| Summary: | <i>Background</i>: Pica, the craving and purposeful consumption of nonfoods, is poorly understood. We described the prevalence of pica among women on Mfangano Island, Kenya, and examined sociodemographic and health correlates. <i>Methods</i>: Our cross-sectional study included 299 pregnant or postpartum women in 2012. We used a 24-h recall to assess pica, defined as consumption of earth (geophagy), charcoal/ash, or raw starches (amylophagy) and built multivariable logistic regression models to examine sociodemographic and health correlates of pica. <i>Results</i>: Eighty-one women (27.1%) engaged in pica in the previous 24 h, with 59.3% reporting amylophagy and 56.8% reporting geophagy, charcoal, and/or ash consumption. The most common substances consumed were raw cassava (<i>n</i> = 30, 36.6%), odowa, a chalky, soft rock-like earth (<i>n</i> = 21, 25.6%), and soil (<i>n</i> = 17, 20.7%). Geophagy, charcoal, and/or ash consumption was negatively associated with breastfeeding (OR = 0.38, 95% CI: 0.18−0.81), and amylophagy was associated with pregnancy (OR = 4.31, 95% CI: 1.24−14.96). Pica was more common within one of six study regions (OR = 3.64, 95% CI: 1.39−9.51). We found no evidence of an association between food insecurity and pica. <i>Conclusion</i>: Pica was a common behavior among women, and the prevalence underscores the need to uncover its dietary, environmental, and cultural etiologies.
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