Dietary Knowledge, Complementary Feeding Practices and Nutrition Status of Children 6–23 Months Old in Siaya County, Kenya

Abstract

Malnutrition remains a critical public health challenge in Kenya, particularly among children aged 6–23 months during the complementary feeding period. Siaya County reports stunting rates (19.2%) exceeding the national average (18.2%), with Alego Usonga Sub-County contributing 42% of the total county malnutrition cases, indicating urgent need for evidence-based interventions. The aim of the study was to assess dietary knowledge, complementary feeding practices, and nutritional status among children aged 6-23 months in Siaya County, Kenya. Three specific objectives target caregiver knowledge assessment, practice determination, and nutritional status evaluation with associated predictors. An explanatory sequential mixed-methods design was employed, collecting cross-sectional data from 282 caregiver-child pairs through semi-structured questionnaires and focus group discussions. Anthropometric measurements were analyzed using ENA for SMART (2015) software and compared against WHO growth standards. Statistical analysis was conducted using SPSS Version 26, with chi-square tests examining associations and logistic regression identifying predictors at p<0.05 significance level. The study found that while 70.2% of caregivers initiated complementary foods at the recommended age (6-8 months), significant practice gaps persisted: only 36.5% achieved minimum dietary diversity (MDD), 5.0 % met minimum meal frequency (MMF), and 4.6% achieved minimum acceptable diet (MAD). Malnutrition prevalence included stunting (29.08%), underweight (13.1%), and wasting (4.96%). Girls experienced significantly higher stunting rates than boys (36.55% vs 21.17%, p<0.05). Maternal education level showed significant association with MDD achievement (p=0.03), while male sex significantly increased odds of wasting (OR=13.4, p=0.013) and stunting (OR=2.15, p=0.005). Early solid food introduction at 4-6 months substantially increased stunting risk (OR=2.42-4.66, p<0.05). Despite adequate knowledge of feeding timing, caregivers demonstrated poor implementation of dietary diversity and meal frequency practices. Interventions on complementary feeding need to prioritize maternal education, address gender-specific feeding vulnerabilities, and strengthen community-based nutrition programs.