = 0.028, poor hand washing OR=3.27 (1.15-11.25) p = 0.028 and shortage of water OR=12.14 (2.40-61.50) p = 0.003.  

Conclusion: Findings show that caregiver practices that are related to hygiene, sanitation, and water treatment are a risk for bidirectional  diarrhea-malnutrition. The findings strongly suggest that adopting strategies that improve such practices would contribute  to the reduction of cases of bidirectional diarrhea- malnutrition.