In line with the Sustainable Development Goal 2, The World Food Programme (WFP) conducted a study to identify and resolve issues surrounding adolescent nutrition. The report compiled after the study was aimed at pushing for health and nutrition interventions towards the adolescent population. Here are some of the discussions around the report – Kenya: Tackling The 7 Challenges That Adolescent Girls Face When It Comes To Getting Good Nutrition
Adolescents are children between the ages of 10-19 years. Except for the first year after birth, adolescence is the fastest phase of growth anyone will ever go through. The changes that happen during these time due to hormones affect how an adolescent may react, feel and even their requirements. Adequate nutrition is therefore of great importance in that stage of their lives.
Food insecurity in Kenya is seemingly a regular occurrence resulting from regular droughts and other factors such as high cost of food production and Kenyans living in abject poverty. One of the key determinants of nutrition in the country are the supermarkets. Increased levels of obesity are linked to dependency on low cost, high calorie, low nutrient foods.
This situation has increased the levels of stunting in children under 5 by 26% and rendering adults overweight or obese. 26% of rural-dwelling women and 43% of urban dwelling women of reproductive age are overweight or obese. This in itself shows a prevalence of nutrition deficiencies even for adolescent children. The study which was conducted between March and December 2017 involved collection of data from three areas; Nairobi, Samburu and Meru.
When talking about food and nutrition available to adolescent children, the report focused on 3 aspects; food availability, food responsibility and food status and aspirations.
Food and nutrition
The adolescents in urban areas were seen to have adopted a ‘hustling’ mentality. This mentality is characterized by a disorganized, uncertain and unregulated diet. Most adolescents with this mentality went a whole day on very little to eat.
In Samburu, adolescents reported an overconsumption of certain food groups. This is because the major source of food in such areas is the community’s livestock. However, due to the drought, their herds had thoroughly been depleted and having meat was, therefore, a rare occurrence for them. Their diet constituted of starchy carbohydrates such as flour and water.
Adolescents were said to play a key role in sourcing for food for their households and were often left to be in charge of their own food consumption. In all the areas, unmarried adolescent girls were involved in buying foodstuffs while married adolescent girls focused on cooking the food. However, in recent times, with caregivers spending longer hours at work, the burden of sourcing and preparing meals became heavier on adolescent girls. Thus they incorporated the hustling lifestyle to fend for themselves particularly during the day.
Food status and aspirations
Adolescents in the selected areas acknowledged the issue of peer pressure when it comes to food consumption. They linked food with social status and wealth. In areas like Nairobi, the adolescents linked the life of consuming foods such as cake, pizza and the likes to a wealthy lifestyle. They desired these foods because they aspire to the same social status. Thus any income they got on the side was diverted to buy these foods which are not always the best in nutrient quality.
Factors Affecting Adolescent Nutrition
In investigating issues that affect adolescent nutrition, the report focused on;
Most adolescents came from houses of low economic status. They could only afford cheap unhealthy food. In areas such as Samburu, the drought had a negative effect on their livestock which is their main source of revenue. Eventually, most families ended up with very little money to buy food and an inability to sell their animals. The adolescents in those homes were therefore affected by the restrictive diets due to lack of money. In Meru, adolescent boys reported that before the drought hit, they regularly consumed a mixture of blood and milk, a traditional meal known to supplement the diet. However, with the drought, many said they only drank blood.
Income Generating Activities
Both boys and girls were involved in income-generating activities to provide resources for their households. Most of the girls were involved in activities such as washing clothes while the boys worked in miraa production. These children eventually started chewing miraa in order to suppress appetite which brought about health complications. Others were involved in the illicit brewing of beer with some going as far as ingesting it in order to overcome hunger.
Social norms and restrictive food practices.
A couple of social norms were seen as factors affecting adolescent’s access to adequate nutrition. In areas such as Nairobi, the hustling lifestyle meant more focus was put on consuming street food rather than expensive home cooked meals. In Samburu, pregnant adolescent girls suffered greatly in terms of nutrition. To limit the size of the fetus, many were restricted to a diet of water and milk. This diet was barely enough for them. Unmarried adolescent mothers felt like a burden to the household and often restricted their diet, eating as much as one meal a day.
Most adolescents perceived that good nutrition consisted of food that gives energy, makes one full and food that is natural. Thus food such as rice was not considered nutritious because it did not make one full. Most said that they eat to be strong as opposed to getting nutritional sustenance. While some could list what they termed as healthy food, they reported that during drought, the nutritional content did not drive food consumption. Food was merely bought to satiate hunger.
The value of education was highlighted as a means to protect adolescents from early marriages and pregnancies. However, the rate of school dropouts in this areas was extremely high. Attendance was highly dependent on a household’s financial situation.
This was highly felt in Samburu. The drought which threatened the lives of their livestock threatened the resident’s livelihood. The death of their animals availed little to no meat in their households which includes adolescents. Additionally, they were seen to have an emotional connection to these animals thus their deaths affected them.
Sexual and reproductive health
Residents in livestock-based communities turned to marrying off their adolescent girls as a way to get income in order to supplement their dwindling herd. It was reported that 85% of married girls in Meru and 78% in Nairobi between the age of 15-19, used contraception. However, only 18% of adolescent girls in Samburu were open to contraception. National stakeholders highlighted that pregnant adolescents and teenagers with HIV are particularly vulnerable to malnutrition.
Service delivery issues
Health facilities are an important avenue to ensure that families get proper nutritional information especially for pregnant mothers who attend antenatal clinics. However, pregnant mother or adolescents reported that they had not attended any clinics. This is because the negative attitude towards pregnant teens made them stay away. Other adolescents stayed away from health facilities and regarded them as places for old and sickly people. Additionally, the adolescents stayed away from the health centres due to mandatory HIV tests that were part of acquiring health services.
The report highlighted that effectively engaging adolescents is essential to assessing how nutrition specific and nutrition sensitive interventions can be delivered. Throughout the study, the adolescents highlighted how best their needs and priorities could be met.
‘Come to us, fit around our lifestyles’ -Most adolescents expressed the need for these interventions reaching them in areas they frequent. They asked that the interventions be tailored to fit their lifestyles.
‘Use our groups, do not group us’- The adolescents expressed preference of being grouped together unless interactions were gender sensitive. They also liked to be grouped in life stages such as married and unmarried girls.
‘Make it entertaining’- They attached great importance to entertainment as a key to bring many of them onboard. This way the process can be more entertaining and easier to understand.
‘Ask us, include us’- They asked that they are included in issues that affect them. Instead of using billboards and posters, they stated that they preferred to be directly confronted. This way, they could ask questions if they wanted to.
‘Balance tradition and modernn’-Though less apparent in Nairobi, teenagers in Samburu expressed the need to fuse traditional and modern food in their diets.
‘With food, we need energy now’- They asked that their diet include food that was of immediate benefit to them. They reported that having energy was a priority for them to ensure they got things done.
Strengthening the visibility of adolescents
- There is need to disintegrate available data and allow for a systematic routine collection of adolescent-specific data.
- The definition of an adolescent at the national level might not the definition at the community level. This may lead some adolescents to seek youth-related services. The interventions should be sensitive to age, gender and socioeconomic status.
- Policy and programmatic levels often group adolescents with children or youth reducing their visibility. It is of great importance that they are given their own platforms and policies specific to them. This way, their issues are not diluted.
- Adolescents should not be viewed as a standard group. There are different life stages and each should be accounted for. Interventions need to be formulated in either an age, gender, context-specific or sensitive manner.
Influencing adolescent nutrition
- Increasing communication and information will not help when outcomes to addressing nutritional needs of adolescents. The interventions should be tailored to fit into other key aspects of their lives.
- Reducing poverty by increasing safe income generation activities is key. However, these opportunities should be designed to keep the adolescents in school.
- New and emerging urban agricultural methodologies should be may be relevant when reaching adolescence. These methodologies should be included when addressing agricultural practices.
- A system based approach that considers restrictive social norms, sexual and reproductive issues should be practised. It is critical when dealing with the improved nutritional status of these adolescents.
Platforms for adolescent engagement
- Adolescents should be engaged more through multiple avenues or platforms that are mutually supportive. Their dynamic needs show that there is no ‘one size fits all’ delivery channel.
- The existing research and documented programs highlighted a particular bias against girls and sexual reproductive health and HIV programming. There should programs that address these needs and implemented at scale.
- Most programs reached engaged these adolescents at the community level in informal spaces. Most did not even attend these meetings. Taking after the Ministry of Health, more programs can try reaching these adolescents at religious institutions.
- Leveraging technology is a promising way of engaging adolescents. It is important to negotiate the use of new technologies with parents and caregivers. This way, adolescents may be privy to information share there.
If you have teenagers in the house, here are tips from nutrition expert Professor Judith Kiminywe on the best way to approach adolescent nutrition.
Want to know how you can incorporate healthy foods from the supermarket into your diet? Health: Superfoods Found In Every Market