ABSTRACT
Better nutrition has been shown to have an impact on both cognitive and spatial memory/ academic performance. Parents of lower socioeconomic status tend to have children who are less successful in school and have a lower education attainment and poorer health outcomes than those with higher socio-economic status. Thus, this study was carried out to assess the effect of Socio-Economic Characteristics of parents on Anthropometric status of Infants (0-59 months) in Essien Udim Local Government Area of Akwa Ibom state. A cross-sectional study design was used. Data were collected by using pretested questionnaires. A multi-stage sampling technique was used to select a total of 250 mothers and their children. The IBM SPSS version 21.0 computer programme and WHO anthro plus were used to analyze the data. Significant relationship was judged at p ≤ 0.05. Data obtained were analyzed using frequency, percentage, mean and standard deviation. Pearson correlation was used to analyze the relationship between parental socio-economic status of the children and anthropometric indices of the children The result showed that 42.4% and 42.8% of the mothers had secondary and tertiary education while 34.0% and 54.4% of fathers had secondary and tertiary education. However, 66.8% of the respondents breastfed their children after delivery, introduced breastfeeding within 60 minutes after birth, some (28.4%) of the mothers did gave their children breast milk after 3 days and little below 48.0% introduced water and other foods after the first six months as 24% breastfed for 6 months. Many (72.0%) of the respondents gave their children Infant formula, 24% introduced it at age of 1-2 months and 3-5 months respectively while 28% did not use it at all. During complementary feeding (23.2%) used only soya bean to enrich their baby food. In terms of skipping of meals, 14% of the children skipped meals, of which breakfast (9.6%) was mostly skipped. The weight-for-height status revealed that 4.2% of the children were severely wasted while the weight-for-age status revealed that 8.5 % were severely underweight. The height-for-age status showed that 18.7% of the children were severely underweight as their BMI for age showed that 10.2% were obese. However, there was a significant relationship (p≤ 0.05) between mother’ monthly income, father’s occupation and anthropometric status of the children. No significant relationship were found between mother’s educational status, father’s educational qualification, mother’s occupation and the anthropometric status of the children. Conclusively, educating the mothers on ways to improve breastfeeding practices will help to reduce the number of children at risk of under nutrition as evidenced by their low weight-for-age, height-for-age and weight-for-height z-scores.
TABLE OF CONTENT
TITLE PAGE i
CERTIFICATION ii
DEDICATION iii
ACKNOWLEDGEMENT iv
TABLE OF CONTENT v-vii
LIST OF TABLES viii
ABSTRACT ix
CHAPTER 1: INTRODUCTION
1.1 Background
of the Study 1-4
1.2 Statement
of Problem 4
1.3 Objectives of the Study 5
1.3.1 General Objective of the study 5
1.3.2 Specific Objectives of the Study 6
1.4 Significance of the Study
6
CHAPTER
2: LITERATURE REVIEW
2.1 Nutritional
Status of Children 7
2.2 Indices
of Malnutrition in Children 9
2.2.1 Underweight
9
2.2.2 Stunting 10
2.2.3 Wasting 10
2.2.4
Low Birth Weight 11
2.3 Parental
Socio-Economic Status and Child Nutrition 11
2.3.1 Mothers
Education and Knowledge 11
2.3.2 Parental
Education and Child’s Nutritional Status 13
2.3.3 Parental
Occupation and Child’s Nutritional Status 14
2.3.4 Parental
Income and Child’s Nutritional Status 15
2.4 Benefits
of Exclusive Breast Feeding for Infants and Mothers 16
2.5 Complementary
Feeding of the Breastfed Child 17-19
CHAPTER 3:
MATERIALS AND METHODS
3.1 Study Design 20
3.2 Area of Study 20
3.3 Population of the
Study 21
3.4 Sampling and
Sampling Technique 21
3.4.1 Sample Size 21-22
3.4.2 Sampling Procedure 22-23
3.5 Preliminary Activities 23
3.5.1 Preliminary Visits 23
3.5.2 Training of Research
Assistants 23
3.5.3 Ethical Approval 24
3.6 Data Collection 24
3.6.1 Questionnaire
Administration 25
3.6.2 Questionnaire
Validation 25
3.6.3 Interview 25
3.6.4 Anthropometric
Measurement 26
3.6.4.1 Weight Measurement 26
3.6.4.2 Height Measurement 26
3.6.4.3 Mid Upper arm Circumference 27
3.6.4.4 Age Assessment 27
3.7 Data analysis
27 3.8
Statistical analysis 28
CHAPTER 4: RESULTS
AND DISCUSSION
4.1 Personal
Characteristics of Parents 29
4.2 Socio-Economic
Characteristics of the Parents 32
4.3 Feeding
Pattern of the Children 35
4.4 Frequency
of Food Consumption of the Children 42
4.5 Anthropometric
Indices of Children 45
4.6 Relationship
between the Parental Socio-Economic Status and
Anthropometric
Status of the Children 49
CHAPTER 5:
CONCLUSION AND RECOMMENDATIONS
5.1 Conclusion 51
5.2 Recommendations 51
References 53
Appendix 62
LIST OF TABLES
Table 4.1a: Personal Characteristics
of Parents ………………………………………….. 30
Table
4.1b: Personal
Characteristics of Children………………………………………… 31
Table 4.2
Socio-Economic Characteristics of the Parents ………………………... 34
Table 4.3 (a-c) Feeding
Pattern of the Children ………………………………….. 39-41
Table 4.4 (a-b) Frequency of Food
Consumption of the Children ………………..
43-44
Table 4.5 Anthropometric Status of the Children
………………………………… 48
Table 4.6 Relationship between the
Parental Socio-Economic Status and
Anthropometric Status of the
Children ………………………………… 50
CHAPTER 1
INTRODUCTION
1.1 BACKGROUND OF THE
STUDY
Globally,
malnutrition contributes to nearly half of all infants and young child’s death
which is more than 3 million each year (Black et al., 2013). Each year about 1 million Nigerian children die
before their 5th birthday (United Nations, 2013). Up to 1 million Nigerian
children under age 5 are affected by severe acute malnutrition (SAM) each year (Children’s
Investment Fund Foundation (CIFF), 2014).
Malnutrition
is broadly classified as under-nutrition which is as a result of insufficient
intake of energy and other nutrients, while over-nutrition is due to excessive
consumption of energy and other nutrients (Beer et al., 2004; Allen et al., 2011).
Under-nutrition alone is responsible for more than one third of child death
globally (Black et al., 2013; Bhutta et al., 2013), and account for 11 % of
global burden of disease, it is more prevalent in low and middle income
countries, (United Nations International Children Emergency Fund (UNICEF), 2007),
and it manifests as stunting, wasting and underweight in children. The
prevalence of malnutrition has been associated with many factors such as food
availability, child care practices, diarrhea, household size, income, mother’s
education and poor sanitary conditions (Iram and Butt, 2006). The National
Nutrition and Health Survey (NNHS, 2015) reported the overall global acute malnutrition
(GAM) prevalence for children under-five based on weight-for-height Z-score (WHZ)
as 7.2 %, while the prevalence of severe acute malnutrition (SAM) was 1.8 %,
showing an improvement since 2014 when GAM was reported at 8.7 % and SAM at 2.2
%. Disaggregation by geopolitical zones confirmed last year findings. Acute malnutrition
was highest in the North West (10.2 %) and North East (9.5 %) and low in the
South states and particularly in the North Central states, where it was less
than half at 4.5 %. Hence, the prevalence of acute malnutrition at state levels
exhibits the same level of variability, ranging from 1.4 % in Benue to 12 % in
Jigawa. In 2014, GAM and SAM were reported above critical cut off points (15 %
for GAM and 2 % for SAM) in three states, namely Jigawa, Bauchi, and Yobe. None
of the states surveyed in 2015, reported such critical prevalence decrease
in prevalence of malnutrition in 2011 report of the multiple indicators cluster
survey (MICS) in Nigeria with 34% of children under-five stunted, 31%
underweight and 16% wasted, while about 15% of children have low birth weight (MICS,
2011).
In
Nigeria, malnutrition has been reported to be associated with increased
morbidity and mortality among children under-five years of age, about one
million Nigerian children die before their 5th birthday (Adeyele and
Ofoegbu, 2015). Almost 30 % of Nigerian children are overweight and this was
more than the portion of neighboring Ghanaian children who are underweight
(ICF, 2013). The percentage of children in Nigeria who are wasted has steadily
increased over the last decades rising from 11 % in 2003 to 18 % in 2013 (NNPC
and ICF, 2013). It is evident from the 2013 Nigerian demographic and health
survey (NDHS) that the portion of children who are stunted has been decreasing
over the years. However, the extent of wasting has worsened, indicating a more
recent nutritional deficiency among children in the country (UNICEF, 1998; NDHS,
2003, 2008 and 2013).
Nutritional
status refers to the nutritional health of a person as determined by
anthropometric measures (e.g. height, weight, circumferences), biochemical
measurements of nutrients or their by-products in blood and urine, clinical
(physical) examination, dietary analysis and environmental, economic evaluation
(Byrd-Bredbenner, 2013; Wardlaw et al,
2007). Childhood malnutrition has
received little attention relative to the magnitude of the problem (UNICEF,
2006). Although Nigeria recorded a
decline in under-5 stunting from 41% in 2008 to 37% in 2013 (National
Population Commission (NPC) (2014) and International Children Fund (ICF),
2014). Nigeria still accounted for 11 million out of the world 60 million
stunted children in the year 2012 (Ehikioya and Adanikin, 2012).
Nigeria
demographic and health survey (NDHS), (2013) 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.
Generally, practice of exclusive breastfeeding which could help improve the
under-5 nutritional status remains very low among child bearing women in
Nigeria. For instance, only 17% of children under the age of six months are
exclusively breastfed in Nigeria - a situation that has remained unchanged over
the past 5 years (Madoka, 2012).
Evidence suggests that malnutrition is prevalent in Nigeria in general
and Northwest Nigeria in particular− where basic essential needs of life; food,
shelter and clothing−are often not within the reach of the majority poor (Wardlaw
et al., 2007).
In
Nigeria, surveys have reported prevalence of malnutrition in children at
various locations (National Population Commission (NPC) (2014) and
International Children Fund (ICF), 2014). Onimawo et al. (2007) emphasized high incidence of stunting, wasting, and
underweight among rural pre-school children in Essien Udim L.G.A, Akwa Ibom
State. A number of studies have documented the importance of adequate intake of
nutrients in the first 0-59 months of life (Omobuwa, 2010; Jeffery, 2011;
Madoka, 2012). Various interventions aimed at improving the nutritional status
of Nigerian children by various stakeholders are ongoing. For example, some
state government embarked on school feeding programmes in primary schools with
the ultimate goal of improving the nutritional status of primary school pupils
while, health promotion and nutritional information are being disseminated to
address under-5 malnutrition. Some of the interventions provided nutritional
packs that is “Ready to Use Therapeutic Food” (RUTF) as well as provision of
health care services for severely malnourished children.
Despite
the investments, improvement in under-5 nutritional status is hampered by lack
of reliable data on the prevalence of malnutrition to inform evidence-based
intervention, coupled with unrest in Northern Nigeria with displacement of
people especially children who are currently domiciled in internally displaced
camps (IDC) where facilities and services are poorly provided (Jeffery, 2011). Thus,
this study was therefore designed to determine the effect of socio-economic
characteristics of the parents on the anthropometric status of infants (0-59 months)
in Essien Udim LGA of Akwa Ibom state.
1.2 STATEMENT OF
THE PROBLEM
Better
nutrition has been shown to have an impact on both cognitive and spatial memory
plus academic performance. Children with histories of either type of
malnutrition confined to infancy had significantly lower scores on the national
high school examination than healthy children (Jeffery, 2011). The Nigeria
national minimum wage of N18, 000:00 in
which some states of the federation are still battling to pay cannot afford the
basic commodity needs of average family. According to Averett and Stifle (2007)
who studied the effect of overweight and underweight on the cognitive
functioning found that malnourished children tends to have lower cognitive
abilities when compared to well-nourished children who do not get enough to eat
they are likely to suffer from stunted growth and hindered mental development. As
reported by Jacob and Ludwig, (2009), food insufficiency is a serious problem
affecting children’s ability to learn and that offering a healthy breakfast is
an effective measure to improve academic performance and cognitive functioning
among undernourished population. Parents of lower socioeconomic status tend to
have children who are less successful in school and have a lower education
attainment and poorer health outcomes than those with higher socioeconomic
status (Jacob and Ludwig, 2009). This can be partly related to lack of access
to health care and other resources due to lower income, other factors such as
education level, supportive familial and social networks and personal factors
are clearly involved.
Inadequate nutrition within the first
one thousand days of a child’s life can also lead to stunted growth with
impaired cognitive ability which may not be easily reversed and reduced school
work performances (Grantham et al.,
2007). This study therefore was focused towards investigating the effect of
socio-economic characteristics of parents on anthropometric status of infants
0-59 months) in Essien Udim LGA of Akwa Ibom State.
1.3 OBJECTIVES OF THE
STUDY
1.3.1 General objective
of the study
General
objective of this study was to assess the Effect of Socio-Economic
Characteristics of parents on Anthropometric Status of infants (0-59 Months) in
Essien Udim LGA of Akwa Ibom State.
1.3.2 Specific Objectives of the Study
The
specific objectives of this study were to;
i.
Elicit the personal and
socioeconomic data of parents in Essien Udim LGA of Akwa Ibom State.
ii.
Assess the dietary intake
of children.
iii.
Compare the feeding habit
of children of different socioeconomic backgrounds.
iv.
Assess the anthropometric
status of children (weight, height), head circumference and MUAC.
v.
Evaluate the
anthropometric indicators (weight for age, height for age and weight for
height) of the children.
vi.
Correlate parental
socioeconomic status with the anthropometric status of children.
1.4 SIGNIFICANCE OF THE STUDY
1. The findings of
this study will enlighten the parents on the nutritional status of their
children and on effect of poor nutrition on their academic performances and
thereby enable them to make adjustment in their children feeding pattern.
2. It will also
review the necessities of education to future parents and therefore aid in
eradicating parental illiteracy in the families and the society at large.
3. It will also be
of interest and useful to health practitioners, nurses, doctors and
educationists by providing them with the information on the nutritional status
of children 0-5 years, and the extent to which malnutrition has spread in the
community.
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