Prevalence of Malnutrition Among Children Under Five
CHAPTER ONE
Generalย Objectives:
To determine the prevalence of malnutrition among children under five of age inย theย Pastoralist communityย of Barkin Ladiย LGA,ย Plateau state.
Specificย Objectives
- Whatareย theย majorย contributingย factorsย forย malnutritionย in communityย under study?
- To determine prevalence ofstuntingย of under five children in the studyย area
- Toestimateย prevalenceย ofย wastingย ofย under five childrenย in the studyย area
- To assess the knowledge and practice of mothers/caretakers on complementary andsupplementaryย feedingย ofย theย child
CHAPTERย TWO
LITERATUREย REVIEW
GeneralBackground
Adequate food and nutrition are essential for proper growth and physical development toย ensureย optimalย workย capacity,ย normalย reproductiveย performance,ย adequateย immuneย mechanism,ย andย resistanceย toย infection.ย Inadequateย dietย mayย produceย severalย formsย ofย malnutritionย inย children,ย theย mostย importantย beingย proteinย energyย malnutritionย (PEM),ย Nutritional anemia, Vitamin A deficiency and Iodine deficiency disorder. These and otherย nutritional disorders may also serve as predisposing factors for several chronic and cripplingย diets related non- communicable diseases and have lasting effects throughout the life spanย (17).
Deficienciesย ofย keyย vitaminsย andย mineralsย continueย toย beย pervasive,ย andย theyย overlapย considerably with problems of general under nutrition (underweight and stunting). A recentย global progress report states that 35 percent of people in the world lack adequate iodine, 40ย percent of people in the developing world suffer from iron deficiency, and more than 40ย percentย ofย childrenย areย vitamin Aย deficient (18).
The three commonly used indicators of malnutrition are height-for age, weight-for-age, andย weight-forย height.ย Childrenย whoseย measurementsย fallย belowย twoย standardsย deviationsย fromย theย referenceย medianย areย generallyย consideredย malnourished.ย Eachย indicatorย capturesย differentย aspects ofย malnutrition (19).
Magnitudeย ofย Malnutrition
Stunting, or low height for age, is considered an indicator of chronic malnutrition. Height for age measures linear growth and therefore a low score is indicative of a cumulative growth deficit. Stunting is often the result of inadequate feeding practices over a long period and/or repeated illness. It is likely to persist even after these conditions are eliminated. Wasting, or low weight-for-height, measures body mass in relation to body length and is generally considered to reflect acute malnutrition. As an indicator, wasting is likely to vary over short periods of time due to food availability and disease prevalence. Underweight, or low weight for age, is a composite of height for age and weight for height. It is generally considered a general indicator of malnutrition, since a child that is underweight could be stunted or wasted, or both stunted and wasted (19).
Understanding the problem of nutrition in a developing country like Nigeria and arriving at aย consensus on the synergies and the integration of various causes of malnutrition are deemedย essential as a background for the development of a National Nutrition Strategy (NNS). Threeย clusters of causes of malnutrition are identified as key sets of determinants for the process ofย developing the NNS. These include the immediate causes, the underlying causes, and theย basicย orย root causes.
CHAPTERย THREE
Research Methodology
Studyย Design
Five Homes were selected randomly from Barkin Ladi. Selected under five of age children inย the selected villagesย wereย theย studyย population.
The study assessed the nutritional status of children by using height and weight scale. Theย source population was all children 6-59 month of age in pastoralist community of Barkin Ladi andย Communityย based Descriptiveย method design will beย used.
Studyย Population
From the total 14 homes of Barkin Ladi five homes were selected randomly by using lotteryย method. The total sample was distributed for each homes by using proportional to sizeย allocation.ย Fromย thisย homesย eligibleย sampleย ofย householdsย wereย selectedย usingย simpleย random sampling technique. Data of 3112 households with children in the age group under five of age were taken from health extension workers. Depending on the data obtainedย from HEWs, sampling frame was prepared.ย For the family that had more than one childย withinย this ageย theย youngestย child was selected.
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A total of 816 children participated making the response rate 99.7%, with mean age andย standard deviation of children 22 ยฑ 12 months. The list of households those who have under five of age children were obtained from health extension workers. By using the list as aย samplingย frameย aย totalย ofย 816 children participatedย in this study.
CHAPTERย FOUR
DATAย PRESENTATIONSย ANDย RESULTS
Socioย Demographicย Characteristics
The age ranges of children considered in the study were under five of age.ย Majority ofย children, which accounted for 673(82.5), were aged 6- 36 months. From the total studyย participantsย 442(54.2%)ย wereย malesย andย 374(45.8%)ย wereย femalesย respectivelyย (Tableย 4.1).
Table 1 shows that 582(71.3%), of mothers were below the age of 36 years. Regarding familyย size 737(90.3%) of the respondents had greater than or equal to four family members. Of theย total respondents 621(71.6%) of them had more than one under five of children. Andย 653(80%)ย mothers reportedย that, theyย hadย given birthย forย threeย orย moreย children.
In the majority of the respondents, 812(99.5%), of them the head of the house hold were male. Regarding education status 754(92.4%) of mothers were illiterate. Of all interviewed Mothers, 797(97.7%) of them were married, 10(1.2%) of them were Divorced, and the rest of them were widowed. When we see the ownership of the house about 792(97.1%) of the house was owned by the respondent. Around half of the respondents, 398(48.8%), reside in the house which had only one room.
CHAPTERย FIVE
SUMMARY, CONCLUSIONSย ANDย RECOMMENDATIONS
Summary
Descriptive survey research design was employed to undertake the study. From the total 114ย homesย ofย Barkin Ladiย LGA,ย fiveย homesย wereย selectedย randomlyย byย usingย lotteryย method. The total sample was distributed for each homes by using proportional to sizeย allocation. From the 3112 households residing in the LGA, the list of households that haveย under five of age children were taken as a sampling frame and 816 children within the ageย ofย 6 -59 months wereย selected as studyย participants.
The findings in the research indicate that the morbidity rate identified in the study subjectsย using symptom complex such as: diarrhea, fever and chills, and cough and difficulty toย breathe in the last two weeks. During bi variant analysis febrile illness shows significantย association with wasting. But in multivariate analysis no significant different was observed inย stuntingย andย morbidity.ย Ageย atย firstย marriageย hadย significantย associationย withย stunting.ย Children from those mothers who got marriage before the age of eighteen were 2.3 timesย more likely to be stunted than children from those mothers who married after the age ofย eighteen.
Magnitude of Stunting was found to be very high with 35.8%, underweight 11.6% andย wastingย 9.2%,ย amongย children ofย Barkin Ladi
Generally in this study, it was observed that childhood malnutrition was among the mainย nutritional related problems of the population of Barkin Ladi and different factorsย wereย interrelatedย toย causeย childย malnutrition.ย Theย effectย ofย nutritionalย problemsย affectsย survivalย ofย individualsย andย developmentย atย theย family,ย societyย andย evenย atย theย nationalย level.
Moreover,ย Health,ย foodย security,ย childย careย requireย specialย attentionsย toย achieveย rapidย reductionย inย childย malnutrition.ย Accessย toย education,ย healthcare,ย safeย water,ย andย environmentalย sanitation areย theย keyย elements to alleviateย this problem.
Conclusion
- Based on the study findings, Maternal educational status , income, Water source,Number of under five children in the house hold, breast feeding, age at firstย marriageย were found to be a major associated factors for chronic malnutrition or
- Using unprotected water source, breast feeding and income were variables whichshowย association withย So,ย theyย areย theย majorย predictorsย ofย wasting.
- Childmorbidityย canย aggravateย malnutrition;ย anotherย keyย associationย wasย identifiedย betweenย havingย diarrhealย diseaseย andย ย Andย incomeย wasย alsoย found theย main predictorย ofย underweight.
- Income was the variable which show significant association with all nutritionalproblems, (Stunting, wasting and underweight), breast feeding were found theย predictorย forย both stuntingย and
- Breast feeding was one of the variable which shows significant association withย Childrenย thoseย everย notย breast feedย hadย great chanceย to beย stunted.
- Feeding the children for less than six times per day will increase the chance to be
- Child Immunization, the sex of the head of the House Hold, and sex of the childwereย not significantlyย associated with stunting
Recommendations
Theย multi-facetedย natureย ofย theย causesย ofย malnutritionย canย effectivelyย beย alleviatedย byย multispectral approach in order to co-ordinate and prevent duplicating and contradicting eachย otherย duringย planningย and implementation. ย Therefore,
- To that end Food and nutrition policy will be an important tool for bringing thisharmony both conceptually and practically. Consequently there is a need for regionalย healthย bureauย toย developย regionalย foodย andย nutritionย policyย inย harmonyย withย participationย ofย communityย and other
- Zonal Health Departmentsshould go to the grass root level and undertake continuousย supportive supervision especially to alleviate the root cause of nutritional problem inย that area. And also should support Barkin Ladi by providing financial as well material
- Barkin Ladi Health office should give due attention in tackling this problem by givingtrainingย forย healthย workers,ย byย educatingย theย communityย onย feedingย frequency,ย exclusive breast feeding, family planning and on environmental sanitation. And alsoย incomeย generatingย conditionsย shouldย haveย toย beย facilitatedย forย communitiesย inย harmony with other stakeholders. They have to work hard in improving water supplyย in harmony with different governmental and nongovernmental stake holders so as toย decrease water born disease and for the improvement of child. Additionally, they haveย toย facilitateย theย conditionย andย openย theirย doorย forย differentย nongovernmentalย organizationsย thoseย who work on nutrition.
- Health Extension workers shouldwork hard in tackling nutritional problem due to lack of awareness by educating the community on proper breast feeding of the child, feeding frequency of the child, encouraging programs to improve women role and education, combined with child feeding practice.
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