ABSTRACT
Malnutrition is an imbalance in
nutrition, ranging from overnutrition to undernutrition. This
research work was carried out to investigate prevalence of malnutrition among
under five years old in Adegbola, Community, Akure. The sampling
technique used this in this study was simple random. Two hundred (200)
questionnaires were administered but one hundred and eighty (180) were
retrieved successfully. Those with high level of education usually feed their
child exclusively. This is as a result of the knowledge they had as a means of
their educational knowledge. This study also revealed that 99 representing 65%
of the respondents said no their child has not suffered from any infection of
recent. Children that were exclusively breastfed are not sick often. It was
recommended that health workers should explain importance of nutritional
supplements for example vitamin A, zinc among others to the mothers. Also, government through its
concerned line ministries should promote skilling that permits formal
employment in caregivers to children under five years so as to enable them
adequately support their children in preventing malnutrition.
TABLE
OF CONTENTS
Title i
Certification ii
Dedication iii
Acknowledge iv-v
Abstract vi
Table of contents vii-viii
List of tables ix
CHAPTER ONE
Introduction 1-2
Background of the study 2-4
Statement of the problem 4-5
Aims of the study 5
Objectives of the study 5
Significance of the study 5-6
Assumptions 6
Definition of terms 6-7
CHAPTER TWO
Literature
review 8
Nutrition
8-10
Prevalence
of malnutrition among under-fives 10-12
Patterns
of malnutrition 12
Factors
associated with malnutrition 12-16
Symptoms
in children 16
Underlying
factors that influence the prevalence of malnutrition among children aged five
years and below. 16-22
Basic
factors contributing to malnutrition among children under five years 22-23
Specific
interventions to control malnutrition 23-25
Preventing malnutrition in Nigeria 25-27
CHAPTER THREE
Research methodology 28
Study design 28
Study area 28-29
Sample size determination 29
Sampling technique 29
Method of data collection 29
Ethical consideration 29
Chapter Four
Data Presentation & Analysis 30-43
Chapter Five
Discussion of Findings 44-45
Summary 46
Conclusion 46
Recommendations 46-47
Reference 48-51
Appendix 52
LIST OF TABLES
Table 1: Distribution of child’s age of the respondents 30
Table 2: Distribution of age of the respondents 30
Table 3: Gender of the respondents 31
Table 4: Marital of the respondents 31
Table 5: Educational status of the respondents 31
Table 6: Occupational status of the respondents 32
Table 7: Religious status of the respondents 32
Table 8: is your child breast feeding? 33
Table 9: For how long did you breastfeed the child? 33
Table 10: Has the child suffered from infection of recent? 34
Table 11: Do you have any knowledge on balanced diet? 34
Table 12: How many times do you feed a child in a day? 34
Table 13: What is the immunization status of your child? 35
Table 14: Are there any foods that your child cannot or is not supposed
to eat?35
Table 15: Do you often wash your hands while preparing food for the
family and for the baby? 36
Table 16: Has your child ever got congenital heart diseases? 36
Table 17: Do you think poor feeding makes the child unhealthy? 37
Table 18: Has the child been dewormed? 37
Table 19: What type of weaning child do you give your children? 38
Table 20: do you often give the required food material to the baby? 38
Table 21: Factor that facilitate malnutrition? 39
Table 22: Review MUAC of under 5 children in Adegbola community between
Jan-Dec 2019 40
Table 23 Review MUAC of under 5 children in Adegbola community between
Jan-Dec 2020 41
Table 24: Review MUAC of under 5 children in Adegbola community between
Jan-Dec 2021 42
Table 25: Review MUAC of under 5 children in Adegbola community between
Jan-Jun 2022 43
CHAPTER
ONE
INTRODUCTION
Malnutrition
is an imbalance in nutrition, ranging from overnutrition to undernutrition (Norman ,2008).
It is a major public health problem in both developed and developing countries
affecting all age groups but is particularly noticeable in children because
they are undergoing a period of rapid growth. The cause of malnutrition in
surgical patients is multifactorial; this includes deficiency in dietary
intake, increased requirements related to the stage of the disease,
complication of primary disease expressed in reduced absorption or excessive
loss of nutrient or a combination of the above factors (Soeters et al., 2008). Patients
who undergo abdominal surgery are at increased risk of malnutrition due to
prolonged period of starvation (Permsombut et al., 2013) and
those with pre-operative malnutrition are at a higher risk of developing post-operative
complications, longer duration of hospital stay, and increased hospital costs (Reilly et al., 2018).
The magnitude of the
problem of malnutrition in the developing countries and its association with
the high rate of infant and child mortality has placed more emphasis on child
and maternal nutrition (State of the World's Children, 2005).
The
UNICEF report shows that 37% of Nigerian children below the age of 5 years are
stunted, 18% are wasted, and 29% are underweight. The proportion of stunted
children has declined since 2008 from 41% to 37% (Nigeria
Demographic and Health Survey 2009). Malnutrition is
associated with more than 50% of death (approximately 2.3 million) annually in
children from developing countries (Correia et al., 2013).
The reported prevalence
of malnutrition in surgical patients is in the range of 40–67% depending on the
patients’ population studied and criteria used for diagnosis (Bruun et al.,2019,
Hill et al.,2017). This
percentage seems to be unchanged over time and remains problematic until now.
Akinbami et al., (2010) reported 24.4% of underweight, 18.9% of
stunting, and 13.4% of wasting in non-surgical children admitted at emergency
ward in an institution in Nigeria, whereas 5 years later, Balogun and
Omokhodion (2015) in another study among children with congenital heart defects
in the same institution found 34.9% of wasting, 41% of stunting, and 47%
underweight in children with acyanotic heart disease and in cyanotic heart
disease, 29% wasting, 17.6% stunting, and 47% underweight, suggesting the role
of severe congenital anomalies on the nutrition and growth of these children
Balogun and Omokhodion (2015)
Adequate information on
the prevalence of malnutrition and the associated risk factors in pediatric
patients undergoing elective general surgical procedures in our center is
lacking. We, therefore, studied the prevalence of malnutrition and its risk
factors in surgical children for elective general surgical procedures.
BACKGROUND OF THE STUDY
Malnutrition results
from the interaction between poor diet and diseases which leads to nutritional
deficiencies observed among under-five children. Social, economic, biologic,
and environmental factors are the underlying causes for the insufficient food
intake or ingestion of food with proteins of low nutritional quality that leads
to protein-energy malnutrition (PEM) (Asfaw et
al., 2015).
According to the World
Health Organization (WHO), 462 million adults are underweight, while 1.9
billion adults are overweight and/or obese. In children under 5 years of age,
155 million are stunted, 52 million are wasted, 17 million are severely wasted
and 41 million are overweight and/or obese (WHO, 2019). The manifestation of
malnutrition is multifold, but the paths to addressing prevention are key and
include exclusive breastfeeding for the first 2 years of life, diverse and
nutritious foods during childhood, healthy environments, access to basic
services such as water, hygiene, health and sanitation, as well as pregnant and
lactating women having proper maternal nutrition before, during and after the
respective phases (levels and trends) (Global Nutrition Report, 2018).
It is vital that
malnutrition is addressed in children as malnutrition manifestations and
symptoms begin to appear in the first 2 years of life (Shrimpton et
al., 2011). Coinciding with the mental development and growth periods in
children, protein energy malnutrition (PEM) is said to be a problem at ages 6
months to 2 years. Thus, this age period is considered a window period during
which it is essential to prevent and/or manage acute and chronic malnutrition
manifestations (Bern et al., 2015, Benson et al., 2015). Child and
maternal malnutrition together have contributed to 3.5 million annual deaths.
Furthermore, children less than 5 years of age have a disease burden of 35%
(Black et al., 2008). In 2008, 8.8 million global deaths in children less than
5 years old were due to underweight, of which 93% occurred in Africa and Asia.
Approximately one in every seven children faces mortality before their fifth
birthday in sub Saharan Africa (SSA) due to malnutrition (Walton et al., 2011).
Wasting is low weight
for height. It indicates current weight loss, because a child consumes
insufficient food or they are exposed to infectious diseases like diarrhea,
which causes them to lose weight. Stunting is low height for age. Stunting
indicates children who are too short relative to their age. Stunting is the
result of poor nutrition in early childhood which can last a lifetime
(WHO,2020). Globally, about 149 million under-5 children are stunted, it
results from chronic under-nutrition, typically related to poor socio-economic
status, inappropriate maternal nourishment, recurrent illness, and/or improper
child feeding and care in infancy (WHO,2020).
Underweight is low weight for age and it includes stunting, wasting or
both (Pravana et al., 2017)
Malnutrition is a
prevalent problem affecting everyone at some time in their lifespan, but young
children are at a greater risk of malnutrition. Optimizing nutrition from conception
to two years of age, ensures the best possible start in life with long-term
benefits (Assembly et al.,2016)
Malnutrition results from a deficiency of good nutrition, caused by not having
adequate food to eat, or not consuming enough of the right things. Many poor
nutritional outcomes begin in the uterus and are manifested as LBW,
prematurity, and intrauterine growth restriction
Malnourished children are at risk for
infection and they are more prone to death due to common infantile respiratory
and diarrheal disease. United Nations Decade of Action on Nutrition from 2016
to 2025 proclaimed to eliminate malnutrition and guarantee worldwide access to
improved diets everywhere and for every (SDG2) and ensuring healthy lives for
all ages (SDGs, 2015).
STATEMENT OF THE PROBLEM
Normal
growth and development of a child depends upon the nutritional status of the
new born which is related to the nutritional status of the mother and the
nutrients intake of the infants, the nutritional status of a child is of paramount
importance for the proper physical, mental and social development of a child
especially in early childhood (UNICEF, 2013). Up to 1 million Nigerian children
under 5 years are affected by severe acute malnutrition (SAM) each year
especially in the rural communities (Children Investment Foundation, 2014).
These children have severely low weight for their height and are at risk of
dying unless given urgent attention, (Children Investment Foundation, 2014).
Malnourished children have an increased risk of disability and are highly
predisposed in infectious diseases and premature death. Malnutrition situation
in Nigeria is a serious public health problem among pre-school children.
About 3
out of every 10 young children are undernourished. Nearly 2 out of every 10
babies born die before their 5th birth day.
Undernutrition is an important cause of death. Knowledge on the prevalence of
malnutrition and determinations of the nutritional status particularly in rural
areas is essential in designing appropriate and context relevant program
responses. This is because a large proportion of the malnourished reside in
rural communities. So, this study aim to investigate the prevalence of
malnutrition using Adegbola as a case study.
AIM OF THE STUDY
The aim of this study is
to investigate the prevalence of malnutrition among under five
years old in Adegbola, Community, Akure.
OBJECTIVES OF THE STUDY
The objectives of the
study are to
ü Investigate
the prevalence of malnutrition among under five
years old in Adegbola, Community, Akure.
ü Identify the causes of malnutrition among under five years
old in the study area
ü Examine the prevention of malnutrition among under five years
old in the study area.
RESEARCH QUESTION
ü Is there prevalence of malnutrition among under five years old
in Adegbola, Community, Akure?
ü What are the causes of malnutrition among under five years
old in the study area?
ü Are there any means of preventing malnutrition among under
five years old in the study area?
SIGNIFICANCE
OF THE STUDY
This study will help
provide data on the existing level of knowledge on malnutrition among
under-five years children in Adegbola Akure South Local Government Area. It
will help in providing baseline information on the prevalence of malnutrition
in Adegbola. This study will contribute to the data pool of malnutrition in
Nigeria. It will also help in the development of interventions targeted at
reducing the prevalence of malnutrition among children under-five years in
Adegbola Akure South Local Government Area. Thus, promoting general over all
development
ASSUMPTION OF THE STUDY
1. There is no difference in disease
conditions among the children in the two State.
2. There is no difference in the level of
knowledge of mothers in adequate nutrition in the two State.
3. There is no difference between the
nutritional status of children under-2 years in Adegbola.
DEFINITION OF TERM
Low birth weight is a term used to
describe babies who are born weighing less than 5 pounds, 8 ounces (2,500
grams).
Malnutrition: This
will be refer to as lack of food nutrients in the body or lack of adequate
nourishment.
Prevalence: This
will be refer to as the total number of disease cases in a given statistical
population at a given time.
Starvation is a severe deficiency
in caloric energy intake, below the level needed to maintain an organism's
life.
Stunting:
Will be refer to as children who are too short for their age
Under five: This
will be refer to Children who are below 59 months.
Underweight:
will be refers to as a child whose body weight is too low for his/her age or to
healthy
Wasting:
will be refers to a child that the normal body weight, looking thin and
emaciated.
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