Adolescent Nutrition In Kenya

“The importance of the Adolescent nutrition is relevant for current, future and inter-generational health.”

Immaculate Nyaugo, Ministry of Health.

Last week, the Ministry of Health held a forum to discuss the “Formative Research to Inform Adolescent Programming in Kenya” report compiled by The World Food Program (WFP). The report focused on issues surrounding adolescent nutrition in Kenya. The report is in line with the Sustainable Development Goal 2 which advocates for Zero Hunger.

This report was discussed with the intention of addressing the nutritional needs of adolescent girls as one of the key steps towards achieving the objective of ending malnutrition by 2030. The release of the report followed the World Health Day celebrations held every year on 7 April under the leadership of World Health Organisation (WHO) to create global health awareness. This year’s theme was Universal Health coverage which cuts across all of the health-related Sustainable Development Goals (SDGs) and brings the hope of better health and protection for the world’s poorest.

In Kenya, the proportion of the total population that is adolescents is 22%,  indicating the sheer need of this population in requiring more investment in their health, nutrition, education, livelihoods and participation. There is an increasing need to support  trusted adolescents to assume positions of leadership to represent the voice of their peer group to help in addressing their issues.

Did you know that Kenya’s nutrition situation is characterised by high levels of stunting and micronutrient deficiencies, and increasing prevalence of obesity especially among the youth? The National move towards all health facilities adopting a “youth friendly approach” is a realistic goal that should be supported, as it is likely to have a greater and more sustainable impact. Additional factors affecting adolescents especially in young girls include: 

• Anaemia: among children between 5-14 years, 16.5% are affected and children in the ages of 15-19 years, 13.8% are affected
• Deficiency: the zinc deficiency among adolescents stands at 80% which highlights an increased need for the focus on adolescent nutrition
• Pregnancy and Malnutrition: the number of girls that are pregnant and malnourished is estimated to be at 18%. This increases their risk of preconception anaemia,pre-eclampsia and gestational hypertension. In addition to this, 47.7% of these girls lack vitamin B12

In schools, the Ministry of Health, Ministry of Education and Ministry Agriculture are understanding how to effectively engage adolescents. This is an essential step in addressing how nutrition specific/sensitive interventions can be delivered and best related to other components of the adolescent equations. Some initial ways to improve adolescent nutrition as demonstrated by the Government have been achieved through:

• Working with schools to sensitize them to improve nutrition through education, school feeding programs, supplementation and deworming.
• Reaching out to adolescents via youth and religious groups
• Delayed age at first pregnancy for teenage girls
• Increased school enrolment via free primary education by the Government.

  “Did you know that in Kitui county, it’s illegal to have a child out of school? They are keen on ensuring that all children are educated.”

Adolescent Nutrition Study Report Highlights

Dr. Theresa Jones, shared highlights of the Adolescent Nutrition study which included definitions of who they are, key themes of adolescence and key insights on adolescent nutrition. She also shared that programmes targeting adolescents must take into account the nutritional challenges faced in different contextual settings and the impact these have on overall growth, development and well- being. Another key thing to note, is that adolescents play a key role in the household regarding decision making around food consumption and influencing their younger siblings. 

However, in some communities, there are factors affecting adolescent nutrition including but not limited to:

• Social norms and restrictive food practices in different communities
• Service delivery issues: There is an urgent need to overcome bottlenecks in school feeding programmes and to improve its efficiency particularly in drought affected areas.
• Adolescents take up income generation activities in a bid to get food creating sexual and reproductive health issues among this age group
• The absence of school feeding programs in some communities where absenteeism would be reduced if food was available
• Limited food knowledge

During the study, it emerged that there are some key delivery channels that can be used to reach out to adolescents through peer education; sports and recreation; media like Shujaaz (created by Well Told Story) – a great platform that speaks to adolescents. There were also tips shared by adolescents on how best to engage with them by:

• Finding them where they are. They lead busy lives.
• Making your interactions with them entertaining
• Speaking their language to better communicate with them in a language they understand
• Talking to them with respect, asking their opinion and including them in programs affecting them.

These are the best places to implement nutritional interventions. (Image source: Janet Mbugua)

“We should promote healthy living and its benefits within the youth. Peer pressure is real and all around us. We’re more likely to grab a natural juice when everyone is doing it.” ~Baraka

Nutrition is a highly neglected area in different communities and increased sensitization is needed to encourage communities to consume locally grown produce, for healthier living and to help reduce the growth in numbers of non-communicable diseases (NCDs) like cancer or diabetes. By improving diets and increased physical activities, the chances of NCDs can be reduced at early stages of life i.e. Adolescence. Teach them young!

“Engaging with communities and raising awareness of the importance of proper nutrition is key in encouraging a culture that values the same”. ~ACORD Africa

There are many behavioural risk factors for non communicable diseases (NCDs) which account for 33% of the deaths in Kenya. Some of the causes of these diseases may include: the use of Tobacco; harmful use of alcohol; unhealthy diets; physical inactivity

There are various ways to promote integrated healthier living in schools through the:

• Integration of healthy living into teaching subjects
• The creation of school kitchen gardens for healthy vegetables
• Teachers health clubs
• Teachers involvement in physical education (P.E) classes.

Challenges have been faced while communicating the need for healthier living as a result of:

• Socio-cultural practises and perceptions
• Curriculum constraints: the academic focus in schools is high
• The association of fruits and vegetables as only consumed by children
• Some adults saying that they are too old to be active

“Unfortunately, in some counties, students with type 1 diabetes are stigmatized.”  ~Dr. Catherine Karekezi

It has been noted by various organizations that the some of the nutritional behavior concerns among adolescents include: Fast food preference; snacking frequently; skipping meals; the risk of eating disorders; the omission of certain foods from diets and occasional dieting. As a result of these concerns, the Global Alliance for Improved Nutrition(GAIN) begun a program for adolescent girls to take part in football training sessions that include a nutritional component. Through this program, recommendations that arose included:

• Increased support & training for participants of this prograThe importance of sexual reproductive health for the adolescent stage of life
• Involving parents in the nutrition conversation to help them

The Government, Parents and Society play a key role in influencing adolescent nutrition and can influence their nutritional needs by:

• Using a system based approach in addressing their needs. Communication is not enough.
• Being cognizant of the household economic status, restrictive social norms and agricultural practices in different communities
• Engaging students and parents in the promotion of healthier living and physical activities. Don’t do anything for them, without them.
• Supporting policy implementation that will improve the nutritional needs of this age group
• Providing much-needed support to the trainers, participants and partners in programs aimed to improve adolescent nutrition.
• Embracing the power of technology and using it to communicate effectively with this age group

“We can only achieve higher nutrition standards by embedding good nutrition habits into consumers’ daily lives,” said Dr. Myriam Sidibe, Global Social Mission Director, Unilever.