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CHAPTER FOUR

RESULTS

This chapter describes presentation of the study results in tables, figures and text. Data was collected from 30 respondents using a questionnaire.

4.1 Socio-demographic Characteristics of the respondents

Figure 1 Showing age category of respondents                          (n=30)

According to figure 1 above, most of the respondents 13 (43.3%) were in the age bracket of 26-35 years of age while the least 2 (6.7 %) were above 45 years

Table 1 Marital status of respondents

(n=30)

The study from table 2 above indicates that majority of the respondents 17 (56%) were married, while minority 1 (3.3%) were widowed and separated

Table 2 Showing occupation of respondents

(n=30)

According to the findings in table 2 above most of the respondents 10 (33.3%) didn’t have a specific profession, while the least 1(3.3%) were peasant farmer.

Figure 2 Showing marital status

(n=30)

According to the findings in figure 2 above, majority of respondents 21 (70%) were married while minority 1(3.3%) were divorced and separated.

Table 3 Showing the level of education of respondents                                (n=30)

According to the results in table 3 above majority of the respondents 12 (40%) had finished secondary school education, while minority 1(3.3%) never went to school.

Figure 3 Showing Religion of respondents                                 (n=30)

The findings from figure 3 above indicates that majority of the respondents 18 (60%) were Christians while minority (3.3%) mentioned other religion.

Figure 4 Showing educational level of respondents                       (n=30)

The findings in figure 4 above indicates that majority of the respondents 13 (43%) were secondary school dropouts, while minority 1 (3.3%) had never attended school.

4.2 Level of knowledge of mothers about complementary feeding in children under two years

Figure 5 Showing knowledge of complementary feeding       (n=30)

According to the results in the figure 5 above majority of the respondents 16 (53.3%) asserted that they had no knowledge on complementary feeding, while 14(46.7%) of them had knowledge on complementary feeding.

Figure 6 Showing the Source of Information about complementary feeding

(n=30)

According to the results in figure 6 above of the most of the respondents 15 (50%) said that they got information regarding complementary feeding from social media, while the least 1(3.3%) mentioned other sources.

Table 4 showing what age should a child require complementary feeding

(n=30)

According to the findings in the table above, majority of the respondents 13 (43.3%) of the respondents have 1-6 months children, while a minority 8 (26.7%) said 6 -12 months.

Table 5 Showing the importance of complementary feeding to a child

(n=30)

According to table 5 above majority of the respondent 19 (63, 3%) said that the importance of complementary feeding to a child is to provide essential nutrients while minority 1(3.3%) mentioned other uses.

Figure 7 Showing whether respondents have ever been sensitized about complementary

(no=30)

According to figure 7 above, majority of the respondents 16 (53.3%) asserted that they have never been sensitized about complementary feeding while minority 14 (46.7%) said that they have ever been sensitized.

4.3 Complementary feeding practices of mothers with children under two years

Table 6 Showing respondents practice complementary feeding on your children

(no=30)

According to the results in table 6 above majority of the respondents 27 (90%) asserted that they practice complementary feeding with their children, and minority 3 (10%) disagreed.

Table 7 Showing how often complementary foods are given to children

(n=30)

The table 7 above indicates that the majority of the respondents 15(55.6%) said that they give complementary food at least twice a day or every time the baby is hungry. While no one admitted to giving complementary food once a day.

Table 8 Table 8 Showing why some mothers do not practice complementary feeding

The table 8 above shows that majority of the respondents 2(66.7%) couldn’t afford complementary feeding while minority 1(33.3%) said they are always at work.

Figure 8 Figure 8 Showing how complementary feeding is administered.

(n=30)

The figure 8 above shows that majority of the respondents 21 (70%) said that they administered complementary feeding through a bottle, cup and spoon, while none mentioned other ways.

4.4 Social economic factors affecting mothers carrying out complementary feeding with children under two years

Table 9 Showing the distance of the health center from the respondents’ homes no=30

According to table 9 majority of the respondents 12 (40%) said the move long distances over 4km to the health center unlike the minority 3 (10%) who said they move just 1km to the health center.

Figure 9 Showing whether respondents have jobs.

Majority of the respondents 20(70%) said that they have jobs while minority 9(30%) of the respondents do not have jobs.

Table 10 Showing the amount earned by respondents per month                         (no=30)

According to the findings in table 10 above, majority of the respondents 10(37.1%) earn between 50,000 -100,000shs per month while minority 3(11.1%) earn between 100,000-150,000shs every month.

Figure 10 Showing who supports the respondents handle complementary feeding of the children                                                                                          (n=30)

The results in figure 10 above half of the respondents 15(50%) said they support themselves with the complementary feeding of their children. While minority 3(10%) have support from their husbands.

Figure 11 Showing at what age range did the respondents have their first child

(no=30)

According to results in figure 11, majority of the respondents 12(40%) had their children between the age of 25-29 while minority 3(10%) gave birth between the age of 15-19.

Table 11 Showing if the respondents administer complementary feeding themselves.                                                                                       (n=30)

Table 12 above shows that majority of the respondents 20(66.7%) said that they don’t administer complementary feeding themselves while the minority 10(33.3%) do.

Table 12 Showing who helps the respondents practice complementary feeding.                                                                                                                                                                                                                                                       (n=30)

According to table 13 above, half of the respondents 15 (50%) said their elder children help them to practice complementary feeding while minority 3(10%) said the get help from other sources.

Figure 12 Showing why respondents are not able to administer complementary feeding to their children themselves                                                        (n=30)

Figure 12 above shows that most of the respondents 12(40%) said they have elder children who can help administer complementary feeding while least of them 3 (10%) mentioned other reasons.

CHAPTER FIVE

DISCUSSION OF FINDINGS, CONCLUSION, RECOMMENDATION IMPLICATION FOR NURSING PRACTICE AND AREAS OF FURTHER STUDY

5.0 Introduction

This chapter presents discussion of the findings, conclusion, recommendations of the study implication to nursing practice obtained from data analysis.

5.1 Discussion of findings

5.1.1  Socio-demographic Characteristics of the respondents

The results in the study revealed that, majority of the respondents 13 (43.3%) were in the age bracket of 26-35 years of age and the least was 2 (6.7 %) who were above 45 years. This indicates that most of the respondents were in child bearing age and were carrying out complementary feeding

The results also indicated that majority of the respondents 17 (56%) were married, while minority 1 (3.3%) was widowed and separated. This result shows that respondents had families and were having children who needed complementary feeding.

The results in the study showed that most of the respondents 10 (33.3%) didn’t have a specific profession, while the least 1(3.3%) was a peasant farmer. This shows that the professional respondents were health workers but the rest had no specific profession

The study results showed that majority of the respondents 12 (40%) had finished secondary school education, while minority 1(3.3%) had never gone to school. This implies that most of the respondents had attained basic education and had some information about complementary feeding

The results also show that majority of the respondents 18 (60%) were Christians, while minority 1 (3.3%) were from other religion. This implies that the Christian faith was dominant among the respondents

5.1 .2 Knowledge about complementary feeding practices

According to study findings which revealed that majority of the respondents 16/30 (53.3%) asserted that they had no knowledge on complementary feeding, while minority 6(20%) of them had knowledge on complementary feeding. This is in line with WHO, (2013), which revealed that mothers’ knowledge about nutritious meals for the children influences how the child is fed but in many developing countries, infants and young children are most vulnerable to malnutrition because of lack of knowledge by mothers and care takes on how to feed a child and yet feeding practices have a lot of implication for the nutritional status of the child.

The results of the study revealed that most respondents 15 (50%) said that they got information regarding complementary feeding from social media while the minority 1(3.3%) mentioned other sources. This is in line with Hague et al., (2012), who in their interventional study in India where nutritional education was given to mothers by health workers to improve awareness about infant feeding in the variety,     quantity, quality and consistency of complementary feeding showed that, Majority of complementary feeding practices were inadequate in quality, quantity, frequency and consistency (Sethi et al., 2013). In a similar study in south India, mothers were counseled about the choice of appropriate complementary foods and feeding frequency. The intervention group had improved feeding practices such as avoiding feeding bottles and improved on dietary diversity and the types of complementary foods.

The results of the study revealed that majority of the respondent 19 (63, 3%) said that the importance of complementary feeding to a child is to provide essential nutrients while minority 1(3.3%) mentioned other uses such as proper growth, boosts immunity among others. This is contrary to WHO (2010) that laments that mothers should understand the importance of exclusive breastfeeding for 6 months confers several benefits to the infant and the mother herself. Chief among these is the protective effect against gastrointestinal infections, which is observed not only in developing but also in industrialized countries.

According to the results of the study, majority of the respondents 16 (53.3%) asserted that they have never been sensitized about complementary feeding while minority 14 (46.7%) said that they have ever been sensitized which implies that most of the responds had no knowledge about complementary feeding. These results re in line with Blattman, et al (2015) who in his study in Porkpa District of Liberia, about infant feeding among 38000 mothers, 68% had not been sensitized about complementary feeding.

5.1.2 The complementary feeding practices of mothers with children under two years

According to the results in the study, majority of the respondents 27 (90%) asserted that they practice complementary feeding with their children, and only 3 (10%) disagreed.  Which corresponds with Qiong et al (2013) who carried out a study in Wuyi county, China and found out that mothers practiced complementary feeding among children aged 6-23 months showed that, their dietary diversity was quite poor as only one out of ten children (10.0%) was fed with foods from at least four food groups. Similarly, a study by Nisha (2012) on inadequate feeding of infants and young children in India revealed that although 92% of children were between the ages 12 and 18 months, only 17% of them were fed adequately from four or more food groups

According to the results of the study, majority of the respondents 15(55.6%) said that they give complementary food at least twice a day or every time the baby is hungry. While no one admitted to giving complementary food once a day. This is in line with (WHO 2010), which stated  breastfed children 6-8 months old be fed 2 times per day and those 9-23 months old be fed 2-3 times per a day while the non-breastfed ones be fed 4 times per day. KNBS and ICF Macro, (2010) further commends that , the minimum meal frequency in Kenya  is low as per WHO recommendations, the Kenya Demographic and Health Survey of 2008-09 revealed that of all the children 6-23 months, only two thirds were fed the minimum number of times. Another study that is in line with this finding A study done in rural Utter Pradesh (Kumudha et al, 2010) on the frequency of feeding showed higher number of children (63%) aged 6-23 months who were given the minimum recommended number of feeds.

The study further that majority of the respondents 21 (70%) said that they administered complementary feeding through a bottle, cup and spoon, while none mentioned other ways. This is in line with Shamin et al (2009), who argued that about infant feeding practices including the use of bottle and their determinants, from economically underprivileged mothers in a Peri-urban area of Karachi, Pakistan, showed that only 17% of the infants under the age of 3 months were offered bottle, 69% between 4 to 6 months increased to 76% in infants from 7 months to 1 year. The continued practice of bottle feeding is a concern because of the possible contamination leading to higher morbidity rates in children.

4.1.3 The social economic factors affecting mothers with children under two years

According to the table most of the respondents 12 (40%) said that they move long distances over 4 km to the health center unlike the minority 3(10%) who said they move just 1km to the health center. This corresponds with Porter, G. (2011) who explained that most villages in sub Saharan Africa are so remote that women move very long distances in order to access a health center where they can access complementary feeding information.

Majority of the respondents 21 (70%) said that they have jobs while minority 9(30%) of the respondents do not have jobs. this resonates with Camara, S.,et al  (2015) who reported that the occupation of the mothers can prevent them from properly administering complementary feeding of their children. Nutrition Officers in Tanzania reported the infants born to working mothers were more likely to consume processed food due to their mothers’ work. Such mothers end up leaving their children with caretakers like aunties, young brothers or sisters and sometimes maid who are not well trained to administer complementary feeding to their young children.

(Nestle, M. 2013) further states that although young mothers are generally aware of the nutritional value of different kinds of food, appropriate feeding times, and hygiene practices, they are often inconsistent about feeding their children accordingly because they are away from home due to their school work or employment. Young mothers that are engaged in a variety of cash-earning activities that make taking care of their children difficult.

According to the findings in the study, majority of the respondents 10 (37.1%) earn between 50,000 -100,000 shs per month while minority 3(11.1%) earn between 100,000-150,000shs every month which indicates that most respondents were low income earners and so they could hardly afford proper complementary feeding of their children. This is in line with Cleland, J., et al (2016) who argued that most families in rural Uganda are low income families that survive on less than a dollar a day. He explains that most women only survive on subsistence farming.

According to the findings of the study, majority respondents 15(50%) said they support themselves with the complementary feeding of their children. While minority 3(10%) have support from their husbands. This implies that majority of the fathers are not involved with the complementary feeding of their children. All the complementary feeding practices are left for the women. This is in line with Nestle, M. (2013) who laments that in most African countries men don’t get involved in taking care of their children. They leave all the work to the women.

According to the findings of the study most of the respondents 12(40%) had their children between the age of 25-29 while minority 3(10%) gave birth between the age of 15-19. Which implies most mothers are mature enough to take care of their children meanwhile there exists teenage mothers too who can’t take care of their children. This contradicts with Meekers, D. (2012) who in his study revealed that most women start giving birth when they are still teenagers due to cultural and religious factors.

The study shows that majority of the respondents 20 (66.7%) said that they don’t administer complementary feeding themselves while the minority 10 (33.3%) agreed that they do. Which is in line with Gardner, H, et al (2015) who revealed that most mothers trust their other children to administer complementary feeding especially when they leave for work or go to the garden. It is common for mothers to leave a little cash with the caregivers who are usually children too, so they can buy food from local groceries or vendors to feed themselves and the young baby. There are also some home-cooked meals at home, but caregivers (elder sibling, neighbor, elderly relative/kin) are generally unable to properly feed young children below two years of age because they lack knowledge about nutrition and hygiene needs.

5.2 Conclusion

The study concludes that the women in rural areas should be sensitized through their local leaders and at health Centers about complementary feeding of their children.

The study further concludes most women should be encouraged to practice complementary feeding of their children because at 6 months, exclusive breastfeeding is no longer sufficient to meet all energy and nutrient needs by itself, and complementary foods should be introduced to make up the difference.

The study concludes that social economic factors like unemployment, long distances from the health center, poverty, do affect the complementary feeding of young children.

5.3 Recommendation

5.3.1 Recommendation to the government

The study recommends that government should support women to access credit and use it to  engage in income generating activities  like agriculture poultry farming market vending  which will provide employment opportunities to the women so that they can be able to handle complementary feeding costs.

The study also recommends that the government should expand the health facility so that it could accommodate the growing number of mothers who seek information about complementary feeding.

5.3.2 Recommendation to the health workers

The study recommends that that health workers should advocate for the sensitization of the local population about the benefits of complementary feeding and encourage ladies to attend training session at health centers in order to acquire information about complementary feeding.

The study further recommends that health workers should increase on their efforts to sensitize mothers about the befits of complementary feeding and even carry out fieldwork education e.g. home visits and train those who can’t access the health center about complementary feeding.

5.3.3 Recommendation to the community

The study recommends that community leaders should mobilize their subjects to adhere to the advice given to them by health workers about complementary feeding and practice them effectively as per health worker prescription.

5.4 Implication to the nursing practice

Registered nurses play a major role in health education of patients, families and communities about how to complementary feeding

Health workers are also in a position to help mothers embrace the modern way of grooming a health child and refute myths and other misinformation. While its best to show respect for their opinions.

Nurses can guide those mothers who are biased about which type of food should be given as a complementary food and those that are not.

5.4 Areas of further study

The study recommends the following areas of further study;

• The influence of complementary feeding to the health of children
• Challenges in administering complementary feeding among mothers in the rural areas
• Influence of poverty on the health of children

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Apprey, C. (2015). Nutritional intervention in children undergoing chemotherapy for cancer (Doctoral dissertation).

Asiki, G., Newton, R., Marions, L., Seeley, J., Kamali, A., & Smedman, L. (2016). The impact of maternal factors on mortality rates among children under the age of five years in a rural Ugandan population between 2002 and 2012. Acta Paediatrica, 105(2), 191-199.

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Camara, S., de Lauzon-Guillain, B., Heude, B., Charles, M. A., Botton, J., Plancoulaine, S. & Lioret, S. (2015). Multidimensionality of the relationship between social status and dietary patterns in early childhood: longitudinal results