ABSTRACT
Childhood malnutrition is the single biggest contributor to under-five mortality, due to greater susceptibility to infections and slow recovery from illness caused by nutritional inadequacy which tends to hamper the development of the body and if it continued for long periods of time could result in growth faltering manifested in the form of low weight, small height and low IQ. This is cross sectional study designed to assess the nutritional status of children, 0-5 years in Internally Displaced Persons’ Camps, in Benin City, Nigeria. A structured questionnaire was used to elicit personal information of the children, socio-economic data of their mothers/care givers, feeding habit, breastfeeding practices, complementary feeding practices and health status of the children. Anthropometric measurement of weight-for-height, weight-for-age and height-for-age z- scores. Data were analyzed using descriptive statistics and Chi square. From the result, some of them (29.1%) were within 36 months old. Thirty-six point four (36.4%) of their mother were within the age 31-35 years. majority (90%) sourced their drinking water from borehole and 85.4% used improve/covered pit toiled. Most (65.9%) ate three times. Most (63.6%, 45.9%, 60% and 75.9%) sometimes go to bed without food, starve due to lack of food, consumed spoilt/low quality food because that was the only food in the house and reject food because he/she was given the same type of food, respectively. About 20.5% of the women breastfed their babies exclusively. Majority (86.7%) stopped breastfeeding their children immediately after the introduction of complementary food. Some 32.7% and 21.8% of the children experienced fever and diarrhea in the 2 weeks. Prevalence of wasting, stunting and underweight was among 2.7%, 52.7% and 24.5% of the children. Considering the number of those who were stunted, underweight and those who suffered fever and diarrhea in this study, there is need for the government and individuals to come to the aid of these internally displaced persons by providing food and medical facilities for them.
TABLE OF CONTENTS
Tile Page i
Certification ii
Dedication iii
Acknowledgement iv
Table of content v
Lists of tables vi
Abstract vii
CHAPTER 1
INTRODUCTION
1.1 Statement of the problem 2
1.2 Objective of the study 4
1.2.1 General objective 4
1.2.2 Specific objectives 4
1.3 Significance of the study 4
CHAPTER 2
LITERATURE REVIEW
2.1 Prevalence of childhood malnutrition 6
2.1.1 Global prevalence 6
2.2 Consequences of childhood malnutrition 9
2.2.1 Increased risk of morbidity 9
2.2.2 Susceptibility to non-communicable diseases later in adulthood 10
2.2.3 Increased risk of mortality 11
2.2.4 Decreased economic productivity 12
2.3 Causes of malnutrition 14
CHAPTER 3
MATERIALS AND METHODS
3.1 Study design 16
3.2 Area of study 16
3.3 Population of the study 17
3.4 Sampling and sampling techniques 17
3.4.1 Sample size determination 17
3.4.2 Sample procedure 18
3.5 Preliminary activities 19
3.5.1 Preliminary visits 19
3.5.2 Informed consent 19
3.5.3 Training of research assistants 19
3.6 Data collection 19
3.6.1 Questionnaire administration 19
3.6.2 Nutritional status assessment 20
3.6.2.1 Weight measurement 20
3.6.2.2 Height measurement 20
3.6.2.3 Mid-Upper arm circumference 20
3.7 Data analysis 21
3.8 Statistical analysis 22
CHAPTER 4
RESULTS AND DISCUSSION
4.1 Personal characteristics of the children 23
4.2 Socio-demographic data of the mother/caregiver 26
4.3 Feeding habits of the children (0-5 years) in benin IDP CAMP 31
4.4 Breastfeeding practices of the children 38
4.5 Complementary feeding practices of the children 44
4.6 Health status of the children 51
4.7 Anthropometric status of the children 56
4.8 Relationship between socio-economic characteristics and the
weight-for-age of the children 62
4.9 Relationship between feeding habit and weight-for-age 72
4.10 Relationship between breastfeeding practices and weight-for-age of the children 75
CHAPTER 5
Conclusion and recommendations
5.1 Conclusion 82
5.2 Recommendations 82
References
LIST OF TABLES
Table 4.1: Personal characteristics of the children 24
Table 4.2a: Socio-demographic data of the mother/caregiver 26
Table 4.3a: Feeding habits of the children (0-5 years) in Benin IDP camp 31
Table 4.3b: Feeding habits of the children (0-5 years) in Benin IDP camp 35
Table 4.4a: Breastfeeding practices of the Children 40
Table 4.4b: Relationship between breastfeeding and educational level of parents 43
Table 4.5a: Complementary feeding practices of the children 45
Table 4.5b: Diversity of foods given to the child 48
Table 4.6a: Health status of the children 53
Table 4.7: Anthropometric status of the children 58
Table 4.8a: Relationship between socio-economic characteristics and the weight-for-age of the children 63
Table 4.8b: Relationship between socio-economic characteristics and the weight-for-height of the children 67
Table 4.8c: Relationship between socio-economic characteristics and the height-for-age of the children 70
Table 4.9: Relationship between breastfeeding practices and weight-for-age of the children 73
Table 4.10: Relationship between breastfeeding practices and weight-for-age of the children 76
Table 4.11a: Relationship between dietary diversity scores of the children and their health status 78
Table 4.11b: Relationship between dietary diversity scores of the children and their anthropometric indices 80
CHAPTER 1
INTRODUCTION
Malnutrition is one of the leading causes of under-five mortality in developing countries, though the severity and various dimensions of the situation has been poorly researched and documented in Nigeria (Alabi et al., 2016). More than 10 million under-5 children die annually worldwide and malnutrition accounts for about 60% of these deaths (Ahmad et al., 2000; World Health Organization (WHO), 2003).
Alabi et al. (2016) pointed out that malnutrition is a major Public Health challenge in Nigeria, especially as it affects children under less than five years of age. Pushpa and Rani (2015) noted that children are in a remarkable phase of development, their brain is developing and bones are growing. These growing children require adequate supply of calories, proteins and micronutrients to keep pace with the increased demands of the body. Nutritional inadequacy will hamper the development of the body and if this nutritional in adequacy is continued for long periods of time, it results in growth faltering manifested in the form of low weight, small height and low IQ (Rani, 2015).
According to the United Nations High Commission for Refugees (UNHCR) (2017), there were 27.8 million new displacements in 127 countries around the world in 2015. This number included 8.6 million new displacements associated with conflict and violence in 28 countries and 19.2 million new displacements associated with disasters in 113 countries. It was further stated that over the past eight years, 203.4 million displacements have been recorded, an average of 25.4 million each year (UNHCR, 2017).It is also noteworthy that approximately half of the world’s refugee population are children under the age of 18 years (Dawson-Hahn et al., 2016).
Ibekwe (2014) revealed that Nigeria had the highest number of persons internally displaced by conflict in Africa, with a population of 3.3 million people. The United Nations Office for the Coordination of Humanitarian Affairs (2016) also noted that in the three most affected states of Adamawa, Borno and Yobe, almost 7 million people are in need of humanitarian assistance, more than 50 per cent of whom are children and in newly accessible areas, vulnerable host populations are in critical need of humanitarian interventions including food, water, sanitation, protection, education, shelter and health services.
1.1 STATEMENT OF PROBLEM
Pushpa and Rani (2015) stated that child malnutrition is a widespread public health problem which has international consequences, since good nutrition is an essential determinant for their well-being. It was further stated that childhood malnutrition is the single biggest contributor to under-five mortality, due to greater susceptibility to infections and slow recovery from illness (Pushpa and Rani, 2015).
Although Nigeria recorded a decline in under-5 stunting from 41% in 2008 to 37% in 2013, Nigeria still accounted for 11 million out of the world 60 million stunted children in the year 2012 (Nigeria Population Commission (NPC), 2013; Alabi et al., 2016). Nigeria demographic and health survey showed that the trend in nutritional status worsened from 24% in 2003 to 23% in 2008 and 29% in 2013 for underweight and 11% in 2003 to 14% in 2008 and 18% in 2013 for wasting (NPC, 2013).
The problem of poor nutritional status is even more apparent in camps where internally displaced people live and refugee populations where they are displaced from war torn areas or are forced to leave their abodes due to natural disasters or other factors to neighboring cities or countries and are exposed to factors that put them at greater risk for undernutrition than the general population(Shash, 2011). Moreover, it has been shown that scarcity of water, poor sanitation, and overcrowding also contribute to undernutrition in children; thus types, frequency, quality, and availability of food, are not the only causes of undernutrition (World Bank, 2006). All these risk factors are evident in refugee camps where the main food resources come from humanitarian assistance and where overcrowding and harsh living environments are common. In fact, the length of stay in anIDP camp has been shown to be associated with poor health outcomes, not only for children but also in the elderly population (Goette, 2005). This study is therefore essential to provide useful insight into the nutritional status of children (0-5 years) living in IDP camps.
1.2 OBJECTIVES OF THE STUDY
1.2.1 General objective
The general objective of the study is to assess the nutritional status of children, 0-5 years in Internally Displaced Persons’ Camps.
1.2.2 Specific objectives
The specific objectives of the study are to:
i. determine the socioeconomic/sociodemographic factors affecting internally displaced persons.
ii. ascertain the health status of children, 0-5 years.
iii. assess the nutritional status of children, using anthropometric measurements.
1.3 SIGNIFICANCE OF THE STUDY
This study will provide very useful information to the government and the ministry of health concerning the nutrition situation of children in IDP camps in Nigeria. It will thus create more awareness as regards the condition of children in internally displaced camps in Nigeria.
Furthermore, findings from the study will be beneficial to the World Health Organization, United Nations High Commission for Refugees, the United Nations Children’s Fund, the International Committee of the Red Cross, Oxfam International, Save the Children, Refugees International, as well as other bodies which are involved in meeting the needs of internally displaced persons, including religious organizations, non-governmental organizations and others.
The study will further be relevant to nutritionists and dieticians and other health professionals. It will provide very vital insight into the condition of children in IDP camps, especially with regards to their nutrition. In addition, researchers will be motivated to carry out more studies in IDP camps to generate even more data concerning conditions in IDP camps.
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