ABSTRACT
Food security is an important dimension of well-being which tends to affect health and nutritional status of populations. This cross sectional study was carried out to assess the food security and anthropometric status of preschool children in Nnewi North Local Government Area of Anambra State. A total of 253 pre-school children were selected using simple random sampling technique. Structured questionnaire was used to obtain information on socio-economic characteristics and food habit of the respondents. Food security status of the respondents was assessed using the USDA guide for measuring household food security while dietary diversity was scored using WHO standard. Anthropometric indices of the preschool children were collected and grouped using WHO anthro. Data obtained were analyzed with SPSS version 20.0, using descriptive statistics such as frequencies and percentages and chi-square. The result showed that 54.9% of the children were 2-4 persons in their homes. About 46.1% and 41.1% of their mothers and fathers were graduates. Most of the children adopted good eating habit. Slightly above half (55.7%) of the children were food insecure with moderate hunger where as 26.5% were food insecurity with hunger severe. However, 17.8% were food insecure without hunger. Majority (95.2%) consumed more than four food groups. Prevalence of wasting, stunting and underweight was low among 3.6%, 8.3% and 2.4% of the children. However, prevalence of overweight was high probably due to their food insecurity levels that had predisposed them to excessive carbohydrate consumption. There was no significant relationship between nutritional status of the children and their food security status, dietary diversity scores. Similarly, no significant (p>0.05) relationship was found between weight-for-height, height-for-age and socioeconomic status of the children’s parents. Household size and occupation of the children’s parents significant determine their weight-for-age. Similarly, parents educational levels and occupational status significant (p<0.05) determine the food security levels of the children. There is need for the parents to diversify the food given to their children, by including foods from the egg, fruits and vegetable groups.
TABLE OF CONTENTS
Title page i
Certification ii
Dedication iii
Acknowledgement iv
Table of content v
Lists of tables viii
Abstract ix
CHAPTER 1
INTRODUCTION
1.1 Statement of Problem 4
1.2 Objectives of the Study 5
1.2.1 General objective 5
1.2.2 Specific objectives 6
1.3 Significances of the Study
CHAPTER 2
LITERATURE REVIEW
2.1 Food security 7
2.1.1 Food availability 8
2.1.2 Food access 8
2.1.3 Food utilization 9
2.1.4 Other food security indicators 9
2.1.5 Influence of food security on nutritional status of children 10
2.2 Nutrition and malnutrition 11
2.2.1 Malnutrition in Children 12
2.2.2 Nutrient needs of children 13
2.3 Dietary diversity 14
2.3.1 Dietary diversity and food security 15
2.3.2 Dietary diversity and nutritional status 16
2.3.3 Dietary intake of children 17
2.4 Factors that affects the nutritional status of children 17
2.4.1 Food Choice 18
2.4.2 Perception of Different Types of Food 18
2.4.3 Child Care Practices and Parent Workload 18
2.4.4 Culture Beliefs and Practices 19
2.4.5 Income Education and Occupation 19
2.4.6 Knowledge of Food and Nutrition 20
2.4.7 Time Constraints 20
2.4.8 Location (Rural Area) 21
2.5 Assessment of nutritional status 21
2.6 Anthropometric indicators 22
2.6.1 Z –Scores 23
CHAPTER 3
MATERIALS AND METHODS
3.1 Study design 25
3.2 Area of study 25
3.3 Population of the study 26
3.4 Sampling and sampling techniques 26
3.4.1 Sample size 26
3.4.2 Sampling procedure 28
3.5 Preliminary activities 28
3.5.1 Preliminary visits 28
3.5.2 Training of research assistants 28
3.5.3 Informed consent 28
3.5.4 Construction of questionnaire 29
3.5.5 Validation of questionnaire 29
3.6 Data collection 30
3.6.1 Questionnaire administration 30
3.6.2 Food security module 30
3.6.3 Anthropometric measurements 31
3.6.3.1 Body weight 31
3.6.3.2 Length measurements 32
3.6.3.3 Body Mass Index 32
3.6.3.4 Mid Upper Arm Circumference (MUAC) 32
3.7 Data analysis 33
3.7.1 Classification of anthropometric data 33
3.7.2 Dietary diversity classification 34
3.7.3 Food security classification 34
3.8 Statistical analysis 35
CHAPTER 4
RESULT AND DISCUSSION
4.1 Socioeconomic characteristics of the children 36
4.2 Food habit of the children 40
4.3 Food security status of preschool children 43
4.4 Dietary diversity scores of the children 44
4.5 Anthropometric status of the children 45
4.6 Relationship between food security and nutritional status of the children 48
4.7 Relationship between dietary diversity and nutritional status of the children 49
4.8 Relationship between weight-for-height and socioeconomic characteristics of the children 50
4.9 Relationship between height-for-age and socioeconomic characteristics of the children 51
4.10 Relationship between weight-for-age and socioeconomic characteristics of the children 52
4.11 Relationship between food security and socioeconomic characteristics of the children’s parents 54
CHAPTER FIVE
CONCLUSION AND RECOMMENDATIONS
5.1 Conclusion 56
5.2 Recommendations 56
References
Appendix: Questionnaire
LIST OF TABLES
Table 4.1: Socio-economic characteristics of the children 36
Table 4.2: Food habit of the children 40
Table 4.3: Food security status of preschool children 43
Table 4.4: Dietary diversity score of the children 44
Table 4.5: Anthropometric status of the children 45
Table 4.6: Relationship between food security and nutritional status of the children 48
Table 4.7: Relationship between dietary diversity and nutritional status of the children 49
Table 4.8: Relationship between weight-for-height and socioeconomic characteristics of the children 50
Table 4.9: Relationship between height-for-age and socioeconomic characteristics of the children 51
Table 4.10: Relationship between weight-for-age and socioeconomic characteristics of the children 52
Table 4.11: Relationship between food security and socioeconomic characteristics of the children’s parents 54
CHAPTER 1
INTRODUCTION
BACKGROUND OF THE STUDY
Food is a basic necessity of life, it is regarded as the basic means of sustenance, and an adequate food intake in the terms of quantity and quality is a key for healthy and productive life (Food and Agriculture Organization FAO, 2005). Besides, the nutrients contained in food are necessary for proper body functions (Muhammad and Omotesho, 2010). Food security is an important dimension of well-being. Food security encompasses three dimensions: availability (a measure of food that is, and will be, physically available in the relevant vicinity of a population during a given period); access (a measure of the population’s ability to acquire available food during a given period); and utilization (a measure of whether a population will be able to derive sufficient nutrition during a given period). (Cook et al., 2004). Although it may not encapsulate all dimensions of poverty, the inability of households to obtain access to enough food for a productive healthy life is an important component of their poverty. In this context, devising an appropriate measure of household food access is useful for several reasons: to identify the food insecure; to characterize the nature of their insecurity (for example, seasonal versus chronic); to monitor changes in their circumstances; and to assess the impact of interventions (Cook et al., 2004).
Food security is an important matter of concern for both the developed and developing countries. However, the situation in developing countries is terrible. About 906 million undernourished people live in developing countries out of the total 925 million undernourished people of the world. The situation is getting worse in Africa and Asia where more than 800 million undernourished people live (FAO, 2012).
A vast pool of evidence shows that food security is associated with a number of human and economic development outcomes (Cook et al., 2008). Despite this recognition, millions of people in low and middle income countries suffer from extreme hunger and malnutrition (FAO, 2012). Household food insecurity is associated with poor nutritional health (Cook et al., 2008). Among children, poor nutritional status has negative consequences on growth and development, especially during the early years of life (Grantham et al., 2007). While poor nutrition status in children includes over nutrition, it often refers to cases of undernutrition (Ahmed et al., 2012). Undernutrition refers to deficiency of protein energy, micronutrients and vitamins as well as minerals essential for growth. (Ahmed et al., 2012).
Despite the fact that world food production has doubled during the past three decades, the numbers of malnourished people are soaring above 900 million around the world. (FAO, 2009), Malnourishment exists when households’ caloric intake goes below the minimum dietary energy requirement (FAO, 2010). “Food security exists when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life (FAO, 2010). Household food security is the application of this concept to the family level, with individuals within households as the focus of concern (Pandey et al., 1996).
Food insecurity, on the contrary, is known to be the absence of any of the conditions stated in the definition of food security at any level i.e. household, regional and national level (FAO, 2010).
It is considered as severe food insecurity when individuals continuously take insufficient amounts of food to meet their daily dietary energy requirements. This may lead to hunger, the most severe stage of food insecurity (FAO, 2010).
Anthropometry is the longest used measure of human variation, and since it measures surface morphology, is intuitively understood at the elementary level (Ulijaszek and Taylor, 2005). The anthropometric indicators commonly used to assess children nutritional status are “weight for height”, “height for age” and “weight for age (Keller and Fillmore, 1983). Traditionally, values of weight for age below certain percentage of the median in a reference population from an affluent setting are used to diagnose “ protein energy malnutrition”. However, “weight for age” reflects two distinct components which are typically unrelated to each other, “height for age” and “weight for height” (Keller and Fillmore, 1983). Children who are very short for their age are conventionally said to be “stunted” and children who are very thin for height are said to be “wasted” (Gorstein et. al., 1994).
Nutrition interventions generally neglect preschool children despite their high prevalence of malnutrition and micronutrient deficiency (Best et al., 2010). Iodine, iron and folic acid micronutrient deficiencies affect the development of the brain and cognitive functions of preschool children (Bryan et al., 2004). Iodine deficiency, even mild, could impede full intellectual potential with differences in intellect as large as 10–15% between iodine deficient and non-deficient populations (Gordon et al., 2009). On the other hand, deficiencies of vitamin A and zinc are associated with different scenarios affecting school performance, such as absenteeism due to increased morbidity (Black et al., 2001).
1.1 STATEMENT OF PROBLEM
According to a report by the Federal Ministry of Health (FMH) (2012), Malnutrition is an underlying cause of more than 35% of the 1 million under-five deaths each year. Although Nigeria is regarded as a middle-income country, more than half the population lives below the poverty line and many lack access to healthcare, water and sanitation (FMH, 2012). This situation makes the problem of child malnutrition an essential issue of national concern.
Irohibe and Agwu (2014) pointed out that the dimensions of food security make it clear that the concept of food problem is a complex one with many dimensions. At one level, the concern is with national food security, which is the ability of countries to produce or increase sufficient food all the year to meet the requirement for both private and public distribution. At another level, the concern is more with the problem of malnutrition (Irohibe and Agwu, 2014).
Irohibe and Agwu (2014) further emphasized that, in Nigeria, the majority of households are food insecure, especially the rural farming households. Also, evidence from the International Fund for Agricultural Development (IFAD) suggests that majority of the world’s food insecure live and work in the rural areas (IFAD, 2001). This indicates that reducing rural food insecurity is very important to reducing overall food insecurity. . In view of the role of agriculture in the Nigerian economy, food insecurity and poverty could be attributed to the poor performance of the agricultural sector, which in turn, creates food availability and accessibility problems at the household and national levels (Akinsanmi and Doppler, 2005). In other words, the poor performance of the sector directly creates supply shortages and indirectly creates demand shortages by denying the rural farming households access to sufficient income (Irohibe and Agwu, 2014).
1.2 OBJECTIVES OF THE STUDY
1.2.1 Main objective
The main objective of this study is to assess the food security and anthropometric status of preschool children in Nnewi North Local Government Area of Anambra State.
1.2.2 Specific objective is to:
i. assess the socio-economic factors affecting the food security status of preschool children.
ii. evaluate the food security status of preschool children.
iii. assess the nutritional status of preschool children using anthropometric indicators.
iv. determine the dietary habits of the preschool children.
v. determine the association of anthropometric indicators with food security.
vi. determine the association of anthropometric indicators with dietary diversity.
vii. determine the association of anthropometric indicators with socio economic factors.
1.3 SIGNIFICANCE OF THE STUDY
Emphasis has been placed on exclusive breast feeding, appropriate complementary feeding practices and dietary intake and nutritional status of school age children. But the period between weaning and school age has received little attention with little documentation on dietary intake and nutritional status of preschool children 2 years and above after they have fully transitioned into household foods. The findings of this study will go a long way to alert parents of pre-school children of their role in meeting the nutritional needs of the children. This will be a wake-up call for the parents to improve and intensify their efforts in meeting the basic needs of the children.
In addition, the findings will benefit the Community Health workers in the community. The health workers will be informed through the study about the true nature of the nutritional status and the feeding pattern of the preschool- children. This will help them to design a scheme for reaching out to both parents in their educational duties to help lift up nutritional education. By the nature of their work, the community health nurses educate both parents on proper feeding practices.
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