Worker productivity and the nutritional status of

Kenyan road construction laborers12

June C. Wolgemuth,3 M.N. S., M.P.H., Ph.D.,
Michael C. Latham,4 M.D., M.P.H., D. TM. & H., Andrew Hall,5 B. Sc., M. Sc., Ph.D.,
Andrew Chesher,6 B.Soc.Sci., and D. W. T Crompton,7 M.A., Ph.D., Sc.D.

ABSTRACT The effects of energy supplementation (group I received 200 kcal/day and group
II received l000/kcal day) were examined on road workers in Kenya. Anthropometric, dietary,
worker productivity, clinical hematology, and parasitology data were collected from 224 workers
of both sexes or, subsamples of these workers, at base-line, midpoint, and final measurement
periods. Sixty-seven percent of the work force was less than 85% of weight for height. Females

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tended to be better nourished than males. Multiple regression analysis showed that increases in
arm circumference and Hb levels were associated with significant productivity gains of about 4%.
At the midpoint, group II males gained 1.10 kg (p <0.0003) while group I males showed no change.
Weight loss during the latter part of the study resulted in no significant final weight change for
males. Successful supplementation was weakly associated with a productivity increase for group
II workers of 12.5% (p <0.10). Am J Clin Nuir l982;36:68-78

KEY WORDS Much productivity, nutrition status, undernutrition, energy supplementation,

parasitology, anthropometry

Introduction tivity was found when workers were given

energy supplements.
Much attention has been paid to the need The failure to either increase or detect an
for rural development in low income coun- increase in productivity after supplementa-
tries (1, 2). The productivity of the rural tion may be attributed to a number of factors
worker (both male and female) is a key to including: 1) the short duration of energy
this development. Poor health and nutritional supplementation, 2) inadequate sample size
status of the worker may reduce this produc- of workers who were underweight, 3) failure
tivity (3). Only a limited number of studies to increase total daily energy intake to meet
have measured the productivity of agricul- energy needs, and 4) substitution of the sup-
tural workers and the changes in productivity plement for a portion of the normal dietary
of malnourished laborers after a dietary sup- intake.
plement (4-7). These studies have shown that In 1974, the Rural Access Roads Program
anemic or underweight workers are less pro-
ductive than their better nourished cowork- From the Division of Nutritional Sciences, Cornell
ers. The results of one study suggest that University, Ithaca, NY 14853.
underweight laborers are as active as normal 2 Supported by grants from the World Bank, Wash-
weight laborers during regular working hours ington, DC and the Ministry of Overseas Development,
but reduce their activity by resting during UK.
Research Assistant, Cornell University. Author
leisure time (8). However, the potential ben-
to whom requests for reprints should be ad-
eficial effects of providing a dietary supple- dressed. Professor of International Nutrition, Cor-
ment are still unclear. Basta et al. (4) showed nell University. Research Assistant, Cambridge Uni-
that, after receiving an iron supplement, pre- versity, England. 6 Lecturer, University of Birming-
viously anemic plantation workers increased ham, England and Consultant to the World
Bank. Lecturer in Parasitology, Cambridge Univer-
their productivity to a level comparable with sity, England.
that of nonanemic workers. In other investi- Received September 11, 1981.
gations (5-7), no increase in worker produc- Accepted for publication December 15, 1981.

68 The American Journal of Clinical Nutrition 36: JULY 1982, pp. 68-78. Printed in U.S.A.
1982 American Society for Clinical Nutrition
 WORKER PRODUCTIVITY AND NUTRITION IN KENYA 69

(RARP) was begun in Kenya to increase the recorded initial worker productivity measurements; and
number of all-weather rural roads. The pri- 4) attendance record for the approximately 4 wk period
between clinical examination and the initiation of feed-
mary aim of this program is to promote rural
ing. This procedure meant that each worker had an equal
development through the construction of opportunity of being assigned to groups I or II but
roads to previously poorly accessible com- ensured that the two groups would be similar for these
munities. The roads are projected to increase four characteristics. While the age of the workers ranged
from 12 to 69 yr, only workers without serious physical
the access of the rural inhabitants to agricul-
impairment between 16 to 60 yr of age were included in
tural markets, schools, health facilities and the worker productivity measurements.
job opportunities. Since local manual labor is Data were collected in six subject areas during three
used rather than mechanical equipment, measurement periods. During the base-line period the
workers are able to participate directly in the following information was collected: 1 ) clinical exami-
nations; 2) anthropometric measurements; 3) hematol-
development of their communities and, at the
ogy and parasitology investigations; 4) socioeconomic
same time, receive a wage that may be used data; 5) dietary practices; and 6) worker productivity
to improve their farms and level of living (9). measurements. Data concerning anthropometric mea-
Many of these RARP workers labor on the surements and dietary practices were again collected at
the midpoint of the study (about 7#{189}
wk after feeding
roads in the morning and on their farms in

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was started) and at the end of the study (about 4 months
the afternoon. For this reason concern was after feeding was started). Final worker productivity
expressed by the sponsoring agencies for the measurements were recorded during the last month of
health and welfare of these workers whose feeding.
nutritional status was in question. This con-
cern initated the design of this study. The Clinical examinations

purposes of this research were 1) to determine Clinical examinations were completed by a physician-
the relationship between the nutritional status nutritionist for each worker in order to identify clinical
signs of malnutrition, disease, and deformity that might
of road workers and their work productivity,
interfere with normal physical activity. Whenever pos-
and 2) to compare the effects of a high energy sible, treatment was provided for minor health problems
and a low energy dietary supplement on their while workers with more serious diseases were referred
nutritional status and productivity. to a nearby medical facility.

Anthropometric data
Materials and methods Height, weight, arm circumference, and triceps skin-
fold thickness were measured by the same nutritionist at
Location
each examination using the same instruments. Height
The work crews on two road sites in Muranga and was taken using a steel tape fixed to a vertical post and
Kirinyaga Districts of the Central Province of Kenya recorded to the nearest 0.1 cm. Weight was measured on
were selected for participation in this study. Road 1 is an Avery heavy duty clinical scale calibrated to 0.25 kg.
located about 30 km north of road 2, and passes along Each worker was asked to remove his shoes before
the sides of steep hills which are quite fertile and received weighing. Men were weighed wearing only trousers or
much rain throughout the study period. Road 2 follows shorts, and women were asked to remove excess clothing
a course around the base of a mountain and parallels the such as sweaters, headcloths, and heavy jewelry. Correc-
Sagana River for about 7 to 12 km. The area beyond the tions in weight were made for the clothing worn during
river is normally arid (10) although it did receive large weighing by determining the weight of samples of cloth-
amounts of ran during the 1978 wet season (October and ing normally worn by the workers.
November). The road sites were chosen for their pre- Arm circumference was measured to the nearest 0.1
dicted large labor force. Although construction on road cm halfway between the acromial process of the scapula
1 began 6 months before the start of this study, close to and the olecranon process of the ulna of the left arm
60% of the workers were hired within 3 months of the while the arm hung loosely and relaxed (11). A non-
study. Hiring of the labor force on road 2 coincided with stretchable polyvinyl chloride-coated, fiberglass tape was
the start of this investigation. used. The triceps skinfold measurements were taken at
the same midpoint on a relaxed arm using a Lange
Design and sampling skinfold caliper from which values to the nearest 0.5 mm
can be read. Arm muscle area and arm fat area were
Initially, 224 workers participated in the base-line
calculated using the formula reported by Frisancho (12).
measurements. Of this number, 138 (62%) were males
Anthropometric measurements were expressed as a per-
and 86 (38%) were females. Workers were assigned
to
centage of values using the reference tables of Jelliffe
one of two groups: group I received a low energy food
(11) for healthy adults.
supplement (200 kcal/day) and group II received a high
energy food supplement (1000 kcal/day). Assignment to
Hematology and parasitology
a group was made by cross-stratification using the fol-
lowing four characteristics: I) sex; 2) initial percentage Blood was taken from a finger prick made using a
of the reference values (11) for weight for height; 3) sterile lancet. Duplicate 20 zl samples were mixed with
70 WOLGEMUTH ET AL.

10 ml of Drabkins solution and Hb levels were estimated measuring worker output in other low income countries.
within 6 h of collection by the cyanmethemoglobin He was assisted by locally hired field workers who he
method (13) using a Cecil CE 404 oolorimeter (Cecil had trained. The parameters recorded were type of task,
Instruments, Cambridge, UK) at the Veterinary Inves- time to complete each task, and volume of earth moved.
tigation Laboratory, Karatina. The oolorimeter was cal- The results are expressed as volume of earth moved
ibrated using three Hb standards (Dade, Miami, FL). (cubic meters) per man hour (m3/mh). Only tasks of
For the estimation of hematocrits, duplicate blood sam- excavation, digging ditches, and sloping the roads were
ples were collected in microcapillary tubes, spun in a considered to be of a relatively uniform nature to be
centrifuge, and read on a microhematocrit reader (Gel- used to measure productivity. Men and women were
man-Hawkesley, Lancing, UK). assigned the same tasks. Analysis of the data showed
A fecal sample weighing about 0.5 g was collected that work output values for excavation were approxi-
from 182 road workers (81%) and examined qualitatively mately 0.38 -3/mh higher than for ditching and sloping.
by a parasitologist for the presence of the following Thus, 0.38 was added to the latter tasks to adjust for this
parasites: hookworm, Trichuris trichiura, Ascaris lumbri- difference. Initial productivity measurements were ob-
coides, Schistosoma mansoni, Taenia sp., and protozoa tamed on 84 male and female workers while final mea-
cysts. Each sample was fixed in a preweighed bottle surements were taken on 42 of the original sample of
containing polyvinal alcohol/Schaudinns fluid and pro- male workers from which both initial and final measure-
cessed using a quantitative ether sedimentation tech- ments were obtainable. Five of these 42 workers labored
nique described by Hall(l4). It was then microscopically at two types of tasks during the study period. Since each

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examined for the presence ofova or cysts ofthe parasites. task was considered as a separate observation, there was
a total of 47 cases. The tasks performed by females were
Socioeconomic information the same as those performed by males.
Socioeconomic data were collected from each worker
Each worker was given a uniform, premeasured task.
by means of a pretested questionnaire. The purpose of
The road worker usually began between 6:30 to 8:30 AM
and completed the task within 4 to 6 h. A diary was kept
these data collections was to identify the nature of the
workers family responsibilities, farm size, and alterna-
to record worker attendance. This record was maintained
separately from that of the Ministry of Works records.
tive wage income opportunities. Each of these factors
could have an effect on work performance through its
impact both on actual work output as well as attendance Dietary supplementation
at the work site. The analysis of the preintervention anthropometric
data as well as the work of Brooks et al. (5) suggest that
Dietary practices Highlands RARP workers might be receiving inadequate
Dietary habits were investigated to determine the calories. For this reason, the supplement chosen was
adequacy of the road workers diets particularly for designed to provide a major energy contribution to the
calories, protein, and iron. The 24-h dietary recall and diets of the experimental group workers (group II). The
the home weighing methods were used to supply this supplement was based on a commonly used Kenyan
information. A base-line 24-h dietary recall was recorded dish, a maize meal porridge (uji), to which milk and
for 195 (87%) workers to assess dietary intake before sugar may be added. Group I workers received 1#{189}cups/
food supplementation. A midpoint and a final 24-h day of the maize porridge which also contained dried
dietary recall were completed on the remaining work skim milk and provided these workers with 200 kcal, 7.5
force to determine changes in both the home diet and g of protein, and 1.36 mg of iron. Group II workers
total intake which may have occurred both as a result of received 3 cups of maize porridge per day containing full
seasonal food availability or of the food supplement. cream milk powder and sugar which provided 1000 kcal,
Kenyan field workers were trained by a nutritionist 18.5 g of protein, and 2.18 mg of iron. The supplement
to perform the 24-h dietary recalls. This step was neces- was eagerly accepted by workers in both groups. The
sary to overcome local language problems. Recalls were difference in quantity of porridge given to each group
taken under the supervision of the nutritionist and each resulted in very few complaints. It was necessary, how-
was carefully checked. The road workers were assisted ever, to add milk powder to the porridge of group I
in reporting quantities by placing before them samples workers since a pilot study had indicated that workers
of utensils and containers normally found in their homes. felt unfairly treated when milk powder was added only
In rural communities of developing countries, these uten- to the group II porridge. The daily consumption of the
sils and containers are often limited in number and supplement by each road worker was recorded by a field
design so that it is believed that a relatively complete worker.
representation was made.
Home weighings were completed on a subsample of Statistical analysis
26 male workers from both roads. The home weighings The statistical analysis was computer processed using
provided not only quantitative measures of intake, but the Minitab statistical computing system (15) for initial
also provided recipes for calculating the quantity of each descriptive data anlysis and for some comparisons of two
ingredient in combination food reported in the 24-h group means. The statistical analysis system (SAS) (16)
dietary recalls. and Users manual for Regan, a general regression
analysis programme (17) were used for the remaining
Worker productivity measurements
analyses.
Worker productivity measurements were obtained by To account for the fact that some individuals worked
Mark Sharrock, a consultant engineer with experience in more days than others, weighted regression equations
 WORKER PRODUCTIVITY AND NUTRITION IN KENYA 71

were estimated using where nlk is the number of study for each group and sex are shown in
days of productivity measurements taken for each indi-
Table 3. Group II males gained a significant
vidual, i, at each task, k. The result is to give more weight
to the data for individuals who worked more days.
amount ofweight (1. 10 kg, p < 0.0003) during
the first half of the study. Group I females
Results also showed a significant gain in weight (0.68
kg, p < 0.05). No other sex group showed a
Clinical examinations significant weight gain. During the second
half of the study, males of both groups lost
The clinical examinations revealed few ab-
weight while females showed little weight
normalities that might adversely affect pro-
change. Group II males lost the most weight
ductivity. Signs of malnutrition and of other
(-0.70 kg, p < 0.0003). Thus, over the whole
clinical abnormalities were quite evenly di-
study there was no significant weight gain for
vided between the two groups. Among the
any group except for group I females who
most frequent findings were evidence of den-
tal fluorosis (48%), cheilosis of the lips (17%),
gained 0.7 1 kg (p < 0.05). The weight changes
suggest that females were better able than
gingivitis (20%), splenomegaly (7%), inguinal
males to regulate their dietary intakes to meet
hernia (8%), and hypertension (4%).

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or exceed energy needs in the presence of
Anthropometry dietary supplementation.
Mean percentage of the reference values Mean Hb values for males for each group
for weight for height and arm circumference were more than acceptable8 (l4.0 g/dl) as
figures ranged between 80 to 89% (Table 1). were mean values for females (12.0 g/dl)
Triceps skinfold percentages were much (Table 1). Hb values ranged between 8.6 to
lower but good standards are not available. 17.4 g/dl for males and 9.9 to 15.7 g/dl for
Females have significantly greater anthropo- females. Mean hematocrits for males were
metric values than males for all three mea- marginal (37 to 43%) but acceptable for fe-
surements. The greatest difference is shown males (31 to 37%). Hematocrit values ranged
for mean triceps skinfold measurements of from 27.0 to 49.5% among males and 30.0 to
males (38% of reference values) from both 44.55 for females. Mean corpuscular Hb con-
groups whose measurements are approxi- centration values were acceptable for both
mately one-half those of females. Arm muscle groups and sexes (30 g/dl) (18). Hemato-
circumference (10) calculated from the mean logical values were not available for all work-
figures in Table 1 show that arm muscle ers due to the loss of some samples during the
development of females was quite similar to analysis.
that of males and differed by only 2.2 cm or When the hematological results are classi-
less. Females from both groups had an arm fied by the percentage of workers with
muscle circumference of 21.4 cm while males deficient, marginal, and acceptable
had an arm muscle circumference of 23.6 cm. values (18), 17% of the female workers had
These figures are 91 and 94% of standard marginal or deficient Hb values (<12 g/dl)
and 26% of the males had marginal to defi-
values. While workers had close to acceptable
arm muscle development, skinfold thickness cient Hb values (<124 g/dl). In the same
measurements were low. manner, 29% of the females had marginal or
Among the 94 workers for whom anthro- less (<38%) hematocrit values, while 52.3%
pometric values were recorded throughout of male workers had marginal or less (<44%)
the study, 67% (63 workers) weighed less than hematocrit values. These figures again indi-
85% of reference values (Table 2) at the be- cate that these Kikuyu female workers were
ginning of the study. Twenty-three percent better nourished than were male workers.
(22 workers) were seriously underweight On the basis of the stool examinations, the
(<75% of reference values). Only 17% (16 frequency distribution of the number of total
workers) had weight for heights of 955 or positive cases of parasitic infections are not
above. Between 62 and 65% of the workers statistically different between groups I and II
weights for heights did not rise above 85% of 8 Definitions of ranges for acceptable, marginal,
reference values throughout the study. and deficient hematological values are found in Ref-
Weight changes which occurred during the erence 18.
72 WOLGEMUTH ET AL.

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 WORKER PRODUCTIVITY AND NUTRITION IN KENYA 73

TABLE 2
Frequency distribution of initial percent of weight
for height for each group*

Difference between
Group i Group
groups
% of WI for hI
Cumulative Cumulative Signiti.
X df cantt

<75 9 20.9 20.9 13 25.5 25.5 1.15 3 NS

75-84 21 48.8 69.7 20 39.2 64.7
85-94 7 16.3 86.0 8 15.7 80.4
95 6 14.0 100.0 10 19.6 100.0

Total 43 100.0 51 100.0

* The values for comparison are those from the WHO publication of Jelliffe (11).

tp<0.05.

TABLE 3

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Weight changes of each group and sex during
three periods of intervention

Group I Group II Differences between periods

Paired i test

N SEM N SEM
Group I Group II

kg kg

Females
Base-line to midpoint 18 0.68 (0.28) 15 0.39 (0.47) 2.44* 0.83
Midpoint to final 18 0.04 (0.24) 15 0.24 (0.30) 0.15 0.80
Base-line to final 18 0.71 (0.34) 15 0.63 (0.59) 2.09* 1.07

Males
Base-line to midpoint 25 0.68 (0.43) 36 1.10 (0.26) 1.56 4.14f
Midpoint to final 25 -0.36 (0.26) 36 -0.70 (0.18) -1.38 -3.99t
Base-line to final 25 0.31 (0.44) 36 0.39 (0.28) 0.72 1.41

Total per group 43 51

* p <0.05.
tp<0.0003.

(Table 4). Group I did have more cases of A. ily members, in addition to parents and chil-
lumbricoides (16 cases or 16.5% of the work- dren, were supported.
ers) than did group 11(10 cases or 11.8% of About half (53%) of the road workers
the workers). There were also more cases of owned or depended on farms of less than 4
Entameba spp. (55 cases) in group I than acres. Most of the farms were owned by the
group II (34 cases). However, the heaviest worker, or the workers father or husband.
burdens of A. lumbricoides, hookworm, Pro- Twenty workers (9.6%) hired the land which
tozoa cyts, and T trichiura were found in they cultivated. Less than 5% of the workers
group II. For this sample, parasite burdens reported earning wage income from any other
were generally considered to be light. source.

Socioeconomic data Dietary practices

The average number of children of female Mean energy intakes of males and females
and male workers of both groups is about 2.5 in both groups were less than 67% of FAO
(Table 1) with a maximum of nine children. recommendations (19) for individuals doing
Household size ranged from 0 to 14 members heavy labor (Table 5). There was no signifi-
which suggests that in some households, fam- cant difference in energy intake between the
74 WOLGEMUTH ET AL.

TABLE 4
Frequency of parasitic infection of workers in
groups I and II

Protozoa
Hookworm A. lumbricoides S. mansoni T irichiura
cysts
Ova/g feces
n %t n %f n %f n n %t

Group I
0 77 79.4 81 83.5 42 43.3 88 90.7 89 91.8
1-45 12 12.4 2 2.1 34 35.1 4 4.1 7 7.2
46-100 4 4.1 3 3.1 9 9.3 2 2.1 1 1.0
101-500 4 4.1 9 9.3 II 11.3 3 3.1 0 0.0
501-1000 0 0.0 1 1.0 1 1.0 0 0.0 0 0.0
1000+ 0 0.0 1 1.0 0 0.0 0 0.0 0 0.0

Total examined 97 100.0 97 100.0 97 100.0 97 100.0 97 100.0

Total positive 20 16 55 9 8
Rangeofova/gfeces 330 1356 1518 281 91

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Group II
0 64 75.3 75 88.1 51 60.0 78 91.7 77 90.6
1-45 13 15.3 2 2.4 19 22.4 4 4.7 4 4.7
46-100 4 4.7 3 3.5 3 3.5 1 1.2 3 3.5
101-500 3 3.5 2 2.4 11 12.9 2 2.4 0 0.0
501-1000 1 1.2 1 1.2 1 1.2 0 0.0 0 0.0
1000+ 0 0.0 2 2.4 0 0.0 0 0.0 1 1.2

Total examined 85 100.0 85 100.0 85 100.0 85 100.0 85 100.0

Total positive 21 10 34 7 8
Range of ova/g feces 523 5988 899 116 1039

Difference between roads of total positives

2 df Significant

2.50 4 No*
* The unit of measurement for protozoa cysts is cysts per field scan.

t Percentage of total samples examined.

tp>0.05.

same sex ofeach group. Mean protein intakes tween base-line and midpoint measurements,
of workers were considered satisfactory (47 66 workers of group I increased their caloric
to 73 g). Over 70% of the workers exceeded intakes by a mean of only 69 (SEM = 104.2)
FAO recommendations for protein intake. kcal/day while group II workers increased
Iron intake was estimated according to the their caloric intakes by only 549 (SEM =

amount of available iron (20). Both male and 106.6) kcal/day (p < 0.001). During the 5cc-
female intakes were quite low (0.67 and 0.68 ond half of the study, negative net changes
mg). Female workers were much less able to were recorded in workers diets, particularly
meet the RDA (21) than were males. The in the diets of male workers. This decrease in
hematological results would predict the op- total energy intake is attributed to a prehar-
posite, i.e.,
that female workers were more vest food shortage period.
closely meeting their dietary iron needs than
Worker productivity
were male workers.
An examination of the changes in energy Presupplementation results. The initial av-
intake after dietary supplementation and erage productivity (X) of a subsample of 84
through seasonal changes showed that the workers was 0.773 m3/mh (SD = 0.25). The
group II workers did not increase intakes by initial average Z-score (see footnotes to Table
the total value of the food supplement. Be- 6) for productivity (Z) was 0.098 m3/nih (SD
 WORKER PRODUCTIVITY AND NUTRITION IN KENYA 75

0 = 0.63). Males exceeded females in produc-

.
,lI N
Nifi
_
a
a tivity by 0.204 m3/mh. Both and Z were
. 8. I I- I I I higher on road 1 than on road 2.
iI aI I-
5 . I 0 The results of fitting the regression equa-
5
I I -.
#A tions for and 2 are shown in Table 6. Seven
ONC 0
fi I : , independent variables were used: age, arm
I < circumference, Hb levels, parasitic infection,
C NOso
I C C E sex, road site, and type of task. Weight for
v 2 height is not included for it was shown here
.
0 not to be an important determinant of pro-
.-.RR
C N 4) ductivity.
ac .a When is used as the dependent variable,
iI z.
2
0. an mcrease m 1 SD in arm circumference
0 (17.86 mm) is weakly associated with 3.9%
0000 a
C C n (0.030 m3/mhj increase in productivity (p <
Nr1O
r- N 0. 10). When Z is used, a similar increase in
a

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N
u productivity of 4% (0.034 m3/mh) is found
1<
I n ri
C C #A
(p<0.05).
The Hb coefficients are also significant (X
=p<0.Ol andZ=p<0.05).ASDrisein
-
S I ut
so0.0
N 0
u

Hb productivity
in (1.30 g/dl) isusing
associated
equation in a 5.6%
and increase
a 3.5%
a.,I u
211 5
0 0 increase in productivity using equation 2.
2 The parasitic infection coefficients for pro-
Nei ,0c6
if C , . ductivity are not significant but are negative
o , . which suggests that productivity is reduced in
0
N the presence of infection. Using as the
I < .a(,4)4) - dependent variable, the presence of infection
I
I
n N N a is estimated to reduce productivity by 0.047
H ot)a
00
m3/mh or by 6%.
5 . .IP
a
., Age is weakly significant for the 7 equa-
. I N0
E I -
00
, o 3E tion.
suggests The that
negative
workers sign over
of the50 age coefficient
yr of age are
0 I -
a I au.9
Cu I n less productive. Further testing of an age
I N N 2
#e-
a
0
squared coefficient suggested that productiv-
.; NC <U
E I
N
r E ity increases for males and females until the
52 j
aLl 0
. I .. age of 37.6 yr and then falls. When only
l 0 males are considered, productivity was found
C
-
0
- N
. to peak at about 40 yr of age.
Cu vi-
- ... 2 0 an Significance is shown in both equations for
- __j (W
-R& n .
,
,
a8 the
road dummy
in the Zvariables,
equation. sexTheand positive
task, and
sign for
of
00 I C0
i- 2 I . - . Cu the task coefficient suggests that excavation
0 .D , has a higher productivity than the other tasks.
-4 I NC

. 0N a -
The
0.15 productivity
m3/mh (19%) of lower
female thanworkers
that ofis males
about
- . when the other variables are considered.
. Supplementation results. From the sample
a of male workers it was possible to record
4+ -

.2 0 base-line and final productivity measure-

- .9.9 E a u ments for 47 cases. The mean attendance of
,6) #{176}aZ
Z < the workers at the road sites was 76.0 (SD =
0 2 *
< 2 2 > 2 1.5) days out of a total of about 108 days.
76 WOLGEMUTH ET AL.

TABLE 6
Estimated relationships between worker productivity
and seven variables*

5t
regression SEt regression SEt
coefficient coefficient

Age (yr) -0.087 (0.61) -0.389 (0.229)

Arm circumference (mm) 0.0017 (0.001) 0.0087 (0.003)
Hb (g/dl) 0.033 (0.013) 0.100 (0.018)
Parasitic infectionj -0.047 (0.032) -0.121 (0.122)
Sexf -0.24711 (0.063) -0.71911 (0.236)
Roadt -0.096 (0.070) -0.46l (0.264)
Task 0.38011 (0.071) 0.598 (0.266)
Constant -0.191 (0.251) -3.485 (0.941)
#{128}#{128} 8.132 114.372
* : = the average productivity for each worker for each task performed. Equations using 5 as the dependent
variable are weighted using v where nlk is the number of days of productivity measurements for each worker. Z
= the difference in productivity of a worker from the average productivity for the day among all workers. It is a type
of Z-score. This equation is not weighted.

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t Standard error of the estimate.
:1:These five variables are dummy variables.
p<0.IO.
II p<O.OS.
lip < 0.01.
** The sum of squared least squared residuals.

The mean number of days fed was 53.2 (SD (2) Xt - #{149}6) = 0.3517 + 0.OO179TK - 0.00451DW
= 21.3) days. The mean change in worker (4.69) (1.81) (-3.93)
productivity was 0.065 (SD = 0. 175) m3/ S = 0.3076 n = 47 R2 = 0.226
mh.
The results of the following weighted least TK is positive and weakly significant (p <

squares equation shows that productivity of 0.10). DW is negative and is highly significant
group II workers increased by 0. 10 m3/mh (p < 0.0001). The fact that DW is more than
(p < 0. 10) at the end of the study after twice that of TK suggests the expenditure of
supplementation had been introduced:9 energy in labor was not sufficiently compen-
sated for by the workers total energy intake.
(1) - .#{176} = 0.0254 + 0.1030E
(0.58) (1.84)
Discussion
5=0.3415 n=47

where E is the feeding group assignment For nutritional planning in this rural com-
(_0 = group I and 1 = group II), and X -
munity in Kenya, the most important find-
xo i. the change in productivity from period ings are the inadequate energy intakes and
1 (X ) to period 3 ( X#{176}).These coefficients the low anthropometric values. While the
represent a 12.5% gain in productivity by energy intakes ofboth male and female work-
group II workers. In contrast, the gain in ers were much less than that recommended
productivity by group II workers receiving ( 19, 2 1), the levels of intake are similar to
the low energy supplement is only 0.03 m3/ those reported in dietary studies by other
mh and is not significant. Equation (1) is researchers in Kenya (22, 23; Jensen A, Kusin
applicable when all workers in a group re- J, Lokhani 5, van Steenbergen W, Mannetje
ceived the same treatment and will be the W, unpublished observations). While the
definition of successful supplementation. limitations of the 24-h recall method are rec-
The following unweighted equation (2) ognized, the above studies show consistent
considers both the varying number of days
worked (DW) and total caloric intake from
9 Figures in parentheses are t ratios; S = SE of the
the supplement (TK) for the individual estimate; n = number of cases; R2 = squared coefficient
worker during the study period. of multiple correlation.
 WORKER PRODUCTIVITY AND NUTRITION IN KENYA 77

findings. The dietary intakes of 24-h dietary The initial impact of dietary supplementa-
recalls from Kenyan workers are either re- tion was to increase the weight of group II
peatedly underreported or they are reasona- males. However, there appears to have been
bly representative and indicate very low en- a number of other factors that negated the
ergy intakes. initial beneficial effect of the dietary supple-
Also of interest are the hematological re- ment. These factors include 1 ) substitution of
sults which show that few workers in the the supplement for part of the normal home
highland area had deficient hematological dietary intake, and 2) a preharvest food short-
values but that roughly twice the proportion age period.#{176}
of males (52%) as compared to females (29%) The base-line worker productivity results
had hematocrit values that were marginal or showed that the better nourished workers, as
less. Epidemiological work in low income determined by arm circumference and Hb
countries generally shows a higher prevalence levels, were more productive than the less
of anemia among women as compared to well-nourished workers. With successful sup-
men (24). plementation, workers increased their pro-
The anthropometric results also indicated ductivity. However, when the suplement was

Downloaded from ajcn.nutrition.org by guest on November 26, 2014

a relative well-nourished female population used as a partial food substitute at home,
considering the burden of road working in when there was a preharvest food shortage,
addition to normal domestic and cultivating and when attendance and feeding were not
responsibilities. Mean anthropometric values regular, the total caloric intake was not suf-
of the women were better than those of the ficient to meet the energy needs of many
men. Once the food supplement began, fe- workers. Thus, we conclude that improved
males gained or maintained their weight bet- nutritional status and successful supplemen-
ter than men. During a suspected preharvest tation are both associated with increased
food shortage period, they were able to main- worker productivity. However, successful
tain their weight. This ability of the women supplementation is not always easy to
workers to regulate their energy equilibrium achieve. a
to their advantage may be explained, in part,
The authors thank Mr. Mark Sharrock for his assist-
by their role in food preparation. Since fe- ance in obtaining the worker productivity measurements.
male energy needs are usually less than males, The authors are grateful to Dr. Lani Stephenson, Ms.
their frequent access to food during its prep- Linda Buttel, Dr. Samir Basta, and Mr. Clell Harral for
technical, statistical, and other assistance. The authors
aration may have contributed proportion-
also acknowledge the help of several Kenyan field work-
ately important additional quantities of cal- ers, of officials in the Ministry of Works, and of the road
ories to their diets. It is also likely that they workers themselves.
were able to adjust their energy expenditure
to their dietary intakes. References
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nity. where.
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