Feeding Young Children in Food Insecure Environments: A Photovoice Study in Kenya's Drylands.

Child wasting remains a global public health challenge, with persistently high levels in dryland regions such as Turkana and Samburu Counties in Kenya. Food scarcity is linked to spikes in wasting prevalence in these counties, but little is known about women's lived experiences of food insecurity and how they perceive its relationship to child wasting. A total of 126 women across diverse livelihood zones in Turkana and Samburu Counties participated in a photovoice activity as part of the Nawiri mixed-methods longitudinal study. The women took photos based on four prompts related to food security and discussed their photos in groups of six. Transcripts of the discussions were analyzed thematically. In both counties, most households relied on local markets, shops, and kiosks for food. Diets were dominated by maize year-round but included wheat products, meat, a limited number of vegetables, and milk in times of plenty. During dry periods, households coped with food insecurity by adding liquids to stretch food, reducing the number of meals per day, and consuming wild fruits. This partially addressed hunger, but participants said that lack of food and poor-quality food contributed to child wasting. Barriers to food security included low and unreliable incomes, issues related to shops (i.e., limited types of food, frequent stockouts, short opening hours, and distance from communities), high food prices, and lack of transport. Participants highlighted the need to increase the availability of fruits and vegetables in shops. The Nawiri program used these findings to adapt multisectoral activities to address these challenges and decrease wasting.