Home processed complementary foods, caregivers' knowledge, attitude, and practice in a rural community in Kenya: a mixed method study.

Introduction: despite evidence of the health benefits of fermented and germinated foods, consumption is waning, particularly among children in Kenya. We conducted this study to explore the knowledge, attitudes, and use of fermented and germinated complementary foods in Homa-Bay County to advocate for their use as an additional tool to address the prevalent iron and zinc deficiency among children. Methods: an explorative mixed-study design. Six focus group discussions; followed by a cross-sectional quantitative survey with 314 caregivers. Atlas-ti software and SPSS were used for qualitative and quantitative data analysis. Results: this community was aware of and practiced germination and fermentation of foods. However, the older caregivers knew 1.5 times more foods than younger caregivers. Caregivers' inadequate knowledge about the benefits of germinated and fermented complementary foods and a negative attitude, prevented children been offered these foods. The caregivers´ greatest concerns were diarrhea following the consumption of fermented food and the potential for stomach ulcer development due to the acidity in these foods. The caregiver's attitude, age, and level of education significantly influenced the use of fermented and germinated complementary foods. A positive attitude (AOR 4.897, 95% CI: 1.616-14.844), being 35 years or older (AOR 2.7, 95% CI: 1.670-4.428), and having no or only a primary level of education (AOR 3.344, 95% CI: 1.319-8.480) were all associated with a higher likelihood of using fermented or germinated foods. Conclusion: to encourage caregivers to use germinated and fermented complementary foods, there must be concerted efforts to educate the community on the benefits of consuming these foods.