The influence of caregivers’ formal and nutrition literacy levels on health care of children born to adolescent girls in Ndhiwa sub county, Homa Bay county

Abstract

Child deaths have been a serious health challenge in Kenya and this is attributable to poor nutrition and frequent bouts of illness in children. Despite government efforts to curb this menace, data from the Kenya Demographic and Health Survey (2014) revealed that deaths among children aged 5 and below are still in elevation at 74 cases for every 1000 live deliveries compared to the expected standard of 25 cases for every 1000 live deliveries as per Sustainable Development Goal number 3. Previous studies associated these deaths to preventable diseases while giving little focus on the role of caregivers in lessening the worst effects of these illnesses. The current study thus analyzed the influence of caregivers’ formal and nutrition literacy levels on healthcare of children born to adolescent girls in Homa Bay County. Specifically, the study examined how caregivers’ formal and nutrition literacy influences feeding practices among children born to adolescent girls, how their literacy influences access to health services among children born to adolescent girls and to explain how these literacy levels influence engagement in playing activities with the under-fives. These aspects are flagged in the National Maternal, Infant and Young Child Nutrition Policy, 2013. The study was conducted in Ndhiwa, Homa Bay County which is amongst areas with high child mortality and teenage pregnancy cases. The study was anchored on descriptive design and correlational design allowing for a mixed method approach combining qualitative and quantitative data. It was guided by Ecological Systems Theory which suggests that the microsystem: the closest surrounding a child lives in, has a great impact to their overall growth. In a study population of 1470 caregivers and 497 Community Health Volunteers various data collection techniques were used in collecting both Quantitative and Qualitative data. Using Yamane’s formula, applicable for a finite population, 204 caregivers were systematically sampled for responses. The researcher used the principle of maximum variation to conduct interviews with as many Community Health Volunteers as possible until they reached a point of saturation. Primary information was acquired through Questionnaires, Interviews, Focus Group Discussions and Observation whereas Secondary information was obtained from government documents, journals and books. Descriptive statistics was utilized in analyzing quantitative data from questionnaires. Regression analysis and Chi square tests were used to identify the relationship between independent and dependent variables. Statistical significance was established using a p-value of <0.05. The study used frequency tables, percentages and charts to summarise data. Qualitative data collected through interviews and focus group discussions was analyzed through coding, where themes were generated to capture the original content of the data. The findings of the study revealed an existence of a significant association between caregivers’ formal and nutrition literacy and feeding practices where p-value was 0.000, less than alpha, 0.05. It was also established that formal and nutrition literacy is significantly associated with good health seeking practices of caregivers since these two forms of literacy help them improve their health seeking behavior. Finally, the findings from the Chi square tests on caregivers’ formal and nutrition literacy versus engagement in playing activities with the under-fives showed p-value to be 0.000 which confirms existence of a significant relationship between these variables. In order to improve on the adopted policies including the National Maternal, Infant and Young Child Nutrition Policy (2013) and the Kenya Health Policy 2014-2030, the study recommends that the government enhances the provision of education for girls. This can be achieved through strengthening the implementation of the Kenya School Health Policy, 2018. Acquiring education will equip them with good child care practices during motherhood and have the capability to make the right decisions for their children.