Trends and determinants of undernutrition among young Kenyan children: Kenya Demographic and Health Survey; 1993, 1998, 2003 and 2008-2009

Objective: To report on the trends and determinants of undernutrition among children <5 years old in Kenya. Design: Data from four nationwide Kenya Demographic and Health Surveys, conducted in 1993, 1998, 2003 and 2008-2009, were analysed. The Demographic and Health Survey utilizes a multistage stratified sampling technique. Setting: Nationwide covering rural and urban areas in Kenya. Subjects: The analysis included 4757, 4433, 4892 and 4958 Kenyan children aged <5 years in 1993, 1998, 2003 and 2009-2009, respectively. Results: The prevalence of stunting decreased by 4.6 percentage points from 39.9% in 1993 to 35.3% in 2008-2009, while underweight decreased by 2.7 percentage points from 18.7% in 1993 to 16.0% in 2008-2009. The effects of household wealth, maternal education and current maternal nutritional status on child nutrition outcomes have changed dynamically in more recent years in Kenya. Inadequate hygiene facilities increased the likelihood of chronic undernutrition in at least three of the surveys. Small size of the child at birth, childhood diarrhoea and male gender increased the likelihood of undernutrition in at least three of the surveys. Childhood undernutrition occurred concurrently with maternal overnutrition in some households. Conclusions: The analysis reveals a slow decline of undernutrition among young children in Kenya over the last three decades. However, stunting and underweight still remain of public health significance. There is evidence of an emerging trend of a malnutrition double burden demonstrated by stunted and underweight children whose mothers are overweight.