ABSTRACT
This study was aimed at assessing the Anthropometric characteristics and feeding patterns of children 2-5years in Rural Communities in Ikwuano and Umuahia North Local Government Areas. A cross sectional study was conducted on 383 household in Ikwuano and Umuahia North LGA. A multi-stage sampling was adopted in selecting the respondents from the 4 communities (Umudike, Umuariaga, Ahiaeke and Government College) used in the study. Data was collected with a validated questionnaire and analyzed using statistical package for social sciences (SPSS) version 25.0. Anthropometric indices measurement carried out using the standard procedure and were calculated using the WHO Anthro software. Descriptive analysis was used for the general characteristics of the respondents.The study showed that 17(8. %) male was wasted compare to 9(5.3%) females. 23(10.8%) of males are stunted compared to 13(7.6%) of the females. About 8(3.8%) of the males were underweight compared to 4(2.3%) females. 29(13.7%) males were overweight compared to 17(9.9%) female. It was observed that there was a significant (p> 0.05) positive correlation between Weight for Age Z-score (WAZ), Height for Age Z-score (HAZ) and mothers age, mothers educational level, mothers estimated monthly income, fathers age and fathers educational level. In addition, there was a significant (p> 0.05) positive correlation between Mid-Upper Arm Circumference (MUAC) and birth weight of child. The results of the study showed that the prevalence of malnutrition among under-five children in the study area is lower than the national average. On the whole, under-five nutritional status in the study fell within the recommendations by WHO because of the relatively low percentage of under-nutrition among children in the study area.
TABLE OF CONTENTS
TITLE
PAGE i
CERTIFICATION
ii
DEDICATION
iii
ACKNOWLEDGEMENT
iv
TABLE
OF CONTENTS
v
LIST
OF TABLES ix
ABSTRACT x
CHAPTER
1
INTRODUCTION
1
1.1 background of the study
1
1.2 statement
of problem
3
1.3 objectives
of the study
6
1.3.1 General Objective of the
Study
6
1.3.2 Specific Objectives of the
Study
6
1.4 significance of the study
7
CHAPTER
2
LITERATURE
REVIEW
8
2.1 global burden of childhood
malnutrition
8
2.2 overview and trend of malnutrition in
Nigeria
11
2.3 The
organization of health services in Nigeria 15
2.4 Epidemiology of childhood malnutrition 15
2.5 Etiological factors of childhood malnutrition
16
2.5.1 Basic Causes
16
2.5.2 Underlying Causes
17
2.5.3 Immediate Cause 18
2.6
Nutrition and nutritional needs of children
18
2.7
Assessment of nutritional status 19
2.7.1 Anthropometry
20
2.7.2 Weight
22
2.7.3 Height
22
2.8 Nutritional status
indicators
23
2.8.1 Weight for age
23
2.8.2 Height for age
24
2.8.3 Weight for height
25
2.8.4 Body mass index (BMI)
26
2.8.5 BMI for age 28
2.8.6 Mid- upper arm circumference
(MUAC)
28
2.8.7 Head Circumference (HC) 29
2.8.8 Skin fold thickness (SF)
29
2.9 Other methods of nutritional
assessment 30
2.9.1
Biochemical assessment
30
2.9.2
Clinical assessment
31
2.9.3
Dietary assessment
32
2.9.4
Food frequency questionnaire 32
2.9.5
24hours dietary recall
33
2.9.6
Diet record
33
2.9.7 Weighed food
records
34
CHAPTER
3
MATERIALS
AND METHODS 35
3.1 Study Design
35
3.2 Area of study
35
3.3 population of the study
36
3.4.1 Sample size
36
3.4.2 Sampling techniques
37
3.5 preliminary activities
38
3.5.1 preliminary visit 38
3.5.2 Informed consent
38
3.5.3
Training of research assistants
38
3.5.4 Ethical approval
38
3.6 questionnaire design
38
3.7 anthropometric measurements
39
3.7.1 Weight Measurement
39
3.7.2 Height Measurement
39
3.7.3 Mid Upper Arm Circumference (MUAC) 39
3. 8 Data analysis 40
3.9 Statistical
analysis
41
CHAPTER 4
RESULT AND DISCUSSION 42
Table 4.1a basic characteristics of under 5 children 42
Table 4.1b basic characteristics of under 5 children 44
Table 4.1c socio-demographic characteristics
of parents 45
Table 4.1d socio-demographic characteristics
of parents 47
Table
4.1e household utilities
49
Table 4.2 feeding habits of the child
50
Table 4.3a: Anthropometric characteristics of the child
based on sex 52
Table 4.3b: Anthropometric characteristics of child based on age 54
Table 4.4 socio-demographic and other factors associated with
malnutrition 57
CHAPTER
5
CONCLUSION
5.1 conclusion
59
5.2 Recommendation
59
REFERENCES
61
APPENDIX I 71
APPENDIX
II 75
APPENDIX III
APPENDIX IV
LIST OF TABLES
Table
4.1a basic characteristics of children aged 2-5years
41
Table
4.1b basic characteristics of children aged 2-5years
43
Table 4.1c socio-demographic
characteristics of parents 44
Table 4.1d socio-demographic
characteristics of parents 46
Table 4.1e Household
utilities 48
Table
4.2 feeding habits of the child 49
Table 43.a: Anthropometric characteristics of the child based
on sex 51
Table
4.3b: Anthropometric
characteristics of child based on age 53
Table 4.4 socio-demographic
and other factors associated with malnutrition 56
CHAPTER 1
INTRODUCTION
1.1 BACKGROUND OF THE
STUDY
Malnutrition
is the intake of an insufficient, surplus or disproportionate amount of energy
and/or nutrients (WHO, 2020). Malnutrition is a significant global public
health burden with greater concern among children under five years (Simonyan et al., 2020). It is frequently part of a vicious
cycle that includes poverty and disease. These three factors are interlinked in
such a way that each contributes to the presence and permanence of the others.
Socioeconomic and political changes that improve health and nutrition can break
the cycle; as can be specific nutrition and health interventions (WHO, 2017).
Inadequate diet and disease, in turn, are closely linked to the general
standard of living, the environmental conditions, and whether a population is
able to meet its basic needs such as food, housing and health care (Aruna, and
Sudha, 2015).
However, according World Food Programme
(WFP) defines long ago malnutrition as “a state in which the physical function
of an individual is impaired to the point where he or she can no longer
maintain adequate bodily performance process such as growth, pregnancy,
lactation, physical work and resisting and recovering from disease” (WFP,
2000). The impact of malnutrition usually falls mainly on children under five
years of age. Childhood malnutrition has long-term
effects that are irreversible, such as delayed cognitive and physical
development (dos Santos et al., 2018).
Malnutrition further diminishes sensory-motor abilities, reproductive capacity,
and makes the child more subjected to hereditary diseases, such as diabetes,
reducing productivity in working capital at adulthood (WHO, 2020).
The
problem of child malnutrition is highly concentrated in low and middle income
countries, whereby at least one-third of children are malnourished (Mohammed et al., 2019; Akombi et al., 2017).
Africa
is ranked second only to Asia as the continent with the most malnourished
children in the world, bearing the greatest share of all forms of malnutrition.
Recent data of malnourished children under 5 years of age in the continent
showed that as much as 39 per cent are stunted, 27 per cent are wasted and 25
per cent are overweight (UNICEF, 2018). Within Africa, Nigeria faces the
biggest burden of under-nutrition with the largest population of malnourished
children and occupies the second position in the world with only war-torn Yemen
having more malnourished children (UNICEF, 2018; FAO et al., 2017).
About 14 million children are considered stunted in the country, implying that
one out of every three Nigerian children is malnourished with their body and
brains deprived of key nutrients. Specifically, about 44 per cent of children
in Nigeria are stunted, 32 per cent underweight and 11 per cent wasted (UNICEF,
World Health Organization, and The World Bank, 2018). These children may never
develop to their full cognitive potential with adverse effects on their
physical and mental development. Conversely, poor nutrition impairs labor
productivity, which in turn impedes national economic growth.
This
is more so because the effects of under-five malnutrition are permanent and
cross into
the adulthood stage of the child (Jesmin, et al., 2011).
Though
there has been considerable global decline that has been noticed in childhood
stunting, there are over 150 million, 50 million and 38 million children
remaining stunted, wasted and overweight, respectively (Global Nutrition Report
the Burden of Malnutrition, 2020). However, contrary to the expectation and in
line with a global target on malnutrition to keep the rate of overweight in
children constant, in 2018 there were over 40 million children under five who
were overweight (UNICEF/WHO/World Bank Group, 2019), indicating a gradual
global increase in overweight children. There is the possibility that the
number of overweight children will increase further in the aftermath of
covid-19 global lockdown. Just as most countries are witnessing multiple forms
of malnutrition indices, in the same way, individual children are found to
suffer from two or more forms of malnutrition indicators globally (Global
Nutrition Report the Burden of Malnutrition, 2020).
Given
the foregoing, this study aims to assess the anthropometric characteristics and
feeding patterns of Children 2-5years in Rural Communities in Ikwuano and
Umuahia North Local Government Areas in Abia State.
1.2 STATEMENT OF
PROBLEM
The
problem of child malnutrition is highly concentrated in low and middle-income
countries like Nigeria, whereby at least one-third of children are malnourished
(Global Nutrition Report the Burden of Malnutrition, 2020; UNICEF/WHO/World
Bank Group, 2019).
Generally,
malnutrition can lead to cognitive and physical impairment in children,
especially those under five years old, with a high rate of morbidity and
mortality (WHO, 2013; Akombi et al.,
2017). A child’s fundamental right to a higher level of physical and mental
health development worldwide is boosted with access to good nutrition (Amalia,
2020).
Every
single day Nigeria loses about 2,300 children below 5 years of age and 145
women of child bearing age (UNICEF, 2015). Although analyses of recent trends
show that the country is making progress in cutting down infant and under-five
mortality rates, the pace was too slow in achieving the Millennium Development
Goals of reducing child mortality by 2015 (UNICEF, 2015). At the conclusion of
MDG, the proportion of underweight children was reported to have declined
globally from 25% in 1990 to 15% in 2015, however this decline was not
proportionally distributed in all parts of the world, as nearly 90% of all
underweight children live in sub-Saharan Africa and South East Asia (UNICEF,
2015). Statistics shows that one in seven children will die before attaining
school age as a result of malnutrition (UNICEF, 2012). A study conducted on the
influence of socioeconomic factors on nutritional status of children in a rural
community of Osun state, which is located in the west of Nigeria revealed that
23.1, 9 and 26.7%age of children were underweight, wasted and stunted
respectively. This is not just a loss to families but to the country, as it
negatively affects its economic development. Even more disheartening is the
fact that prompt and essential interventions would have averted most of those
deaths (Sufiyan et al., 2012). A new
2016-2025 nutrition strategy has been initiated by the WHO to work with member
states and partners towards universal access to effective interventions for
sustainable food production (WHO, 2018). Successful implementation of this
initiative will significantly reduce child mortality from malnutrition.
One
of the responsibilities of any government is providing a minimum quantity and
quality of life for all and provides health care needed to ensure that minimum
which leads to a redistributive perspective that favors people who are worse
off. In Nigeria this is not so, as evidenced by the high out-of-pocket payment
by an individual due to the inefficient National Health Insurance Scheme (NHIS)
especially amongst the poor (Timothy et
al., 2014). There is an obvious disparity in resources and opportunities
within citizens of the country and it is like those in dire need of food,
shelter, education and treatment is the very people that lack it (Ndukwu et al 2013). The objective government
whose interest is in seeking the greatest good for the greatest number of her
people, might argue that since our resources are finite and Nigeria is faced
with enormous challenges such as terrorism, that it will be too expensive to
thoroughly focus our attention on eradicating malnutrition at this time. It is
because of views like this that for over two decades malnutrition has plagued
our economy, impeding any chance of meaningful growth. According to Velasquez et al., (2014), one of the greatest
problems of some Africa government is that it fails to consider justice. The
time to tackle malnutrition brutally is now; as any postponement puts our next
generation at risk. This is more reinforced by Timothy et al., (2014), which states that the first 1,000 days of a child’s
life are very crucial to prevent irreversible harm such as growth retardation
and intellectual impairment which is caused by severe malnutrition
Due
to these problems identified, it is worth carrying out the project to assess the
Anthropometric characteristics and feeding patterns of Children 2-5years in
Rural Communities in Ikwuano and Umuahia North Local Government Areas in Abia
State.
1.3 OBJECTIVE OF THE
STUDY
1.3.1 General Objective of the Study
The
general objective of the study is to assess the Anthropometric characteristics
and feeding patterns of Children 2-5years in Rural Communities in Ikwuano and
Umuahia North Local Government Areas in Abia State.
1.3.2
Specific Objectives of the Study
i. To determine the socio-economic
status of parents of these children
ii. To determine the prevalence of
malnutrition among children 2-5years of age
iii. To identify the children's
feeding practices
iv. To determine the factors
associated with malnutrition
1.4
SIGNIFICANCE
OF THE STUDY
The findings of this
study will be used to:
Ascertain the current
anthropometric characteristics and feeding patterns of children aged 2-5years
in the rural areas in Abia State so as to know the present rate compared to
previous studies.
The information gotten
can be used to effectively plot an intervention program for these pre-school
aged children, assist the program implementers and stakeholders make
evidence-based decisions in improving children's health by promoting and facilitating
better feeding practices to reduce malnutrition prevalence in rural areas of
Abia State especially in the most vulnerable period which is the first 1000
days of life.
The findings of this
study will help health professionals in planning and executing appropriate
intervention strategies and programs like school feeding programs and nutrition
education that will help improve the nutritional status of children 2-5years
old.
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