Factors associated with enrollment of children aged 6-23 months into the Maternal Child Health and Nutrition Programme in Kotido District, Uganda

Abstract

Karamoja sub-region scores poorly on key development and health indicators including nutrition. The Maternal and Child Health and Nutrition (MCHN) programme, a stunting prevention programme was therefore introduced in 2005 to curb and reduce stunting levels. Enrollment levels for children aged 6-23months into the MCHN programme is low and yet factors associated with enrollment levels have not been investigated in Kotido district, Uganda.The study determined the individual, health systems and programme factors associated with enrollment of children aged 6-23months into the MCHN programme in Kotido district, Uganda. Experiences about the programme were also explored.This was a concurrent mixed methods study. Mothers with children aged 6-23 months were selected using a 2-stage cluster sampling method. Quantitative data was collected using interviewer administered structured questionnaires administered to 326 respondents. Modified Poisson regression analysis was used to determine independent factors associated with enrollment of children into the programme. All factors with p-value less than 0.2 at bivariate level were integrated in the multivariate model and associations were considered significant at P < 0.05. Quantitative data was summarized as descriptive statistics. Qualitative data was collected using key informant and focus discussion guides and analysed using thematic analysis.The proportion of children who were enrolled into the programme was 77%. The mean age of respondents was 29 years. Almost all respondents had no formal education (95.4%). Multivariate analysis showed that waiting time (APR:0.82;95% CI:0.72-0.93), availability of food at health facility (APR:1.12;95%CI:1.03-1.23), staff conduct (APR:0.89;95% CI:0.82-0.96), distance to the Food distribution Point (APR:0.79;95% CI: 0.68-0.92 and perceived Maternal and Child Health service quality (APR:0.74;95% CI: 0.64-0.86) were significantly associated with enrollment into the programme. The key factors associated with enrollment of children into the Maternal, child health and nutrition programme included; waiting time, availability of food, distance to the food distribution point, perceived quality of maternal and child health services and staff conduct. There is need to decentralize the programme such that under served areas are reached in order to achieve a greater positive impact on nutrition indicators in Kotido district.