Parenting Approaches on Children Food Uptake and Nutrition Status in Kiambu County, Kenya

Parental use of reward and punishment is a key to reinforcement or deterrence of food choices among children an aspect that affects nutritional status throughout an individual’s life span. Kenya has a population of 47,564,296 people according to demographic survey of Kenya 2019, of whom 1.4 % are school-going children aged 6-years in Juja Sub-County of Kiambu, (Kenya National Beural of Statistics,2019). Cross-sectional analytical research design was adopted on 384 parent-child pairs, who were disproportionately sampled. Researcher-administered questionnaires were used to collect data. SРSS software version 26.0 was used to analyse the data with significance p<.05. Anthropometry data was analysed using WHO Anthro-Plus Survey Analyzer and compared to BMI-for-age (BAZ), weight-for-age (WAZ) and height-for-age (HAZ) Scores for the target population. Pearson’s correlation (r) was used to establish association. Boys were 48.0% while girls were 52.0% with a mean age of 6.4± 0.1. Almost half the index children (45.1%) were born first. Mean household size was 5.0± 1.66 with maternal mean age at 34± 4.9 years and that of the fathers at 39± 4.8 years. The majority of mothers (73.0%) and fathers (76.1%) had tertiary level of education with more fathers than the mothers in the formal sector of employment, with a higher income. All (100%) children reported being rewarded by receiving incentives like praise words (60.1%), while majority of them (92.0%) reported being punished in multiple ways by the mothers when they refused to feed yet a third of fathers (61.0%) praised and gifted their children to feed. Prevalence of stunting (6.9%), underweight (7.1%), wasting (7.2%), overweight (16.4%) and obesity (11.7%) was observed in the study population. A positive strong significant relationship (p=0.05, x2=5.2) between age of the mothers and punishment was noted, also shouting threats, grounding, inflicting pain & withdrawal of privileges (p=0.05, x2=9.6) was common among the married mothers. More parents with tertiary education (74.6%) and higher incomes (40.5%) gifted and gave special permissions which had a stronger positive relationship to food choices (p=0.06, x2=4.33) and nutritional status (p=0.04, x2=5.9). Food choices had a strong positive relationship to nutritional status (p=0.05) and so did dietary diversity (p=0.6). Majority of the parents reported that the demographic characteristics (83.8%) and Socio-economic characteristics (90.7%) affected their food choices as a household. Almost all mothers (98.8%) and more than half of the fathers (55.4%) felt that rewarding and punishing the study children in relation to food had an effect on their food choices and approaches