Final Dissertation Feb
Final Dissertation Feb
Final Dissertation Feb
UNIVERSITY
BY
FEBRUARY, 2013
Declaration
I, Tibagonzeka Evas Juliet, declare that this is my original work and has never been presented
for a degree in this or any other University or Institution of higher learning.
This dissertation has been submitted with our approval as the University Supervisors
SUPERVISORS:
Signed: ......................................
Signed: .......................................
Date: ........................................
Date..............................................
Dedication
This Dissertation is dedicated to my best friend and husband; Isaac Wamatsembe, my dear mum;
Joy Nairuba Kifuko, beloved children; Josiah, Jordana and Jude, my brothers; Hudson, Herbert
and Andrew & sisters; Esther & Phoebe and my late grandma who greatly encouraged me
throughout the course.
ii
Acknowledgement
Special thanks to the almighty God for He provided all that I needed.
My sincere thanks go to my University supervisors Prof. John Muyonga, and Dr. Dorothy
Nakimbugwe who tirelessly guided me to put this piece of work together. You were never
disheartened by my mistakes but rather you repeatedly corrected me to the final copy of the
thesis. You are forever appreciated.
To my field supervisor Mr. Wambete Julius who guided me in each step I took in the field.
Thanks for the unending effort you offered me.
Special thanks to McKnight Foundation who sponsored my entire studies. You funded the grain
amaranth project that I was attached to and provided the biggest part of financial support toward
this work. You gave me a reason to study.
I also appreciate my dear mother and friends: Juliet Mpora, Liz Khakasa, loyce, Denis Atuha,
Charles Masalu, Papa Steven, Evelyn, Wilberforce, Vivian, Asha, Aisha, Doreen, Beatrice, Eric,
Hassan, Feddy, Eunice, John and many others for their constant encouragement and support to
complete the work despite the hardships.
Finally heartfelt gratitude to my best friend and husband Isaac Wamatsembe and our children for
psycho-socio and emotional support they accorded me. You permitted me to work for longer
hours of the day depriving you of your time for care.
iii
Table of Contents
Declaration ....................................................................................................................................... i
Dedication ....................................................................................................................................... ii
Acknowledgement ......................................................................................................................... iii
Table of Contents ........................................................................................................................... iv
List of Tables .................................................................................................................................. x
List of figures ................................................................................................................................ xii
Acronyms ..................................................................................................................................... xiii
Abstract ......................................................................................................................................... xv
CHAPTER ONE ........................................................................................................................... 1
1.0 INTRODUCTION .................................................................................................................... 1
1.1 Background to the study ........................................................................................................... 1
1.2 Problem Statement .................................................................................................................... 4
1.3 Objectives ................................................................................................................................. 5
1.3.1 Overall Objective ................................................................................................................... 5
1.3.2 Specific Objectives ................................................................................................................ 5
1.4 Hypotheses ................................................................................................................................ 5
1.5 Significance of the study........................................................................................................... 6
1.6 Justification ............................................................................................................................... 6
1.7 Conceptual framework .............................................................................................................. 7
CHAPTER TWO .......................................................................................................................... 8
2.0 LITERATURE REVIEW ......................................................................................................... 8
2.1 Grain Amaranth ........................................................................................................................ 8
2.1.1 History of Grain Amaranth .................................................................................................... 8
iv
vi
vii
viii
Appendix 1: Questionnaire for determining the current nutrient intake and nutrition related
knowledge and practices among house holds of farmers.................................................. 85
Appendix 2:Questionnaire for the baseline recipe collection ..................................................... 102
Appendix 3:Questionnaires for sensory evaluation of the developed products .......................... 105
Appendix 4: Grain amaranth (g.a) recipes for trials and evaluation by farmer groups .............. 115
Appendix 5:Questionnaire for the farmer group interviews ....................................................... 131
Appendix 6: The 21 farmer groups that participated in the Recipe trials and evaluation .......... 133
Appendix 7: Main ingredients used in the theoretical recipe formulation................................. 133
Appendix 8: Age group Vs Nutrient requirement....................................................................... 134
ix
List of Tables
Table 1: Proximate composition of grain amaranth varieties commonly grown in Kamuli,
Uganda .............................................................................................................................. 11
Table 2: Amaranth content of selected vitamins and minerals ..................................................... 12
Table 3: Amino acid composition of grain amaranth varieties commonly grown in Uganda in
comparison to that of maize and beans Amino Acid Content (g/100 g protein) .............. 13
Table 4: Fatty acids profile for grain amaranth from Kamuli, Uganda ........................................ 14
Table 5: Food groups and their weights used to calculate FCS .................................................... 30
Table 6: Thresholds of food consumption profiles ....................................................................... 31
Table 7: Asset based wealth categories ........................................................................................ 31
Table 8: Thresholds of Nutrient Intakes ....................................................................................... 32
Table 9: Nutritional status cut-offs points for MUAC .................................................................. 33
Table 10: Foods identified to fill identified dietary gaps for Apac, Kamuli and Nakasongola
districts .............................................................................................................................. 35
Table 11 Formulation used for producing the seventeen grain amaranth containing food products
........................................................................................................................................... 37
Table 12: Socio-demographic characteristics of respondents ...................................................... 45
Table 13: Number of meals consumed by the target households ................................................. 46
Table 14: Household Dietary Diversity Score (HDDS) ............................................................... 47
Table 15: Weekly consumption of food groups in Nakasongola, Apac and Kamuli ................... 48
Table 16: Yields & Average crop output per household in the target communities..................... 52
Table 17: Individual Dietary Diversity Score (IDDS) for children aged 6-59 months ................ 54
Table 18: The prevalence of ailments affecting nutrition status of children in the target
communities ...................................................................................................................... 55
Table 19: Percentage of children 6-59months in the different IDDS groups ............................... 59
Table 20: Percentage of number of times Solids, semisolid or soft foods is given to children .... 59
xi
List of figures
xii
Acronyms
ACC/SCN
AIDS
ANOVA
Analysis of Variance
CED
CFSVA
CRS
EPRC
FANTA
FAO
FCS
FEWSNET
FGCs
GA
Grain Amaranth
Hb
Hemoglobin
HDDS
HFISS
HIV
HMIS
IDA
IDDS
IFPRI
IYCF
MAAIF
MOFPED
MOH
Ministry of Health
MUAC
NAS
NCD
NCHS
NECDP
xiii
NI
Nutrient Intake
NQI
NWGFF
RDA
SPSS
SRLP
UBOS
UDHS
UFNS
UNCST
UNDP
UNHS
USFDA
VAD
Vitamin A deficiency
VAM
VEDCO
WFP
WFS
WHO
xiv
Abstract
Malnutrition is widespread in Uganda and is partly attributed to the poor dietary quality. Grain
amaranth is a nutritious food which can be produced in many parts of Uganda. However,
currently, grain amaranth production and utilization in the country is dismal. The aim of this
study was to evaluate the potential of grain amaranth to alleviate malnutrition in Uganda. The
study was undertaken in Kamuli, Apac and Nakasongola districts. The study entailed
determination of prevailing food and nutrition security status of rural households in the 3
districts. This involved interviews with 420 farmers (representing 21 farmer groups from 420
different households) to obtain information about food intake, nutrition related knowledge and
practices, food insecurity indicators, amaranth production and consumption. Mid upper arm
circumference (MUAC) measurements were taken for all children aged 6-59 months in the 420
households studied. Based on food intake data, dietary nutrient gaps were determined. Recipes
containing grain amaranth and other locally available foods were then developed and tested for
acceptability to sensory panelists as well as farmer groups. The recipes were also analyzed for
nutritional composition. Analysis of the demographics of the study respondents showed that of
the majority (89.5%) were females and the dominant age category was 18-49 years. This
category represented 79.58% of the respondents. A total 88.6% of the respondents had attained
some education. The majority (92.1%) of the respondents had subsistence farming as their main
occupation. Food insecurity was generally prevalent, with 36.5% of studied respondents stating
that they ate less than the recommended three meals a day. Apac district had the highest
percentage (48.92%) in this category, while Kamuli had the lowest (20.71%). More than half of
the households (52.2%) had low dietary diversity ( 6 food groups consumed in 7 days).
Nakasongola had the highest percentage of households with low dietary diversity (56.6%) while
Apac had the lowest percentage of households (46.1%). The majority (80.7%) of the households
surveyed in all the 3 districts generally did not consume an adequate diet, based on the Food
Consumption Score (FCS). Children from households with a low FCS (<35) were more likely to
be malnourished than those from households with an acceptable FCS. Only 6% of the H/Hs were
asset rich, while about one third (35%) were asset poor. Children from households categorized
as asset poor were more likely to be malnourished compared to those from asset rich families.
Households categorized as asset poor were also more likely to be food insecure compared to
those who were asset rich. With respect to nutrition status, no case of severe malnutrition was
xv
recorded among the 420 household studied, based on MUAC. Prevalence of moderate
malnutrition was at 22%. The proportion of children at risk of being malnourished was 7%.
Children whose mothers/caregivers had no formal education were more likely to be
malnourished compared to those whose mothers had attained formal education. Regarding child
feeding practices, only 36.9% of children had adequate diets. Child morbidity was found to be
high, with 62.67% of all children reporting cases of diarrhea, vomiting or fever over the 2 weeks
preceding the study. Dietary analysis showed inadequate intake of lipids, niacin, iron, calcium
and zinc. The grain amaranth recipes designed to address these nutrient gaps were found to be
highly acceptable by communities, with 15 out of 17 scoring 4 on a scale of 5. The products
developed using developed recipes were generally acceptable (with 16 out of 17 scoring 4 on a
scale of 5) and found to contain enhanced levels of zinc, iron, calcium and lipids, nutrients found
to be inadequate in the diets in the 3 study districts. The study results show that grain amaranth
has potential to contribute to improvement in nutrition and food security of communities in the
three study districts. The high acceptability of both recipes and products shows high potential for
increased consumption of grain amaranth once the recipes are widely disseminated. Since the
food habits and agro-ecological conditions in the study districts are similar to those in many
other parts of the country, it is recommended that grain amaranth production and utilization be
promoted in other parts of Uganda, as a strategy for improving nutrition and food security.
xvi
CHAPTER ONE
1.0 INTRODUCTION
1.1 Background to the study
Under-nutrition and food insecurity remain significant challenges in Uganda, though the country
has considerable potential to produce enough food. Nineteen (19%) of the countrys population
is undernourished, while the proportion of those unable to access adequate calories increased
from 59% in 1999 to 69% in 2006 (UBOS, 2006). Under-nutrition among children under 5 years
of age is particularly high, with rates of stunting reported at 33%, while those for underweight
and wasting reported at 14% and 5% respectively (UBOS, 2011). Micronutrient deficiencies
especially of vitamin A, iron and zinc are also reported to be widespread (UBOS, 2006; UNAP,
2011-2016).
Both the Uganda Nutrition Action Plan (UNAP) 2011-2016 and the Nutrition Situation Analysis
report (FANTA, 2010) identify inadequate dietary in-take and the high disease burden as largely
being responsible for much of the malnutrition in the country. In addition, they cite low dietary
diversity as one of the causes of the poor quality of household diets and hence under-nutrition in
many parts of the country. Other studies (Horton et al., 2008; Bahiigwa, 1999; FAO, 2008a)
indicate that a majority of rural household diets in the country are based on a narrow range of
staples, usually; maize, rice, millet, sweet potatoes, plantain (matooke) and cassava or
combinations thereof. In their evaluation, enunciated in the National Food and Nutrition
Strategy (UFNS) 2005, the Ministries of Agriculture and Health in the country, cite the fact that
many households with good access to sufficient food for their caloric needs; nevertheless
remain susceptible to suffering from poor nutrition for dietary reasons. One of the reasons cited
was the consumption of monotonous and unvaried diets lacking in most of the critical
micronutrients.
Most of the staple foods cited are much cheaper and more available than nutrient rich animal
foods such as meat, milk products and eggs. However, when consumed on their own or with only
very small amounts of the animal, legume or oil seed products, the result is a poor-quality and
undiversified diet that is inadequate in protein, fat and micronutrients. For example, cassava
root, a cheapest and common staple food in much of sub-Saharan Africa, is particularly low in
protein i.e. 0.8 g protein/100 edible grams (Wargiono, Richana & Hidajat, 2002)
Diet diversification has been identified elsewhere, as one of the food-based strategies with high
potential to improve the quality of individual dietary intakes as well as the nutritional and food
security situation in poor and resource-poor communities (Thompson et al., 2004; Gibson, 2005).
According to Thompson et al. (2004), dietary diversification and modification, combined with
nutrition education can improve availability, access to and utilization of foods with a high
content and bioavailability of micronutrients throughout the year. The same authors cite the fact
that dietary diversification and modification relying on product formulation and recipe
development can enhance the energy and nutrient density of cereal-based porridges.
As previous studies have indicated, under-nutrition in Uganda is not entirely due to an absolute
lack of food but also due to limited diversity in the household diet. Consequently, availability of
diverse and more nutrient-rich food crops in the country, education and support in product
formulation and recipe development offer viable opportunities for communities to improve their
nutrition through dietary diversification and modification. The recent introduction of Grain
Amaranth among resource-poor and marginalized communities in some parts of the country is
such an opportunity.
Grain amaranth is a relatively new plant source food in Uganda. Both the leaves and grain
produced by the plant can be used for food. The plant possesses unique nutritional and
agronomic attributes, making it a valuable food crop especially among resource-poor and
marginalized communities; with potential to contribute to the alleviation of under-nutrition and
nutritional deficiencies.
The crop has high levels of quality protein, whose amino acid composition compares favorably
with the protein standard for good health (FAO/WHO/UNU, 1985; FAO, 2003) and better than
most of the grains and root crops commonly consumed in the country. Grain amaranth is
particularly rich in lysine, one the most critical essential amino acids that must be present in the
diet for good health (Sseguya, 2007). It is also rich in fiber and other valuable nutrients including
calcium, twice the amount available in milk, iron, five times the level available in wheat and
higher amounts of potassium, phosphorous, vitamins, A, E and folic acid than available in most
cereal grains (Becker et al., 1981). The grain is known to contain 610% oil, consisting
predominantly of unsaturated fatty acids, especially the essential linoleic acid. In addition to the
nutritional quality, the crop has a host of beneficial agronomic features including shorter
maturity periods, high yields in marginal soils, resistance to stresses such as low moisture and
soil fertility.
Preliminary reports on the dietary utilization and consumption of grain amaranth in areas where
it has been recently introduced indicate improvements in the general wellbeing of individuals
(SRLP, 2005; Mwangi, 2003). Despite such reported improvements and the genuine potential of
crop highlighted above, grain amaranth production and utilization in Uganda remains rather low.
Annual production in all the areas where the crop appears to have made most advances hardly
exceeds 10 metric tons. It is apparent that, for the crop to release its full potential in mitigating
the countrys malnutrition and food security challenges, more concerted research and
developmental efforts need to be undertaken. The purpose of this study was to assess the
potential of Grain Amaranth towards enhancing nutrition and food security of rural farmer
households in the districts of Kamuli, Apac and Nakasongola and to generate information that
would form the basis for its promotion.
1.2
Problem Statement
Current staple diets for most resource poor people in Uganda are mainly composed of starchy
foods such as maize, rice, millet, sweet potatoes, plantain (matooke) and cassava. Although
these staples dominate diets in both proportion and frequency, they are typically low in lipids,
protein, vitamins and minerals and therefore, do not provide the households with adequate
nutrients. Complementation with nutrient rich foods like grain amaranth can help to improve the
dietary quality.
A number of efforts towards dietary diversification have focused on promoting of identified
nutritious foods. However, there is evidence indicating that food insufficiency per se, may not
necessarily be the major cause of all the malnutrition and micronutrient deficiencies witnessed in
some parts of the country. According to MAAIF (2010), the average caloric intake per person
per day declined from 2,193J in 2002 to 1,971J in 2005 despite general increase in food
production. This indicates that a general increase in food production may not necessarily be
associated with increased consumption. In addition, communities may adopt production of a crop
while targeting sale to obtain income. This is particularly likely if they are not familiar with the
consumption of such a crop and when market opportunities exist.
Grain amaranth production had been promoted in different parts of Uganda. However, the actual
contribution of the crop to nutrition of the communities among which it had been promoted had
not been determined. The purpose of this study was therefore to assess the potential of grain
amaranth to enhance nutrition and food security of rural farmer households in Kamuli, Apac and
Nakasongola Districts.
1.3 Objectives
1.3.1 Overall Objective
The main objective of the study was to assess the potential of grain amaranth towards enhancing
food and nutrition security of rural farmer households in Kamuli, Apac and Nakasongola
Districts
1.4
Hypotheses
Diets of rural households in Kamuli, Apac and Nakasongola are deficient in some
nutrients.
Acceptable nutritious food products can be made from grain amaranth and other locally
produced food materials.
Grain amaranth based recipes are acceptable by rural households in Kamuli, Apac and
Nakasongola.
1.5
Grain amaranth has been adopted by some farmers in Kamuli, Apac and Nakasongola districts.
The study therefore sought to develop recipes that could be used by farmers wishing to utilize
the new crop by incorporating it into already existing foods so as to cover some of the existing
nutrient intake gaps. Growing grain amaranth was likely to benefit resource poor crop producers
directly by contributing to their income, food and nutrition security. Increasing consumption of
grain amaranth could help to alleviate nutrition and health problems faced by people living with
HIV (PLHIV) and other vulnerable groups within the rural households. Children, pregnant and
breastfeeding mothers have special nutritional requirements and consumption of grain amaranth
was likely to contribute towards realization of their nutritional requirements. The problems of
food insecurity are on increase particularly in Uganda. The findings could be of use to policy
makers for formulating strategies which could help in addressing the problem in the process of
implementing food security programs.
1.6
Justification
The current nutritional related knowledge, practices, nutrient intake gaps in Kamuli,
Nakasongola and Apac could be improved through participatory development and dissemination
of recipes containing the nutrient rich grain amaranth. This could also create a wide interest in
the new crop, especially when such a crop is associated with improved food security, nutrition
and health benefits.
1.7
Conceptual framework
Participatory development of recipes/products using grain amaranth (G.A) enrich the local
staples available in the communities of Apac, Nakasongola and Kamuli districts will help in
increased nutrient intakes, dietary diversity and incomes. This will eventually enhance the
nutrition and food security of the households of participants. Figure 1 Gives details of the
framework.
CHAPTER TWO
2.0 LITERATURE REVIEW
2.1 Grain Amaranth
Amaranth (Amaranthus spp) is an herbaceous annual with upright growth habit, cultivated for
both its seeds which are used as a grain and its leaves which are used as a vegetable or greens.
Both leaves and seeds contain protein of unusually high quality (Myers, 2010). Amaranth is
often called a pseudo cereal because it is used much like cereal grains although it is not in the
grass family. Grain amaranth belongs to the cosmopolitan Amaranthus genus of some 60 species
(NRC, 1972). The most important species include A. hypochondriacus, A. cruentus (grain type)
& A. tricolor, A. dubius, A. lividus, A. creuntus, A. palmeri and A. hybridus (vegetable type)
(Teutonico & Knorr, 1985). Grain amaranths and many other amaranth species show tremendous
potential for human consumption and other uses, and are particularly promising as a remedy for
hunger and malnutrition in developing countries (NRC, 1972).
In Uganda, wild amaranth species are weedy and often eaten as vegetable especially in rural
areas. In Kamuli and Nakasongola, the weed is called dodo or amaransa. Three amaranth
species are grown for grain including: Amaranthus candatus has the shortest season (45-75
days), Amaranthus cruentus (60-120 days), Amaranthus hypochondriacus (150 days). The
potential of grain and vegetable amaranth as a food resource has been reviewed extensively by
Haas & Kauffman (1984), Saunders & Becker (1984), NAS (1984), and Sanchez-Marroquin
(1980). Amaranth produces a large amount of biomass in a short period of time (Kauffman &
Weber, 1990) and therefore has the potential to contribute to a substantial increase in world food
production. Grain yield of up to 5,000 kg/ha has been reported (Stallknecht & Schulz-Schaeffer,
1993).
1950b; Pal & Khoshoo, 1974; Early, 1977; Haughton, 1978). Ancient Mexicans made idols of
dough from seeds of the crop they called huahtli, which has been identified as grain amaranth
(Sauer, 1950b; Marx, 1977). Pale-seeded amaranths were also grown in Germany in the 16th
century, India and Ceylon in the 18th century, the Himalayas in the early 19th century, and
interior China and Eastern Siberia in the late 19th century (Sauer, 1977).
eaten as gruel (sattoo) in Nepal and as chapattis in the Himalayas (Vietmeyer, 1978). Amaranth
has been used as seeds or flour to make products such as cookies, cakes, pancakes, bread
muffins, crackers, pasta and other bakery products (Teutonico & Knorr, 1985).
Some specific nutritional and health benefits of amaranth consumption have been elucidated.
Amaranth oil has been shown, in animal studies, to lower total serum triglycerides and levels of
low density lipoproteins (LDL) (Escudero et al., 2006). Similar effects have been reported in
humans (Martirosyan et al., 2007). High levels of serum LDL are associated with coronary heart
disease. The serum LDL lowering effect of amaranth has been attributed to the tocotrienols
(unsaturated forms of vitamin E) and squalene in amaranth oil. These compounds affect
cholesterol biosynthesis in humans (Martirosyan et al., 2007). They are also believed to have
anti-tumor and antioxidative activity (Kim et al., 2006a), pointing to potential anti-cancer effects.
Supplementation of patients with coronary heart disease with amaranth oil has been shown to
contribute to a decrease or disappearance of headaches, weakness, increased fatigability,
shortness of breath during a physical activity, edema of the legs towards the evening hours and
feeling of intermission of heart function in most patients (Martirosyan et al., 2007). In addition,
decrease in body weight has also been reported. Consumption of grain amaranth has also been
10
shown to have potential benefits to diabetics. Studies suggest that supplementation of diets with
amaranth grain and amaranth oil improves glucose and lipid metabolism in diabetic rats (Kim et
al., 2006b). The fasting serum glucose levels and the glucose tolerance of the diabetic rats were
both improved.
Cream amaranth
Golden amaranth
Protein
12.37
13.04
Carbohydrate
Lipid
63
6.89
63.4
7.29
Fiber
Ash
6.33
2.85
7.01
3.6
11
Content (mg/g)
17.4
Zinc
Sodium
Potassium
Calcium
3.7
31
290
175
Vitamin C
Niacin
4.5
1.45
Riboflavin
Thiamine
0.23
0.1
12
Table 3: Amino acid composition of grain amaranth varieties commonly grown in Uganda in
comparison to that of maize and beans Amino Acid Content (g/100 g protein)
Amino Acid
Aspartic acid
Glutamic acid
Serine
Glycine
Histidine
Arginine
Threonine*
Alanine
Proline
Tyrosine
Valine*
Methionine*
Cysteine
Isoleucine*
Leucine*
Phenylalanine*
Lysine*
White
amaranth
7.929
19.248
6.462
8.983
3.346
9.853
2.291
4.216
4.812
3.941
4.812
2.2
0.275
4.491
6.279
4.629
6.233
Golden
amaranth
7.492
19.72
6.09
8.7
2.997
10.295
2.03
4.447
4.833
4.108
4.785
2.513
0.193
4.35
6.187
4.592
6.67
10.61
13.29
4.85
3.3
2.28
4.99
4.01
3.75
3.25
2.94
5.41
1.04
0.09
4.06
7.1
4.96
5.87
5
3.5
4
7
6
5.4
It is critical to know according to Muyonga et al., (2008) that the protein digestibility of the 2
varieties grown in Uganda is around 72% but roasting and popping, the two commonly-used
preparation methods, were found to reduce digestibility to 60.6% and 52.5%, respectively. They
further state that the level of tannins, an anti-nutrient known to reduce protein digestibility, in the
grain amaranth varieties grown in Uganda was found to range from 0.11% catechin equivalent to
0.42%, which is higher than the levels in other grains like millet and sorghum. The level varied
with the geographical area where the amaranth was grown. The levels of other nutrient inhibitors
such as hemagglutinin, trypsin inhibitor and saponins in amaranth have been reported to be
within the non-critical range (Escudero et al., 1999). The carbohydrates in amaranth grain consist
primarily of starch made up of both glutinous and non glutinous fractions. Amaranth starch
13
granules are much smaller (1-3 m) than those found in other cereal grains (Teutonico & Knorr,
1985). Due to the unique size and composition of amaranth starch, the starch may exhibit
distinctive characteristics which could be of benefit to the food industry (Lehman, 1988).
Amaranth starch seems to have potential for use in the preparation of custards, pastes and salad
dressing (Singhal & Kulkarni, 1990a, b). Amaranth grain obtained from farmers in Kamuli was
found to contain 6.9-7.4% oil (Table 1) and the oil was made up predominantly of unsaturated
fatty acids, with high levels of the essential fatty acid linoleic acid (Table 4). Based on its fatty
acid profile, it can be concluded that grain amaranth is reasonably safe for consumption by
individuals that are at high risk of chronic non-communicable diseases such as coronary heart
disease and diabetes. Children need essential fatty acids for proper growth and development.
Therefore, the high content of linoleic acid (an essential fatty acid) in grain amaranth makes it
suitable for consumption.
Table 4: Fatty acids profile for grain amaranth from Kamuli, Uganda
Fatty acid Content (mg/g)
White
Golden
Palmitic acid
1.92
2.31
Stearic acid
0.17
0.21
Oleic acid
2.19
1.92
Linoleic acid
2.8
2.41
14
also important to prevent attack by pests and rodents. Storage pests such as weevils and grain
borers do not commonly attack the amaranth grains, and therefore post-harvest losses are
minimal if storage is under the conditions described above (Muyonga et al., 2008).
Processing of amaranth seeds involves heat treatment (popping, toasting/roasting), sprouting and
milling. Heat treatment helps to overcome milling problems due to the small size of the amaranth
seeds; it also takes away the grittiness of the seeds (Oke, 1993). It may be done by popping and
toasting/roasting. Popping of amaranth seeds is normally done in a large, hot pan at a high
temperature (an air temperature of about 220C for 10 15 seconds). The seeds are stirred
constantly while popping to prevent them from burning and to allow most of them to pop
(Teutonico & Knorr, 1985). Popping of amaranth seeds results in an increase in volume of up to
1,050 % and gives the grains a gritty flavor (Saunders & Becker, 1984). The increased volume
makes milling easier. In Uganda, popping is done using an open fire. The seeds are put on a preheated pan and the seeds stirred until most of them are visibly popped.
Roasting/toasting can be done in an oven at around 200C for 5 - 10 minutes. In rural Uganda,
ovens are rare and toasted seeds are those that remain in the pan, un-popped, after open fire
popping of amaranth seeds. The toasted seeds are brownish and give a nutty flavor as well when
milled (Muyonga et al., 2008). To sprout grain amaranth, clean amaranth seeds are soaked in
water overnight at room temperature. The seeds are removed from the water and heaped on a
tray, then covered with a clean towel to keep the seeds warm. After 2 days the spouted seeds are
sun dried for 2 days. The dry seeds are rubbed together to get rid of the shoots (these give a bitter
taste to the product made out of sprouted seeds), winnowed and the seeds stored (as described
above under the preparation and storage section) until ready for milling into flour. Sprouting the
seeds increases digestibility and bioavailability of nutrients (Muyonga et al., 2008). The seeds
are milled into flour using a milling machine. In Uganda, some families pound the seeds in a
mortar and pestle or grind them using a grinding stone. Pounding and grinding are done on a
small scale and usually for a few meals to be consumed at home. This is because the flour
quickly develops rancidity if it is kept for more than a month at room temperature
15
The current nutritional situation in Uganda is not adequate for good health and sustainable
human development as evidenced by the dismal scores on major nutritional indicators.
Approximately 19% of Ugandas population is undernourished (UBOS, 2006).The majority of
the undernourished are the vulnerable groups like infants, young children and the women of
child bearing age. The immediate factors associated with children malnutrition include;
inadequate dietary intake resulting from sub optimal infant & young childs feeding practices
which include; consumption of monotonous and unvaried diets lacking in most of the critical
micronutrients, low feeding frequency, less nutritious type of food given to the children,
insufficient knowledge on how to; utilize nutrient rich foods like grain amaranth to complement
staple foods, prepare nutritious/balanced meals for the children (6-59 months))and high disease
burden resulting from fever and diarrhea. Other factors include; Lack of household assets, low
household food consumption. The three most important micronutrient deficiencies are Vitamin
A, iron deficiency anemia and Zinc (UNAP, 2011-2016)
The feeding patterns in Uganda are detailed described in the UDHS (2006) report:
Overall, only about 40 percent of breastfed children 6-23 months were fed the minimum
recommended number of times a day. It is common in Uganda for young children to eat the same
foods at the same time as adults in a household: The frequency a child eats is the same as the
number of meals eaten in the household, which might vary by region and season. Households in
16
the north normally reported eating fewer meals in a day. Proportionally more children in the
north east (Karamoja), IDPs were fed at an adequate frequency. According to the National
Household Survey 2005/06, 18 percent of households in northern Uganda reported that they ate
only one meal a day, compared with 5 percent in eastern and 4 percent in western regions.
2.2.3 Prevalence and Trends in Chronic Energy Deficiency (CED) Among Women
The national prevalence of CED, defined by body mass index (BMI) <18.5 kg/m, was 12 percent
among non-pregnant women of childbearing age (ages 15-49 years) in the UDHS 2006 (ORC
Macro, 2006). Overall the prevalence of CED has increased slightly over time, with CED highest
for women 35 and older. This increasing prevalence among older women of childbearing age
might be linked to the increasing prevalence of HIV (and its progression to AIDS with age)
among women and/or the high fertility rate in this age group. The UDHS data reveal that rural
women were more than twice as likely as urban women to be undernourished (14 percent of rural
women vs. 6 percent in urban areas). Similarly, women from households in the lowest wealth
17
quintile were at highest risk of CED (23 percent). Among women with no education, CED was
18 percent compared with 5 percent for women with secondary or higher education. Nationally,
the prevalence of CED among women has risen slightly in the past 10 years (by about 0.4
percentage points per year between 2001 and 2006)
2.2.4 Prevalence of Vitamin A Deficiency in Children and Women
Vitamin A deficiency (VAD) levels among children and women are similar within regions. VAD
negatively affects resistance to illnesses and is the leading cause of blindness in the world. In the
case of children, VAD increases fatality from common childhood illnesses such as measles and
respiratory infections. In Uganda, prevalence of VAD is estimated at 20.4% for children aged 659 months and 19.4% for women aged 15-49 years and VAD is linked to 11,000 cases of
blindness and approximately 8,000 deaths annually (UBOS, 2006). The main source of vitamin
A in the Ugandan diets is green leafy vegetables, usually boiled or steamed with hardly any fat
added. Foods of animal origin, known to supply retinol, a readily available form of vitamin A
are scarce and too expensive for the poor. WHO classifies Uganda as having a moderate public
health problem with VAD (FANTA, 2010)
2.2.5 Prevalence of Anemia and Iron Deficiency in Children and Women
Iron Deficiency Anemia (IDA) is characterized by weakness, low productivity, slow mental
development, poor concentration and poor health and in children, can lead to poor learning and
therefore affects school performance. Data from the ORC Macro 2006 UDHS report indicate
that almost three quarters (73 percent) of children 6-59 months were reported to be anemic (Hb <
11.0 g/dl), with 22 percent mildly anemic (Hb 10.0-10.9 g/dl), 43 percent moderately (Hb 7.0-9.9
g/dl) and 7 percent severely (Hb < 7.0 g/dl). The prevalence of anemia was higher among
children than adults and declined with age. Among women of childbearing age, 49 percent were
anemic (Hb < 12.0 g/dl if not pregnant, < 11.0 g/dl if pregnant), with 35 percent mildly anemic,
13 percent moderately and 0.8 percent severely. This was an increase from the 2001 UDHS
report data, mainly due to a slight increase in the proportion of women with mild anemia. The
majority of women and children affected by anemia fell in the mild or moderate categories. More
women had mild anemia, and more children had moderate anemia across the regions of Uganda.
Anemia is very high in preschool children, and the prevalence appears to be rising across much
18
of Uganda for both women and children. The prevalence of anemia among children under 5
years of age was higher than that for women of childbearing age. The highest prevalence of
anemia for women and children was in the Central 1 region and the lowest was in Kampala.
Anemia is so widespread in Uganda that it is difficult to determine region-specific underlying
causes. It is more likely that across Uganda some common factors are driving the high
prevalence of anemia, such as high disease burden and inadequate dietary sources and intake of
iron. Prevalence of anemia is highly associated with wealth ranking, being lowest in the upper
wealth quintiles. The UDHS 2006 supplemental study correcting for infection determined that
almost all children had iron deficiency (ORC Macro. UDHS, 2006). It also shows that 88 percent
of women had iron deficiency, with or without anemia. About 55 percent of women had iron
deficiency without anemia, while 32 percent had IDA. Only 5 percent of women had anemia
with no iron deficiency. Similarly, almost all children under 5 had iron deficiency, with or
without anemia. About 28 percent of children had iron deficiency without anemia and 70 percent
had IDA. Only 1 percent of children had anemia with no iron deficiency.
2.2.6 Zinc Deficiency
Although limited data exist, given the kind of food staples in most of Uganda, zinc deficiency
could be a potential public health problem. The prevalence of zinc deficiency has been estimated
to range between 20 to 69 percent in children and 21 to 29 percent in adults (Srinivansan, 2007).
The efficacy of zinc as adjunct therapy in the treatment of severe diarrhea. Low zinc levels
among children might have some bearing on the high rates of stunting among young children in
Uganda. WHO recommends that all children with severe diarrhea who are seen at a health
facility be provided with zinc supplementation (Dehbozorgi et al., 2007).
regional level occurs when the nation/region is able to command enough food to meet the
aggregate requirements of its people. In this context attention is paid to fluctuations in aggregate
19
food supply. However, adequacy at the aggregate level does not necessarily ensure adequacy at
the household or individual level. This has redirected focus on food security from macro level
towards the household and still further towards the individual (FAO, 1996). Food security is
therefore a broad and complex concept. It is determined by the interaction of a range of agrophysical, socioeconomic, and biological factors. There is no single direct measure of food
security. It is generally accepted as entailing not only food availability (adequate supply of food)
but also food access through home production, purchase in the market or food transfer. It also
includes food utilization, which refers to the appropriate biophysical conditions (good health)
required to adequately utilize food to meet specific dietary needs (FAO, 2003). Effective food
utilization depends to a large extent on knowledge of food storage and processing techniques,
basic principles of nutrition and proper childcare, and illness management within the household
(FAO, 2003; Bonnard et al., 2002; USAID, 1999).
20
reduced wages and rising food prices appear to be factors in the prevalence of food security.
Overall, low wages and incomes, dependence on agriculture and lack of diversification in
livelihood activities appear to be factors that reduce food security (CFSVA, 2009)
21
CHAPTER THREE
3.0 METHODOLOGY
3.1
The study was conducted in three districts of Uganda which included Nakasongola, Kamuli and
Apac. These districts represented 3 of Ugandas agro-ecological zones namely: the bananacoffee system, the banana-millet-cotton system and the northern system respectively. They
therefore represented agro-ecological diversity in the country.
3.1.1 Apac
Apac is located in Northern Uganda. It is bordered by Oyam District to the northwest, Lira
District to the northeast, Dokolo District to the southeast, Amolatar District to the south,
Nakasongola District to the southwest and Masindi District to the west. The main economic
activity in Apac district is subsistence agriculture. The major crops grown include tobacco,
cotton, simsim, maize, beans, sunflower, potatoes, cassava and ground nut. Fishing and livestock
husbandry are also important economic activities. The topography of Apac is characterized by
low plains and rolling hills. The vegetation is predominantly of the dry savannah type. The soils
consist of a reddish-brown layer of clay loam which covers almost all cultivable land (90 per
cent) and is very suitable for rain-fed agriculture. Apac has dry and wet seasons. The wet season
extends from April to November with a total annual rainfall of 1,330 mm. On average, the
maximum temperature is 29 and the minimum is 17. Apac population estimate is 490,688
people with population density of 106 persons per km2 (2007 estimates).
3.1.2 Kamuli
Kamuli district is located in southeastern Uganda. It lies at average altitude of 1083m above sea
level and extends from latitude 00- 56 N /330-05 E to longitude 01- 20 N /330- 20 E. Kamuli
covers an area of 4,348km2 of which 3332km2 is land and 1016km2 (23%) is water. The
predominant vegetation cover in the district is the forest/ savannah type of mosaic consisting of a
mixture of forest remnants and savannah trees with grass and shrubs. Much of it is secondary
22
vegetation that has succeeded the original forest cover as a result of farming, fuel harvesting and
other forms of land use. Kamulis population is estimated at 662,407 people and the population
density is approximately 236 persons per sq km (2007 estimates). The district experiences a
bimodal type of rainfall with peaks in March June as well as August November. The annual
average rainfall is 1350 mm; while the monthly mean is 75 mm to 100 mm. Kamuli is a warm
district with average annual temperature range in most areas of 19 C 25C. Livestock
husbandry, fishing and subsistence crop farming are the major economic activities in Kamuli.
Crops grown include potatoes, rice, beans, bananas, maize, millet, vanilla, coffee, cocoa, cotton,
groundnuts, citrus fruits, mangoes.
3.1.3 Nakasongola
Nakasongola district is located in Central Uganda. It boarders with the districts of Masindi in the
West and North West, Luwero and Nakaseke in the south, Kayunga in the east, Amolatar in the
north east and Apac in the North. The district covers an area of 3424 sq km representing about
1.42% of the countrys total surface area. Nakasongola is generally flat area topographically
adulating between 3800ft above sea level. Much of the low lying areas are drained by seasonal
streams into Lake Kyoga in the North, and has tributaries to rivers like Sezibwa in the east,
Lugogo on the west, south and Kafu on the north western. The District is mainly covered by
Bululi soil catena, and the Lwampanga catena in the low lying areas and valleys. Vegetation
type is mainly open deciduous savannah woodland with short grasses. Dominant tree species
include cumbersome ssp, Terminala and Acacia. Nakasongola receives rainfall ranging from
500-1000mm per annum. There are two rain seasons. The main seasons occur in march-AprilJune/July and October to Nov/Dec. It is estimated that the population of Nakasongola District is
approximately 156,200 (2009 estimates). Subsistence crop production and livestock husbandry
are the main economic activities in Nakasongola district. The main crops grown include cassava,
maize, sweet potatoes, sorghum, bananas, millet, coffee and cotton
23
24
3.2
The study followed a cross-sectional block design, covering 3 districts and a total of 9 subcounties purposefully chosen to represent area variation. Pretesting the questionnaire was done
to improve the reliability and accuracy of the tools. Pretested Structured questionnaires were
used to obtain data from 420 households. Out of each of the selected districts, the farmers that
belong to VEDCO (a leading NGO that supports farmers in the study area) were organized into 7
separate strata i.e. farmer groups. Each stratum/farmer group was then sampled as an
independent sub population, out of which individual farmers who had children aged 6-59 months
were randomly selected. From each of the selected Farmers, base line information regarding
nutrient intake, nutrition knowledge, food insecurity indicators, amaranth production and
consumption were collected. Cross tabulations between the nutrition related data and household
demographics were then made.The Snowball Sampling Method was used to select sites and
participants in the collection and evaluation of baseline data relating to Grain Amaranth
utilization through one on one interviews The results from the 2 surveys were used to design
recipes (using a participatory approach) to cover the nutrient intake gaps. Since maize, cassava,
rice, beans and wheat are major staples in all the study areas, these were chosen to act as bases
for complementation by combining them with identified nutrient rich foods. (Sesame, soybeans,
groundnuts and ginger). Particular foods were combined with grain amaranth in different ratios.
Mass balance was used to determine the ratio of ingredients required to achieve recommended
USFDA theoretical nutrient levels. Traditional preparation methods were then used to produce
different food products. The developed products (39) were subjected to a nine-point hedonic
scale sensory analysis using untrained panel of 54 to determine acceptability. The best ranking
products (17) were analyzed in the laboratory to confirm that they were fit to be used in bridging
the identified nutrient intake gaps. The tested best ranking recipes were further subjected to trials
and evaluation by 21farmer groups (within the study area) using group interviews entailing a
5point hedonic scale to determine their acceptability and assess applicability. The basis of this
design was therefore to have recipes/products that are nutritious, affordable, sustainable, well
balanced and worth because the intended /target consumers preferred them.
25
3.4
The instrument for data collection were interviewer-administered questionnaires which was
divided into four major groups according to the study objectives; the first questionnaire was to
collect information on nutrition and food security, the second was to collect the baseline grain
amaranth recipes, the third questionnaire entailing the 9 point hedonic scale was for sensory
evaluation and ranking of products by panelists and the last questionnaire was to evaluate both
the products and recipes by the target farmers in the field. Interviewer-administrated
questionnaires were preferred to other types of instruments because a higher completion rate was
expected. Open ended and closed ended questions were used, to obtain information about
specific aspects outlined by the researcher as well as unanticipated views from respondent
26
(Kabali &Mwesigye, 2003). A 5 point hedonic scale was used during the group interviews to
establish acceptability by ranking the products and recipes.
The questionnaires were tested for its reliability during the pre-testing exercise. Twenty farmers
were selected from Apac, Kamuli and Nakasongola who were interviewed twice by the
researcher using the same questionnaire. The interval between the interviews was two weeks.
Two weeks were appropriate because it is anticipated that the respondent would have forgotten
the previous response. This was meant to check for the consistency of the responses given by the
same respondents during the two interviews. When the results were correlated, reliability
coefficients ranging from0.57 to 0.68 were obtained. Hence the questionnaires were considered
reliable for data collection, as the reliability coefficients were reasonably high.
3.4.1 Data Collection
The average length of the questionnaire interview for objective one (first questionnaire) was 45
minutes. For each district, data were collected for a period of four days. The major problems
encountered during the fieldwork included: resistance of respondents to reveal exactly what they
ate and the assets they owned for fear that it could be a government plan to impose taxes. This
had a potential to impact on data quality but the well trained enumerators assured the
respondents that data collected was to be held in a confidential manner and that the survey was
done for the sole purpose of determining how best grain amaranth could contribute to the diets of
the households. High data quality was also maintained in the field by spot checking
questionnaires in order to determine their completeness and consistency.
3.5 Food Security Assessment
This entailed determination of diet quantity (i.e. number of meals consumed by the household),
dietary diversity and quality (recall period-24 hours), food consumption scores (recall period-7
days), weekly consumption patterns, asset ownership and average crop yield/output per
household.
27
After collecting data on the HDDS for every H/H, the average HDDS for the Households under
the survey was calculated using the formula below;
28
29
the appropriate weight as indicated in Table 5. The weights were assigned based on the nutrient
density of the food groups. The highest weight was attached to foods with relatively high energy,
good quality protein and a wide range of micro-nutrients that can be easily absorbed. All the
scores were summed up to give a Food Consumption Score (FCS). The FCS were used to set the
thresholds for Food Consumption Groups (FGCs) based on the frequency of the scores.
No.
1
Food
Weight
Groups
Maize , sorghum, , wheat, Rice, millet, cassava, potatoes, yams, Staples
Pulses
leafy greens, egg plants, Bitter tomatoes, Pumpkin, Tomatoes, onion, Vegetab
green pepper, cabbage, Mushrooms, carrots
3
1
les
Beef, goat, mutton, pork, poultry, eggs, liver, offals, white ants, Meat
Grasshoppers, and fish(Nile perch, Tilapia, Mukene, Nkejje, Cat and fish
fish)
6
Milk
Sugar
0.5
Vegetable oil, animal fats (ufuta, mukwano, kimbo, cowboy, blue band)
Oil
0.5
30
Profiles
0-21
Poor
Food insecure
21.5-35
Borderline
Vulnerable
> 35
Acceptable
Food secure
Wealth Category
0-3
Asset poor
4-8
Above 9
Asset rich
31
The NQI was the ratio of its percentage standard relative to the standard of calories. In other
words, if a given food contained X mg of a nutrient in C kcal and the US RDA for that nutrient
was mg of a nutrient in C kcal and the US RDA for that nutrient was Y mg in 2000 kcal, then
NQI values 1.0 were desirable
US THRESHOLDS
Macro Nutrients
Proteins
50g
Fiber
25g
Fat
65g
Vitamins
Thiamine
1.5mg
Riboflavin
1.7mg
Niacin
20mg
Vitamin C
60mg
Minerals
Calcium
1000mg
Zinc
15mg
Iron
18mg
Energy
2000Kcals
Source: 1999 - 2002 Dietary Reference Intakes, Institutes of Medicine 2005 Dietary Guidelines
Children's Nutrition Research Center at Baylor College of Medicine
32
Only children above six months were assessed for MUAC. The measurement was taken on the
left arm, halfway between the shoulder and the elbow. MUAC was recorded to the nearest 0.1
cm.
Table 9: Nutritional status cut-offs points for MUAC
MUAC
Diagnosis
< 11cm
Severe malnutrition
Moderate malnutrition
13.5 cm
Source: MOH
3.8 Morbidity
Any episodes of diarrhea, fever/malaria and vomiting occurring in the two weeks preceding the
assessment among children aged 6-59 months were recorded. This allowed for morbidity
patterns to be assessed within a short time frame to account for appropriate recall periods. The
prevalence of diarrhea, fever and vomiting were estimated from the number that reported cases
of illnesses over the last 2 weeks prior to the assessment.
Nutrition related knowledge and practices of mothers and caretakers with regard to feeding of
children (6-59 months) was determined through one on one interview using the questionnaire
(appendix 1)
3.9 Practices
Two of the core feeding practices that affect the nutrient intakes of infants and young children
(6-23 months old) were determined according to WHO, 2010 - Indicators for measuring Infant
and Young Child feeding practices part 2.
33
Formulation of grain amaranth recipes to target identified nutritional gaps was done by:
3.10 Identification of Grain Amaranth Recipes Used By Communities
The Snowball Sampling Method, targeting persons already utilising grain amaranth within the
study areas, was used to select participants in the collection and evaluation of data relating to
grain amaranth utilization, recipe and product development. The participants were interviewed
using a one on one approach to identify the grain amaranth recipes they use.
Figure 2: Farmers in Nakasongola (left) and Kamuli (right) districts being interviewed on how
they utilized grain amaranth at their households during the baseline recipe collection exercise
34
3.11
Based on the baseline survey which sought to determine the current nutrient intakes, the
identified nutrient intake gaps included calcium, zinc, iron, fats and niacin. Table 10, show
locally produced foods identified to enrich products with the nutrients identified to be
deficient in the diets in the study districts.
Table 10: Foods identified to fill identified dietary gaps for Apac, Kamuli and Nakasongola
districts
Nutrients
Zinc
Iron
Calcium
Niacin
Lipids
Foods
Sesame, soybeans, groundnuts, ginger
Sesame
Sesame, soybeans
Peanut, millet
Sesame, soybean
Since maize, cassava, rice, beans and wheat are major staples in all the study areas, these were
chosen to act as bases for complementation by combining them with identified nutrient rich
foods. All these foods were combined with grain amaranth in different ratios.
Mass balance was used to determine the ratio of ingredients required to achieve recommended
USFDA nutrient levels. Traditional preparation methods were then used to produce different
food products. The developed products were subjected to a nine-point hedonic scale sensory
analysis using panels of 54.The best ranking recipes were further subjected to trials and
evaluation by farmers using group interviews entailing a 5point hedonic scale determine their
acceptability and assess applicability. The final formulations used for the different food products
are provided in Table 11. Figures from the USDA Nutrient Database in appendix 7 were used in
the recipe formulations.
3.12 Pre-processing and preparation of Materials
3.12.1 GA Winnowing and Cleaning
Before further processing and use in recipe formulation, GA was cleaned to remove sand and
debris using winnowing methods traditionally used for finger millet grain.
35
36
saucepan on very low charcoal fire. The roasting stopped when grain started popping, giving off
sweet aroma and becoming firm when pressed. The roasted grains were cooled and kept in a dry
plastic container. The roasted grains were used directly in recipe formulations or ground into
flour using a domestic mortar and pestle.
3.12.7 Groundnut Roasting
The groundnuts were roasted over very low charcoal fire. The roasting stopped when they
became crunchy. The roasted nuts were cooled and kept in a dry plastic container.
3.12.8 Cassava Flour Processing
Fresh cassava roots were washed, peeled and chopped into chips. The chips were sundried for
five days and then ground into flour using a mortar and pestle. The resultant flour was sieved.
3.12.9 Other Ingredients and Materials
Materials such as maize flour and other materials were obtained in shops and markets.
Table 11 Formulation used for producing the seventeen grain amaranth containing food
products
Food products
Preparation method
proportions
Chapatti
salt (15g)
Baggia
37
Sesame balls
sugar (250g)
Creamy soup
(7g), ginger (3g), tomato puree tomatoes and spices were added and mixed
(184g), onion (40g) and
margarine (36g)
38
evaporate.
porridge
grain
amaranths
molten
milk(200mls),porridge
flour(60g),sugar (34g)
Rice porridge
flour(3kgs),Popped grain
amaranth flour (3kgs)
To make porridge: Porridge
flour(100g),fresh
milk(500ml,Fresh
water(1000ml),sugar(125g)
39
stirring.
flour(3kgs),Roasted grain
amaranth flour (3kgs)
To make porridge: Porridge
flour(100g),fresh
milk(500ml,Fresh
water(1000ml),sugar(125g)
Millet
porridge
stirring.
Ingredients hand mixed in a clean dry
saucepan
flour(3kgs),Roasted grain
amaranth flour (3kgs)
To make porridge: Porridge
flour(100g),fresh
milk(500ml,Fresh
water(1000ml),sugar(125g)
Peanut sauce
stirring.
To make the sauce flour mix: Ingredients mixed in a clean dry plastic
Grain amaranth leaf
container.
powder(2400g),Peanut
flour(12kg)
The sauce flour mixture was added to fresh
To make the sauce: Fresh
water(250ml),sauce flour
mix(120g),salt (2g)
Bean Sauce
water(3liters),popped grain
amaranth flour(100g),
salt(30g),curry
powder(3.5g),grounded pilau
40
Masala (2g),grounded
ginger(17g),grounded
onion(43g),margarine(36g)
Preparation of product
was
done by
pounded ginger
with
transparent
polythene
to
of
product
was
done
by
Popped G.A flour were mixed The flours were mixed in a flour blender and
in a ratio of 2:1:1 respectively the mixture used in preparation of stiff
(i.e. 12000g: 6000g: 6000g) porridge using the conventional method.
Water: flour =2:1
Ginger Masala
41
powder
water
methods
Sesame-
Roasted sesame(1000g)
peanut paste
snack
Decorticated beans(300g),
water, popped grain amaranth
flour(300g), salt(30g),curry
powder(3.5g),grounded pilau
Masala(2g),grounded
beans
(soaked
overnight)
ginger(17g),grounded
onion(43g),margarine(36g)
42
ash, crude
fat
and
crude
protein
were determined by oven method, hot furnace, Soxhlet and Kjeldahl (N x 6.25) methods
respectively. Carbohydrates were estimated based on the nitrogen free extract and energy was
derived based on the energy values of the macro-components.
The dietary fiber content of the foods was determined by the method described by Kirk
and sawyer (1991). About 0.5g of the sample was weighed into a 600ml flask, 50 ml of acid
detergent fiber were added and the mixture boiled for 1 hour. The mixture was then filtered over
a Buchner funnel connected to a vacuum pump using a sinter glass. The sinter-glass
crucibles were taken to the oven maintained at 100 C for 45 minutes to drive off the
moisture. Dietary fiber was obtained as the difference between the weight of the empty sinterglass and that after removal from the oven. The food content of iron (Fe) and zinc (Zn) were
determined using Atomic Absorption Spectrophotometer, Perkin-Elmer 2380 (A.O.A.C., 2000).
The flame photometer was applied for calcium (Ca) determination according to the method
described by Pearson (1976). All values were expressed in mg/100g of sample.
43
44
CHAPTER FOUR
RESULTS AND DISCUSSIONS
4.1. Characteristics of respondents
Most (89.5%) of the respondents were females (Table 12). This is consistent with the fact that
most child caregivers are normally female. Most of the respondents (80%) were married. The
majority of the respondents (79.58%) assessed were aged 18-49 years. A total of 88.6% of the
respondents had attained some education. Subsistence farming was named as the main
occupation for 92.1% of the respondents.
Table 12: Socio-demographic characteristics of respondents
Percentage
Socio-demographic
characteristic
Option
Nakasongola Kamuli
Apac
Mean
Male
7.1
7.86
16.55
10.5
Female
92.9
92.14
83.45
89.5
<18
2.1
1.43
1.18
18-49
68.1
81.43
89.2
79.58
>49
29.8
17.14
10.8
19.24
Expectant/pregnant mother
2.13
15.71
6.47
8.1
Lactating/Breastfeeding mother
29.8
31.43
25.9
29.05
5.67
1.43
15.83
7.64
62.4
51.43
51.8
55.21
None
9.93
15.7
8.63
11.42
Primary
73.05
62.9
59
65
Secondary
15.6
20.7
26.62
20.97
Tertiary
1.42
0.7
5.75
2.62
Trader
1.4
8.63
3.34
Salaries worker
3.6
5.04
4.55
Main occupation
Subsistence farmer
95
95
86.3
92.1
Marital status
Single
2.8
10.1
5.97
Married
75.2
79.1
53.1
Sex
Age(years)
Physiological state
Education level
attained
45
Household size
Divorced/separated
7.1
86.4
6.5
33.33
Widowed
14.9
3.6
4.3
7.6
4,small
22.7
20.7
20.9
21.43
2-5, moderate
35.5
43.6
38.8
39.3
8-10, big
32.6
26.4
32.4
30.47
9.2
9.3
7.9
8.8
Nakasongola
Kamuli
Apac
Mean
2.84%
2.14%
0.72%
36.17%
18.57%
48.92%
39.01%
20.71%
49.64%
56.03%
72.14%
50.36%
4.25%
7.14%
0%
3.80%
0.71%
0%
0%
0.24%
60.99%
79.28%
50.36%
63.54%
Total
100%
100%
100%
100%
2%
34.50%
36.50%
59.50%
46
had less than three meals a day. Kamuli and Apac districts had households having HDDS from
as low as 1 to12. Each of these extreme cases contributed 0.7%.
Table 14: Household Dietary Diversity Score (HDDS)
HDDS
Percentage of households
Nakasongola
Kamuli
Apac
Mean
1.43
0.72
0.7
2.1
2.14
5.04
3.1
5.5
6.43
3.6
5.2
12.1
7.14
6.5
8.6
15.6
12.14
11.5
13.1
21.3
24.3
18.7
21.4
56.6
53.8
46.1
52.2
23.4
21.4
19.4
21.4
11.3
15.7
11.5
13
2.8
6.4
9.35
6.2
10
4.96
1.4
10.79
5.7
11
0.71
0.71
1.44
0.9
12
0.71
1.44
0.7
43.4
46.2
53.9
47.8
4.4
The food groups least eaten by the respondents households were pulses (1.2 days a week), meat
(0.7 days a week) and milk (0.2 days a week) while those most frequently consumed included the
staples (5.4 days a week), vegetables (4.6 days a week) and fruits (3.9 days a week) (Table 15).
The results reveal that most of the households had a limited dietary diversity. Starchy foods,
fruits and vegetables formed the bulk of the diet for most households. Such diets may not
provide the adequate amounts of all the required nutrients and this would contribute to
malnutrition. Furthermore, results indicate that there was limited consumption of protein
containing foods. The protein foods consumed were mainly of plant sources which provide low
quality proteins compared to animal sources.
47
Table 15: Weekly consumption of food groups in Nakasongola, Apac and Kamuli
FOOD GROUPS (FREQUENCY OF WEEKLY CONSUMPTION)
DISTRICT
Staples
Pulses
Vegetables
Fruits
Meat
Milk
Sugar
Oil
Mean
Nakasongola
5.4
1.4
4.8
0.6
0.02
2.7
1.8
28.33
Kamuli
5.3
0.8
5.2
3.4
0.7
0.1
4.3
28.56
Apac
5.5
1.3
4.6
3.6
0.7
0.04
3.6
3.2
29.42
5.4
1.2
4.6
3.9
0.7
0.2
3.5
2.7
28.77
ALL
DISTRICTS
4.5
The results indicate that the majority (80.7%) of the households surveyed in all the 3 districts
generally did not consume an acceptable diet, based on the FCS (Figure 3). The diets for 19% of
the households were in the poor category while 61.7% were at the borderline with FCS mean of
28.4. Only 19.3% of the total households surveyed were in the acceptable group of food secure
households with a mean FCS of 41.5. Nakasongola district had the highest percentage of
households (19.8%) in the acceptable food consumption group while Kamuli had the lowest
percentage (18.7%) of households in the same group. The mean Food Consumption Score for all
the three districts was (28.77%). This falls under the borderline profile of food security.
48
A chi square test (p = 0.039, odds ratio=4) indicated that children from households with a low
food consumption score (<35) were more likely to be malnourished than those from households
with an acceptable food consumption. The significant association between child malnutrition and
food consumption score of the households seems to suggest that there may be no preferential
treatment for children over adults.
4.5.1Consumption of Food Groups (the day preceding the survey)
The food groups that were widely consumed included: Roots and tubers and bananas (92.1%),
while the groups least eaten included eggs (5.2%) and milk (1.9%). The animal protein foods
were generally not widely consumed by households (Figure 4).
4.5.1.1Consumption of Grain Amaranth
A mean of only 10% of the household surveyed consumed grain amaranth in the 24 hours
preceding the study. This shows that promotion of grain amaranth within the communities is
required for significant nutritional benefits to be recorded. Apac district consumed grain
49
amaranth most (16.5%) of H/Hs, Kamuli district (10%) while Nakasongola consumed least
(3.5%) of H/Hs.
Figure 4: Food groups consumed by farmer households in Nakasongola, Kamuli and Apac
districts based on 24 hour recall data
50
51
Maize (60%), sweet potatoes (56%) cassava (52.38%) and beans (42.14%) were the most
common crops grown by the households (Table 16). This information was useful in designing
grain amaranth recipes. Those least grown included; onions (0.24%), cotton (0.24%), coffee
(0.48%) The accessibility to agricultural land implies that with adequate farming inputs, most of
the households may be able to achieve food security. The average harvest of grain amaranth per
household (based on the households which reported grain amaranth production) was found to be
only 0.6 bags). This also implies that promotion of grain amaranth within the communities is
required for significant nutritional benefits to be recorded.
Table 16: Yields & Average crop output per household in the target communities
Total land(acreage)
Total yield(bags)
CROP
Households (%)
Amaranth
2.25
25.2
0.6
Matooke
2.5
30
0.071
0.95
Beans
172.01
342.805
0.816
42.14
Cassava
196.6
2495.76
5.942
52.38
Yams
1.125
21.5
0.051
0.95
Coffee
0.75
0.019
0.48
Cotton
0.5
0.007
0.24
G. nuts
18
67
0.160
6.43
Maize
310.85
1163.45
2.770
60.00
Millet
34.75
97.75
0.233
10.50
Onions
0.016
0.24
Peas
10.25
19
0.045
2.14
S. potatoes
194.65
2471.695
5.885
56.00
Rice
4.5
33.5
0.080
1.43
Simsim
45.0625
125.5
0.299
11.00
Soya beans
3.06
7.5
0.018
1.20
Sun flower
0.005
0.24
52
Tomatoes
1.5
11.75
0.028
0.71
Sorghum
1.5
0.004
0.24
The average land per household was 3.9981 acre. This land can be put to great use if Grain
amaranth is to be considered, because its high yielding and does not take a lot of space.
Grain Amaranth is not grown as a major crop in the three districts of study. The average acreage
used for grain amaranth production was found to be 0.28 acres. A small proportion of
respondents in Kamuli (2.0%) and Nakasongola (1.6%) districts considered grain amaranth one
of the major crops they grew. The average crop output per household is low for all crops. In
particular G.A output of 0.6 bags is still very low.
4.9 Nutrition Status for Children Using MUAC
The households which had children (6-59 months) were 317, within these households, a total of
434 children in the same age bracket were assessed. No case of severe malnutrition was
recorded, based on MUAC, while moderate malnutrition was 22%. The proportion of children at
risk of being malnourished was 7%.
Chi-square test (p = 0.048, odds ratio=2.5) revealed that the children whose mothers/caregivers
had no formal education were more likely to be malnourished compared to those whose mothers
had attained formal education. This is consistent with other studies (Smith et al., 2002;
Quisumbing et al., 2001; Quisumbing, 2003) which have identified mothers/caregivers education
level as a major determinant of children nutrition status. Therefore it is possible that the
relatively low level of mothers/caregivers education among the study respondents was a
contributing factor to the relatively poor nutritional status of their children.
Children from households with poor diet were more likely to be malnourished compared to those
from households with an acceptable diet according to a chi square test (P=0.036, odds ratio=4).
The poor dietary diversity coupled with limited consumption of proteins could explain the high
levels malnutrition among children 6-59 months.
53
Kamuli (%)
Apac (%)
Mean (%)
2.3
9.6
0.9
4.4
20.2
22
17.4
19.3
14
20.8
18
30.7
18.4
22.6
23.3
4 groups
60.3
62.2
66.3
63.1
26.1
23.7
13
20.5
6
7
10.2
3.4
7
3.5
6.9
5.2
7.9
4.1
2.6
5.2
2.8
3.4
1.6
>4 groups
39.7
37.8
33.7
36.9
Total
100
100
100
100
Figure 6: Percentage of food groups given to children (6-59 months) in Kamuli, Nakasongola
and Apac
4.12
Morbidity
Out of the 434 children within the study respondents households, 62.67% had experienced
diarrhea, vomiting or fever in the 2 weeks preceding the study (Table 18). Fever was the most
prevalent ailment reported for 33.64% of the children. These ailments can negatively affect the
nutritional status of the children by either lowering appetite thereby causing low dietary intake or
causing mal absorption leading to low utilization and nutrient intake
Table 18: The prevalence of ailments affecting nutrition status of children in the target
communities
Disease
No. of Children
Percentage
Diarrhea
86
19.8
Vomiting
40
9.22
Fever
146
33.64
55
272
62.67
No ailment
162
37.33
434
100
4.13
Nakasongola had the highest average energy intakes (2125.1Kcals) while Kamuli had the lowest
energy intakes (1861.1Kcals). Overall the mean intake for the 3 districts was 2001.4Kcals which
meets the US set standard of 2000Kcals (Dietary Reference Intakes for Energy, Carbohydrate.
Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (2002/2005)). Only Kamuli
district had mean energy intake lower than the standard USRDA of 2000 Kcal. The Food and
Agriculture Organizations Food Balance Sheets estimate Ugandas average per capita dietary
energy availability at 2,380 kcal per day, well above Ugandas computed minimum per capita
daily energy requirement of 1,700 kcal per day (FAOSTAT, 2010).This implies the three are
above the Ugandas computed minimum energy requirement but rather lower than the FAO
estimates.
Figure 7: Average Energy Intakes of the target districts the day preceding the assessment
4.14
Nutrient Intakes
Based on the NQI values, the nutrients that were deficient in the diets of the respondents were
fats, thiamine, niacin, calcium and zinc (Figure 8). Fat intake was low probably because in the
56
rural setting vegetables which are widely used as sauce are simply boiled in water without any
fat added. While the NQI for iron was above 1(1.08), the intake for a large proportion (74.1%) of
the respondents was below the recommended level (Figure 9), showing a need for dietary iron
enrichment. The NQI for proteins was 1.23 indicating that the respondents were not deficient in
proteins. However, it should be noted that most of the proteins consumed were of plant origin an
indication that they were low quality proteins. The protein quality could be boosted by
incorporation of grain amaranth which is more balanced than most other plant source proteins.
Fiber and vitamin C intake were exceptionally high. This may be attributed to seasonal fruit
harvest peaks.
57
Figure 9: Distribution of study population based on adequacy of the intake of the different
nutrients
58
IDDS GROUP
FREQUENCY
PERCENTAGE
6 to 23
67
41.6
>4
94
58.4
161
100
98
62.8
>4
58
37.2
Total
24-59
Total
6 to 59
156
4
200
63.1
>4
117
36.9
317
100
Total
4.15.2 Practice of Giving Solids, Semisolids Or Soft Foods To Children Aged 6-59 Months
In Households
Most of the children were given solids, semi solids/soft foods two (39.4%) to three (39.1%)
times a day. Only 3.7% of children were given the food five or more times the previous day as
recommended by the IYC Feeding guidelines (WHO, 2010). Children have small stomachs and
therefore have to feed on thick (dense) solid food in order for them to benefit from the little
intake. The denser the feed could also imply more nutrient intake for the child.
Table 20: Percentage of number of times that children were given Solids, semisolid or soft foods
No. of times
Frequency
Percentage
22
6.9
125
39.4
124
39.1
34
10.7
2.8
0.9
317
100
59
Frequency
Percentage
273
86.1
44
13.9
Total
317
100
60
Frequency
Percentage
Yes
228
72
No
89
28
Total
317
100
Frequency
Percentage
35
11.04
115
36.28
135
42.59
26
8.2
1.58
0.32
317
100
61
Attribute
Respondents who had about
kitobero
Option
Frequency
Yes
128
40.4
No
189
59.6
317
100
Yes
39
12.3
No
89
28.1
128
40.4
Right
10
3.15
Wrong
29
9.15
39
12.3
28
8.83
2 to 3 times
2.84
0.63
Total
39
12.3
66
20.8
21
6.62
0.32
0.32
89
28.1
Total
Practiced cooking kitobero
Total
Respondent's Knowledge
about Kitobero
Total
Frequency of preparation of
kitobero (in 7 days)
Percentage
Once
Total
62
63
Figure 10: Percentage utilization of grain amaranth in Kamuli, Apac and Nakasongola during
the baseline survey for recipe collection
64
Chapatti
Baggia
Pancakes
Balls
Sauce
Sesame Instant porridge
Millet porridge
G.A Maize porridge
G.A Rice porridge
G.A Cassava meal
G.A Millet-Cassava meal
G.A Rice meal
G.A Tea Masala
G.A Soups
G.A Paste
G.A Snack
Texture
8
8.3
7
8.8
7.3
8.8
7.3
7
7.5
8.5
8
7.5
9
7.5
7
7.8
Flavor
8.3
7.3
8.8
9
7.3
8
8.3
7.3
7.5
8.8
8.8
8.3
8.5
8.3
8.8
8
Appearance
9
8.8
8.3
7.8
9
7.3
8.8
7.3
7.3
7
7.8
8.8
8.3
9
8.3
8.5
Odor
7.5
8
7.8
8
8.5
8.8
7.8
8.5
8.8
8
8.3
7.8
9
7
8.9
8.3
Overall
acceptability
8.2
8.1
7.9
8.4
8
8.2
8
7.5
7.8
8.1
8.2
8.1
8.7
7.9
8.2
8.1
7.3
7.5
7.7
65
G.A Chapatti
GA-Peanut-sesame paste
G.A Baggia
G.A Beans
G.A Pancakes
G.A-Cassava flour
66
According to the panelists, the chapatti, sesame balls, paste, peanut sauce, bean-peanut snack,
and sesame instant porridge products with grain amaranth were preferred to the ones without
grain amaranth (Table 26). Grain amaranth contributed to improvement in flavor, odor and
overall acceptability of all the products.
Table 26: Statistical significant differences of the products with and those without Grain
amaranth
Products
Chapatti
Baggia
Pancakes
Sesame balls
Bean sauce
Sesame Instant porridge
Millet porridge
Maize porridge
Rice porridge
Cassava meal
Millet-Cassava meal
Rice meal
Ginger Masala
Sesame-peanut Paste
Bean-peanut Snack
Peanut sauce
P-value at alpha=0.05
0.037
0.541
0.171
0.038
0.444
0.036
0.146
0.934
0.928
0.983
0.992
0.940
0.997
0.038
0.028
0.013
Statistical differences
significant
significant
significant
significant
significant
significant
The method of preparation of grain amaranth did not significantly affect the sensory properties of
the products (Table 27).
Table 27: Effect of method of cooking grain amaranth on product preference
Product
Bean sauce
Millet porridge
Maize porridge
Rice porridge
Cassava meal
Millet-Cassava meal
Soup
67
Preference
popped
popped
popped
popped
popped
roasted
roasted
P-value at 0.05
0.443
0.998
0.669
0.863
0.802
0.997
0.984
Energy
(Kcals)
460.91
499.81
453.36
441
453.59
Protein
(g)
9.1
8
3.38
11.29
17.05
Fat
(g)
16.41
34.63
38.8
24
4.13
Carbohydrates
(g)
69.2
39
22.65
44.96
87.1
Fiber
(g)
3.8
3.82
2.94
8.11
4.72
Ash
(g)
1.48
2.25
1.8
3.1
6.06
Moisture
(g)
31.2
6.48
24.38
5.43
3.72
Zn
(mg)
1.1
1.25
0.7
3.35
1.26
Fe
(mg)
2.5
1.94
1.8
7.47
3.05
Ca
(mg)
46.6
55
34.8
383
68.1
428.7
394.26
366
400.5
377.55
12.6
12.2
10.25
9.76
9.1
22.49
5.64
5.44
4.22
3.95
43.97
73.7
69
80.9
76.4
12.6
9.07
1.37
1.7
3.18
2.2
2.9
2.7
1.1
2.82
86
85.2
88
89.4
42
3.7
2.87
2.3
1.84
2.1
8.57
7.61
5
3.98
3.94
373.6
86.5
83
84.5
50.75
399.22
388.12
363.24
395.42
9.11
9.76
9.985
0.45
3.95
4.22
7.29
0.54
81.81
77.8
64.4
97.2
8.07
1.19
7.83
0.58
2.7
2.6
4.4
1.25
40.3
45
7.58
90.26
2.12
1.84
3.6
2.6
3.94
3.98
168
8
50.75
84.5
125
17
543
18.39
42.6
21.5
2.76
3.4
2.49
5.45
10.2
603.3
463.7
534
20.15
21.72
29.8
45.2
28.73
10.1
17.5
8.2
3.83 3.23
6
6.9
2.64
3.31
3.65
2.26
82.3
68.1
68
were recorded in the levels of the minerals (Zn, Fe and Ca). Grain amaranth markedly enhanced
the nutrient content for cassava meal. It also generally enhanced nutrient content for maize,
millet and rice albeit to a lower extent. This shows the value of incorporating grain amaranth
in diets dominated by starchy staples. On the other hand, in sesame balls, grain amaranth
incorporation was found to cause a reduction in the levels of all nutrients except protein.
Generally the benefit of incorporating grain amaranth into oil seeds and pulses was lower that
observed for starchy staples.
Table29: Nutrient changes due to grain amaranth incorporation
Grain amaranth product
Chapatti
Baggia
Pancakes
Sesame balls
Bean sauce
Sesame Instant porridge
Millet porridge
Maize porridge
Rice porridge
Cassava meal
Millet-Cassava meal
Rice meal
Ginger Masala
Sesame-peanut Paste
Bean-peanut Snack
Peanut sauce
4.17.5 Contribution of the Developed Products to the RDA of Children Aged 4-8 Years
Sesame-peanut Paste, Bean-peanut Snack, Sesame balls are exceptional products to such a child
because they contribute to at least 20% of RDA for all the nutrients in just one serving. Sesame
balls among the snacks have the highest nutrient contribution for all the nutrients.
Peanut sauce gives the highest contribution towards energy, protein and fat while sesame balls
have the highest contribution towards zinc, iron and calcium (table 30). This is an indicator to
69
show that when such recipes are adopted and practiced in favor of these children, deficiencies of
the nutrients will significantly reduce.
Table 30: Contribution of the developed products to the RDA of children aged 4-8 years
Grain amaranth
products
Typical
Amount
(g)
serving
Energy
Ca
Chapatti
100
1 piece
25.8
47.9
25.2
13.8
25
5.8
Baggia
200
1 packet
55.9
84.2
106.6
31.3
38.8
13.8
Pancakes
100
4 pieces
25.3
17.8
59.7
8.8
18
4.4
Sesame balls
200
4pieces
49.3
118.8
73.8
83.8
149.4
95.8
Bean sauce
Sesame Instant
porridge(flour)
200
1 ladle
50.7
179.5
12.7
31.5
61
17
60
In 1 tumpeco
14.4
39.8
20.8
27.8
51.4
28
Millet porridge(flour)
34
In 1 tumpeco
7.5
21.8
12.2
25.9
3.7
Maize porridge(flour)
34
In 1 tumpeco
18.3
2.8
9.8
17
3.5
Rice porridge(flour)
34
In 1 tumpeco
7.6
17.5
2.2
7.8
13.5
3.6
Cassava meal(flour)
Millet-Cassava
meal(flour)
100
for 1 plate
21.1
47.9
6.1
26.3
39.4
6.3
100
for 1 plate
22.3
47.9
6.1
26.5
39.4
6.3
100
for 1 plate
21.7
51.4
6.5
23
39.8
10.6
Ginger Masala
1tea spoon
1.4
3.7
0.8
3.2
117.6
1.1
Soup
100
1 ladle
22.1
2.4
0.8
32.5
80
2.1
Sesame-peanut Paste
72
2 table spoons
21.9
69.7
47.2
49.1
73.4
54.3
Bean-peanut Snack
200
1 packet
51.8
212.1
91.7
66
73
20.6
Peanut sauce
200
1 ladle
59.7
228.6
139.1
82.8
45.2
17
70
products made using the developed recipes were also found to be highly acceptable by the farmer
groups, with 16 out of 17 scoring 4 on a scale of 5 (Table 32,figure 12). The high acceptability
of both recipe and products shows high potential for increased consumption of grain amaranth
once the recipes are widely disseminated.
Table 31: Farmer rating of grain amaranth containing recipes
Product
Chapatti
Baggia
Pancake
Sesame balls
Soup
Sesame instant porridge
Rice Porridge
Maize Porridge
Millet porridge
Peanut sauce
Bean sauce
Rice meal
Cassava meal
Millet-Cassava meal
Ginger Masala
Paste
Bean peanut snack
Kamuli
4.7
4.5
5
5
3.5
5
4.5
5
5
3.5
4
3.5
5
5
5
4
4.5
Apac
5
4.3
4.5
5
4.5
5
4.5
5
5
4
4
3
5
5
4
4.5
4
Figure 12: Farmers tasting grain amaranth-millet bread during participatory recipe/products
trials and evaluation in Apac district
71
Table 32: Farmer group acceptability scores for different grain amaranth products
Product
Score on 5 point Scale
Kamuli
Apac
Nakasongola
Overall mean
Chapatti
5
5
5
5
Baggia
4.5
4.7
4.5
4.6
Pancake
4.5
4.5
5
4.7
Sesame balls
5
5
5
5
Soup
3.5
4
4
3.8
Sesame instant porridge
5
5
4.5
4.8
Rice Porridge
5
4.5
4.5
4.7
Maize Porridge
4.5
4.5
4
4.3
Millet porridge
4.5
4.5
4.5
4.5
Peanut sauce
4
4
4.5
4.2
Bean sauce
4
4
4
4
Rice meal
3.5
4.5
4
4
Cassava meal
5
5
5
5
Millet-Cassava meal
5
5
5
5
Ginger Masala
5
4.5
5
4.8
Paste
4
4.5
4.5
4.3
Bean peanut snack
4
4.5
5
4.5
72
CHAPTER FIVE
5.0 CONCLUSIONS AND RECOMMENDATIONS
5.1 Conclusions
The current nutrition and food security status of rural households in Kamuli, Apac and
Nakasongola is rather poor and require attention. The factors associated with malnutrition in
these districts included; consumption of monotonous and unvaried diets lacking in most of the
critical micronutrients, insufficient knowledge on how to prepare nutritious/balanced meals more
especially children(6-59 months), Inadequate dietary intakes and high disease burden.
The study showed that amaranth could be combined with a variety of locally available foods to
make highly acceptable products containing enhanced levels of Ca, Zn, Fe, etc, nutrients
identified to be low in diets for people in Kamuli, Nakasongola and Apac districts.
In addition to this, the study demonstrated that grain amaranth has potential to contribute to the
alleviation of malnutrition because the recipes developed through this study were found to
contain enhanced levels of the nutrients previously reported to be inadequate in the diets of the 3
study districts. These recipes have not only been able to fill the nutritional gaps but were found
to be highly acceptable to the farmers in the rural households of Kamuli, Apac and Nakasongola.
Once widely disseminated and adopted, these recipes are likely to markedly contribute to
improved nutrition in the three districts.
This is a clear testimony to Ugandas understanding that tackling nutrition problems will contribute
to the attainment of its broader development goals. The prevalence of malnutrition across a
predominantly agrarian country like Uganda and its potential economic implications indicate the
importance of understanding the link between agricultural productivity and nutrient intake. Such
an understanding will highlight the importance of different nutrients (and nutrient rich foods like
grain amaranth) available across Uganda, thus guiding policymakers in prioritizing and
developing appropriate programs to tackle malnutrition and improve agricultural productivity.
Generally, the study showed that there is a positive potential benefit of incorporating grain
amaranth in the diets of rural households in Kamuli, Apac, Nakasongola Districts and Uganda as
a whole because it significantly contributed to improvement in nutrition and food security
73
5.2 Recommendations
Production of grain amaranth should be encouraged by MAAIF, MOH, and NAADS among
others because of its nutritional values and income generation potential. It requires small plots of
land, implying that the landless can afford to grow it. There is need to promote farmers access
to grain amaranth markets in order to increase the returns on investment, which in turn will
motivate farmers to expand on production and promote local food-grain amaranth recipes.
The dietary diversity of indigenous African leafy vegetables(including grain amaranth), in
addition to providing essential nutrients and micronutrients, may also offer broad health benefits
due to inherent benefits of dietary diversity, reinforcing food cultures, and functional properties
of leafy greens.
The documentation and dissemination of more recipes will not only help diversify diets but will
also give others a chance to enjoy other peoples foods. A number of recipes are on the verge of
being lost as cultural erosion continues.
Many local foods in Uganda have the potential for commercialization but this potential is only
realized (unlocked) after promotion. Promotion of grain amaranth consumption within the
communities by local leaders and village health teams, Community nutrition and health workers
is required for significant nutritional benefits to be recorded.
Programmers that aim to reduce malnutrition in the rural communities should focus on
improving IYCF practices, hygiene & sanitation practices, and reducing disease burden. These
factors can negatively affect food intake which eventually affects nutrition even when nutrient
rich foods like G.A have been promoted. They should also advocate for increased resources for
scaling up nutrition interventions to address the needs of young children and mothers and to create
awareness among the general population of the human, social, and economic costs of malnutrition.
There should be more practical ways of improving diet diversity and increasing the energy and
nutrient density of local diets. Both food-based approaches and micronutrient-specific
interventions will be needed. The scope of such programming must seek to integrate nutrition,
74
gender and livelihood activities, targeting households in rural settings where undernutrition is
higher. Increasing the target populations consumption of diverse nutritious foods should be done by
increasing the production of and access to micronutrient-rich foods like grain amaranth at the
household and community levels
The WFP has been identified as support for food supplementation to IDPS in northern Uganda,
refugees in northern and western Uganda and to the food-insecure Karamoja. The study therefore
recommends that it (WFP) designs a new strategy to include a preventive community nutrition
component like supplementing their diets with nutrient rich foods such as grain amaranth
75
References
A.O.A.C. (2000). Official Methods of Analysis (16th ed). Association of Official Analytical
Chemists. Washington, D. C.
Bahiigwa, A.G.B (1999). Household food security in Uganda: An empirical analysis. Economic
Policy Research Center.
Becker, R., Wheeler, E.L., Lorenz, K., Stafford, A.E., Grosjean, O.K., Betschart, A.A. &
Saunders, R.M. (1981). A compositional study of amaranth grain. Journal of Food Science. 46:
1175 - 1180.Chiles to chocolates: Foods the Americas gave the world. University of Arizona
Dehbozorgi, P., Mohseni,P., & Mazloom,Z.( 2007). The Influence of Zinc Sulfate on the Growth
of School Age Children in Villages around Shiraz 2002, 2003. Journal of Medical Sciences 7(4):
690-3.
Devereux, S., Baulch, B., Hussein, K., Shoham, J., Sida, H. & Wilcock, D. (2004). Improving
the analysis of food insecurity. Food insecurity measurement, livelihoods approaches and policy:
Applications in FIVIMS
Early, D. (1992). The renaissance of amaranth. p. 15-33. In N. Foster and L. S. Cordell (eds.).
Economic Policy Research Centre/Monitoring and Evaluation management Services
(EPRC/MEMS) (2006). Understanding food insecurity in Uganda. USAID Report.
Ellis, A., Manuel, C.& Blackden, C.M. (2006). Gender and Economic Growth in Uganda:
unleashing the power of women. Directions in Development Series. The World Bank.
Ellis, F. (2003). Human Vulnerability and Food Insecurity: Policy Implications. Forum for Food
Security in Southern Africa.
76
Escudero, N. L., Zirulnik, F., Gomez, N. N., Mucciarelli, S. I. & Ginnez, M. S. (2006).
Influence of a protein concentrate from Amaranthus cruentus seeds on lipid metabolism.
Experimental Biological and Medicine. 231: 5059.
Escudero, N.L., Albarracin, G., Fernndez S, De Arellano, L.M. & Mucciarelli, S. (1999).
Nutrient and antinutrient composition of Amaranthus muricatus. Plant Foods for Human
Nutrition 54: 327-336.
FANTA (2000). Potential uses of food aid to support HIV/AIDS mitigation activities in subSaharan Africa. FANTA Project, Academy for Educational Development. Washington, D.C.
FANTA (2002). Dietary Diversity as Household Security Indicator. Technical Note No.4
Academy for Educational Development. Washington, D.C.
FANTA
(2006).
Household
Dietary
Diversity
Score
(HDDS) for Measurement of Household Food Access: Indicator Guide. Version 2. Food and
Nutrition Technical Assistance. www.fantaproject.org (Accessed September 2009)
FANTA (2010). The Analysis of the Nutrition Situation in Uganda. Food and Nutrition
Technical Assistance II Project (FANTA-2), Washington, DC: AED, 2010.
FAO
&
WFP
(1997).
Crop
and
food
supply
assessment
mission
to
Uganda.
FAO (1996).World Food Summit: Rome Declaration on World Food Security, and World Food
Summit Plan of Action. FAO, Rome.
FAO (2003). A Conceptual Framework for National Agricultural, Rural Development, and Food
Security Strategies and Policies. ESA Working Paper No. 03-17.
77
FAO (2003). Sustainable rice production for food security, Proceedings of the 20th Session of
the International Rice Commission, Bangkok, Thailand, 23-26 July 2002, Rome.
FAO (2010). Uganda Nutrition Profile Nutrition and Consumer Protection Division
Gibson, R.S. (2005). Principles of Nutritional Assessment. Second Edition. Oxford University
Press, New York, NY.
Grubben, G.J.H., van Sloten, D.H. (1981). Genetic Resources of Amaranths, Intl. Board for Plant
Genetic Resources, Food and Agric. Org., Rome.
Haas, P.W., Kauffman, C. S. (1984). Grain amaranth: an overview of research and production
methods. Regenerative Agric. Assoc., Emmaus, PA.
Hansen, R. G. (1973). An Index of Food Quality. Nutrition Reviews. 31: 17.
http://www.iufost.org/publications/books/documents/IUFoST_Handbook.pdf.
Haughton, C.S. (1978). Green Immigrants: Plants that Transformed America. Harcourt Brace
Jovanovich, New York.
Horton, S., Alderman, H. & Rivera, A.L. (2008). Copenhagen Consensus 2008 Challenge
Paper:
Kauffman, C. S., Haas, P.W. (1983). Grain amaranth: A crop with low water requirements and
high nutritional value. Environmentally Sound Agric. W. Lo~Keretz: 299.
78
Kauffman, C.S.,Weber, L.E. (1990) Grain amaranth. In: Advances in New Crops, J. Janick & J.E.
Simon (Eds). Timber Press, Portland, Oregon: pp. 127-139.
Kikafunda, JK, AF Walker, and JK Tumwine. (2003). Weaning Foods and Practices in Central
Uganda: A Cross-Sectional Study. African Journal of Food Agriculture Nutrition and
Development 3 (2):1-13.
Kim, H. K., Kim, M.J., D.H. Shin (2006b). Improvement of lipid profile by Amaranth
(Amaranthus esculantus) supplementation in Streptozotocin-induced diabetic rats. Annals of
Nutrition and Metabolism. 50: 277-281.
Kim, H.K., Kim, M.J., Cho, H.Y., Kim, E.U., D.H. Shin (2006a). Antioxidative and anti-diabetic
effects of amaranth (Amaranthus esculantus) in streptozotocin-induced diabetic rats. Cell
Biochemistry and Function 24: 195 199.
Kirk R. and R. Sawyer (1991). Pearsons Chemical Analysis of Foods. Essex: Longman Group
Limited.
Lehman, J. (1988). Carbohydrates of amaranth. Legacy 1: 4-8 Amer. Amaranth Inst. Bricelyn,
M.N.
Martirosyan, D.M., Miroshnichenko, L.A., Kulakova, S. N., Pogojeva, A. V.& Zoloedov, V.I.
(2007). Amaranth oil application for coronary heart disease and hypertension. Lipids in Health
and Disease. 6: 1-12.
Marx, J.L. (1977). Amaranth: A comeback for the food of the Aztecs? Science 198: 40.
McKinney, P. (2009). Comprehensive Food Security and Vulnerability Assessment: Uganda.
VAM Food Security Analysis. Rome: WFP.
Melgar-Quinonez, H. (2004). Testing Food Security Scales for Low-cost Poverty Assessment.
Draft report to Freedom from Hunger.
79
Ministry of Agriculture Animal Industry and Fisheries (MAAIF). (2009). Uganda National Rice
Development Strategy 2nd Draft (UNRDS). Government of the Republic of Uganda.
http://www.jica.go.jp/english/operations/thematic_issues/agricultural/pdf/uganda_en.pdf
Ministry of Finance and Economic Planning (MFEP) Uganda (2004). Poverty eradication Plan
(PEAP) p52. Ministry of Finance and Economic Planning Kampala, Uganda.
Muyonga, J., Nabakabya, D., Nakimbugwe, D. N., D. Masinde. (2008) Efforts to promote
amaranth production and consumption in Uganda to fight malnutrition. Chapter 8. In Using Food
Science and Technology to Improve Nutrition and Promote National Development, ed. G.L.
Robertson and J.R Lupien. IUFoST:
Mwangi, D. (2003). Amaranth as a Promising Crop for Food, Nutrition. Healing and Poverty
Eradication
in
Africa
published
by
the
Jefferson
Institute,
Columbia,
MO,
www.jeffersoninstitute.org
Myers, L. (2010). GRAIN AMARANTH, A Lost Crop of the Americans published by the
Jefferson Institute, Columbia, MO, www.jeffersoninstitute.org
National Academy of Sciences (NAS). (2006) Lost Crops of Africa: Volume II: Vegetables
http://www.nap.edu/catalog/11763.html
NRC (1984). Amaranth Modern Prospects for Ancient Crop. Washington DC: National
Academy Press.
OBrien, G., Kelly & Price, L. (2008). AMARANTH Grain & Vegetable Types, Published by
ECHO. Available at http://www.echonet.org/oil application for coronary heart disease and
hypertension.
Oke, O.L. (1983). Amaranth. oil application for coronary heart disease and hypertension. Lipids
in Health and Disease 6:1. In: Handbook of Tropical Foods, H.T. Chan (Ed). Marcel Dekker,
Inc., New York: p. 1.
80
Okidi JA, McKay A. Poverty dynamics in Uganda: (1992-2000). CPRC Working Paper No. 27.
May 2003.
Opinion Research Corporation Macro International, Inc (ORC Macro). (2006). Uganda
Demographic Health Survey 2006. Supplemental Test Report. Calverton, MD: ORC
Macro.Calverton, MD: ORC Macro.
Quisumbing, A. R. (2003). Household structure and child well-being: Evidence from KwazuluNatal. In Household decisions, gender, and development. A synthesis of recent research, ed. A.
R. Quisumbing. Washington, DC: IFPRI
Radimer, K.L., Olson, C.M. & Campbell, C.C. (1990). Development of indicators to assess
hunger. Journal of Nutrition 120: 15441548.
Railey,
R.
(2008).
Amaranth:
Healthy
Grain
for
Vegetarian
Recipes.
http://chetday.com/amaranth.html.
Saunders, R.M., Becker, R. (1984). Amaranthus: a potential food and feed resource. Adv. Cereal
Sci. Tech. 6: 357-396.
Seinfeld, J. & Beltran, A. (2009) Identifying successful strategies for fighting child malnutrition
in Peru, Research for Public Policy, Human Development, Sheridan Waldron, Nutrition and
81
diabetes: global challenges for children and parents May 2007, Diabetes Voice | Volume 52 |
Special Issue
Singhal, R.S., Kulkarni, P.R. (1990a.) Utilization of Amaranthus paniculatas (Rajgeera) starch in
salad dressing. Starch/Starke 42: 52-53.
Smith, L. C., & Haddad, L. (2000) Overcoming malnutrition in developing countries: Past
achievements and future choices. 2020 Discussion Paper 30. Washington, DC: IFPRI
Smith, L.C & Haddad, L. (2000) Explaining Child Malnutrition in Developing Countries: A
cross-country Analysis International Food Policy Research Institute, Washington, D.C.
Srinivansan, M. (2007). The efficacy of zinc as adjunct therapy in the treatment of severe
pneumonia in children admitted to Mulago Hospital. Masters thesis, Makerere University.
Sseguya, H. (2007). Annual evaluation program report for the Livelihoods Program in Uganda.
Center for Sustainable Rural Livelihoods, Iowa State University, Ames, IA.
82
Tagwira, M., Tagwira, F. Dugger, R., Okum, B. (2006). Using grain amaranth to fight
malnutrition. RUFORUM working document No. 1, pp. 201-206.
Thompson, F. E., Midthune, D., Subar, A. F., Kahle, L. L.,Schatzkin, A., and Kipnis, V. (2004).
Performance of a shorttool to assess dietary intakes of fruits and vegetables, percentage energy
from fat and fibre. Public Health Nutr. 7,10971105.
Uganda Bureau of Statistics (UBOS), Uganda Demographic and Health Survey, (2006).
Uganda Bureau of Statistics (UBOS), Uganda Demographic and Health Survey,( 2011).
Uganda Food and Nutrition Strategy (UFNS) (2005).
Uganda MOH.( 2009). Policy Guidelines on Infant and Young Child Feeding. January 2009.
Page 8.
Uganda Nutrition Action Plan (UNAP) (2011-2016).
UNDP & UNDP/Uganda. (2007). Millennium Development Goals: Ugandas Progress Report
2007. Geneva: UNDP. http://www.undp.or.ug/mdgs/25 (Accessed ). 23rd october, 2012.
United States Agency for International Development (USAID) (1995). Food Aid and Food
security policy paper. Washington, D.C.
83
Food
Von Braun, J, Howarth B, Shubh K, and Rajul PL (1996). Improving Food Security of the Poor:
Concept, Policy and Programs. International Food Policy Research Institute. Washington, D.C.
WHO
(2003).
Guiding
principles
for
complementary
feeding
of
breastfed
child.
http://www.who.int/nutrition/publications/guiding_principles_compfeeding_breastfed.pd.
Accessed 30th April, 2010.
World Bank. (2005). Uganda: From Periphery to Centre A Strategic Country Gender
Assessment. Washington, DC: World Bank.
World Food Programme (WFP) (1999). Recurring Challenges in the Provision of Food
Assistance in Complex Emergencies the problems and dilemmas faced by WFP and its
partners, Ron Ockwell, Office of Evaluation, Rome, Italy.
World Food Programme (WFP) (2002). Food Aid in Conflict. Workshop Report, Division of
Strategy and Policy, Rome, Italy.
World Food Programme, Comprehensive Food Security and Vulnerability Mapping (CSFVA),
(2008)
World Food Programme, Comprehensive Food Security and Vulnerability Analysis, April 2009
World Food Summit definition: http://www.fao.org/wfs/index_en.htm, March 2010.
Zohra Lukmanji & Ellen Hertzmark (2008). Tanzanian food composition tables. Muhimbili
University of Health and Allied Sciences(MUHAS), Dar es Salaam Tanzania andTanzania
Food and Nutrition Centre (TFNC),Dar es Salaam Tanzania andHarvard School of Public
Health (HSPH), Boston, USA
84
APPENDICES
APPENDIX 1: QUESTIONNAIRE FOR DETERMINING THE CURRENT NUTRIENT
INTAKE AND NUTRITION RELATED KNOWLEDGE AND PRACTICES AMONG
HOUSE HOLDS OF FARMERS
Date
Consent form
This baseline survey is aimed at determining the current nutrient intake and nutrition
related knowledge and practices. This is an initiative which will be aimed at alleviating
malnutrition, food insecurity and poverty of resource poor farmers in the districts of Apac,
Kamuli and Nakasongola. Makerere University in collaboration with Volunteer Efforts for
Development Concerns (VEDCO), National Agricultural Research Organization (NARO), and
district authorities is implementing this project.
This questionnaire is meant for farmers in various farmer groups in the districts of Kamuli,
Apac and Nakasongola where the grain amaranth project (09-517) is in operation to promote
production and utilization of grain amaranth for improved nutrition and health in Uganda.
You have been randomly selected among farmers to give us information about the current
nutrient intake and nutrition knowledge and practices at your household where the project will be
implemented. Information collected will help us to better design the Project activities for
households in this area. Your answers will be kept confidential and your participation is
voluntary.
At this point, do you have any questions about the study? Also, in case you have additional
questions after we leave this area, you can contact any of the following numbers: +256-414533865, +256-753481481, +256-701684241
85
Characteristic
Operational area:
1.0: District
1.1:Sub-county
1.2:Parish
1.3:Village
1. Male
2. Female
1.6:
Age
of
Respondents
(years)
2. Primary
3. Secondary
4. Tertiary
86
1. Trader
2. Salaries worker
3. Subsistence farmer
4. Others (specify).
1. Single
2. Married
3. Divorced/separated
4. Widowed
(people)
2. Grand mother
3. Daughter/son
4. House help
5 .Other (specify).
1.13:
Relationship
of
the 1. Mother
3. Sister
4. House help
5.Other (specify)
87
SECTION TWO
2.0 FOOD INTAKE (FOOD FREQUENCY & HOUSEHOLD DIETARY DIVERSITY)FOR WOMEN TO BE GIVEN FIRST PRIORITY.
Please narrate everything that your house hold members ate yesterday during the day or night,
at home.
a) Think about when you first woke up yesterday. Did you eat anything at that time? If yes:
Please tell me everything you ate at that time. Probe: Anything else? Until respondent says
nothing else. If no, continue to Question b).
b) What did you do after that? Did you eat anything at that time?
If yes: Please tell me everything you ate at that time. Probe: Anything else? Until respondent
says nothing else. Repeat question b) above until respondent says the whole household went to
sleep until the next day. If respondent mentions mixed dishes like a porridge, sauce or stew,
probe:
c) What ingredients were in that (Mixed Dish)? Probe: Anything else? Until respondent says
nothing else. As the respondent recalls foods, underline the corresponding food and circle 1 in
the column of YES under Last 24 hours.
If the food is not listed in any of the food groups below, write the food in the box labeled other
foods. If foods are used in small amounts for seasoning or as a condiment, include them under
the MISCELLANEOUS food group.
Once the respondent finishes recalling foods eaten, read each food group where 1 was not
circled, ask the following question Yesterday during the day or night, did you drink/eat any
(FOOD GROUP ITEMS)?
and Circle 1 if respondent says YES fill in the columns for food measure and 2 if NO. For the
columns of food frequency; D=Daily, W=Weekly, M=Monthly, O=Occasionally. Assign 4, 3, 2,
1respectively. Score 0 if no item from the food group is mentioned, Score 1 if any item from the
food group is mentioned Could you please tell me how many days in the past one week (seven
days) your household has eaten the following foods-read out the whole list of foods provided on
the questionnaire (write 0 for items not eaten over the last 7 days)
you=whole household
88
2(b)
FOOD
FOOD MEASURE
Last 24 hrs
FREQUENCY
Last7
days
FOOD
NO.
GROUP
FOOD GROUP
SCORE
YES
NO
ITEMS
QTY
UNIT
D W M O No. Of
days
EATEN
Eaten
last 7
days
ENERGY GIVING
FOODS
A
CEREALS
1
Maize meal(ugali)
Wheat products:
2.1
A.
Kg
4 3
Chapatti
Pieces
4 3
2.2
biscuit
Pieces
4 3
2.3
cookies
Pieces
4 3
2.4
cakes
Pieces
4 3
2.5
Doughnut,
Pieces
4 3
2.6
Spaghetti/macaroni
Packets
4 3
Rice, boiled
Kg
4 3
Millet ugali
Kg
4 3
Kg
4 3
(Kaalo)
5
B
Sorghum ugali
ROOTS
,TUBERS
&
BANANAS
6
Irish Potatoes
Stem tubers 4 3
Orange-fleshed
Root tubers
4 3
Cassava
Root tubers
4 3
Yams(Amayuni)
Root tubers
4 3
10
White fleshed
Root tubers
4 3
Sweet Potatoes
89
11
Matooke
Clusters
4 3
Bundles
4 3
Whole
4 3
4 3
4 3
4 3
4 3
4 3
4 3
PROTECTIVE FOODS
(VITAMINS AND
MINERALS)
C
VEGETABLES
12
13
Egg plants
(Biringanya)
14
Bitter tomato
C.
vegetables
1
(Entula )
15
Pumpkin
vegetables
1
(ensujju)
16
Tomatoes
Whole
Whole
pumpkin
Whole
tomatoes
17
Onion
Whole
onions
18
Green pepper
Whole
pepper
19
Cabbage
Whole
cabbage
20
Mushrooms
cups
4 3
21
Carrots
Whole
4 3
4 3
4 3
4 3
carrots
D
FRUITS
22
Mango
Whole
fruits
23
Passion fruits
Whole
fruits
24
Tangerines
(Mangadda)
Whole
fruits
90
25
Jackfruit (ffene)
D.
26
Pineapples
Whole
4 3
4 3
4 3
4 3
4 3
4 3
4 3
4 3
fruits
1
Whole
fruits
27
Pawpaw
Whole
fruits
28
Apples
Whole
fruits
29
Pears
Whole
fruits
30
Guavas
Whole
fruits
31
Oranges
Whole
fruits
32
Water melon
Whole
fruits
33
Banana (Ndiizi,
clusters
4 3
Whole
4 3
Bogoya).
34
Avocado
fruits
BODY BUILDING FOODS
(PROTEINS)
E
MEAT,
POULTRY,
Beef
Kg
4 3
36
Goat
Kg
4 3
37
Mutton
Kg
4 3
38
Pork
Kg
4 3
39
Chicken
pieces
4 3
40
Turkey
pieces
4 3
41
Kg
4 3
Kg
4 3
E.
(ekibumba)
42
Offals
91
43
Liters
4 3
sheep)
44
White ants
tablespoons 4 3
45
Grass hoppers
tablespoons 4 3
Whole eggs 4 3
EGGS
46
F.
Nile perch
Kg
4 3
48
Tilapia
Kg
4 3
49
Mukene
Kg
4 3
50
Nkejje
Kg
4 3
51
Cat fish
Kg
4 3
Kg
4 3
Kg
4 3
G.
PULSES,LEGUMES AND
NUTS
52
53
Peas(all kinds)
54
Groundnut
Kg
4 3
55
Simsim
tablespoons 4 3
tumpeco
4 3
tumpeco
4 3
H.
I
MILK & MILK
PRODUCTS
56
Cow-milk/goat
milk(powdered/cond
ensed, liquid)
57
Yoghurt(bongo,
ekiviguto)
I.
58
Cheese
tablespoons 4 3
59
Butter
tablespoons 4 3
60
Ghee
tablespoons 4 3
61
Soy milk
tumpeco
LIPIDS
J
FATS AND OILS
92
4 3
62
Oils(Liquid) - any
kind (e.g. Ufuta,
tablespoons 4 3
tablespoons 4 3
Kg
4 3
tablespoons 4 3
J.
Mukwano)
63
Fats(Solids) any
kind( Kimbo,
Cowboy, Blue band)
Sugar
65
Honey
K.
OTHERS
L
MISCELLENIOUS
66
Tea
tumpeco
4 3
67
Coffee
tumpeco
4 3
68
Cocoa
tumpeco
4 3
69
Soda
bottles
4 3
70
Busheera
tumpeco
4 3
L.
GRAINAMARANT
H (G.A)
71
G.A Porridge
tumpeco
4 3
72
G.A meals
tumpeco
4 3
73
G.A paste
tablespoon
4 3
74
G.A snack
handfuls
4 3
75
G.A sauce
ladles
4 3
M.
OTHER FOODS: PLEASE WRITE DOWN OTHER FOODS IN THESE SPACES THAT RESPONDENT
MENTIONED BUT ARE NOT IN THE LIST ABOVE:.
.. .
HDDS for the house hold is/ 13
2(c) which food taboos do you follow most in your area? .........................
93
SECTION THREE
3.0 ASSESSMENT OF INFANT AND YOUNG CHILD (6-59MONTHS) FEEDING
PRACTICES & ANTHROPOMETRY IN THE HOUSE HOLD- This section is meant for
the youngest child in the household who is below 5years but is above 6 months.
DAY.............................|___|___|
(NAME)
is.months/years
94
NO
INTERACTIVE
MONTHS
3
Please describe everything that (NAME) ate yesterday during the day or night, whether at home or
outside the home.
a) Think about when (NAME) first woke up yesterday. Did (NAME) eat anything at that time? If
yes: Please tell me everything (NAME) ate at that time. Probe: Anything else? Until respondent
says nothing else. If no, continue to Question b).
b) What did (NAME) do after that? Did (NAME) eat anything at that time?
If yes: Please tell me everything (NAME) ate at that time. Probe: Anything else? Until respondent
says nothing else.
Repeat question b) above until respondent says the child went to sleep until the next day.
if respondent mentions mixed dishes like a porridge, sauce or stew, probe:
c) What ingredients were in that (MIXED DISH)? Probe: Anything else? Until respondent says
nothing else.
As the respondent recalls foods, underline the corresponding food and circle 1 in the column next
to the food group. If the food is not listed in any of the food groups below, write the food in the box
labeled other foods. If foods are used in small amounts for seasoning or as a condiment, include
them under the condiments food group.
Once the respondent finishes recalling foods eaten, read each food group where 1 was not
circled, ask the following question and Circle 1 if respondent says yes, 2 if no and 8 if dont
know:
Yesterday during the day or night, did (NAME) drink/eat any (FOOD GROUP ITEMS)?
OTHER FOODS:
PLEASE WRITE DOWN OTHER FOODS IN THIS BOX THAT RESPONDENT MENTIONED
BUT ARE NOT IN THE LIST BELOW:
.. .
.. .
. ..
QUESTIONS& FILTERS
CODING CATEGORIES
YES
95
NO
2
DK
8
C.
E.
G.
MEAT,POULTRY,FISH,SEAFOOD
EGGS
Eggs (Ducks, hens)
PULSES/LEGUMES/NUTS
nuts, or seeds
G
any of these
I
I.
How many times did (NAME) eat solid, semi- NUMBER OF TIMES............... |___|___|
4
96
Qty
drinks
1.
1.
2.
2.
3.
3.
4.
4.
Qty
1. Yes
2. No
10. What time does the child normally separately from adults
eat his/her last meal?
1. Yes
2. No
97
Ingredient
Quantity
5
13. Have you heard of kitobero as 1. Yes
applied
to
special
preparation
2. No
of
childrens food?
2. No
6. Other (specify)
1st
2nd
3rd
4th
ingredient
ingredient
ingredient
ingredient
1
2
98
Red
Yellow
Green
Measurement(cm)
Child1
Child2
Child3
Child4
Child5
Child6
Child7
Child8
Child9
YES
Diarrhea
Vomiting
Fever
99
NO
4.2
4.3
4.4
4.5
4.6
4.7
4.8
4.9
4.10
4.11
4.12
4.13
H/h Food
last month
Consumption
Patterns
Food
Acr
Total
Bags
Bags
Bags
Bags
Food
Purchase
Kilos
How
In the
Weeks
eage
No.
curre
sold
used
used
suppl
d food
purc
many
month
last year
(tent
of
ntly
for
for
last
hase
days
after the
in
hs)
bags
in
brewi eatin
17(w
month?
did
harvest,
which
ng
eeks)
1.yes
you
how
you had
(>>4.10)
depe
many
only
2.No
nd on
major
one
(>>4.12)
purch
meals
major
ased
does
meal
food
your
per day
in the
family
last
usually
30
eat per
days
day
16har stora
veste
ge
16. Probe to establish the average amount of food stuff that makes a bag where necessary
17. Food supply means the time a particular type of food stuff takes to get exhausted from the time of
harvest
100
5. HOUSEHOLD ASSETS
5.1
5.2
5.3
Asset Ownership
5.4
5.5
5.6
Animal &Poultry
5.7
5.8
5.9
6.0
Land Ownership
6.1
Land Usage
Ownership
Asset
Owned?
Animal &
Owned?
Poultry
1.Yes
of acres Ownership
(>>5.3)
(>>5.6)
(Tenths13)1.Communal
family Use
2No
2No
2.Customary
(Tenths)
(>>5.4)
(>>5.7)
3.Free Hold
1Yes
Qty
Qty
Acres
Use
rented for
s
(Ten
ths)
4.Lease
5.Kibanja
6.Other-Specify
Radio
Milk
Grain
TV
Cows
Amaranth
Bicycle
Other
Motorcycle
Cows
Perennial
Car/truck
Bulls
14
Oxen
Seasonal
crops
Hoes
Ploughs
15
crops
Wheelbarrow
Pumps/sprays
Sheep/
Goats
Storage shade
Other(spe
cify)
Animal
Pigs
buildings
Building for
Chicken
h/h business
Other(specify)
Turkeys
Others
(Specify)
seasonal crops is useful because the asset value for land with trees is likely to be higher than the
value for the other land. Perennial crops (e.g. tea, coffee, fruits, etc.)
maize, cassava, sweet potatoes, cotton etc)
101
Acre
Information:
You have been purposefully selected as an experienced woman farmer (in the area of grain
amaranth preparation/ cooking) to participate voluntarily in the development of G.A based
recipes. Information collected will help us to design and document the recipes and protocols.
We all know that grain amaranth has the potential to contribute to the improvement of the
nutritional status of vulnerable populations such as children and the sick. By developing recipes
of a variety of amaranth-based products, consumption of grain amaranth can be increased beyond
non-producing communities. Later on Promotion of the value-added products can also contribute
to expanding the market for amaranth. Your co-operation is highly needed.
Feel free to air out your views on how you actually prepare the grain amaranth (popping,
roasting, sprouting, and milling) and eventually how you make your soups, porridge, paste, pops,
stiff porridge among others. Clearly stating the names and amounts of ingredients you use, the
type of fuel used, how many minutes it takes you to prepare and cook the dishes mentioned. You
are also requested to tell us how many people can be served from your dish and how much of
that dish can be served to an individual at your house hold.
In case of any questions contact any of the following numbers: +256-414-533865, +256753481481 or +256-701684241
102
CODE
1. Gruels (porridge)
2.Meal/Bread/stiff porridge
3.Amaranth Sauce
4.Amaranth snack
5.Medicinal Amaranth
6.Amaranth paste
RECIPE NAME:
RECIPE CODE:
INGREDIENTS USED
UNIT
QUANTITY
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Makes:
Preparation time: ..
Cooking time:
Fuel:
Number of H/H Members served:
Preparation/cooking method:
103
APPENDIX 2.1
Table: PARTICULARS OF RESPONDENTS (BASELINE RECIPE COLLECTION):
Farmers Name
Farmers Name
Farmers Name
Kamuli
Nakasongola
Apac
Saabi Jane
Nalweyiso Janet
Easter Ogwal
Ngonzi Tappy
Namwenje Harriet
Anna kongor
Mugoberezi Betty
Namiramu Edissa
Michael Wontwoni
Nattimba Margaret
Lillian Ogwang
Nabiryo Suzan
Nakalema Jane
Adoch Bito
Sodo Irene
Nansubuga Mary
Mugalagala Josephine
Nabukenya Cate
Margaret Akello
Namugaya Hanifah
Namirimo Editha
David Eyee
Waideno Mebra
Nambuusi Alice
Lucy Oceng
10
Ntogona Margaret
Nalweyiso Stephania
Mango Ayoo
11
Twiino Miriam
Nakiligya Beatrice
Erimalina Opodo
12
Mutalaga Irene
Kyamujoli Carol
Shelli Oruru
13
Isabirye Florence
Nanyombi Josephine
Acen Evaline
14
kyatte Sarah
Omach Geoffrey
15
Nampala Zeulensi
Nakivumbi Sarah
Semmy Adoko
16
Tinka Rose
Namuwonge Damalie
Ketty Oceng
17
Nangobi Christina
Okello Cosmas
18
Bujuni Rose
Rose Ococh
19
Wambi Beatrice
Rose Oruru
20
0uma Monica
Lilian Tapi
21
Nakiwala Margaret
22
Kasubo Naima
23
Timugibwa
24
Namabiro Suzan
25
Musowanire Jessica
26
Namugaya Mangarita
27
Nakawoma Florence
28
Namia Rose
29
Kauma Tappy
No.
104
30
Sipiyoza Tibiwa
31
Kateme Samalie
32
Isabirye Mary
33
Nankwanga Monica
34
Nakayiima Ruth
Texture
Flavor
6
7
8
9
like
like
like
like
slightly moderately very
extremely
much
Appearance
Odor
105
2
Dislike
very much
3
Dislike
moderately
4
Dislike
slightly
Texture
5
Neither
Like nor
dislike
Flavor
6
like
slightly
Appearance
7
like
moderately
8
like
very
much
9
like
extremely
Odor
2
Dislike
very much
4
Dislike
Dislike Neither
moderately slightly Like nor
dislike
Texture
Flavor
106
6
like
slightly
Appearance
7
like
like
moderately very
much
Odor
9
like
extremely
820
2
Dislike
very much
3
Dislike
moderately
Texture
4
Dislike
slightly
5
Neither
Like nor
dislike
Flavor
6
like
slightly
Appearance
7
like
moderately
8
like
very
much
9
like
extremely
Odor
2
Dislike
very much
3
Dislike
moderately
Texture
4
Dislike
slightly
5
Neither
Like nor
dislike
Flavor
6
like
slightly
Appearance
7
like
moderately
8
like
very
much
9
like
extremely
Odor
1
Dislike
extremely
2
Dislike
very much
3
Dislike
moderately
Texture
4
Dislike
slightly
5
Neither
Like nor
dislike
Flavor
6
like
slightly
Appearance
7
like
moderately
8
like
very
much
9
like
extremely
Odor
Texture
Flavor
6
7
8
9
like
like
like
like
slightly moderately very
extremely
much
Appearance
Odor
2
Dislike
very much
3
Dislike
moderately
4
Dislike
slightly
5
Neither
Like nor
dislike
109
6
like
slightly
7
like
moderately
8
like
very
much
9
like
extremely
Texture
Flavor
Appearance
Odor
2
Dislike
very much
3
Dislike
moderately
4
Dislike
slightly
Texture
5
Neither
Like nor
dislike
Flavor
6
like
slightly
Appearance
7
like
moderately
8
like
very
much
9
like
extremely
Odor
110
2
Dislike
very much
3
Dislike
moderately
4
Dislike
slightly
Texture
5
Neither
Like nor
dislike
Flavor
6
like
slightly
Appearance
7
like
moderately
8
like
very
much
9
like
extremely
Odor
1
2
3
4
Dislike
Dislike
Dislike
Dislike Neither
extremely very much moderately slightly Like nor
dislike
Sample Code attribute
703
370
730
Texture
Flavor
111
6
7
8
9
like
like
like
like
slightly moderately very
extremely
much
Appearance
Odor
2
Dislike
very much
3
Dislike
moderately
4
Dislike
slightly
Texture
5
Neither
Like nor
dislike
Flavor
6
like
slightly
Appearance
7
like
moderately
8
like
very
much
9
like
extremely
Odor
112
Please remember to rinse your mouth with water provided before testing the next sample. Please
feel free to give any comments about any of the samples.
Note: Attached are instructions on how to prepare this Meal.
1
Dislike
extremely
2
Dislike
very much
3
Dislike
moderately
4
Dislike
slightly
Texture
5
Neither
Like nor
dislike
Flavor
6
like
slightly
Appearance
7
like
moderately
8
like
very
much
9
like
extremely
Odor
2
Dislike
very much
3
Dislike
moderately
Texture
4
Dislike
slightly
5
Neither
Like nor
dislike
Flavor
6
like
slightly
Appearance
7
like
moderately
8
like
very
much
9
like
extremely
Odor
113
2
Dislike
very much
3
Dislike
moderately
Texture
4
Dislike
slightly
5
6
Neither
like
Like nor
slightly
dislike
Flavor
Appearance
7
like
moderately
8
like
very
much
9
like
extremely
Odor
2
Dislike
very much
3
Dislike
moderately
Texture
4
Dislike
slightly
5
Neither
Like nor
dislike
Flavor
6
like
slightly
Appearance
7
like
moderately
8
like
very
much
9
like
extremely
Odor
114
2
Dislike
very much
3
Dislike
moderately
Texture
4
Dislike
slightly
5
6
Neither
like
Like nor
slightly
dislike
Flavor
Appearance
7
like
moderately
8
like
very
much
9
like
extremely
Odor
Baggia
INGREDIENTS/ group
3 leveled Tumpeco cups (1400g) of wheat Flour (Preferably Azam)
600g (5 heaped table spoons + half kilo)of Popped Grain Amaranth flour
Liter (1 Tumpeco cup) Oil
2 finely grated medium size carrots(156g)
115
Pancakes
Balls
Soup
sesame Instant
porridge
Rice-GA Porridge
Optional: Sugar
Maize-GA Porridge
116
Millet-GA Porridge
G.A-Peanut sauce
Convenient Bean
sauce
Instant rice-G.A
Meal
Cassava meal
Millet-cassava-G.A
Meal
Ginger-G.A Masala
117
Paste
Bean-peanut-G.A
Snack
INSTRUCTIONS:
1. Chapatti
Make Popped G.A Flour locally (As follows :)
Pre-heat a large pan using an open fire
Put clean seeds on a pre-heated pan
Stir the seeds constantly while popping to prevent them from burning and to allow most
of them to pop until the majority are
Pound in a motor
Sieve the flour to get the finest powder- now you have your popped GA flour
Sift wheat and popped grain amaranth flour; this is done to incorporate air into the flour.
Mix the two flours and salt very well
In a large bowl, add together flour, carrots, onions and 3 tablespoons of oil. Adding a
little bit of hot water at a time, mix the ingredients together to form dough.
118
Knead the dough for 10 minutes or until it does not stick to your hands. The secret to
really soft Chapattis lies in the kneading and use of hot water. The dough must be smooth
and just the right softness - medium.
Divide the dough into equal portions, roughly the size of a golf ball. Roll between your
palms, applying a gentle pressure, till the balls are smooth and without cracks. Once
completed, lightly brush each piece of dough with oil and then sprinkle a pinch of flour
on top.
Sprinkle flour over the table where you will be rolling the chapattis out. Use your rolling
pin to push the dough into round flat circles about 5 inches wide. Flip the dough as you
roll and make sure you add flour if it is sticking to the table or the rolling pin.
Take either a spatula or an empty flour bag and fold it down from the top to the bottom.
Slowly press down on the chapatti as you turn it.
The Chapatti is ready for its first flip when you begin to see raised bumps on its surface.
Use a spatula to turn it on to its other side. Remove from the pan when both sides appear
golden in color as shown in figure b below.
120
Remove of the flour and keep aside for dusting the dough and the board
Peel the bananas and place them in the remaining of the sifted flour.
Mash the bananas and ground ginger into the of the flour.
Once fully mashed, knead to make big round dough.
Add 3 tablespoons (21mls) of oil when the dough is sticky.
Dust the rolling stick and board (whenever necessary) with the flour that had been kept
aside
Roll out the dough and cut out into small round shapes as shown below.
121
Gently stir the mixture and remove the cover to allow some of the water to evaporate for
60 minutes.
When the mixture is a little thick add the margarine and allow it to melt.
Strain the contents through a sieve (to get a thick clear soup) into a clean dish ready for
consumption.
6. Sesame-G.A instant porridge
Sort sesame to remove visible stones/dirt
Wash it twice in fresh clean water
Allow it to settle so that the remaining stones settle at the bottom for easy separation
Drain(remove the water from) the Sesame on a big sieve
Roast the sesame over low fire(remember not to salt it) until it begins to pop giving off
sweet aroma(it should be firm when pressed)
Pour the roasted sesame in a large pan once its ready
Pop the amaranth
Pour all the popped amaranth in the pan with the roasted sesame
Add the sugar into this very pan
Stir continuously at low heat
Let the sugar melt but do not let it caramelize (turn brown). At this point the melted sugar
will bind the sesame and G.A.
Remove the contents from fire but continue to stir until they have cooled
Transfer the contents into a motor and pound with a pestle until a powder is formed
Sieve the powder to get a finer powder
Seal in a polythene bag or a clean dry container with a tight fitting lid (in order to make
the instant porridge :)
Boil clean water and milk in a clean pan
Put the flour into a clean container
Add the boiling water/milk mixture while stirring
123
124
Roast G.A until golden brown(see figure for roasted grains in making the soup)
Make roasted/ toasted G.A flour by pounding in a motor and sieving to obtain a fine flour
Mix the 2 flours (G.A& Millet) in a ratio of 1:1 ( 250g (1/4kg) millet to 250g (1/4kg) of
G.A) )
then in order to make the porridge
Boil clean water in a clean saucepan
Put the flour into a clean plastic container
Add cold water to the flour and stir to make a light paste using a spoon
Add the paste to the boiling water while stirring and boil for 15 minutes
Add milk to a desired consistence and continue boiling for 10 minutes (optional)
Add sugar to taste and serve in cups
10. G.A Leaf powder-Peanut sauce
Pick G.A leaves from the garden.
Clean them thoroughly to remove dirt and worms.
Wash them in running water.
Place the clean leaves in a sauce pan with a tight fitting lid.
Steam the leaves for 15- minutes.
Remove the sauce pan from the fire but keep the lid on until the contents are cold.
Remove the leaves from the sauce pan and dry them under direct sun shine on a clean
drying stand.
Cover with a transparent polythene to prevent contamination from flies.
Continuously turn the leaves until all have dried and fragile.
Place the leaves into a motor and pound them into powder using a pestle.
Sieve the powder to get the finest powder.
Seal in polythene or store in a dry container with a tight fitting lid.
Roast the Peanut over low fire
125
126
127
128
Pound to fineness
Mix the Popped G.A flour with the grounded ginger so that its fluid will form paste with
the G.A
Mould into tiny flat pieces that can easily dry
Dry the pieces until they can easily break
Pound in a motor to form powder
Sieve to get the finest powder
Seal in polythene as shown below, or pack it in a clean dry container with a tight fitting
lid
129
1 Chapatti
2 Baggia
3 Pancakes
4 Balls
5 Soup
6 sesame Instant
porridge
7 Rice-GA Porridge
8 Maize-GA Porridge
9 Millet-GA Porridge
QN 1.
QN 2.
QN 3.
What do you
like about this
recipe?
131
10 G.A-Peanut sauce
11 Convenient Bean
sauce
12 Instant rice-G.A
Meal
13 Cassava meal
14 Millet-cassava-G.A
Meal
15 Ginger-G.A Masala
16 Paste
17 Bean-peanut-G.A
Snack
Key: To be used by the interviewer. (The interviewer will clearly explain this table and
take control of the group interview so that the views of the interviewees are within
answers in the table below.)
QN 1.
QN 2.
Ingredients are
It is a simple way of
It is not time
None of
easily
consuming
these
available
(ease of processing)
Extremely
Moderately
Neither acceptable
Moderately
Extremely
unacceptable
unacceptable
nor unacceptable
acceptable
acceptable
132
QN 3.
Extremely
Moderately
unacceptable
unacceptable
Neither acceptable
nor unacceptable
Moderately
Extremely
acceptable
acceptable
Appendix 6: The 21 farmer groups that participated in the Recipe trials and evaluation
KAMULI
NAKASONGOLA
APAC
Kyabutaika F.G
Atakulaba F.G
Bakuseka majja
Tibikoma F.G
Kamukamu F.G
Babigumira F.G
Twekembe F.G
F.G=Farmer Group
Appendix 7: Main ingredients used in the theoretical recipe formulation
MAIN
CODE
Total
INGREDIENTS
Wt
Energy
Protein
lipid
OF PRODUCTS
(g)
(Kcals)
(g)
(fat) (g)
100
144
9.16
100
585
100
565
Ca(mg)
Fe(mg)
Zn(mg)
1.08
62
2.48
1.06
23.68
49.66
54
2.26
3.31
16.96
48
989
14.76
7.16
Beans, yellow,
mature seeds,
cooked, boiled,
A
with salt
Peanuts, all types,
dry-roasted,
without salt
Seeds, sesame
butter, tahini, from
roasted and toasted
kernels (most
common type)
133
Millet flour
100
373
10.75
4.25
14
3.94
2.63
grain, white
100
361
6.93
3.86
2.38
1.73
Cassava, raw
100
160
1.36
0.28
16
0.27
0.34
100
366
5.95
1.42
10
0.35
0.8
Grain amaranths
100
371
13.56
7.02
159
7.61
2.87
100
441
34.8
21.86
188
5.82
3.58
roasted
Wheat flour, white,
all-purpose,
unenriched
100
364
10.33
0.98
15
1.17
0.7
ginger
100
335
8.98
4.24
114
19.8
3.64
Sugar
100
387
0.05
0.01
blue band
100
604
0.2
70
Calcium(mg) iron(mg)
270
11
500
7
800
10
1300
8
1300
11
1300
15
1000
8
1000
18
1000
8
1000
18
1200
8
1300
27
1000
27
1300
10
1000
9
Nutrient Requirement
Zinc(mg) Protein(g)
Energy(Kcals)
Fat(g)
3
11
999
30
5
13
1404 ND
8
19
1789
65
11
34
2265
65
9
52
2840
65
11
46
2000
65
8
56
2818
65
8
46
2000
65
11
56
2554
65
8
46
2000
65
8
46
2000
65
13
71
2500
65
11
71
2500
65
14
71
2700
65
12
71
2700
65
Source: 1999 - 2002 Dietary Reference Intakes, Institutes of Medicine 2005 Dietary Guidelines
Children's Nutrition Research Center at Baylor College of Medicine
134