Socio-economic factors predisposing under five-year-old children to Severe protein energy malnutrition at the Moi teaching and referral hospital, Eldoret, Kenya

  • SO Ayaya Senior Lecturer, Department of Child Health and Paediatrics, Faculty of Health Sciences, Moi University, P.O. Box 4606, Eldoret, Kenya
  • FO Esamai Associate Professor, Department of Child Health and Paediatrics, Faculty of Health Sciences, Moi University, P.O. Box 4606, Eldoret, Kenya
  • J Rotich Senior Lecturer, Department of Epidemiology and Preventive Medicine, Faculty of Health Sciences, Moi University, P.O. Box 4606, Eldoret, Ken
  • AR Olwambula Graduate Assistant, Department of Home Economics, School of Consumer Science and Technology, Maseno University, Private Bag, Maseno, Kenya


Background: Malnutrition is one of the leading causes of morbidity and mortality in children aged five years and below. Risk factors for severe protein energy malnutrition (PEM) have been identified as ignorance, family size, mothers and fathers education, poverty, residence, chronic infections, and congenital defects or malformations. The role of such social factors as the caretaker, extended family, homestead surroundings, and family cohesiveness have not been studied in Kenya.

Objective: To determine the social and economic factors that predispose children to severe PEM as seen at the Moi Teaching and Referral Hospital (MTRH), Eldoret.

Design: Prospective and case control study.

Setting: The MTRH, Eldoret, Paediatric wards, outpatient and MCH clinics over a 12 month period (June 2001 to June 2002).

Subjects: Sixty six children aged 3 to 36 months with severe PEM attending the MTRH outpatient clinics and those admitted in the Paediatric wards were age-matched with 66 controls. Methods: A standard pretested questionnaire was used to interview caretakers with severely malnourished children and age-matched controls. The children were weighed after interviewing the caretakers. The data was entered on a computer and analysed using the statistical package for social sciences (SPSS) programme.

Results: The social risk factors for PEM were single mothers (Odds Ratio) OR 14.93, p= 0.00001), young mothers aged 15-25 years (OR 3.95, p= 0.00020), the child's living conditions such as Iiving in a temporary house (OR 3.627 p= 0.00257), caretaker who was not married to the child's parent (OR 0.10, p= 0.00005) and not staying with both parents in the past six months (OR 0.28606, p=0.00101). The economic risk factors were father's lack of ownership of land (OR 0.401, p= 0.01732), cattle (OR 0.24, p=0.00022), not growing maize (OR 0.15, p=0.00013), not growing beans (OR 0.36, p=0.00484) and ownership of small piece of land by grandfather (OR 6.00, p= 0.02274). Other risk factors were incomplete immunization (OR 3.87, p= 0.00151) and female sex (p=0.03721).

Conclusion: Poverty, social conditions under which the child was living, sex of the child and incomplete immunizations were risk factors for the severe protein energy malnutrition.

East African Medical Journal Vol.81(8) 2004: 415-421

Journal Identifiers

eISSN: 0012-835X