ABSTRACT
This study assessed the food security and anthropometric status of adolescent school girls in Enugu North 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 school girls. Data on personal information of the adolescent school girls and socio-economic status of their parents and food security were collected using structured and validated questionnaire. Anthropometric status were gathered using standard procedures. The IBM SPSS version 22.0 computer programme was used to analyse the data. WHO Anthro plus was used to grade the anthropometric status of adolescent school girls. Data obtained were described using frequency and percentage. Chi-square was used to determine the association between socio-economic characteristics of the parents, food security status and anthropometric status of the adolescent school girls. Significant association was judged at p ≤ 0.05. The result from the study showed that there was a high prevalence (68.6%) of food insecurity among the adolescent school girls. Most of the adolescent school girls in this study were found to be food insecure. The anthropometric status of the adolescent school girls showed that some (4.3) of the adolescent school girls were stunted. The Prevalence of thinness (6.0%), overweight (14.3%) and obesity (4.3) were also observed in this study. There was a significant association (p < 0.05) between occupation of the mothers, occupation of fathers, educational qualification of mothers and food security level of the adolescent school girls. For food security to be achieved, all four components such as food availability, accessibility, utilization and stability must be present. Therefore, both governmental and non-governmental organizations working in nutrition sensitive and nutrition specific program should perform their tasks in averting unacceptably high prevalence of household and adolescent food insecurity.
TABLE OF CONTENTS
Title page i
Certification ii
Dedication iii
Acknowledgement iv
Table of content viii
Lists of tables ix
Abstract x
CHAPTER 1: INTRODUCTION
1.1 Statement of Problem 4
1.2 Objective of the Study 5
1.3 Significance of the Study 6
CHAPTER 2: LITERATURE REVIEW
2.1 Growth during the period of adolescence 7
2.2 Nutritional needs during adolescence 8
2.2.1 Macronutrient requirement of adolescent girls 8
2.2.2 Micronutrient requirements of adolescent girls 10
2.2.2.1 Iron 10
2.2.2.2 Calcium 12
2.2.2.3 Folate 12
2.2.2.4 Vitamin D 13
2.3 Food security 15
2.3.1 Factors affecting food security 16
2.3.1.1 Income and poverty level 17
2.3.1.2 Household size 18
2.3.1.3 Age of household head 19
2.3.1.4 Female-headed household 19
2.3.1.5 Educational status 21
2.3.1.6 Food Price 21
2.4 Food security and anthropometric status of adolescent School
girls 22
2.4.1 Stunting 22
2.4.2 Wasting 22
2.4. 3 Food insecurity as a cause of obesity 23
2.5 Adolescent anthropometric indicators 25
2.5.1 The height-for-age (HAZ) 25
2.5.2 The weight-for-height (WHZ) 26
2.5.3 Body mass index (BMI) for age 26
CHAPTER 3: MATERIALS
AND METHODS
3.1 Study design 27
3.2 Area of study 27
3.3 Population of the study 27
3.4 Sampling and sampling techniques 28
3.4.1 Sample size 28
3.4.2 Sampling Procedure 29
3.5 Preliminary activities 30
3.5.1 Preliminary visits 30
3.5.2 Training of research assistants 30
3.5.3 Informed Consent 30
3.6 Data collection 31
3.6.1 Questionnaire Design 31
3.6.2 Questionnaire administration
31
3.6.3 Interview 31
3.6.4 Anthropometric measurement 32
3.6.4.1 Weight measurement 32
3.6.4.2 Height measurement 32
3.6.5 Assessment of food security 33
3.7 Data analysis 35
3.8 Statistical analysis 35
CHAPTER 4: RESULTS AND DISCUSSION
4.1 Personal characteristics of the adolescent school girls 35
4.2 Socio economic characteristics of the adolescent’s parents 38
4.3 Food security status of the adolescent school girls 41
4.4 Anthropometric status of the adolescent school girls 43
4.5 Association between socio economic characteristics
of the parents and food security status of the adolescent school girls 45
4.6 Association between socio
economic characteristics of the parents,
anthropometric
status and food security status of the adolescent school girls 47
4.7 Relationship between anthropometric status and food
security status of the adolescent school girls 48
CHAPTER 5: CONCLUSION AND RECOMMENDATION
5.1 Conclusion 50
5.2 Recommendation 50
References 51
Questionnaire
LIST OF TABLES
Table Pages
4.1: Personal characteristics of the adolescent
school girls 37
4.2: Socio economic characteristics of the
adolescent’s parents 40
4.3a: Food security status of the adolescent school
girls 42
4.3b: Food
security level of the adolescent school girls 43
4.4: Anthropometric status of the adolescent
school girls 44
4.5: Association between socio
economic characteristics
of the parents,
anthropometric status and food security status
of the adolescent school girls. 46
4.6 Association between anthropometric
status and food
security status
of the adolescent school girls 48
4.7 Relationship between anthropometric
status and food security status of the adolescent school
girls 49
CHAPTER 1
INTRODUCTION
Food is a
universal human right and an important determinant of health (Mikkonen and
Raphael, 2015). Achieving food security is necessary for the attainment of
the sustainable development goals (SDG) and ending all forms of poverty as well
as hunger and malnutrition by 2030 (Pérez-Escamilla, 2017). Food security
is said to exist when all people, at all times, have physical, social and
economic access to sufficient, safe and nutritious food which meets their dietary
needs and food preferences for an active and healthy life (Food and Agriculture
Organization (FAO), 2016). 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 (Food and Agriculture
Organization (FAO, 2016). The pillars of food security are food
availability, food access, and food utilization. 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).
The World Health Organization (WHO) (2017a) has
defined adolescence as the age group of 10-19 years. It 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). This period has also been identified as a
period of potential interest in correcting nutritional imbalance and
insufficient growth from childhood (Voelker et
al., 2015). It has been indicated
that adolescents are particularly vulnerable to nutrient inadequacies as their
bodies undergo various physiological changes, and as they become more socially
independent, which often impacts negatively on their dietary intakes (Bhutta et al., 2017). The nutrient needs of
adolescents are higher than those of prepubescent children and adults. Given
the increasing autonomy in diet and eating habits that adolescents experience
as parental control lessens, adolescence can be a key entry point for
interventions that will underlie healthy practices in adulthood (Bhutta et al., 2017).
Malnutrition is a major problem that contributes to decreased growth in
adolescents (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). Adolescents need food to have
appropriate nutritional status and also to sustain life (Food and Agriculture
Organisation/International Fund for Agricultural Development/United Nations
Children Fund (FAO/IFAD/UNICEF),
2019). Food insecurity has become a problem among low-income households in
developing and underdeveloped countries globally (FAO and UNICEF, 2017). People
do not have economic, social, and physical access to sufficient and nutritious
food that can meet their dietary needs for an active and healthy life. Food
must be available, accessible, utilized adequately, and in stable condition to
meet the nutritional demand of adolescents (FAO and UNICEF, 2017).
Anthropometric measurements are a series
of quantitative measurements of the muscle, bone, and adipose tissue used to
assess the composition of the body. The core elements of anthropometry are
height, weight, body mass index (BMI), body circumferences (waist, hip, and
limbs), and skinfold thickness (Kyle
and John, 2021). 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).
In the low-income household, the burden of food insecurity is more among
adolescents than in younger children (Moffitt and Ribar, 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).Addressing the food
security and nutrition needs of adolescent girls could be an important step in
breaking the vicious cycle of intergenerational malnutrition, chronic diseases,
and poverty. Thus, the aim of this study is to assess the food security and
anthropometric status of adolescent school girls in Enugu North Local
Government Area, Enugu State.
1.1 STATEMENT OF PROBLEM
The provision of food continuously has remained a serious challenge, as
food is one of the basic needs of humanity for optimal nutrition (World Health
Organization (WHO), 2013a). Globally, food insecurity is a growing public
health issue and a barrier to achieving adequate nutrition (Mukigi et al., 2018). The threat of food
insecurity is more in low- and middle-income countries (especially in
sub-Sahara Africa), where the burden is huge and national prevalence is high
(FAO, 2017). The vast majority of the world’s hungry people live in
low-income countries, with approximately 60% being food insecure
(Pérez-Escamilla, 2017). Food security is a priority, as malnutrition is a
contributing factor to morbidity, mortality, reduced productivity, and poor
cognitive development (Alam et al.,
2018).
The global
growth of population, the changes in climate, the rising price of food, and
insurgency have a severe impact on food security (International Food Policy
Research Institute (IFPRI), 2014). In 2019 and 2020, the proportion of the
population facing food insecurity increased, and between 112 and 123 million
people across 50 countries in the world were in crisis or in the worst form of
food insecurity. About 183 million people in 47 countries were classified in
stressed food insecurity condition (FAO, 2020).In 2019, the acute food
insecurity level in Nigeria was almost 5 million (5%) of the population in 16
states analysed (FAO, 2020).In a study conducted by Shapu et al. (2020), majority (73.5%) of the adolescent girls studied
were in a very low food security level. Food insecurity is a contributing
factor to poor health outcomes and deficiency of nutrients among adolescents
are most likely to be due to inadequate intake of nutrients (Ukegbu et al., 2019).In a Nigerian study
conducted by Omobuwa et al. (2014),
7.6% of the adolescents were obese while the prevalence of underweight among
the adolescent girls in the study was 23.4%. Prevalence of thinness among
adolescent girls in Nigeria was 23% (National Population Commission (NPC),
2013). Thus, this study was aimed to assess the food security and
anthropometric status of adolescent school girls in Enugu North 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 North Local Government Area, Enugu
State.The specific objectives of this study are to:
i.
Determine the personal data of the adolescent school girls
and the socio economic characteristics of their parents.
ii.
Ascertain the food
security status of the adolescent school girls.
iii.
Assess the anthropometric status of the adolescent school
girls.
iv.
Determine the association between socio economic characteristics
of the parents, food security status and anthropometric
status of the adolescent school girls.
1.3 SIGNIFICANCE OF THE STUDY
The findings of this study
will aid in designing appropriate policies and interventions that can
effectively alleviate food insecurity in households. The result obtained from
this study will extensively provide information on the extent of food insecurity
among adolescent school girls in Enugu North Local Government Area, Enugu State.
It will also provide the need to improve food production and the socioeconomic
status of households in order to improve adolescent food security. Findings
from the study will generate information that can be used by Organizations like FAO, WHO, UNICEF.
The information will help them in forming food policy which will improve the nutritional
status of adolescent girls. The information will also indicate health and
nutritional related problems that are associated with poor feeding among
adolescent school girls and finding possible solution to households that are
food insecure. It will also help the organizations in identifying subgroups or regions with severe food insecurity.
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