Humidtropics conference

1. Agbo A. E., Kouamé C., Kahia J., Diby L., Coulibaly L., Mahyao A. and Kehlenbeck K.
IITA, Ibadan 3-6 March 2015
FEEDING HABITS AND NUTRITIONAL STATUS OF
YOUNG CHILDREN AND THEIR MOTHERS IN COCOA
PRODUCING SMALLHOLDER HOUSEHOLDS
OF SOUTH-WEST COTE D’IVOIRE
International Conference on Integrated Systems Research
for Sustainable Intensification in Smallholder Agriculture

2. OUTLINE
• INTRODUCTION
• METHODOLOGY
• RESULTS and DISCUSSION
• CONCLUSION

3. INTRODUCTION
- 12.5% of the population are undernourished in terms
of energy intake,
• World - 2 billion people suffer from micronutrients
deficiencies,
- approximatively 26% of children are stunted.
However, agricultural sector is seriously affected by
malnutrition despite the fact that it provides foods. In fact,
a recent mapping of malnutrition in the major cocoa
producing areas revealed stunting rates of 25 to 34%.
In Côte d’ivoire, the national nutritional status of children
less than 5 years old revealed that 30% of them suffered
from stunting. In addition, anemia prevalence is around 75%.
FAO (2013); INS and ICF (2013); De Vries et al. (2012)

4. INTRODUCTION
• During the last 15 years, cocoa productivity decreased
and the government has endeavoured to promote
intensification of cocoa-farming systems. However, this
has occurred at the expense of food crops previously
cultivated by cocoa farmers.
 In Soubré, capital of the NAWA region which provides
40% of cocoa production in Côte d'Ivoire, the situation
has caused a food crisis, resulting in the shortage of major
commodities in the local market.
Coulibaly (2013)

5. INTRODUCTION
So, the current work was conducted with the main
objective to:
- Evaluate the families food habits.
- Assess the nutritional status of mothers and children
under 5 years old.
The Vision for Change project (V4C) has been implemented
in this region to revitalize cocoa sector by empowering
farmers producing cocoa on diversified farms with greater
productivity and improving nutrition and education.

6. METHODOLOGY
• The survey was conducted in 38
communities of the Nawa region in Côte
d’ivoire
• 1,069 households were randomly sampled
and surveyed
• Anthropometric measurements were
performed on 1,475 children.
Localities
Figure 1 : Spacial representation of surveyed localities

7. METHODOLOGY
• The survey was carried out from February to
March 2014 by 20 enumerators.
2 - Anthropometric measurements (weight, size
and brachial scope)
Anthropometric measurement of
children and mother
For children:
-Weight-for-height index acute malnutrition
(wasting)
-Height-for-age index chronic malnutrition
(stunting)
- Weight-for-age index underweight
- Brachial scope index acute malnutrition
For adults:
- Body mass index (BMI) malnutrition
and overweight (except pregnant women)

8. METHODOLOGY
3 - Dietary diversity score and food insecurity scale
• Women dietary diversity score (WDDS) FAO guide
(Kennedy et al., 2013).
• Children dietary diversity score (WHO, 2009).
• Scale of food insecurity (USAID, 2006).
4 - Data Processing
• STATA software for survey data.
• ENA (Emergency Nutrition Assessment) software for
anthropometric data.

9. 1 - Consumption
1-1 Food diversity level
Dietary diversity of the
surveyed population
was low with 80% of
women and 94% of
children consuming
less than 3 different
food groups the day
before the interview.
Figure 3: Children food diversity level
Figure 2: Women food diversity level
0
10
20
30
40
50
60
70
80
90
Lower food
diversity (≤ 3
groups of food)
Average food
diversity (4 or 5
groups of food)
Higher food
diversity (≥
6groups of food)
Percentage(%)
Series1
80
0
10
20
30
40
50
60
70
80
90
100
Lower food diversity (≤ 3
groups of food)
Average food diversity (4
or 5 groups of food)
Percentage(%)
Series1
94
RESULTS

10. RESULTS
Food groups (%) of
women
White starchy food 92.3
Green leafy vegetables 3.3
Fruits, vegetables and
tubers rich in vitamin A
and red oil palm
5.7
Others fruits and
vegetables
16.4
Meat and fish 10.8
Beans, nuts and seeds 0.3
1-2 Women Dietary Diversity
Score (WDDS)
 The mothers 24-hours recall
found that around 90% of
them consumed white
starchy food. This is not
surprising since majority of
producers are native from
Center Côte d’Ivoire where
tubers are the staple food.
 About 11% consumed fish
and meat, 9% vegetables
and leaves rich in vitamin A
and 16% others fruits and
vegetables.
Table 1: Women dietary diversity score
Dagou (2009)

11. 1-3 Children dietary diversity
score
• Children staple food were
cereals (42%) and tubers
(39%) essentially. However,
they also ate fish and fruit
(32.5 and 24.5%
respectively), eggs (11.8%),
meat (10.4%) and 14.5%
vitamin A-rich vegetables
fruits and tubers
• Some of them (20%) received
additional food: porridge rice,
vermicelli and fried banana.
RESULTS
Figure 4: Children 24-hours recall
Figure 5: Children eating habits
0
5
10
15
20
25
30
35
40
45
Cereals Tubers Dairy
products
Vegetables Meat
Series1
0
5
10
15
20
25
30
35
Eggs Meat Fishes Vegetables
richs in
vitamin A
Fruits Vegetables
and nuts
Series1
41.5%
38.7%
32.5%
24.5%
14.5%

12. RESULTS
2- Food security level
In the region, there was a
lack of food during 7
months, from February to
August, with a peak in
March.
• The average score on the
scale of food insecurity
was 3.91 / 14.
• Most households were
food secure (64.6%) and
35.4% were in a situation
of food insecurity.
Figure 7: Households food insecurity level
0
10
20
30
40
50
60
70
Food security Moderate
food security
Average food
insecurity
Severe food
insecurity
Percentage(%)
Series1
64.6%
35.4%

13. RESULTS
3 – Mothers and children nutritional status evaluation
3-1 Women body mass
index (BMI)
• In our study 65.4% of
women have a normal
weight and 21.3% are
overweight. It was also
noted that 2% are
malnourished and
3.1% are morbidly
obese.
Figure 8: Women BMI classification.
0
10
20
30
40
50
60
70
Percentage(%)
Series1
65.4%
21.3%
2% 3.1%

14. 0
20
40
60
Acute
malnutrition
Chronic
malnutrition
Underweight MUAC acute
malnutrition
Prevalence(%)
Malnutrition
Total Boys Girls Region prevalence (2011)
RESULTS
The global acute malnutrition was around 11.3% with 12% for
boys and 10.5% for girls.
11.3% > 6.3% prevalence for the Nawa region and is serious.
The global chronic malnutrition was around 48.7% with
52.4% for boys and 44.9% for girls.
48.7% (critical) > 27.1% prevalence of the region
The underweight prevalence was around 28.8% with 29.6%
for boys and 27.9% for girls.
28.8% is serious > 14.4% (region prevalence).
The prevalence of global acute malnutrition according to the
MUAC was 5% with a marked prevalence of 6.1% for girls.
This rate is not very different from that of the region which is 4.5%.
However, this prevalence is also high because the higher it is,
the more it reflects the increased risk of mortality.
Ministry of Health, 2011

15. • According to the Chi-2 test (p = 0.05)
malnutrition didn’t depend to mother BMI.
• Complementary food reduced malnutrition to
37%. (= Bhutta et al.,2013)
• The consumption of fruits and vegetables by
households reduced malnutrition risk to 47%.
RESULTS

16. CONCLUSION
• The survey conducted in households has revealed
dietary habits and nutritional status of populations
cocoa producing of the NAWA.
• The diet is less diversified for both children and
adults.Tubers and cereals were found to be the
staple food. This corresponded with the extremely
high chronic malnutrition rate (48.7%) and high
levels of food insecurity (35%) of the surveyed
households.
Recommendations:
To adopt a sustainable intensification of food
production system in order to address malnutrition and
food insecurity in the region, as the land has been
extensively used for cash crops production (cocoa and
rubber) at the expense of food crops.

17. THANK YOU FOR YOUR ATTENTION
Acknowledgements:
• Local government and heads of surveyed villages,
• Respondents in the surveyed households,
• World Cocoa Foundation,
• A4NH (Agriculture for Nutrition and Health), Mars.
• ICRAF through the Vision for Change project and CRP4
(Agriculture for improved Nutrition and Health).