Utilization of fortified foods in households with children 6 - 59 months in Kampala, Uganda

Abstract

Introduction: Worldwide, the three most common forms of Micronutrient Deficiencies are; Iron Deficiency Anemia (IDA), Vitamin A Deficiency (VAD) and Iodine Deficiency, these affect at least one third of the world’s population, the majority of who are in developing countries (United Nations, 2016).Statistics from the country’s Uganda Demographic and Health Surveys (UDHS), 2016 indicate that Iron Deficiency Anemia among children 6-59 months is 32% and Vitamin A Deficiency is 38%. There are various interventions that are in place to address Micronutrient Deficiency (MND) in Uganda; these are food fortification (fortified foods) and supplementation among others. Despite various interventions, the prevalence of micronutrient deficiencies is still high; this is attributed to low utilization of fortified foods (Kodish, et al, 2016).The Food Fortification (fortified foods) Policy advocates for utilization of fortified foods, however in Kampala District, particularly Kawempe Division, there is inadequate information about Utilization of Fortified Foods in Households for Children 6-59 months. Objectives and Significance: The general objective of this study was to assess utilization of fortified foods in households with children 6 – 59 months in Kampala. The specific objectives of this study were; to determine the level of utilization of fortified foods in households with children 6 – 59 months and to establish the factors associated with utilization of fortified foods in households with children 6 – 59 months thereafter inform policy makers about the current state of utilization of fortified foods in households with children 6 – 59 months Kampala, Uganda. Methods: A cross sectional study design was used to conduct this study in Kawempe division which is one of the five divisions in Kampala, Uganda. Cluster sampling was used to select 617 respondents (caretakers of children 6-59 months) who participated in this study. Trained research assistants were used to assess the level of utilization of fortified foods using a 24 hour food recall, a standardized questionnaire was used to collect information about the factors associated with utilization of fortified foods such as social demographic factors and dietary practices among others. Data analysis was done using SPSS. Univariate analysis was done using descriptive statistics such as frequencies, means and standard deviations for age, sex and education level among others. Bivariate analysis was done using chi- square test to test for the relationship between the dependent and independent variables. A P value of less than 0.05 at a confidence interval of 95% was considered statistically significant. Odds ratios and 95% confidence intervals were also used to xii test for associations and statistical significance between the dependent and independent variable. Multivariate analysis was done using multiple logistic regression so as to test for the observed significant variables in bivariate analysis and control for confounders. Results: Of the 617 study participants 93.0% were found to be using fortified salt, 91.4% fortified vegetable cooking oil, 86.7% fortified sugar, 48.5% fortified margarine, 9.1% fortified maize flour and 1.8% fortified orange sweet potatoes. The factors that were found to be associated with fortified foods and were statistically significant were wealth index particularly with the fourth quartile with AOR (95%CI) 0.021(0.06-0.69), P value of 0.010 and the cost of fortified foods AOR (95%CI) 0.45(0.23-0.89), and P value 0.021. Conclusion: Utilization of fortified salt, fortified vegetable cooking oil, fortified sugar and fortified margarine approximates high utilization of fortified foods then utilization of fortified maize flour and fortified orange sweet potatoes approximates low utilization of fortified foods. The factors that are statistically associated with utilization of fortified foods are wealth index or socioeconomic status / index and the cost of fortified foods.