Malnutrition in Children Under the Age of 5, in Selected Primary Health Care Centers in Ika North East, Delta State
Chapter One
Significance of the Study
In Nigeria, under-five malnutrition is still a serious public health concern that has a catastrophic impact on a child’s growth, cognitive development, and general well-being. Because it seeks to offer data-driven insights that can impact policy, enhance healthcare services, and raise community awareness, this study is especially important. A multi-sectoral approach is necessary to properly address malnutrition, and this research will significantly benefit different stakeholders in child nutrition and healthcare.
CHAPTER TWO
REVIEW OF RELATED LITERATURE
Conceptual Review
Concept of Malnutrition
Millions of children worldwide suffer from malnutrition, a serious public health concern that is most prevalent in underdeveloped nations among children under five. Stunted growth, decreased immunity, cognitive impairments, and higher susceptibility to infections are among the negative health effects that result from this disorder, which is caused by an imbalance between nutritional intake and the body’s needs (World Health Organisation [WHO], 2018). With high rates of undernutrition among children, especially in rural and neglected populations, malnutrition is still a major issue in Nigeria (UNICEF, 2022).
According to Ubesie et al. (2022), who focus on the physiological effects of malnutrition, especially in young children who are at a critical stage of growth and development, scholars have defined malnutrition from a variety of perspectives, taking into account both its clinical and socio-economic dimensions. Mengistu, Alemu, and Destaw (2023) define malnutrition as an imbalance between dietary intake and the body’s metabolic needs, which is frequently influenced by socio-economic factors such as poverty, maternal education, and access to healthcare.
In contrast to the findings of Hamel et al. (2023), who highlight that childhood malnutrition is frequently rooted in maternal health during pregnancy, breastfeeding practices, and overall child-rearing conditions, Goon et al. (2021) present a more comprehensive view, arguing that malnutrition is not just a dietary issue but a multifaceted problem linked to inadequate maternal care, food insecurity, poor sanitation, and lack of access to quality healthcare. This suggests that interventions must go beyond food supplementation to include maternal education and improved healthcare services.
Even though there is broad agreement on what constitutes malnutrition, some criticisms point out the shortcomings of current viewpoints. Although diverse locations have distinct nutritional issues, the WHO’s definition of malnutrition from 2023, for example, tends to standardise malnutrition assessment globally. For instance, protein-energy malnutrition is still common in sub-Saharan Africa, although dietary changes are making childhood obesity a concern in some metropolitan locations (Akombi et al., 2023). According to the World Health Organisation (2023), the majority of definitions of malnutrition concentrate on undernutrition, ignoring the growing prevalence of overnutrition, which is increasingly a contributing factor to non-communicable diseases like diabetes and cardiovascular problems.
Another criticism is that, by ignoring more complex socioeconomic factors, malnutrition is frequently portrayed as a problem with food consumption. Reinhardt and Fanzo (2024) contend that merely boosting food production or offering food assistance won’t address the problem unless measures are also made to enhance household income, access to healthcare, and sanitation. In a similar vein, Asuzu (2024) argues that malnutrition in Nigeria is directly related to the shortcomings of the healthcare system, as the country’s few basic healthcare facilities fall short in meeting the nutritional requirements of children who are at risk.
CHAPTER THREE
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RESEARCH METHODOLOGY
Introduction
This chapter outlines the research methodology used in the study, including the research design, population, sampling technique, data collection instruments, data collection procedures, reliability and validity measures, and methods of data analysis. The study adopted a quantitative approach using a survey research design to investigate the determinants of malnutrition in Delta State, Nigeria. Primary data was collected through structured questionnaires, and the analysis was conducted using SPSS version 27, employing both descriptive and inferential statistical techniques. The chapter also highlights the ethical considerations taken into account during the research process.
Research Design
This study adopted a quantitative survey research design, which allows for systematic data collection from a large population and facilitates statistical analysis to identify patterns and relationships (Saunders, Lewis, & Thornhill, 2019). The choice of this design was justified by its ability to generalize findings across the study population while minimizing biases associated with qualitative methods. A survey design was particularly suitable because it enables researchers to measure variables numerically and assess relationships between different factors influencing malnutrition (Bell, 2022). The structured nature of the survey ensured that responses could be analyzed statistically, allowing for objective conclusions.
Population of the Study
The target population of this study consisted of 5,800,000 individuals in Delta State, Nigeria, including children under five years old, mothers, healthcare professionals, and nutrition experts. The inclusion of multiple groups was necessary to ensure a holistic understanding of the factors influencing malnutrition. Delta State was selected because of its high malnutrition prevalence, particularly among children, which has been linked to poverty, food insecurity, and inadequate healthcare services (UNICEF, 2023). Focusing on this population allowed the study to capture diverse perspectives and insights into malnutrition determinants, including maternal education, household food security, and access to healthcare.
CHAPTER FOUR
DATA PRESENTATION AND DISCUSSION OF FINDINGS
Introduction
This chapter presents the analysis and interpretation of data collected to examine malnutrition among children under five in Ika North East. The study aimed to determine the prevalence of malnutrition, identify socio-economic and environmental factors contributing to it, assess the effectiveness of nutritional interventions, and propose strategies for improvement. The data were analyzed using descriptive and inferential statistics, including frequency distribution and a one-sample t-test. The results provide insights into the effectiveness of existing interventions and highlight areas requiring policy adjustments and improved healthcare strategies to combat child malnutrition in the region.
CHAPTER FIVE
SUMMARY, CONCLUSION, RECOMMENDATIONS AND SUGGESTIONS
Summary
This study examined the prevalence of malnutrition among children under five in Ika North East, the socio-economic and environmental factors influencing malnutrition, the effectiveness of nutritional interventions provided by primary health care (PHC) centers, and the role of awareness in combating malnutrition. The findings provided valuable insights into the extent of malnutrition in the study area and highlighted the need for targeted interventions to address the issue.
The results indicated a significant prevalence of malnutrition among children under five in selected PHC centers. The statistical analysis showed that the mean value and t-value exceeded the critical threshold, confirming that malnutrition is widespread in the study area. This suggests that a considerable proportion of children suffer from inadequate nutrition, which can lead to developmental challenges, weakened immune systems, and increased susceptibility to diseases. The high prevalence underscores the need for immediate interventions to improve child nutrition and overall well-being.
The study also found that socio-economic and environmental factors play a significant role in malnutrition. Economic hardship, food insecurity, poor maternal education, and limited access to healthcare services were identified as key contributors. Many households struggle to afford nutritious food, leading to inadequate diets that fail to meet children’s nutritional needs. Poor maternal education further exacerbates the problem, as mothers with limited knowledge of proper feeding practices may not provide balanced diets for their children. Additionally, environmental factors such as poor sanitation and lack of clean water contribute to malnutrition by increasing the risk of infections, which can impair nutrient absorption and overall health.
An assessment of the effectiveness of nutritional interventions provided by PHC centers revealed that these programs were not sufficiently addressing malnutrition. The statistical results indicated that the mean value did not meet the expected threshold, suggesting that the existing interventions were ineffective. Factors such as inadequate funding, poor implementation, and limited reach of nutritional programs may contribute to their ineffectiveness. Without proper support and resources, PHC centers are unable to provide adequate nutritional counseling, supplementation, and food aid programs to children in need. Strengthening these interventions by increasing funding, improving healthcare infrastructure, and training healthcare workers could significantly enhance their impact on reducing malnutrition rates.
The study further explored the relationship between awareness of child nutrition and malnutrition rates. The findings indicated a significant relationship, suggesting that higher levels of awareness contribute to better nutritional outcomes among children. Parents and caregivers who are well-informed about proper feeding practices, breastfeeding, and balanced diets are more likely to provide nutritious meals for their children, reducing the risk of malnutrition. Awareness campaigns, community education programs, and the involvement of healthcare professionals in promoting child nutrition can play a crucial role in addressing malnutrition.
Overall, the study highlighted the multifaceted nature of malnutrition and the need for a comprehensive approach to tackling the issue. The significant prevalence of malnutrition underscores the urgency of implementing effective interventions, while the role of socio-economic and environmental factors suggests that broader policies aimed at poverty reduction, food security, and maternal education are necessary. The ineffectiveness of current PHC interventions indicates the need for a review of existing programs to ensure they are properly funded and tailored to meet the needs of vulnerable children. Additionally, the strong link between awareness and malnutrition rates emphasizes the importance of health education in promoting better nutritional practices.
The findings of this study provide a foundation for policy recommendations aimed at reducing malnutrition rates in Ika North East. Addressing the issue requires a multi-sectoral approach involving government agencies, healthcare providers, non-governmental organizations, and community stakeholders. By improving access to nutritious food, strengthening healthcare services, enhancing maternal education, and increasing public awareness, significant progress can be made in combating malnutrition and improving child health outcomes in the study area.
Conclusion
The findings from the hypotheses tested in this study provide critical insights into the prevalence, causes, and possible solutions to malnutrition among children under five in Ika North East. The results confirmed that malnutrition is significantly prevalent in the study area, highlighting an urgent need for targeted interventions to improve child nutrition. Socio-economic and environmental factors were also found to have a significant influence on malnutrition, emphasizing the impact of poverty, food insecurity, poor maternal education, and inadequate access to healthcare services on children’s nutritional status.
The study further revealed that the nutritional interventions provided by primary health care centers were not sufficiently effective in addressing malnutrition. This suggests a need for improved funding, better implementation strategies, and expanded coverage of these programs to ensure they meet the nutritional needs of vulnerable children. Additionally, the significant relationship between awareness of child nutrition and malnutrition rates indicates that increasing public knowledge about proper feeding practices and maternal care can contribute to reducing malnutrition.
In conclusion, tackling malnutrition in Ika North East requires a multi-faceted approach involving government support, healthcare improvements, socio-economic development, and community awareness initiatives. Strengthening existing interventions and promoting sustainable strategies will be crucial in ensuring better nutritional outcomes for children.
Recommendations
The following recommendations are proposed based on the findings of this study:
- Enhance Nutritional Programs at Primary Health Care Centers: The effectiveness of nutritional interventions at PHC centers needs improvement. There should be an increase in the provision of fortified foods, vitamin supplements, and therapeutic feeding programs to address malnutrition among children under five. Regular monitoring and evaluation should be conducted to ensure these interventions are meeting their intended objectives.
- Strengthen Public Awareness on Child Nutrition: Since awareness was found to have a significant impact on malnutrition rates, there should be widespread sensitization campaigns on proper infant and young child feeding practices. Health workers, community leaders, and media platforms should be engaged in educating parents, especially mothers, on exclusive breastfeeding, complementary feeding, and balanced diets.
- Address Socio-Economic Barriers to Nutrition: Given the significant role of socio-economic factors in malnutrition, government and non-governmental organizations should implement financial support programs for low-income families. Subsidized food programs, cash transfer initiatives, and women empowerment programs can help improve household food security and access to nutritious meals.
- Improve Healthcare Infrastructure and Services: The availability and quality of healthcare services in rural and underserved areas should be enhanced. PHC centers should be equipped with adequate resources, trained personnel, and functional nutrition units to ensure children receive proper diagnosis, treatment, and follow-up care for malnutrition-related issues.
- Implement Stronger Agricultural and Food Security Policies: Food security plays a key role in preventing malnutrition. Policies that promote sustainable agriculture, improve local food production, and reduce post-harvest losses should be implemented. Encouraging backyard farming and supporting farmers with agricultural inputs and training will help communities have better access to nutritious food.
Suggestions for Further Research
Future research should explore the long-term impact of nutritional interventions on child growth and development in different regions. While this study assessed the effectiveness of primary health care interventions, further research could examine how factors such as cultural feeding practices, seasonal food availability, and dietary diversity influence child nutrition outcomes. Additionally, longitudinal studies tracking children over several years could provide deeper insights into the sustained benefits of these interventions and identify gaps that require policy adjustments.
Another area for further research is the role of technology in addressing child malnutrition. Digital health solutions, mobile nutrition apps, and artificial intelligence-driven dietary monitoring systems could be evaluated for their effectiveness in promoting better feeding practices and early detection of malnutrition. Research could also investigate the integration of community-based nutrition programs with government policies to create a more holistic approach to combating malnutrition. By exploring these areas, future studies can contribute to more comprehensive and sustainable strategies for improving child nutrition and reducing malnutrition rates.
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