Median consumption was 1.0 cup (0.5, 1.5) of fresh milk overall; 0.5 (0.5, 1.0) for the no milk and emerging groups and 1.0 (0.5, 2.0) for the advanced
In regression models, controlled for maternal and household characteristics: site, sex of child, age of child, age of primary caretaker, years of education, household size, household asset score, food consumption score, and farm land owned
Amanda Wyatt (IFPRI) - Dairy Intensification in Kenya and Young Child Nutrition
Dairy Intensification in Kenya and Young Child Nutrition AIFSC – ILRI Food Security and Nutrition Workshop September 11, 2012 Nairobi, KenyaAmanda WyattSenior Research AssistantCGIAR Research Program - Agriculture for Nutrition and HealthInternational Food Policy Research Institute
East Africa Dairy Development• Goal: To double the dairy incomes of smallholder dairy farmers in the region in 10 years through improved agricultural methods and market access.• Time period: Dec 2007—Dec 2011• Location: Kenya, Rwanda, Uganda; EADD2 in Tanzania and Ethiopia• Partners: Heifer International, TechnoServe, International Livestock Research Institute, African Breeders Services, World Agroforestry Center• Funder: The Bill and Melinda Gates Foundation
ILRI and Emory University, June-July 2010 What is the impact of dairy intensification on young child nutrition?Four pathways Nutritional Considerations• Direct consumption • Household milk consumption • Consumption patterns for different household members (children <5 yo)• Income • Food quantity and quality • Intra-household decision making • IYCFP• Maternal time allocation • Childcare quality • Food safety• Exposure to health risks • Synergy between disease and nutrition
ILRI and Emory University, June - July 2010 What is the impact of dairy intensification on young child nutrition?• Three study sites in Rift Valley Province, Kenya• Methods • 27 Focus Group Discussions • 3 groups of farmers • Male farmers, female farmers, and female farmers with young children • 3 levels of dairy production • No milk (0 ltr), Medium (0.1-5.9 ltr) , High (6+ ltr) • Household survey, n=94 • Households identified by randomly generated GPS coordinates • Selection criteria • Resident child <5 years old
Results: Nutrition • Milk consumption • Household diets and diets of young children • Infant and young child feeding practices
Milk Consumption of Young Children* Parental report from the household survey 100 90 80 70 60 No milk (n=25) 50 Mid (n=28) 40 High (n=27) 30 20 10 0 No fresh milk 0.5 cup > 1 cup*Young children defined as 6-60 months
“Without milk they won’t be healthy, their hairwould get brown, the kids wouldn’t get full andtheir legs would be like this [indicatedbowlegs].”“We want the children to have beautiful andhandsome faces, that’s why we give milk.”“But when there is no milk the children are nothealthy. Their hair turns red and big stomachsbecause they don’t get enough food.”“It even helps their brains.”Why is milk good for young children?Selected responses from the FGDs with female farmers.
Household food consumption7654 No milk3 Medium2 High10 *p ≤ 0.05; **p<0.0001 Staples Pulses* Veggies Fruits Meats* Milk**Child dietary diversity• Results groups • Overall dietary diversity score • Other Studies • 5.1 ± 1.2 • Rift Valley Province (Kenya DHS) • 80% met min requirements • 56% met minimum reqs • 100% consumed dairy previous day • Western Province (Ekesa, 2008) • No diffs between production • 30.6% had not consumed any
Infant and Young Child Feeding Practices1210 8 Cows milk (n=80) 6 Porridge (n=81) 4 Mashed or semi- solid foods (n=76) 2 0 No milk Emerging Advanced • Engaging in increasing levels of dairy production was associated with lower odds of EBF. • Mothers from the high production group were nearly 4x more likely to introduce cow’s milk before the child reached 6 months.
Lessons Learned: Dairy Intensification• Appears to contribute to household dietary diversity • Cow’s milk is key in the diets of young children, but level of household dairy production is not an independent contributing factor.• Preference for cow’s milk and its availability in this population may have a negative influence on EBF. • Education and awareness should focus on age-appropriate intro of milk and promote cow’s milk in maternal diets during pregnancy and while BF.• Maternal time allocation needs to be explored further.• EADD is an example of a nutrition-sensitive intervention, but to maximize nutritional benefits, it should be combined with an investment in more nutrition-specific interventions.
Acknowledgements Collaborators Funding• Int’l Livestock Research Institute • East Africa Dairy Development Project (ILRI), Nairobi, Kenya • Global Health Institute, Emory • Isabelle Baltenweck • Delia Grace University • Jemimah Njuki • Thomas Randolph • The Halle Institute, Emory University• Emory University, Atlanta, Georgia • Program in Development USA Studies, Emory University • Craig Hadley (faculty, Anthropology, HDGH) • Peter Little (faculty, Anthropology, Development Studies) • Claire Null (faculty, HDGH, Economics) • Usha Ramakrishnan (faculty, HDGH, Nutrition) • Aimee Webb-Girard (faculty, HDGH, Nutrition) • Kathryn Yount (faculty HDGH, Sociology) • Shreyas Sreenath (student, Economics) • Amanda Watkins (student, Nursing) • Anna Yearous-Algozin (student, Nursing)• University of Nairobi, Nairobi, Kenya • Prof. Erastus Kang’ethe• Egerton University, Njoro, Kenya • Samwel Mbugua