ABSTRACT
Malnutrition refers to deficiencies, excessive or imbalance in energy and nutrients intake. This study is carried out to evaluate malnutrition among children 2-5 years in Ohabiam, Uratta and Obuda communities which are urban area of Aba South Local Government Area, Abia State. Cross-sectional research design was adopted for the study. Multi-stage sampling techniques was used to select 382 respondents from the three (3) communities in the aforementioned study locations. Data was collected from the respondents with the use of a well-structured and validated questionnaire. The anthropometry assessment of the respondents was done by measuring their height, weight and mid-upper arm circumference and it was analyzed with the use of both WHO anthropometric calculator and Statistical Package Service Software (SPSS) version 23.0 and the result was compared to a reference standard to ascertain the respondents’ status. The result of the analysis was presented in frequency and percentage, p-value (P<0.05) was statistically accepted. Findings of the study shows that more than half (59.5%) of the respondents lived in Ohabiam, 36.6% lived in Obuda while few (3.9%) remaining of the respondents lived in Uratta. More than half (50.8%) of the respondents were males while 49.2% were females. More than half (62.4%) of the children that participate in the study were between the ages of 4-5 years, 73.7% of the children were in nursery classes and majority (92.1%) of the children were born with healthy birth weight of 2.5-4.0kg showing that their mothers practice good nutrition before and during pregnancy. However, more than half (79.2%) of the mothers who participated in the study practiced exclusive breastfeeding which could be linked to the awareness and education they received at antenatal and maternity clinics which also reflect in the birth weight of the children. More than half (91.8%) of the respondents immunized their children against infectious diseases. Findings of the study also showed the prevalence of wasting, stunting and underweight to be 1.1%, 33.2% and 3.4% among the children that participated in the study. Higher percentage of stunting among the respondents can be attributed to a long term inadequate food and nutrients intake. Less than quarter (16.8%) of the respondents were undernourished with MUAC assessment. The findings of the study also shows that parent’s age, educational and income status has a significant association (p-value <0.05) with malnutrition, this implies that the level of parental education and income status is a crucial determinant of infant and young children nutritional status and overall health status. This study is therefore recommended to medical professional and health agencies to increase sensitization and awareness showing evidence of adequate nutrition to achieve an optimum health status and healthy society at large.
TABLE OF CONTENTS
TITLE
PAGE i
CERTIFICATION ii
DEDICATION iii
ACKNOWLEDGEMENT iv
TABLE
OF CONTENTS v
LIST
OF TABLES viii
ABSTRACT ix
CHAPTER 1
1.1 Background of
the study 1
1.2 Statement of
problem 3
1.3 General
objectives of the study 4
1.3.1 Specific
objectives 5
1.4 Significance
of the study 5
CHAPTER 2
2.1 Malnutrition 7
2.2 Classification
of malnutrition 11
2.3 Malnutrition
in childhood 20
2.4 Malnutrition
management pathophysiology 23
2.5 Diagnosis and
measurement 23
2.6 Prevention 25
2.7 Treatment 26
2.8 Global trends
on childhood malnutrition 28
2.9 The burden of
malnutrition in Africa at a glance 30
CHAPTER 3
3.1 Study Design 32
3.2 Study Area 32
3.3 Population of
the Study 33
3.4 Sampling and
Sampling Techniques 33
3.4.1 Sampling
Size 33
3.4.2 Sampling Techniques 34
3.5 Preliminary
Activities 34
3.5.1 Preliminary
Visits 34
3.5.2 Informed
Consent 35
3.5.3 Training
Research Assistants 35
3.5.4 Ethical
Approval 35
3.6 Data
collection 35
3.6.1
Questionnaire Administration 35
3.6.2
Anthropometric Measurement 36
3.7 Data Analysis 36
3.8 Statistical
Analysis 36
CHAPTER 4
4.1 Basic Characteristics of Under-Five Children 38
4.2 Parental Socio-Demographics
Characteristics 41
4.3 Food Habit of
the Participants 49
4.4 Factors
Associated with Malnutrition 51
4.5 Anthropometric Characteristics of Under 5
Children Based on Age 53
4.6 Socio-Demographic and Other Factors Associated With Malnutrition 56
CHAPTER 5
5.1 Conclusion 58
5.2 Recommendation 59
References 60
Appendix I 70
LIST OF TABLES
Tables Page
Tables 2.1:
Classification of Under Nutrition 12
Table 2.2:
Nutritional Status Assessment 14
Table 4.1: Basic
characteristics of under-five Children 40
Table 4.2:
Parental socio-demographic characteristics 43
Table 4.2b:
Parental socio-economic characteristic 46
Table 4.2c:
Household utilities 48
Table 4.3: Food
habit of the children 50
Table 4.4:
Anthropometric characteristics of under 5 children based on sex 52
Table 4.5:
Anthropometric characteristics of under 5 children based on age 55
Table 4.6:
Socio-demographic and other factors associated with malnutrition 57
CHAPTER 1
INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Adequate nutrition is vital for healthy growth and development
during childhood (Nyaradiet al.,
2017). Malnutrition refers to deficiencies, excesses or imbalances in a
person’s intake of energy and/or nutrients (WHO, 2018).The term malnutrition
covers 2 broad groups of conditions. One is ‘undernutrition’- which includes
stunting (low height for age), wasting (low weight for height), underweight
(low weight for age) and micronutrient deficiencies or insufficiencies (a lack
of important vitamins and minerals) (WHO, 2018). The other is overweight,
obesity and diet-related non-communicable diseases (such as heart disease,
stroke, diabetes, and cancer), (WHO, 2018). Wasting, stunting, and underweight
are among those anthropometric indicators commonly used to measure under
nutrition in a population of under-five children (Zemenu et al., 2017).
According to the World Health Organization (WHO), wasting, stunting, and
underweight are defined as Z-scores less than -2 standard
deviations of weight for height, height for age, and weight for age,
respectively (WHO and UNICEF, 2015). Child malnutrition continues to be the
leading public health problem in developing countries. In
2020, globally, 149.2 million children under the age of 5 years of age were
stunted, 45.4 million wasted, and 38.9 million overweight. The number of
children with stunting is declining in all regions except Africa (UNICEF et
al., 2021). More than half of all children affected by wasting live in
Southern Asia and Asia as a whole is home to more than three-quarters of all
children suffering from severe wasting. Nigeria
has the second highest burden of stunted children in the world, with a national
prevalence rate of 32 percent of children under five. An estimated
2 million children in Nigeria suffer from severe acute malnutrition (SAM)
(NBS, 2017).
Under-five children are the most susceptible age group for
malnutrition. Malnutrition at the early stages of life can increase risk
infections, morbidity, and mortality together with decreased mental and
cognitive development (Engle et al.,
2017). The effect of child malnutrition is long lasting and goes beyond
childhood. For instance, malnutrition during early age decreases the
educational achievement and labor productivity and raises the risk of chronic
illnesses in later age (UNICEF et al., 2021). The factors that
contribute to the prevalence of malnutrition in children varies. The primary
determinants of malnutrition, as conceptualized by several authors related to
unsatisfactory food intake, severe and repeated infections, or a combination of
the two (Manary et al., 2018). The interaction of these conditions with
the nutritional status and overall health of the child and by the extension of
populations in which the child is raised have been shown in the UNICEF
conceptual frame work of child survival which sees malnutrition as factors that
impair access to food, maternal and child care, and health care. It is the very
factors that impact the growth of children(UNICEF,
2020). In 2020, the burden of malnutrition
remains unsolved, particularly in low- and middle-income countries, where about
200 million children are affected by stunting or wasting and almost twice as
many suffer from deficiencies in vitamins and other essential micronutrients
(UNICEF, 2020). At the same time, the number of children with overweight and
obesity continues to rise, increasingly affecting poorer children, households
and countries.
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 (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). Martinez and Fernandez
identified three analytical areas of concerns in addressing the burden of
malnutrition. First is the analyses of the capacity of any society to be
self-sufficient in terms of food security for all. Secondly, they look at how
variations in the demographic and epidemiological set-up have affected the
nutrition status of the population, and thirdly, they look at how the
life-style of the people has affected their nutrition status (Amalia, 2020). To
effectively address the problem of malnutrition, especially in resource-scarce
communities, knowing the prevalence, causes and risk factors associated with it
are essential steps.
1.2 STATEMENT OF PROBLEM
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 (World Health Organization,
2020). In an attempt to address this global challenge of malnutrition, the
World Health Organization (WHO) member states recently signed into effect a
commitment to nine global targets by 2025, including a 40% reduction in
childhood stunting, a less than 5% prevalence of childhood wasting, to ensure
no increase in the number of children who are overweight (UN, 2020), and to end all forms of malnutrition by 2030 (UN, 2020). With less than five years to the target date, the progress has
remained relatively slow, with no country working toward full actualization of
the nine targets (UNICEF, 2019). 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 (UNICEF, 2019). 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 (Kennedy et al.,
2006), 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 (UNICEF, 2019).
1.3 OBJECTIVE OF THE STUDY
The general objective of this study is to assess malnutrition
among children 2-5 years in
Ohabiam, Uratta and Obuda communities, which are urban areas of Aba South Local Government Area, Abia State.
1.3.1 SPECIFIC
OBJECTIVES
The specific objectives
of this study include to;
1. assess the socioeconomic
and demographic status of the children’s parents
2. determine the food
habits of the children
3. ascertain the
nutritional status of the children
4. examine the prevalence
of malnutrition among the children
5. evaluate factors
associated with malnutrition among children
1.4 SIGNIFICANCE OF THE STUDY
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. The findings will also
help to know the burden of malnutrition and establish baseline data where other
related issues will hinge on. It is
hoped that this will add to the body of knowledge available on malnutrition and
the findings of this study could form the template for intervention strategies
in helping to reduce the prevalence and managing such cases.
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 the prevalence of malnutrition in rural areas especially in the most vulnerable period
which is the first 1000 days of life.
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