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Article
Publication date: 11 November 2019

Dorah Kwamboka Momanyi, Willis O. Owino, Anselimo Makokha, Esther Evang, Habte Tsige and Michael Krawinkel

This paper aims to describe food insecurity status, food consumption patterns of households and nutritional status of families residing along the baobab belt in Kitui and Kilifi…

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Abstract

Purpose

This paper aims to describe food insecurity status, food consumption patterns of households and nutritional status of families residing along the baobab belt in Kitui and Kilifi counties of Kenya. It also explores associations between these and household socio-demographic characteristics.

Design/methodology/approach

A cross-sectional study design was performed with a sample of 216 caregiver/child pairs interviewed. Tablet-based semi-structured questions were used to obtain information on socio-demographic characteristics of children (6-13 years) and caregivers. Food insecurity status was assessed using the household food insecurity experience scale. Information on food consumption was obtained from qualitative 24-h recall as a basis for calculating a household dietary diversity score. Data were also obtained from a non-quantitative food frequency questionnaire. Anthropometric measurements of children and caregivers’ height and weight were taken to assess their nutritional status. Data were analyzed using Statistical Package for Social Science version 24 and WHO AnthroPlus 1.0.4.

Findings

The majority (98.2 per cent) of the households were food insecurity despite 81.5 and 57.4 per cent in Kitui and Kilifi counties, respectively, owning baobab trees. About 32.1 per cent of the households had poor dietary diversity scores (< 4). The prevalence of stunting (28.6 per cent), wasting (11.6 per cent) and underweight (25 per cent) rates among children were high. A significant association was observed between the children stunting rates with their age (p = 0.027), and also with household’s food security status (p < 0.001). Of the caregivers, 14.8 per cent were underweight, 18.1 per cent were overweight and 8.8 per cent were obese. There was significant association between the nutrition status of the caregivers and gender of the children (p < 0.001) and also with stunting rates of children (p = 0.047).

Originality/value

The study provides data on the current food security status and food consumption patterns of households and nutritional status of families residing along the baobab belt in Kenya which are mostly areas of marginal agricultural potential. The findings indicate a need for appropriate dietary improvements.

Details

Nutrition & Food Science, vol. 49 no. 6
Type: Research Article
ISSN: 0034-6659

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Book part
Publication date: 11 June 2009

Sophie Witter

Objective – The first wave of experiences of exemptions policies suggested that poverty-based exemptions, using individual targeting, were not effective, for practical and…

Abstract

Objective – The first wave of experiences of exemptions policies suggested that poverty-based exemptions, using individual targeting, were not effective, for practical and political economic reasons. In response, many countries have changed their approach in recent years – while maintaining user fees as a necessary source of revenue for facilities, they have been switching to categorical targeting, offering exemptions based on high-priority services or population groups. This chapter aims to examine the impact and conditions for effectiveness of this recent health finance modality.

Methodology/approach – The chapter is based on a literature review and on data from two complex evaluations of national fee exemption policies for delivery care in West Africa (Ghana and Senegal). A conceptual framework for analysing the impact of exemption policies is developed and used. Although the analysis focuses on exemption for deliveries, the framework and findings are likely to be generalisable to other service- or population-based exemptions.

Findings – The chapter presents background information on the nature of delivery exemptions, the drivers for their use, their scale and common modalities in low-income countries. It then looks at evidence of their impact, on utilisation, quality of care and equity and investigates their cost-effectiveness. The final section presents lessons on implementation and implications for policy-makers, including the acceptability and sustainability of exemptions and how they compare to other possible mechanisms.

Implications for policy – The chapter concludes that funded service- or group-based exemptions offer a simple, potentially effective route to mitigating inequity and inefficiency in the health systems of low-income countries. However, there are a number of key constraints. One is the fungibility of resources at health facility level. The second is the difficulty of sustaining a separate funding stream over the medium to long term. The third is the arbitrary basis for selecting high-priority services for exemption. The chapter therefore concludes that this financing mode is unstable and is likely to be transitional.

Details

Innovations in Health System Finance in Developing and Transitional Economies
Type: Book
ISBN: 978-1-84855-664-5

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