Examining the complex dynamics influencing acute malnutrition in Turkana and Samburu counties: study protocol

Acute malnutrition in children under 5 years is persistent in arid and semi-arid lands in Eastern Africa. This study aimed to identify the drivers of acute malnutrition in Turkana and Samburu counties, Kenya. This was a population-based longitudinal mixed-methods observational study. Qualitative and quantitative data were collected at Wave 1 but only quantitative data were collected during follow-up. Participants were a representative sample of children and their primary caregivers from households with children under 3 years at Wave 1. Anthropometric measurements of all children under 5 years in the sampled households were taken at Wave 1 (May to July 2021), and one child under 3 years was randomly selected for follow-up about every 4 months over 2 years for six data collection waves. The study also collected data on socio-demographics; child feeding practices and morbidity, household water and food insecurity; shocks; coping strategies, social safety nets and economic safeguards; water, sanitation, and hygiene; decision making of women; and food consumption. Qualitative data were collected through community dialogues, focus group discussions, in-depth interviews, photovoice and key informant interviews with mothers and fathers with children under 5 years, community leaders, county officials and staff of nongovernmental organizations. The data were coded and analyzed thematically. Data collection is complete, and analysis is ongoing. The analysis includes thematic analysis of qualitative data and descriptive and multivariable regression analysis of quantitative data.