AN INVESTIGATIVE STUDY ON THE PREVALENCE OF MALNUTRITION AMONG UNDER FIVE YEARS OLD IN ADEGBOLA, COMMUNITY, AKURE SOUTH LOCAL GOVERNMENT AREA, ONDO STATE.

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ABSTRACT

Malnutrition is an imbalance in nutrition, ranging from overnutrition to undernutrition. This research work was carried out to investigate prevalence of malnutrition among under five years old in Adegbola, Community, Akure. The sampling technique used this in this study was simple random. Two hundred (200) questionnaires were administered but one hundred and eighty (180) were retrieved successfully. Those with high level of education usually feed their child exclusively. This is as a result of the knowledge they had as a means of their educational knowledge. This study also revealed that 99 representing 65% of the respondents said no their child has not suffered from any infection of recent. Children that were exclusively breastfed are not sick often. It was recommended that health workers should explain importance of nutritional supplements for example vitamin A, zinc among others to the mothers. Also, government through its concerned line ministries should promote skilling that permits formal employment in caregivers to children under five years so as to enable them adequately support their children in preventing malnutrition.

 

 

 

 

TABLE OF CONTENTS

Title                                                                                                                 i

Certification                                                                                                    ii

Dedication                                                                                                       iii

Acknowledge                                                                                                  iv-v         

Abstract                                                                                                           vi         

Table of contents                                                                                         vii-viii         

List of tables                                                                                                    ix         


CHAPTER ONE

Introduction                                                                                                     1-2         

Background of the study                                                                                          2-4

Statement of the problem                                                                                       4-5    

Aims of the study                                                                                           5         

Objectives of the study                                                                                          5         

Significance of the study                                                                                  5-6         

Assumptions                                                                                                    6         

Definition of terms                                                                                           6-7         


CHAPTER TWO

Literature review                                                                                             8         

Nutrition                                                                                                          8-10         

Prevalence of malnutrition among under-fives                                          10-12     

Patterns of malnutrition                                                                                           12         

Factors associated with malnutrition                                                                       12-16

Symptoms in children                                                                                           16         

Underlying factors that influence the prevalence of malnutrition among children aged five years and below.                                                                         16-22

Basic factors contributing to malnutrition among children under five years          22-23

Specific interventions to control malnutrition                                                   23-25

Preventing malnutrition in Nigeria                                                                    25-27


CHAPTER THREE

Research methodology                                                                                          28         

Study design                                                                                                    28         

Study area                                                                                                       28-29

Sample size determination                                                                              29     

Sampling technique                                                                                           29         

Method of data collection                                                                           29         

Ethical consideration                                                                                          29         


Chapter Four

Data Presentation & Analysis                                                                            30-43


Chapter Five

Discussion of Findings                                                                                           44-45

Summary                                                                                                         46

Conclusion                                                                                                      46

Recommendations                                                                                           46-47

Reference                                                                                                 48-51

Appendix                                                                                                      52


 

LIST OF TABLES

Table 1: Distribution of child’s age of the respondents                               30

Table 2: Distribution of age of the respondents                                                   30     

Table 3: Gender of the respondents                                                             31     

Table 4: Marital of the respondents                                                             31     

Table 5: Educational status of the respondents                                                    31     

Table 6: Occupational status of the respondents                                                    32     

Table 7: Religious status of the respondents                                                              32         

Table 8: is your child breast feeding?                                                                  33         

Table 9: For how long did you breastfeed the child?                               33     

Table 10: Has the child suffered from infection of recent?                                   34     

Table 11: Do you have any knowledge on balanced diet?                                       34

Table 12: How many times do you feed a child in a day?                                    34

Table 13: What is the immunization status of your child?                                35

Table 14: Are there any foods that your child cannot or is not supposed to eat?35

Table 15: Do you often wash your hands while preparing food for the family and for the baby?                                                                                                              36     

Table 16: Has your child ever got congenital heart diseases?                          36     

Table 17: Do you think poor feeding makes the child unhealthy?              37     

Table 18: Has the child been dewormed?                                                      37     

Table 19: What type of weaning child do you give your children?                    38     

Table 20: do you often give the required food material to the baby?                      38     

Table 21: Factor that facilitate malnutrition?                                                            39         

Table 22: Review MUAC of under 5 children in Adegbola community between Jan-Dec 2019                                                                                                             40

Table 23 Review MUAC of under 5 children in Adegbola community between Jan-Dec 2020                                                                                                             41     

Table 24: Review MUAC of under 5 children in Adegbola community between Jan-Dec 2021                                                                                                             42     

Table 25: Review MUAC of under 5 children in Adegbola community between Jan-Jun 2022                                                                                                             43     

 


 

 

CHAPTER ONE

INTRODUCTION

Malnutrition is an imbalance in nutrition, ranging from overnutrition to undernutrition (Norman ,2008). It is a major public health problem in both developed and developing countries affecting all age groups but is particularly noticeable in children because they are undergoing a period of rapid growth. The cause of malnutrition in surgical patients is multifactorial; this includes deficiency in dietary intake, increased requirements related to the stage of the disease, complication of primary disease expressed in reduced absorption or excessive loss of nutrient or a combination of the above factors (Soeters et al., 2008). Patients who undergo abdominal surgery are at increased risk of malnutrition due to prolonged period of starvation (Permsombut et al., 2013) and those with pre-operative malnutrition are at a higher risk of developing post-operative complications, longer duration of hospital stay, and increased hospital costs (Reilly et al., 2018).

The magnitude of the problem of malnutrition in the developing countries and its association with the high rate of infant and child mortality has placed more emphasis on child and maternal nutrition (State of the World's Children, 2005).

The UNICEF report shows that 37% of Nigerian children below the age of 5 years are stunted, 18% are wasted, and 29% are underweight. The proportion of stunted children has declined since 2008 from 41% to 37% (Nigeria Demographic and Health Survey 2009). Malnutrition is associated with more than 50% of death (approximately 2.3 million) annually in children from developing countries (Correia et al., 2013).

The reported prevalence of malnutrition in surgical patients is in the range of 40–67% depending on the patients’ population studied and criteria used for diagnosis (Bruun  et al.,2019, Hill  et al.,2017). This percentage seems to be unchanged over time and remains problematic until now. Akinbami et al., (2010) reported 24.4% of underweight, 18.9% of stunting, and 13.4% of wasting in non-surgical children admitted at emergency ward in an institution in Nigeria, whereas 5 years later, Balogun and Omokhodion (2015) in another study among children with congenital heart defects in the same institution found 34.9% of wasting, 41% of stunting, and 47% underweight in children with acyanotic heart disease and in cyanotic heart disease, 29% wasting, 17.6% stunting, and 47% underweight, suggesting the role of severe congenital anomalies on the nutrition and growth of these children Balogun and Omokhodion (2015)

Adequate information on the prevalence of malnutrition and the associated risk factors in pediatric patients undergoing elective general surgical procedures in our center is lacking. We, therefore, studied the prevalence of malnutrition and its risk factors in surgical children for elective general surgical procedures.


BACKGROUND OF THE STUDY

Malnutrition results from the interaction between poor diet and diseases which leads to nutritional deficiencies observed among under-five children. Social, economic, biologic, and environmental factors are the underlying causes for the insufficient food intake or ingestion of food with proteins of low nutritional quality that leads to protein-energy malnutrition (PEM) (Asfaw et al., 2015).

According to the World Health Organization (WHO), 462 million adults are underweight, while 1.9 billion adults are overweight and/or obese. In children under 5 years of age, 155 million are stunted, 52 million are wasted, 17 million are severely wasted and 41 million are overweight and/or obese (WHO, 2019). The manifestation of malnutrition is multifold, but the paths to addressing prevention are key and include exclusive breastfeeding for the first 2 years of life, diverse and nutritious foods during childhood, healthy environments, access to basic services such as water, hygiene, health and sanitation, as well as pregnant and lactating women having proper maternal nutrition before, during and after the respective phases (levels and trends) (Global Nutrition Report, 2018).

It is vital that malnutrition is addressed in children as malnutrition manifestations and symptoms begin to appear in the first 2 years of life (Shrimpton  et al., 2011). Coinciding with the mental development and growth periods in children, protein energy malnutrition (PEM) is said to be a problem at ages 6 months to 2 years. Thus, this age period is considered a window period during which it is essential to prevent and/or manage acute and chronic malnutrition manifestations (Bern et al., 2015, Benson et al., 2015). Child and maternal malnutrition together have contributed to 3.5 million annual deaths. Furthermore, children less than 5 years of age have a disease burden of 35% (Black et al., 2008). In 2008, 8.8 million global deaths in children less than 5 years old were due to underweight, of which 93% occurred in Africa and Asia. Approximately one in every seven children faces mortality before their fifth birthday in sub Saharan Africa (SSA) due to malnutrition (Walton et al., 2011).

Wasting is low weight for height. It indicates current weight loss, because a child consumes insufficient food or they are exposed to infectious diseases like diarrhea, which causes them to lose weight. Stunting is low height for age. Stunting indicates children who are too short relative to their age. Stunting is the result of poor nutrition in early childhood which can last a lifetime (WHO,2020). Globally, about 149 million under-5 children are stunted, it results from chronic under-nutrition, typically related to poor socio-economic status, inappropriate maternal nourishment, recurrent illness, and/or improper child feeding and care in infancy (WHO,2020).  Underweight is low weight for age and it includes stunting, wasting or both (Pravana et al., 2017)

Malnutrition is a prevalent problem affecting everyone at some time in their lifespan, but young children are at a greater risk of malnutrition. Optimizing nutrition from conception to two years of age, ensures the best possible start in life with long-term benefits (Assembly et al.,2016) Malnutrition results from a deficiency of good nutrition, caused by not having adequate food to eat, or not consuming enough of the right things. Many poor nutritional outcomes begin in the uterus and are manifested as LBW, prematurity, and intrauterine growth restriction

Malnourished children are at risk for infection and they are more prone to death due to common infantile respiratory and diarrheal disease. United Nations Decade of Action on Nutrition from 2016 to 2025 proclaimed to eliminate malnutrition and guarantee worldwide access to improved diets everywhere and for every (SDG2) and ensuring healthy lives for all ages (SDGs, 2015).


STATEMENT OF THE PROBLEM

Normal growth and development of a child depends upon the nutritional status of the new born which is related to the nutritional status of the mother and the nutrients intake of the infants, the nutritional status of a child is of paramount importance for the proper physical, mental and social development of a child especially in early childhood (UNICEF, 2013). Up to 1 million Nigerian children under 5 years are affected by severe acute malnutrition (SAM) each year especially in the rural communities (Children Investment Foundation, 2014). These children have severely low weight for their height and are at risk of dying unless given urgent attention, (Children Investment Foundation, 2014). Malnourished children have an increased risk of disability and are highly predisposed in infectious diseases and premature death. Malnutrition situation in Nigeria is a serious public health problem among pre-school children.

About 3 out of every 10 young children are undernourished. Nearly 2 out of every 10 babies born die before their 5th birth day. Undernutrition is an important cause of death. Knowledge on the prevalence of malnutrition and determinations of the nutritional status particularly in rural areas is essential in designing appropriate and context relevant program responses. This is because a large proportion of the malnourished reside in rural communities. So, this study aim to investigate the prevalence of malnutrition using Adegbola as a case study.


AIM OF THE STUDY

The aim of this study is to investigate the prevalence of malnutrition among under five years old in Adegbola, Community, Akure.

OBJECTIVES OF THE STUDY

The objectives of the study are to

ü Investigate the prevalence of malnutrition among under five years old in Adegbola, Community, Akure.

ü Identify the causes of malnutrition among under five years old in the study area

ü Examine the prevention of malnutrition among under five years old in the study area.


RESEARCH QUESTION

ü Is there prevalence of malnutrition among under five years old in Adegbola, Community, Akure?

ü What are the causes of malnutrition among under five years old in the study area?

ü Are there any means of preventing malnutrition among under five years old in the study area?


SIGNIFICANCE OF THE STUDY

This study will help provide data on the existing level of knowledge on malnutrition among under-five years children in Adegbola Akure South Local Government Area. It will help in providing baseline information on the prevalence of malnutrition in Adegbola. This study will contribute to the data pool of malnutrition in Nigeria. It will also help in the development of interventions targeted at reducing the prevalence of malnutrition among children under-five years in Adegbola Akure South Local Government Area. Thus, promoting general over all development


ASSUMPTION OF THE STUDY

1.     There is no difference in disease conditions among the children in the two State.

2.     There is no difference in the level of knowledge of mothers in adequate nutrition in the two State.

3.     There is no difference between the nutritional status of children under-2 years in Adegbola.

 

DEFINITION OF TERM

Low birth weight is a term used to describe babies who are born weighing less than 5 pounds, 8 ounces (2,500 grams).

Malnutrition: This will be refer to as lack of food nutrients in the body or lack of adequate nourishment.

Prevalence: This will be refer to as the total number of disease cases in a given statistical population at a given time.

Starvation is a severe deficiency in caloric energy intake, below the level needed to maintain an organism's life. 

Stunting: Will be refer to as children who are too short for their age

Under five: This will be refer to Children who are below 59 months.

Underweight: will be refers to as a child whose body weight is too low for his/her age or to healthy

Wasting: will be refers to a child that the normal body weight, looking thin and emaciated.



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