The maternal depletion transition in northern Kenya: the effects of settlement, development and disparity

Maternal depletion syndrome, defined as a broad pattern of maternal malnutrition resulting from the combined effects of dietary inadequacy, heavy workloads, and energetic costs of repeated rounds of reproduction, has been determined to be an important predictor of maternal and child health. Debates regarding the existence of maternal depletion syndrome have centred on the inability to identify a single universal pattern of parity-related depletion. However, it is becoming increasingly apparent that patterns of depletion may be linked to overall dietary adequacy and conditioned by socioeconomic development. Therefore, variable patterns of maternal depletion are useful for examining changing patterns of women's nutrition in the process of development. This study examines the nutritional status and dietary intakes of 912 Rendille women in one nomadic and four settled communities in northern Kenya, and tests the assertion that settlement of former nomadic pastoralists results in improved diet and nutrition. Both long-term and short-term reproduction-related changes in BMI, triceps skin fold and upper arm muscle area are examined in relation to parity, age, and socioeconomic factors. Overall community comparisons reveal improvements in dietary adequacy and nutritional status only among women residing in the District capitol, Marsabit. Women in small settlements and the nomadic community, by contrast, display patterns of long-term chronic energy deficiency that obscure short-term reproduction-related energy costs. In addition, data reveal that economic disparity increases in the process of settlement and development and that low socioeconomic status negatively influences dietary intake and nutritional well being. The findings highlight the importance of examining variation within and between communities for understanding the complex nature of the maternal depletion transition.