ABSTRACT
This study assessed the food security and anthropometric status of adolescent school girls in Enugu East Local Government Area, Enugu State. The study was a cross-sectional study. A multi-stage sampling technique was used to select a total of 300 adolescent girls. Data on personal information of the adolescents and socio-economic status of their parents, food security and anthropometry collected using standard processes were collected using structured, pretested and validated questionnaire. Anthropometry was collected using standard procedures. The IBM SPSS version 22.0 computer programme was used to analyze the data. WHO anthro plus was used to analyze the anthropometric status of adolescents. Data obtained were presented using frequency and percentage. Chi-square was used to analyze the relationship between socio-economic characteristics of the parents, food security status and anthropometric status of the adolescent girls. Result from the study showed that some (39.3%) of the adolescent girls were in JSS 2 and majority (98.0%) of them were Christians. Some (35% and 34.7%) of both their fathers and mothers respectively were civil servants while most (60.3% and 60.7%) of them attained higher institution. More than half (58.3%) of the adolescents were food insecure of which 35.3% of them were mildly food insecure, 14% and 9% of them were moderately and severely food insecure. Meanwhile, 21.3% of the adolescent girls were overweight, 5.3% of them were obese while 1.0% were thin (underweight). The prevalence of stunting in the study was 1.7%. However, there was a significant association between food security status of the adolescents and the occupation of their mothers, educational qualification of their fathers and educational qualification of their mothers. Given that adolescence is the second period in life with rapid growth and development, improving food security status of this sensitive segment of the population is to be an agenda of all concerned bodies.
TABLE OF CONTENTS
Title page i
Certification ii
Dedication iii Acknowledgement iv
Table of content v
List of tables viii
Abstract x
CHAPTER 1
INTRODUCTION 1
1.1 Statement of problem 4
1.2 Objectives of the study 6
1.3 Significance of the study 6
CHAPTER 2
LITERATURE REVIEW
2.1 Meaning of adolescence 8
2.2 Adolescents and nutrition 9
2.2.1 Nutritional needs of adolescent girls 10
2.2.1.1 Macronutrient requirement of adolescent girls 11
2.2.1.2 Micronutrient requirements of adolescent girls 13
2.2.2 Factors contributing to nutritional problem of adolescent girls 17
2.3 Concept of food security 20
2.3.1 Dimensions of food security 21
2.3.1.1 Availability 21
2.3.1.2 Access 22
2.2.1.3 Utilization 23
2.3.1.4 Stability 24
2.4 Causes of food insecurity 25
2.4.1 Insufficient production 25
2.4.2 Gender inequality 26
2.4.3 Conflicts and civil insecurity 27
2.4.4 Climate change and natural disasters 28
2.4.5 Low technology for processing and storage 30
2.5 Strategies for achieving food security in Nigeria 31
2.5.1 Economic strategies 32
2.5.2 Social strategies 33
2.5.3 Environmental strategies 34
2.5.4 Technological strategies 34
2.6 Anthropometry of adolescents 35
2.6.1 Weight 36
2.6.2 Height 36
2.6.3 Weight-for-age 37
2.6.4 Weight-for-length/height 37
2.6.5 Length/height-for-age 38
CHAPTER 3
MATERIALS AND METHODS
3.1 Study design 39
3.2 Area of study 39
3.3 Population of the study 40
3.4 Sampling and sampling techniques 40
3.4.1 Sample size 40
3.4.2 Sampling Procedure 41
3.5 Preliminary activities 42
3.5.1 Preliminary visits 42
3.5.2 Training of research assistants 42
3.5.3 Informed Consent 42
3.6 Data collection 42
3.6.1 Questionnaire Design 42
3.6.2 Questionnaire administration 43
3.6.3 Interview 43
3.6.4 Anthropometric Measurement 43
3.6.4.1 Weight Measurement 44
3.6.4.2 Height measurement 44
3.6.5 Assessment of food security 44
3.7 Data analysis 45
3.8 Statistical analysis 45
CHAPTER 4
RESULTS AND DISCUSSION
4.1 Personal characteristics of the adolescent school girls 47
4.2 Socio economic characteristics of the adolescent’s parents 50
4.3 Food security status of the adolescent school girls 54
4.4 Anthropometric status of the adolescent school girls 57
4.5 Relationship between socio economic characteristics of the parents,
food security status and anthropometric status of the adolescent school girls 59
4.6 Association between food security and anthropometric status of the
Adolescents 63
4.7 Relationship between food security and anthropometric status of the
Adolescents 64
CHAPTER 5
CONCLUSION AND RECOMMENDATION
5.1 Conclusion 66
5.2 Recommendation 66
References 68
Appendix: Questionnaire 73
LIST OF TABLES
Table Page
4.1: Personal characteristics of the adolescent school girls 49
4.2: Socio economic characteristics of the parents 53
4.3a: Food security status of the adolescent school girls 55
4.3b: Food security level of the adolescent school girls 57
4.4: Anthropometric status of the adolescent school girls 59
4.5: Relationship between socio economic characteristics of the parents,
food security status and anthropometric status of the adolescent girls 61
4.6: Association between food security and anthropometric status of the
adolescents 64
4.7: Relationship between food security and anthropometric status of the
adolescents 65
CHAPTER 1
INTRODUCTION
The quest for food and the desire to satisfy hunger is undoubtedly man’s most important need (Ijatuyi et al., 2018). To meet this basic need, there must be physical, social and economic provision and access to safe, sufficient, and nutritious food. Meeting the dietary needs and food preferences of all races, at all times, such that an active and healthy life is guaranteed; is commonly referred to as food security (Food Climate Research Network (FCRN), 2018). According to the Food and Agriculture Organization (FAO), (2017), food security is a state when all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food to meet their dietary needs according to their preferences for an active and healthy life. Food insecurity (FI), on the other hand, is experienced when people are economically unable to purchase sufficient quantities of food or balanced meals that they need (FAO, 2017). Food security is achieved when all the four pillars (availability, access, utilization and stability) are met. These three pillars are closely related. Food unavailability and difficult access to food have the potential to increase the risk of malnutrition in various life cycles, including adolescents (Maitra, 2018).
Adolescence is the period of most rapid growth second to childhood characterized by rapid transition to adulthood marked by physical and biological growth and development (Tesfaye et al., 2015). For instance, 50% of adult weight, height and skeletal mass are gained in this period; hence optimal nutrition is critical during this period (Teji et al., 2016; Akseer et al., 2017; Birru et al., 2018). Additionally, it is a period of critical window of opportunity to intervene on the intergenerational cycle of malnutrition (Gonete et al., 2018). Addressing the nutrition needs of adolescents could be an important step in breaking the vicious cycle of intergenerational malnutrition, chronic diseases, and poverty (Lassi et al., 2017; Krebs et al.,2017). However; adolescents from developing countries like Nigeria are susceptible to nutritional deficiencies due to early childhood nutritional problems and adverse environmental conditions including food insecurity which could impact on their development and wellbeing (Fatima et al., 2014).
Malnutrition is a major problem that contributes to decreased growth [(Pinhas-Hamiel et al., 2017). Manifestations of malnutrition can be observed in the nutritional status of adolescents. Nutritional status is the level of nutrients related to normal metabolism in the body (Elmadfa and Meyer, 2014). The high and low intake of nutrients and their use in the body have an impact on nutritional status (Gibson, 2015). The nutritional requirements in adolescents increase rapidly due to the rapid increase in biological or psychological growth, either in boys or girls (Mramba et al., 2017). The second period of a growth spurt after infancy occurs in adolescence (Spear, 2012). Besides that, the highest bone mass reserve is also found in adolescence (Matkovic et al., 2014). Adolescent nutrition will affect the health of adolescents in the present and future, future labour productivity, and improvement in the generation that will be born (Clark et al., 2014).
In adolescents, nutritional status can be determined by using anthropometric indicators, such as body mass index for age (BMI-for-age) and height-for-age (De Onis et al., 2017). Body mass index-for-age and height-for-age less than or equal to -2 standard deviations (SD) are categorized as thin and short, respectively. Meanwhile, weight-for-height less than -2 standard deviations (SD) are categorized as wasted while weight-for age less than -2 standard deviations (SD) are categorized as underweight (De Onis et al., 2017). The potential for increased risk of malnutrition in adolescents is affected by the state of food insecurity (Mramba et al., 2017). The previous review in the adolescent group showed that half of the studies showed a positive association between food insecurity and low nutritional status, especially stunting (Maitra, 2018).
The nutritional status of adolescents affects their health and condition in later life. The high prevalence of chronic energy and micronutrient deficiencies of today's adolescent is directly linked to the quality of the next generation. Without addressing these deficiencies, the vicious cycle of inter-generational under nutrition, chronic diseases, and poverty perpetuates (Alam et al., 2015). Undernourished adolescent girls are likely to grow into undernourished young women who are more likely to give birth to undernourished babies (Smith and Haddad, 2015). Thus, the aim of this study is to assess the food security and anthropometric status of adolescent school girls in Enugu East Local Government Area, Enugu State.
1.1 STATEMENT OF PROBLEM
Globally, food insecurity is a growing public health issue and a barrier to achieving adequate nutrition (Mukigi et al., 2018). Not less than 70% of the Nigerian population is surviving on less than a dollar per day while food insecurity prevalence in the low income urban house-holds and rural areas, respectively stands at 79% and 71% (Akerele et al., 2013). The rural areas have become even more vulnerable to malnutrition, erratic supply of food items, unaffordable food costs, low quality foods and sometimes complete lack of food (Matemilola and Elegbede, 2017). Although food insecurity is a global phenomenon, it is more prevalent in the developing nations including Nigeria. The Food and Agriculture Organization State of Food Insecurity reported that nearly 821 million people are estimated to be chronically undernourished in the world. One in nine people in the world are facing hunger, Africa being the region with the greatest prevalence of hunger in the world (FAO, 2019). The World Health Organization (WHO) (2016) estimated that approximately 60% of all childhood deaths in the developing world are associated with food insecurity, chronic hunger and malnutrition. In developing countries, persistent malnutrition leaves children weak, vulnerable, and less able to fight such common childhood illnesses as diarrhoea, acute respiratory infections, malaria, and measles, while children who are mildly to moderately malnourished are at greater risk of dying from these common diseases (WHO, 2016).
Although food insecurity is a global discourse, the impact of its deficiency is felt more in the developing countries of the world, especially, sub-Saharan Africa (Nwalie, 2017). For instance, a recent report by Food and Agriculture Organization indicated that about 7.1 million people in Nigerian States were challenged by acute food insecurity (Food Security Information Network (FSIN), 2017). Several literatures suggests that food security is a priority as malnutrition is a risk factor for morbidity and mortality, poor cognitive development and ultimately reduced productivity in adolescents (Grantham-McGregor et al., 2017; Victora et al., 2018; Black et al., 2018).
Food insecurity has negative consequences and also affects all age groups, including adolescents. Adolescent girls from food insecure households tend to have lower academic performance and poor health and nutritional status (Fatmaningrum et al., 2016; Hartline-Grafton and Dean, 2017). Adolescent girls are at risk of becoming malnourished due to poor dietary intake. They are likely to have a low-birth-weight baby, which can impact the next generation as the prevalence of low-birth-weight babies is more among adolescent girls (Gundersen and Ziliak, 2015). Food insecurity is a contributing factor to poor health outcomes and deficiency of nutrients among adolescents likely to be due to inadequate intake of nutrients (Ukegbu et al., 2019). Growing evidence indicates that food-insecure adolescents not only have poor nutrition and reduced levels of physical activity, but also impaired cognitive development and increased risk for mood, anxiety and behaviour disorders (McLaughlin, 2012; Fram and Lorrene, 2015). In view of the above, it was considered of interest to assess the food security and anthropometric status of adolescent school girls in Enugu East Local Government Area, Enugu State.
1.2 OBJECTIVES OF THE STUDY
The general objective of this study is to assess the food security and anthropometric status of adolescent school girls in Enugu East Local Government Area, Enugu State. The specific objectives of this study are to:
i. Determine the personal information of the adolescents and socio-economic status of their parents.
ii. Ascertain the food security status of the adolescents.
iii. Assess the anthropometric status of the adolescents.
iv. Determine the association between socio-economic characteristics of the parents, food security status and anthropometric status of the adolescents.
1.3 SIGNIFICANCE OF THE STUDY
Findings from this research will not only contribute to existing academic literature but can be used by Enugu East Local Government, researchers, policy makers, and other relevant stakeholders to develop and implement strategies that can uplift the lives of adolescent girls within Enugu East, Enugu State. It will indicate health and nutritional related problems that are associated with poor feeding among adolescents and finding possible solution to households that are food insecure. This study will generate information that can be used by WHO, UNICEF and other organizations. It will also be of interest and useful to health practitioners, nurses, doctors and educationist by providing them with information on the effects of food insecurity on adolescent girls and the extent to which malnutrition has spread among adolescents.
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