ABSTRACT
Severe Acute
Malnutrition (SAM) remains a major public health challenge in many low- and
middle-income countries, including Nigeria, where it contributes significantly
to childhood morbidity and mortality. This study assessed the causes, clinical
presentation, and management of Severe Acute Malnutrition and examined its
public health implications, using Birnin Kudu General Hospital as a case study.
A descriptive research design was adopted, and data were collected through
structured questionnaires, patient records, and key informant interviews with
healthcare workers. Findings from the study revealed that the major causes of
SAM include poverty, inadequate breastfeeding practices, recurrent infections
such as diarrhoea and measles, poor maternal nutrition, and low parental
education. The common clinical presentations observed among affected children
were severe wasting, oedema, loss of appetite, anaemia, hypothermia, and signs
of micronutrient deficiencies. The hospital employs standard WHO protocols for
the management of SAM, including stabilization, nutritional rehabilitation,
treatment of infections, and follow-up care. However, challenges such as
inadequate staff training, shortage of therapeutic food supplies, and limited
awareness at the community level were identified. The study concludes that SAM
is both a medical and socio-economic problem requiring coordinated efforts at
household, community, and health-system levels. Strengthening nutritional
education, improving maternal and child healthcare services, ensuring
continuous supply of Ready-to-Use Therapeutic Foods (RUTF), and enhancing
community awareness are essential for reducing the burden of SAM. The research
highlights the need for increased investment in nutrition programs and public
health interventions to prevent and manage severe acute malnutrition
effectively.
TABLE OF CONTENTS
Content Pages
Title
page…………………….……….………..………………………………… i
Approval
page………………….…….…….……………………….…………… ii
Declaration
page………………..…………………………………….………..… iii
Certification………………………………………………………….…..……… iv
Dedication………………………………..………….……………….…………… v
Acknowledgement……………………………..………………….…………...… vi
Table of
content……………………..………………………………………..… vii
Abstract……………………………………………………..…………..……….. ix
CHAPTER ONE
1.1 Introduction - - - - - - - - -1
1.2 Background of the Study - - - - - - - -1
1.3
Statement of the Problem - - - - - - - -3
1.4 Aim and Objectives of the
Study - - - - - - -3
1.5 Research question - - - - - - - -3
1.6 Significance of the Study - - - - - - - -4
1.7 Scope of the Study - - - - - - - -4
1.8 Limitations of the Study - - - - - - - -4
1.9 Operational Definition of
Terms - - - - - - -5
CHAPTER TWO
Literature Review
2.1 Introduction - - - - - - - - - -6
2.2
Pathophysiology and Causes - - - - - - -6
2.3
Clinical Manifestations - - - - - - - -7
2.4
Management and Treatment Approaches - - - - - -8
2.5
Policy and Programmatic Responses - - - - - -9
2.6 Empirical Review - - - - - - - - -11
2.7 Theoretical Framework - - - - - - - -12
2.7.1. Social Determinants of Health Theory - - - - - -12
2.7.2. Health Belief Model (HBM) - - - - - - -12
CHAPTER THREE
METHODOLOGY
3.1 Research Design - - - - - - - - -14
3.2 Study Area - - - - - - - - -14
3.3 Population of the Study - - - - - - - -14
3.4 Sample Size and Sampling Technique - - - - - -14
3.5 Instrument for Data Collection - - - - - - -15
3.6 Method of Data Collection - - - - - - -15
3.7 Method of Data Analysis - - - - - - - -15
3.8 Ethical Considerations - - - - - - - -15
CHAPTER FOUR
Data Presentation, Analysis and Interpretation
4.3 Summary of Findings - - - - - - - -22
CHAPTER FIVE
5.1 Discussion of Findings- - - - - - - - -24
5.2 Conclusion - - - - - - - - -24
5.3 Recommendations - - - - - - - - -25
5.4 Suggestions for Further Studies - - - - - - -26
References
Structured
Questionnaire
CHAPTER ONE
1.1 Introduction
Severe
Acute Malnutrition (SAM) is a life-threatening condition affecting millions of
children under five years of age, especially in low- and middle-income countries.
It is characterized by extreme wasting, nutritional edema, or a mid-upper arm
circumference (MUAC) of less than 11.5 cm (Briend et al., 2015). SAM
significantly increases a child's risk of mortality, contributing to nearly 45%
of all deaths among children under five (Black et al., 2013). This study aims
to explore the causes, risk factors, management strategies, and policy
implications of SAM while providing recommendations for sustainable
interventions.
1.2 Background of the Study
Severe
Acute Malnutrition remains a critical public health issue, particularly in
Sub-Saharan Africa and South Asia. According to WHO, about 45 million children
globally suffer from wasting, with 13.6 million experiencing SAM (UNICEF, WHO,
& World Bank, 2021). The underlying causes are multifactorial, including
inadequate dietary intake, food insecurity, infections, poor child feeding
practices, poverty, and limited access to healthcare. Community-Based
Management of Acute Malnutrition (CMAM) has emerged as a promising strategy,
yet access to treatment remains a challenge. This project proposal is designed
to investigate the clinical, social, and policy aspects of SAM to strengthen
intervention programs.
Severe
Acute Malnutrition (SAM) is one of the most critical public health problems
affecting children under five years, particularly in developing countries like
Nigeria. It occurs when children suffer from extreme wasting, stunting, or
nutritional edema due to prolonged food deprivation, recurrent infections, and
inadequate care practices. Globally, malnutrition contributes significantly to
child morbidity and mortality, with Africa bearing a high burden. In Nigeria,
cases of SAM are widespread, especially in northern regions where poverty, food
insecurity, poor maternal education, and cultural feeding practices worsen the
situation. Birnin Kudu General Hospital, located in Jigawa State, records
numerous cases of SAM annually, making it a crucial center for the study of the
causes, clinical presentations, and management of this condition as well as its
implications on public health.
1.3 Statement of the Problem
Severe Acute Malnutrition (SAM)
remains a pressing public health challenge in many low- and middle-income
countries, particularly in sub-Saharan Africa and South Asia. Globally,
millions of children under the age of five are affected by SAM, with high rates
of morbidity and mortality despite ongoing interventions. In Nigeria, for
instance, malnutrition contributes to nearly half of all childhood deaths, and
SAM is among the leading causes of hospital admissions in pediatric wards.
The problem is multifaceted.
Poverty, food insecurity, poor infant feeding practices, limited access to
healthcare, recurrent infections, and inadequate maternal knowledge of
nutrition contribute significantly to the onset of SAM. In addition, poor
sanitation and lack of safe drinking water exacerbate the situation, making
children more vulnerable to infections that worsen malnutrition.
1.4 Aim and Objectives of the Study
Aim
The
aim of the study is to examine the causes, clinical presentation, management
strategies, and public health implications of Severe Acute Malnutrition (SAM)
in Birnin Kudu General Hospital
Specific Objectives
i
To
examine the causes and risk factors of SAM in Birnin kudu general hospital.
ii
To
highlight the clinical signs and diagnostic criteria of SAM Birnin kudu general
hospital.
iii
To
review available treatment and management protocols Birnin kudu general
hospital.
iv
To
identify challenges in the prevention and treatment of SAM Birnin kudu general
hospital.
v
To
suggest evidence-based recommendations to reduce SAM prevalence Birnin kudu
general hospital.
1.5 Research question
i
What
are the causes and risk factors of Severe Acute Malnutrition (SAM) in Birnin
Kudu General Hospital?
ii
What
are the clinical signs and diagnostic criteria of SAM in Birnin Kudu General
Hospital?
iii
What
treatment and management protocols for SAM are currently available in Birnin
Kudu General Hospital?
iv
What
challenges exist in the prevention and treatment of SAM in Birnin Kudu General
Hospital?
v
What
evidence-based recommendations can be suggested to reduce the prevalence of SAM
in Birnin Kudu General Hospital?
1.6 Significance of the Study
This study was significant in
several ways. Firstly, it provided an in-depth understanding of the causes of
severe acute malnutrition in Birnin Kudu, helping health practitioners and
policymakers identify areas where interventions needed to be strengthened.
Secondly, the findings highlighted the clinical features of SAM, thereby
improving early detection and treatment among children. Thirdly, by analyzing
the management practices at Birnin Kudu General Hospital, the study revealed
gaps in care and offered recommendations for improving hospital-based interventions.
Finally, the public health implications discussed in this study guided
policymakers, non-governmental organizations, and the community in designing
long-term preventive strategies to reduce the burden of SAM in the region.
1.7 Scope of the Study
This study was limited to Birnin
Kudu General Hospital, Jigawa State. It focused on children under the age of
five who were diagnosed and managed for severe acute malnutrition within the
hospital. The research did not cover other health facilities in the area, nor
did it include moderate malnutrition cases. The emphasis was on identifying
causes, documenting clinical presentations, and assessing management practices
in order to draw meaningful conclusions about the public health implications of
SAM in the study area.
1.8 Limitations of the Study
Like any research, this study
encountered certain limitations. One possible challenge was the availability
and accessibility of complete hospital records, as some patient data were
missing or incomplete. Another limitation was that the study focused on only
one hospital, which limited the generalization of findings to the wider Jigawa
State population. Additionally, cultural and social factors influencing feeding
practices were not fully captured in a hospital-based study. Despite these
limitations, the study still provided valuable insights into the nature and
management of SAM at Birnin Kudu General Hospital.
1.9 Operational Definition of Terms
- Severe
Acute Malnutrition (SAM): A life-threatening condition characterized by very low
weight-for-height, visible severe wasting, or nutritional edema.
- Clinical
Presentation:
The observable signs and symptoms with which a patient suffering from SAM
presents at the hospital.
- Management: The medical and nutritional
interventions used to treat SAM cases in a hospital setting.
- Public
Health Implications:
The wider consequences of SAM on the health of the population, including
its impact on child mortality, disease burden, and healthcare systems.
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