Agbo A. E., Kouamé C., Kahia J., Diby L., Coulibaly L., Mahyao A. and Kehlenbeck K.

IITA, Ibadan 3-6 March 2015

FEEDING HABITS AND NUTRITIONAL STATUS OF

YOUNG CHILDREN AND THEIR MOTHERS IN COCOA

PRODUCING SMALLHOLDER HOUSEHOLDS

OF SOUTH-WEST COTE D’IVOIRE

International Conference on Integrated Systems Research for Sustainable Intensification in Smallholder Agriculture

OUTLINE

• INTRODUCTION

• METHODOLOGY

• RESULTS and DISCUSSION

• CONCLUSION

INTRODUCTION

- 12.5% of the population are undernourished in terms of energy intake, • World - 2 billion people suffer from micronutrients deficiencies, - approximatively 26% of children are stunted.

However, agricultural sector is seriously affected by

malnutrition despite the fact that it provides foods. In fact,

a recent mapping of malnutrition in the major cocoa

producing areas revealed stunting rates of 25 to 34%.

In Côte d’ivoire, the national nutritional status of children

less than 5 years old revealed that 30% of them suffered

from stunting. In addition, anemia prevalence is around 75%.

FAO (2013); INS and ICF (2013); De Vries et al. (2012)

INTRODUCTION

• During the last 15 years, cocoa productivity decreased and the government has endeavoured to promote intensification of cocoa-farming systems. However, this has occurred at the expense of food crops previously cultivated by cocoa farmers.

In Soubré, capital of the NAWA region which provides

40% of cocoa production in Côte d'Ivoire, the situation has caused a food crisis, resulting in the shortage of major commodities in the local market.

Coulibaly (2013)

INTRODUCTION

So, the current work was conducted with the main

objective to:

- Evaluate the families food habits.

- Assess the nutritional status of mothers and children under 5 years old.

The Vision for Change project (V4C) has been implemented

in this region to revitalize cocoa sector by empowering

farmers producing cocoa on diversified farms with greater

productivity and improving nutrition and education.

METHODOLOGY

• The survey was conducted in 38

communities of the Nawa region in Côte

d’ivoire

• 1,069 households were randomly sampled

and surveyed

• Anthropometric measurements were

performed on 1,475 children.

Localities

Figure 1 : Spacial representation of surveyed localities

METHODOLOGY

• The survey was carried out from February to

March 2014 by 20 enumerators.

2 - Anthropometric measurements (weight, size

and brachial scope)

Anthropometric measurement of

children and mother

For children:

-Weight-for-height index acute malnutrition

(wasting)

-Height-for-age index chronic malnutrition

(stunting)

- Weight-for-age index underweight

- Brachial scope index acute malnutrition

For adults:

- Body mass index (BMI) malnutrition

and overweight (except pregnant women)

METHODOLOGY

3 - Dietary diversity score and food insecurity scale • Women dietary diversity score (WDDS) FAO guide (Kennedy et al., 2013).

• Children dietary diversity score (WHO, 2009).

• Scale of food insecurity (USAID, 2006).

4 - Data Processing • STATA software for survey data. • ENA (Emergency Nutrition Assessment) software for

anthropometric data.

1 - Consumption

1-1 Food diversity level

Dietary diversity of the surveyed population was low with 80% of women and 94% of children consuming less than 3 different food groups the day before the interview.

Figure 3: Children food diversity level

Figure 2: Women food diversity level

0

10

20

30

40

50

60

70

80

90

Lower food diversity (≤ 3

groups of food)

Average fooddiversity (4 or 5groups of food)

Higher food diversity (≥

6groups of food)

Per

cen

tage

(%

)

Series1

80

0

10

20

30

40

50

60

70

80

90

100

Lower food diversity (≤ 3 groups of food)

Average food diversity (4or 5 groups of food)

Pe

rce

nta

ge (

%)

Series1

94

RESULTS

RESULTS

Food groups (%) of

women

White starchy food 92.3

Green leafy vegetables 3.3

Fruits, vegetables and

tubers rich in vitamin A

and red oil palm

5.7

Others fruits and

vegetables

16.4

Meat and fish 10.8

Beans, nuts and seeds 0.3

1-2 Women Dietary Diversity Score (WDDS)

The mothers 24-hours recall found that around 90% of them consumed white starchy food. This is not surprising since majority of producers are native from Center Côte d’Ivoire where tubers are the staple food.

About 11% consumed fish and meat, 9% vegetables and leaves rich in vitamin A and 16% others fruits and vegetables.

Table 1: Women dietary diversity score

Dagou (2009)

1-3 Children dietary diversity

score

• Children staple food were

cereals (42%) and tubers

(39%) essentially. However,

they also ate fish and fruit

(32.5 and 24.5%

respectively), eggs (11.8%),

meat (10.4%) and 14.5%

vitamin A-rich vegetables

fruits and tubers

• Some of them (20%) received

additional food: porridge rice,

vermicelli and fried banana.

RESULTS

Figure 4: Children 24-hours recall

Figure 5: Children eating habits

0

5

10

15

20

25

30

35

40

45

Cereals Tubers Dairyproducts

Vegetables Meat

Series1

0

5

10

15

20

25

30

35

Eggs Meat Fishes Vegetablesrichs in

vitamin A

Fruits Vegetablesand nuts

Series1

41.5%

38.7%

32.5%

24.5%

14.5%

RESULTS

2- Food security level In the region, there was a

lack of food during 7 months, from February to August, with a peak in March.

• The average score on the scale of food insecurity was 3.91 / 14.

• Most households were

food secure (64.6%) and 35.4% were in a situation of food insecurity.

Figure 7: Households food insecurity level

0

10

20

30

40

50

60

70

Food security Moderatefood security

Average foodinsecurity

Severe foodinsecurity

Pe

rce

nta

ge (

%)

Series1

64.6%

35.4%

RESULTS 3 – Mothers and children nutritional status evaluation

3-1 Women body mass

index (BMI)

• In our study 65.4% of

women have a normal

weight and 21.3% are

overweight. It was also

noted that 2% are

malnourished and

3.1% are morbidly

obese.

Figure 8: Women BMI classification.

0

10

20

30

40

50

60

70

Pe

rce

nta

ge (

%)

Series1

65.4%

21.3%

2% 3.1%

0

20

40

60

Acute

malnutrition

Chronic

malnutrition

Underweight MUAC acute

malnutrition

Pre

vale

nce

(%

)

Malnutrition

Total Boys Girls Region prevalence (2011)

RESULTS

The global acute malnutrition was around 11.3% with 12% for

boys and 10.5% for girls.

11.3% > 6.3% prevalence for the Nawa region and is serious.

The global chronic malnutrition was around 48.7% with

52.4% for boys and 44.9% for girls.

48.7% (critical) > 27.1% prevalence of the region

The underweight prevalence was around 28.8% with 29.6%

for boys and 27.9% for girls.

28.8% is serious > 14.4% (region prevalence).

The prevalence of global acute malnutrition according to the

MUAC was 5% with a marked prevalence of 6.1% for girls.

This rate is not very different from that of the region which is 4.5%.

However, this prevalence is also high because the higher it is,

the more it reflects the increased risk of mortality.

Ministry of Health, 2011

• According to the Chi-2 test (p = 0.05) malnutrition didn’t depend to mother BMI.

• Complementary food reduced malnutrition to 37%. (= Bhutta et al.,2013)

• The consumption of fruits and vegetables by households reduced malnutrition risk to 47%.

RESULTS

CONCLUSION

• The survey conducted in households has revealed

dietary habits and nutritional status of populations

cocoa producing of the NAWA.

• The diet is less diversified for both children and

adults.Tubers and cereals were found to be the

staple food. This corresponded with the extremely

high chronic malnutrition rate (48.7%) and high

levels of food insecurity (35%) of the surveyed

households.

Recommendations:

To adopt a sustainable intensification of food

production system in order to address malnutrition and

food insecurity in the region, as the land has been

extensively used for cash crops production (cocoa and

rubber) at the expense of food crops.

THANK YOU FOR YOUR ATTENTION

Acknowledgements:

• Local government and heads of surveyed villages,

• Respondents in the surveyed households,

• World Cocoa Foundation,

• A4NH (Agriculture for Nutrition and Health), Mars.

• ICRAF through the Vision for Change project and CRP4 (Agriculture for improved Nutrition and Health).