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The School of Public Health
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Council on Education
for Public Health (CEPH)
Student makes discoveries about childhood nutrition in Kenya
By Kristina Penny
New School of Public Health graduate Hellen Ndiku, DrPH (2009), went to Kenya to research differences between the nutritional value of two different grains consumed in a specific region.
While there, she made an unexpected discovery: girls in the region seemed to be receiving significantly less nutrition than boys.
Dr. Ndiku interviews a Kenyan mother about her family’s dietary patterns.
"We didn’t worry just if the boys ate more. Our nutrition indices state whether they’re healthy or not healthy. When they ate more, it was translating into better health, and the boys were better nourished," she says.
This came as a surprise to Dr. Ndiku, even though she was born and raised in a Kenyan village similar to the ones she was studying and knew the disadvantages girls often face in the country.
"They believe, whatever they’re given, that’s what their share should be," says Dr. Ndiku.
Yet, Dr. Ndiku hadn’t suspected the nutrition statistics to be quite so drastic. Weight-for-age, girls 5 years of age and younger were 17.5 percent more likely to be malnourished.
Dr. Ndiku conducted the research project as part of her dissertation requirements for the SPH’s doctorate in nutrition. She chose to research and compare the difference between the traditionally grown pearl millet against a more recently introduced grain, corn, to see which one supported better nutrition in the region. As a child, she remembered eating pearl millet but recalled it getting scarcer and scarcer as corn was introduced.
"The last time I had seen it, I was in grade one and 7 years old. Since then, it has been disappearing from our village," says Dr. Ndiku. "But it never left my mind, and my grandmother kept talking about it, how good and nutritious it was, so I really wanted to find out."
Dr. Ndiku administers de-worming medicine to a small child.
Dr. Ndiku discovered that there were still regions that produced pearl millet in bulk and decided to study eight villages consuming mainly pearl millet and eight consuming mainly corn within the same district. Making two four-month trips, she recruited and trained four research assistants from the area to help her weigh and measure the children and conduct questionnaires about their daily food consumption.
"It’s true that in the region where they use the traditional cereal, they have higher average energy intake than the area where they use corn, and get better nutrition," says Dr. Ndiku. Her study reports that children from the pearl-millet-growing region consumed 15 percent more energy than those from the corn-growing region and also received more protein, iron, and vitamin A.
In addition, she says pearl millet is more hardy than corn, able to survive drought better, and requires less labor.
But Dr. Ndiku found the difference between the nutritional health of boys and girls under 5 years old to be far more interesting data than the comparison of different types of grain.
In Kenya, girls are neglected in many cultural issues, including educational and career opportunities. "But I didn’t know that they also were [neglected] in nutritional issues," says Dr. Ndiku. "That was a shock to me."
Dr. Ndiku was born and raised in the same region in Kenya where she conducted the research project. Neither of her parents ever attended school nor learned how to read or write, but she remembers the constant encouragement of her father.
"I had two brothers, and he didn’t see any difference between them and myself," she says. "He told me, ‘Compete with them. You can make it.’ That’s what motivated me."
Her uncle, who came to study in the United States the year she was born, reminded her that there was more to education than elementary school. He came back to Kenya and even helped pay her tuition for high school. This motivated her even further, she says.
"I believe that God can lead in everything," she says. "If you would have asked me before if I ever would have come to the U.S. to go to school, I wouldn’t have been sure, but I knew that God can do anything."
Dr. Ndiku hopes to use her research, and the subsequent data she plans to collect when she goes back in November, to inform Kenyan communities of the current nutritional differences between boys and girls and convince them that "all children are valuable," she says. "But I also want to carry it a bit further and share it with policy makers to see what can be done."
Each of the villages where she did her research consisted of 200-300 fenced homesteads, each having two or three mud huts, one for each family. Residents of the villages had staunch superstitious beliefs passed down through tradition but often didn’t know much about basic health or sanitation principles.
"We did a lot of health and nutritional education because they knew very little, and I didn’t want us to just collect data and walk away," says Dr. Ndiku. She says they became involved in the communities in many ways including distributing food and clothing, transporting the sick to hospitals, buying prescriptions for them, and giving de-worming medicine to the children. They also helped fund the construction of schools and churches and paid the tuition of some students.
At times, the number of people in need became too overwhelming for research team members to handle alone, so they involved the community leaders to help with organization and distribution. In total, Dr. Ndiku estimates that the research team spent about $1,500 helping the community.
"When we started to incorporate community service, they got interested and excited, and we even became great friends. They didn’t want us to leave," says Dr. Ndiku. "These people have nobody to ask very simple questions, so just being there for them was a help."
The team initiated a continuing plan, Project Porridge, to distribute food at 13 Seventh-day Adventist churches in the region.
Dr. Ndiku preached at several churches and conducted Bible studies in the afternoon, but she says the real chance to witness was daily interaction. "When they asked why we were doing all these things, I would just tell them, ‘I’m doing this because Jesus loves you.’ Because they couldn’t understand why someone would come from their home and do all of this."
Dr. Ndiku graduated in June. She plans to finish up her research project and then teach nutrition and conduct research for the University of Eastern Africa, Baraton. She also plans to work with international organizations to promote community health education.
"We can sit in offices. We can brag about our degrees, but if we cannot reach the community, then the system is not complete," says Dr. Ndiku.
Another one of her ambitions is to become an advocate and role model for young girls.
"One reason I came here and decided to go to school is for the sake of the girl child," says Dr. Ndiku. "So that they can have someone they can look at and say ‘if she can do it, coming from a village like that, right here near my village, than I can too.’ That’s why I’m here."