Nutrition Status of Preschool Children During Harvest and Lean Seasons in a High Agricultural Production Region: The Case of Urban and Rural Resource-Poor Households in Trans Nzoia County, Kenya

Abstract It is a common misconception that households in zones of high agricultural productivity are food secure. Thus, such households are not traditionally included in food and nutrition security interventions. Nonetheless, poor households residing in these areas are prone to malnutrition and erratic food supply according to season. This study aimed to establish the association between nutrition status and season among preschool children from resource-poor households in Trans Nzoia County, Kenya. An observational longitudinal design was applied to 90 children under five years from Kipsongok informal settlement (urban) and Chepsiro sub-location (rural). The study participants were subjected to nutrition assessment with a focus on anthropometry and dietary diversity. This was done before and after the maize harvesting season. Demographic data on household adults was also collected and their influence on child nutrition analysed. Statistical tools used in the analysis were t-tests and a two-way ANOVA at a 95% confidence interval. There was a significant difference in the demographic data between rural and urban households. A higher proportion of urban caregivers were married (83.3%) compared to their rural counterparts (65.1%). Rural household heads were more educated, with 33.7% having completed secondary education versus 7% in urban areas. Similarly, more rural female caregivers had completed primary education (80.2%) compared to their urban counterparts (64%). Nutritional outcomes showed urban children were more vulnerable. Before harvest, wasting rates were higher in urban areas (21% vs 9%). After harvest, wasting rates declined significantly in both areas (urban 9%, rural 6%). Dietary diversity varied by season: before harvest, urban preschoolers had higher diversity scores (7.1 vs 6.1), but after harvest rural children scored higher (7.5 vs 6.6). Nonetheless, there was no significant difference in dietary diversity between seasons (p=0.09). Furthermore, residence, whether rural or urban did not have a major influence on nutrition status (p=0.343). Thus, it can be concluded that poor households are more vulnerable to malnutrition regardless of residency. However, urban children were more affected by stunting and wasting than rural children, regardless of season. Seasonal changes did not significantly influence dietary diversity scores. The study recommends targeted food and nutrition interventions for resource-poor households in agricultural surplus zones with emphasis on cash-based food interventions in urban areas. Keywords: Dietary Diversity, Preschool Children, Wasting, Underweight, Food Security