How COVID‐19 affected food systems, health service delivery and maternal and infant nutrition practices: Implications for moving forward in Kenya

• Published in: Maternal and child nutrition 2023-04, Vol.19 (2), p.e13466-n/a
• Main Authors: Ahoya, Brenda, Kavle, Justine A., Kiige, Laura, Gathi, Constance, Samburu, Betty, Maina, Lucy, Ramirez, Lacey, Wambu, Rose, Codjia, Patrick
• Format: Article
• Language: English
• Subjects: Age; Babies; Breast Feeding; breastfeeding; Breastfeeding & lactation; Children & youth; Childrens health; Community health; Community volunteers; Coronaviruses; Counties; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; Data collection; Delayed; Diet; Female; Focus groups; Food; Food prices; Food security; food system; Food systems; Government; Health education; Health facilities; Health information; Health services; Health status; health system; Healthy food; Human nutrition; Humans; Infant; Infant formula; infant nutrition; Infants; Insecurity; Interviews; Kenya - epidemiology; Lactation; Maternal & child health; maternal nutrition; Mothers; Nutrition; Original; Pandemics; Pregnancy; Prenatal Care; Social protection; Stakeholders; Vendors; Volunteers; Women; Workers
• ISSN: 1740-8695; 1740-8709; 1740-8709
• DOI: 10.1111/mcn.13466

This implementation research study sought to examine the impact of the COVID‐19 pandemic on maternal and infant nutrition practices, and related aspects of health and food systems in Nairobi and Uasin Gishu Counties, Kenya. The study triangulated in‐depth interviews with 16 pregnant women, 31 lactating women (including COVID‐19 positive), 10 facility health workers, 10 community health volunteers, 6 focus group discussions (FGDs) with food vendors, 4 FGDs and 15 stakeholder interviews with government and implementing partners. Trends from Kenyan Health Information System indicators (i.e., exclusive breastfeeding and initiation of breastfeeding, antenatal care) were also examined. During the COVID‐19 pandemic, a decline in attendance of antenatal care, and maternity facilities was observed, and corroborated by Kenyan Health Information System data. Lack of clarity among health workers on COVID‐19 breastfeeding guidance and fear of COVID‐19 infection early in the pandemic were key drivers of early infant formula use, mother–child separation following delivery and delayed initiation of breastfeeding. Most women exclusively breastfed due to Government of Kenya restrictions in movement. Unemployment and job loss was linked to food insecurity and worsened by increased food prices and limited social protection measures. In response, pregnant and lactating women resorted to skipping meals and reducing quantity and variety of foods consumed. Efforts to build forward from COVID‐19 in Kenya should include facility and community health education to prevent disruptions in breastfeeding and to support maternal dietary intake, and in the provision of targeted social protection measures alongside other multisectoral interventions (i.e., psychosocial support) for Kenyan pregnant and lactating women. This implementation research study sought to examine the impact of the COVID‐19 pandemic on maternal and infant nutrition practices, and related aspects of health and food systems in Nairobi and Uasin Gishu Counties, Kenya. Unemployment and job loss was linked to food insecurity and worsened by increased food prices and limited social protection measures. In response, pregnant and lactating women resorted to skipping meals, and reducing quantity and variety of foods consumed. Key messages Fear of COVID‐19 infection and government lockdowns contributed to declined attendance to maternal and child health services. Initial lack of clarity around COVID‐19 disrupted early and exclus