School of Vocational Studies

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    The association between dietary diversity and development among children under 24 months in rural Uganda: analysis of a cluster-randomised maternal education trial
    (Public health nutrition, 2021-03) Paul, Kakwangire; Cami, Moss; Nicholas, Matovu; Prudence, Atukunda; Ane, C Westerberg; Per, O Iversen; Grace, Muhoozi
    Objective: To assess the association between dietary diversity and development among children under 24 months in rural Uganda and to establish other factors that could be associated with development among these children. Design: A secondary data analysis of a cluster-randomised controlled maternal education trial (n 511) was conducted on a sub-sample of 385 children. We used adjusted ORs (AORs) to assess the associations of dietary diversity scores (DDS) and other baseline factors assessed at 6–8 months with child development domains (communication, fine motor, gross motor, personal–social and problem solving) at 20–24 months of age. Setting: Rural areas in Kabale and Kisoro districts of south-western Uganda. Participants: Children under 24 months. Results: After multivariable analysis, DDS at 6–8 months were positively associated with normal fine motor skills development at 20–24 months (AOR = 1·18; 95 % CI 1·01, 1·37; P = 0·02). No significant association was found between DDS and other development domains. Children who were not ill at 6–8 months had higher odds of developing normal communication (AOR = 1·73; 95 % CI 1·08, 2·77) and gross motor (AOR = 1·91; 95 % CI 1·09, 3·36) skills than sick children. Girls had lower odds of developing normal gross motor skills compared with boys (AOR = 0·58; 95 % CI 0·33, 0·98). Maternal/caregiver nutritional education intervention was positively associated with development of gross motor, fine motor and problem-solving skills (P-values < 0·05). Conclusions: We found an association between child DDS at 6–8 months and improvement in fine motor skills development at 20–24 months. Child illness status, maternal/caregiver nutritional education intervention and sex were other significant baseline predictors of child development at 20–24 months.
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    Feeding practices, nutrient adequacy and nutritional status of children 12-23 months in Kwania and Apac districts, northern Uganda
    (Kyambogo University (Unpublished work), 2024-08) Ruma, Hendry Daniel
    Sub-optimal feeding practices is responsible for one third of all cases of child malnutrition. The effects are more severe in children between the ages of 12-23 months since this is a crucial period for development with irreversible effects of poor nutrition. The high prevalence of malnutrition among children in rural areas in Uganda, along with a dearth of insight on feeding practices and the nutrient adequacy of local foods, is proving to be a major concern. To determine the association between feeding practices, nutrient adequacy and nutritional status of children 12-23 months in Apac and Kwania district. This was part of an ongoing study which adopted quantitative cross‐sectional and descriptive study design. Based on the 11.5% of children in Lango meeting a minimum dietary diversity, a sample size of 156 children was used. Multi stage simple random sampling was used to select households with the index child 12-23 months. Structured interviews, weighed food record and anthropometric assessment were used for data collection. Nutri-Survey (Version 2007), IMAPP (Version 1.0) and WHO Anthro softwares (Version 3.1) were used to analyze nutrient adequacy and categorize nutritional status respectively. Chi-square test and multinomial regression test were used to establish associates and predictors of nutritional status outcomes respectively. This was performed at a 95% confidence interval (p <0.05). About 18.6% of the children met the minimum dietary diversity (MDD), 28.2% met the minimum meal frequency (MMF) and 9.6% of the children met the minimum acceptable diet (MAD). The children’s diet was inadequate in dietary fibre, vitamin B1, B2, vitamin E, calcium, iron, and zinc. 19.3% of the children were stunted, 12.2% of the children were underweight and 2.5% of the children were wasted. Wasting was significantly associated with bottle feeding (p=0.019, χ2=5.47) practice and late initiation of breastfeeding (p=0.05, χ2=3.606). Stunting was significantly associated with dietary diversity and meeting a minimum acceptable diet (p=0.037, χ2=5.552) and (p=0.042, χ2=3.591), respectively. Children with adequate calcium intake were 0.301 times less likely to be stunted (AOR=0.301, 95% CI: 0.113-0.803, p=0.016). Children who had inadequate intake of vitamin A were 7.9 times more likely to be underweight compared to those who took adequate amounts (AOR=7.967, 95% CI: 1.169-54.309, p=0.034). In conclusion, this study highlights significant concerns regarding the sub-optimal feeding practices and inadequate nutritional content in the foods examined. The findings indicate a pressing need for improved dietary practices and increased attention to essential nutrients, including energy, niacin, iron, zinc, calcium, dietary fiber, and vitamins.
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    Malnutrition and associated risk factors among children 6–59 months old in the landslide-prone Bududa District, Eastern Uganda: a cohort study
    (Current Developments in Nutrition : American Society for Nutrition, 2022-01-18) Nahalomo, Aziiza; Iversen, Per Ole; Andreassen, Bård Anders; Kaaya, Archileo Natigo; Rukooko, Archangel Byaruhanga; Tushabe, Gerald; Nateme, Nancy Catherine; Rukundo, Peter Milton
    Background The United Nations Sustainable Development Goal 2.2 calls for an end to all forms of malnutrition. This might be derailed due to persistent landslide disasters in low-income countries like Uganda. Objectives The prevalence of malnutrition and the impact of seasonal variations and associated factors were assessed among children aged 6–59 mo in the landslide-affected households in Bududa District, eastern Uganda. Methods A prospective cohort study using a 2-stage simple random technique was applied to select 422 households including 392 children during May–August (food-plenty season) 2019. After 6 mo, in January–March (food-poor season) 2020, 388 households and 366 children were assessed. Socioeconomic and demographic data were collected using structured questionnaires. Child malnutrition outcomes were defined according to WHO criteria. Factors associated with malnutrition outcomes were identified by bivariate and multivariate logistic regression.
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    Realization of the right to adequate food and the nutritional status of land evictees : a case for mothers/caregivers and their children in rural Central Uganda
    (BMC International Health and Human Rights, 2018-05-24) Nahalomo, Aziiza; Iversen, Per Ole; Rukundo, Peter Milton; Kaaya, Archileo; Kikafunda, Joyce; Eide, Wenche Barth; Marais, Maritha; Wamala, Edward; Kabahenda, Margaret
    In developing countries like Uganda, the human right to adequate food (RtAF) is inextricably linked to access to land for households to feed themselves directly through production or means for its procurement. Whether RtAF is enjoyed among Ugandan land evictees, is unknown. We therefore explored this among land evictees (rights-holders) in Wakiso and Mpigi districts in rural Central Uganda. We assessed food accessibility and related coping strategies, diet quality and nutritional status of children 6–59 months old, and their caregivers. Effectiveness of the complaint and redress mechanisms in addressing RtAF violations was also explored. Methods: In this cross-sectional study, quantitative data was collected using a structured questionnaire, with food security and nutritional assessment methods from a total of 215 land evictees including 187 children aged 6–59 months. Qualitative data was collected by reviewing selected national and international documents on the RtAF and key informant interviews with 15 purposively sampled duty-bearers. These included individuals or representatives of the Uganda Human Rights Commission, Resident District Commissioner, Sub-county Chiefs, and local Council leaders. Results: We found that 78% of land evictees had insufficient access to food while 69.4% had consumed a less diversified diet. A majority of evictees (85.2%) relied on borrowing food or help from others to cope with food shortages. Of the 187 children assessed, 9.6% were wasted, 18.2% were underweight and 34.2% were stunted. Small, but significant associations, were found between food accessibility, diet quality, food insecurity coping strategies; and the nutritional status of evictees. We observed that administrative, quasi-judicial and judicial mechanisms to provide adequate legal remedies regarding violations of the RtAF among evictees in Uganda are in place, but not effective in doing so. Conclusion: Land eviction without adequate legal remedies is a contributor to food insecurity and undernutrition in rural Central Uganda. It is essential that the Government strengthens and enforces the policy and legal environment to ensure adequate and timely compensation of evictees in order to reduce their vulnerability to food insecurity.