Uptake of preventive nutrition interventions among caretakers of children under 5 years in a pastoral setting of South Sudan: A case of Kapoeta South County

Abstract

Background: Preventive nutrition interventions are usually implemented without understanding how multiple factors affect uptake. Pastoralist populations have shown low uptake. A multidimensional study of uptake in the pastoral setting is vital. The study aimed to assess level and factors influencing uptake of preventive nutrition interventions in children under 5 years in Kapoeta South County of South Sudan. Methods: The study recruited 405 caregivers of children under 5 years. Quantitative data on factors that positively or negatively influence uptake of preventive nutrition interventions were collected through a structured questionnaire. Qualitative data were also collected through Key Informant Interviews (KII) to explain trends from quantitative analysis. Quantitative data were categorized as personal, interpersonal, and community factors and analyzed using Stata version 16.0 software. Factor analysis was used to categorize uptake levels; low, medium, and high. A logistic binary regression model was the best model to evaluate associations between factors and low uptake of preventive nutrition interventions. Results: Uptake of preventive nutrition interventions was low (51.4%). From a combined regression model, caregivers who had ever heard about preventive nutrition interventions (OR=0.16, C.I.=0.10-0.25), number of children in a household (OR=0.40, C.I.=0.26-0.63), and caregivers who made joint decisions (OR=0.31, C.I.=0.19-0.50) were negatively associated with and increased the odds of low uptake of preventive nutrition interventions (PNIs). On the other hand, having an undernourished child (OR=2.59, C.I.=1.73-3.89), time needed to access health facility (OR=1.70, C.I.=1.30-2.23) and absence of a health facility in the community (OR=1.63, C.I.=1.02-2.59) were positively associated with and reduced the likelihood of low intervention uptake. Information from KIIs confirmed undernourishment and accessibility to health facilities in terms of time and availability as barriers influencing low uptake. Conclusions: Uptake of preventive nutrition interventions in Kapoeta South County is low. Nutrition stakeholders should target caregivers to provide information on undernutrition, benefits and availability of PNIs and importance of interpersonal relationships (spousal-supported decision-making). There is need to explore mobile outreach preventive nutrition interventions to increase access among children under 5 in pastoralist communities.