ABSTRACT
The purpose of this study is to assess adolescent girls’ knowledge on infant and young child feeding practices in Umuahia Local Government Area in Abia State. This cross sectional analytical study was carried out in Umuahia South Local Government Area in Abia State, Nigeria. The population study comprises of adolescent girls. Multistage sampling was adopted in determining the sample size for the study among 250 adolescent girls were selected from household and schools. Data were collected using researcher-administered questionnaires. The questionnaire was validated by three lecturers in the Department Of Human Nutrition And Dietetics. The questionnaire was used to collect personal data of the adolescent girls and to assess their knowledge on exclusive breastfeeding, continue breastfeeding and complementary feeding. Data analysis was done using IBM statistical software (SPSS) version 20.0. The result shows that 66.6% of with mean and standard deviation of 2.46±0.77 of the adolescent girls had good knowledge,19.2% had advantage knowledge with mean and standard deviation of (62.30±20.74) while 17.2% had poor knowledge on exclusive breastfeeding with mean and standard deviation of 4.98±1.65. The study also showed that adolescent girls (49.6%) with mean and standard deviation of 2.31±0.76 had good knowledge, 32% had an average grade with mean and standard deviation of 58.10±19.32 while 18.4% with mean and standard deviation of 6.39±2.12 had poor knowledge on continued breastfeeding and complementary feeding. There is a positive and strong relationship between knowledge of exclusive breastfeeding and knowledge of complementary feeding (r=0.359, p=0.000). More so, there was a positive and weak relationship between the age of young adolescent and knowledge of exclusive feeding (r=0.220, p=0.003). Based on the findings, it was recommended that nutrition education should be employed at schools to educate the adolescent girls on the importance of exclusive breastfeeding and complementary feeding.
TABLE OF CONTENT
Title page i
Certification ii
Dedication iii
Acknowledgement iv
Table of
contents v
List of tables ix
Abstract x
CHAPTER 1
INTRODUCTION
1.1 Background of the study 1
1.2 Statement of
the problem 4
1.3 Objectives of the study 5
1.4 Significance of the study
6
CHAPTER 2
LITERATURE REVIEW
2.1 Infant and young child feeding
practices
2.1.1. Infant and
young child nutrition requirements according to world health organization
(WHO). 7
2.1.2. Definition of
terms associated with infant and young child feeding practices 9
2.1.3 Recommended infant and young child practices. 10
2.2. History
of breast feeding 10
2.2.1 Exclusive
breastfeeding and importance 11
2.2.2. Infant formula 11
2.2.3. Dangers of formula/bottle
feeding 12
2.2.4 In some cases
breastfeeding is medically contraindicated 12
2.2.5. Complementary
feeding practices 13
2.3. Adolescent 13
2.3.1. Adolescent
girls development 13
2.3.2. Adolescent
girls and child care 13
2.4 Influence on adolescent on infant and young
child feeding practices 14
2.4.1. Adolescent
knowledge attitude and behavior 14
2.4.2. Educational
influence on adolescent on infant and young child feeding practices 15
2.4.3. Socio economic influence on adolescent on the infant
and young child feeding practices 15
CHAPTER 3
MATERIALSANDMETHHODS
3.1 Study design 20
3.2 Area of study 20
3.3 Population of
the study 20
3.4 Sampling and
sampling techniques 21
3.4.1 Sample size 21
3.4.2 Sample
procedure 22
3.5
Preliminary activities 22
3.5.1 Preliminary visit 22
3.5.2 Training of research assistants 22
3.5.3. Ethical approval 22
3.5.4. Informed consent 22
3.6 Data
collection 23
3.6.1Questionnaire administration 23
3.6.1
Interview 24
3.7 Data analysis 25
3.8 3.8. Statistical analysis 26
CHAPTER 4
RESULTS AND DISCUSSION
4.1. Socio-Demographic characteristics of the
adolescent girls 32
4.2. Household
characteristics of the adolescent girls 33
4.3. Source of
adolescent girls knowledge on exclusive breastfeeding. 38
4.4. Correct
knowledge Response on Exclusive Breastfeeding 40
4.5 Knowledge Response of the Adolescent on
continued breastfeeding and complementary Food preference of the adolescents
subjects 41
4.6.
Relationship between knowledge of exclusive breastfeeding and Complementary
feeding and some selected personal and household characteristics. 42
CHAPTER 5
CONCLUSION AND RECOMMENDATIONS
5.1
Conclusion 49
5.2
Recommendations 49
REFERENCES 51
LIST OF TABLES
Table 4.1. Personal characteristics of the adolescent
girls'. 30
Table
4.2. Household characteristics of the
adolescent girls’. 33
Table
4.3. Source of Adolescent girls
knowledge on Exclusive breastfeeding. 34
Table 4.4 knowledge
Response on exclusive breastfeeding 36
Table 4.5. Knowledge Response on the Adolescent on
Continued Breastfeeding and
Complementary feeding. 37
Table 4.6. Relationship
between knowledge of Exclusive Breastfeeding and Complementary feeding and some
selected personal and household characteristics. 39
CHAPTER 1
INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Adolescent
is a critical life stage for all forms of human development because when poor
adolescent girls become mothers or care givers to impoverished children,
poverty and inequities are passed on to the next generation (UNICEF, 2011). In
low income settings, adolescents are less likely to finish school and mostly
married early, leading to early childbearing and increased risk for maternal
mortality and morbidity.
Approximately
165 million children under the age of five are chronically undernourished
(Black et al., 2013). Stunting, along
with foetal growth restriction, suboptimum breastfeeding, wasting and Vitamin A
and zinc deficiencies are estimated to account for 3.1million annual deaths of
children under five (Black et al.,
2013). Chronic under-nutrition leads to poorer schooling outcomes, lower
economic productivity and a greater likelihood of being poor in adulthood
(Hoddinott et al., 2013). Poor infant
and young child nutrition (IYCN) practices contribute to poor preschool
nutrition outcomes (Avula et al., 2013;
Ahmed et al. 2012) and where infant and young child feeding practices have been improved, promotion have been observed in child’s
heath (Guldan et al., 2000; Bhandari et
al., 2004). For this reason, in a number of countries where the burden of
under- nutrition is high, efforts are being made to improve IYCN practices. Where
these efforts exist, they are nearly always directed to nursing mother as well
as care takers (Avula et al., 2013;
Baker et al., 2013; Nguyen et al., 2014).
According
to UNICEF (2012), in recent years, interest in adolescent girl child
development intervention has increased worldwide with focus ranging from health
and education to economic empowerment (Sawyer et al., 2012). International bodies increase investment in young
people and emphasis on adolescence as a development window of opportunity
offering demographic dividends.
Girls
are often considered an economic burden on families, and arranged marriages
during early adolescence without the consent of their consent are thought to
relieve financial stress on natal families. A perception that girls are costly
to families may be linked to the practice of dowry (goods or monies transferred
from the groom’s to the bride’s family) and create incentive for early arranged
marriages because dowry prices tend to increase as years pass by (Amin et al., 2011)
Globally,
child marriage (under 19 years) affects more than 10 million girls annually
(Raj et al., 2012). Despite national
laws forbidding child marriage, marring of young girls once puberty once
puberty commences is common in rural settings.
Furthermore
girls who marry at their adolescent age tent to have little or no knowledge
about infant and young child feeding. Adolescent girls in rural area of
Bangladesh was found to have less knowledge and understanding of exclusive
breastfeeding practices and the use of nutrition rich complementary food.
Although conveying infant and young child nutrition (IYCN) knowledge to
adolescent girls in a timely manner is important to ensure the well-being of
children.
A
further study of birth cohorts in five counties found that children born to
adolescent mothers aged 19years or younger compared to those 20-24years had an
increased risk of low birth weight, preterm birth and child stunting at 2yrs of
age after adjusting for covariate and in addition, the mothers were at risk of
not completing their secondary education (Fall et al., 2015).
Research
has that 44% of women aged 15-19years were already in a union (married or
cohabitating), 64.95% among women currently aged 20-24years were married by age
18 and 54.1% of women that are currently married aged 15-19years had one or more children already (UNICEF,
2017). For these women, the short duration between marriage, pregnancy, and
birth allows little time to provide correct information on IYCN practices. What
they know about IYCN in adolescence, therefore, may well play an important part
in their IYCN practices (Hecket et al.,
2015).
World
health organization(WHO) and UNICEF (2002) reported that poor breastfeeding and
complimentary feeding practices are wide spread, it is estimated that only
34.8% of infants are exclusively breastfed for the first six months of life,
the majority receives other foods or fluids in the early months (WHO,2009).
Complementary foods are often introduced too early or too late and are often
nutritionally inadequate and unsafe leading to nutritional deficiencies. Poor
knowledge on feeding practices and low education of mothers has also been
implicated in malnutrition of children (WHO, 2003).
Furthermore Malnutrition is one of
the most important health and welfare problems among infants and young
children. It is a result of both inadequate food intake and illness. Inadequate
food intake is a consequence of insufficient food available at the household
level, or improper feeding available at the household level, or improper
feeding practices, or both. Improper feeding practices include both the quality
and quantity of foods offered to young children as well as the timing of their
introduction (UNICEF, 2012).
Adolescent can contribute
meaningfully to a large extent to improve their nutrition, nutrition of the
family and infant and young child feeding nutrition for both current and future
children. This adequate knowledge of infant and young child feeding practices
is essential for optimal growth of children and improves their nutrition status
(FAO, 2015).
Female
adolescence is a window of opportunity for improving health outcome among
future children. Therefore increase investment in early education of adolescent
girls regarding safe infant and young child feeding practices may be an
effective strategy to promote, support and improve feeding practices.
1.2
STATEMENT OF THE PROBLEM
According to Food and Agricultural
Organization (FAO) (2005) Poor nutrition education and lack of knowledge on
good feeding practices contributes largely to the risk of diarrhea, Kramer,
2003) respiratory illness, (Chantry, 2006) malnutrition and reduced cognitive
development.
Its
estimated that suboptimal breastfeeding, especially non exclusive breastfeeding
I the first month of life, result in 1.4million deaths and 10% of the disease
burden in children under the age of 5years (WHO,2003)
Adolescent
knowledge on how to purchase, prepare, hold and feed children appropriately
could lead to malnutrition as a result of poor feeding practices (International
Food Policy Research Institute IFPRI, 2016 )
through reduction in underweight and stunting of which 165million
children where estimated to have stunted growth resulting from malnutrition
(Bhutta et al, 2013).
These
problems associated with infant and young child feeding practices led the
researcher to embark on this study to evaluate and proffer way of proper
feeding practices and the importance of educating adolescence on nutrition
practices.
1.3 OBJECTIVE OF THE
STUDY
The
general objective of this study is to assess the adolescent girls’ knowledge on
infant and young child feeding practices in Umuahia South Local Government Area
in Abia State.
The specific objectives of the study includes
to:
- Determine the
personal and household characteristics of the adolescent girls.
- Assess their
exposure to source of information on infant and young child feeding
practices
- Assess the
adolescent girls’ knowledge on infant and young child feeding practices.
- Determine house hold
influences on adolescent girls knowledge on infant and young child feeding
practices.
1.4 SIGNIFICANCE OF THE
STUDY.
Malnutrition
is both a typical cause and a blemishing consequence of poverty. Malnutrition
or under-nutrition is the physiological outcome of hunger and/or illness and
manifests itself in numerous macronutrient and micronutrient deficiencies. It
has both short-term and long-term consequences. The short-term consequences are
morbidity, disability and mortality; where in the long term it affects a broad
range of issues including educational prospects, productive employment, and
economic capacity.
Adolescent
knowledge on infant and young child feeding practices contributes largely to
the understanding of exclusive breastfeeding, food variety for complimentary
feeding which leads to growth, cognitive development and well-being of the
children and reduce malnutrition.
This
study will provide information to the government and the society at large on
the need to implement programs which will support exclusive breastfeeding and
complementary feeding practices. It will also help policy makers to formulate
polices that will help promote Infant and young child feeding practices.
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