KNOWLEDGE AND UTILIZATION OF VITAMIN A RICH FOODS AMONG HOUSEHOLD IN UMUAHIA NORTH LOCAL GOVERNMENT AREA, ABIA STATE.

Table 4 1     Background information of the subjects          27

Table 4.2     Demographic characteristics of respondents         29

Table 4.3     Socioeconomic characteristics of parents         31

Table 4.4      Awareness of vitamin A rich foods among households                     33

Table 4.5     Knowledge of households towards vitamin A rich food sources        35

Table 4.6    Attitude of the subjects towards vitamin A rich food sources              38

Table 4.7    Utilization of vitamin A rich food by households      40

Table 4.8    Frequency of consumption of some selected vitamin A rich food       43

Micronutrient deficiencies continue to impose a substantial health economic and social burden worldwide (Darnton-Hill et al., 2004). Due to lack of resources, religious observances, limited education and resulting poor nutritional practices, many non-industrialized countries, such as Nigeria, struggle to maintain adequate nutritional status for the entire population (Jones et al., 2003). The consequences of poor nutritional status can include pregnancy complications; reduced work capacity due to anemia; compromised growth, development, cognitive function, behavior and immunity; and increased risk of morbidity and mortality, especially in children and pregnant women (Allen and Gillespie, 2001; Kapil and Bhavna, 2002). Among the deficiencies of vitamins and minerals examined globally, the largest disease burdens were attributed to vitamin A and zinc deficiencies (WHO, 2009a). Many developing countries have vitamin A deficiency as a public health problem due to inadequate intake of vitamin A from food (Underwood, 1998). The prevalence of low serum retinol is about 44% in African children and reaches almost 50% in children in South-East Asia (WHO, 2009b). Vitamin A deficiency raises the risk of mortality in children suffering from diarrhea diseases, 19% of global diarrhea mortality can be attributed to this deficiency. It also increases the risk of mortality due to measles, prematurity and neonatal infections. Vitamin A deficiency is responsible for close to 6% of child deaths under age 5 years in Africa and 8% in South-East Asia (WHO, 2009). More than 9 million children and 6 million mothers were vitamin-A deficient in Nigeria as at 2002 and vitamin A deficiency also contributed to 25 percent of infant, child, and maternal mortality in Nigeria because of reduced resistance to protein-energy malnutrition, ARI, measles, malaria, and diarrhoea (UNICEF, 2002). The 2013 Nigeria Demographic and Health Survey (NDHS) data revealed the immediate causes of under nutrition in Nigeria include micronutrients deficiency such as Vitamin A, Iodine, Iron and Zinc. Approximately 30% and 20% of under-fives are deficient respectively of Vitamin A and Zinc. As high as 63% of women are anemic, while 31% have iodine deficiency (National Population Commission and International Children Fund International, 2014).

Vitamin A deficiency is also common among older children, adolescents and non-pregnant women. Micronutrient deficiencies are highly prevalent typically due to diet consisting mainly of cereals and lacking the optimal diversity and quality to meet the nutrient needs of most people. The Nigeria Demographic and Health Survey (2013) reported that 52% of children age 6-23 months consumed foods rich in vitamin A the day or night preceding the survey. The proportion of children consuming vitamin A-rich foods increases with age, while 65.3% of the children 6-59 months in Abia State consumed vitamin A rich foods daily (National Population Commission and International Children Fund, 2014). The survey also revealed that Mother’s education has a positive relationship with consumption of vitamin A-rich foods, as 44% of children whose mothers have no education consume vitamin A-rich foods, as compared with 62% of children whose mothers have a higher education (National Population Commission and International Children Fund, 2014). Children born to families in the highest wealth quintile were more likely than children born to families in the lowest quintile to consume vitamin A-rich foods 62% as against 42% (National Population Commission and International Children Fund, 2014). Infants and young children are particularly at risk of micronutrient deficiencies because of their high nutritional needs relative to energy intake and the frequent episodes of infection (including sub-clinical infection) at this age which often results in reduced appetite, decreased nutrient absorption, and increased loss of nutrients from the body. Besides its effect on childhood mortality, malnutrition during early life often leads to stunted growth in children who survive (Talukder et al., 2010), and there may also be irreversible sequence from micronutrient deficiencies that affect brain development and other functional outcomes. Micronutrient malnutrition has serious implications on the development of countries due to its long-term impact on health, cognitive function, and work productivity (Gernand et al., 2016).

There are two types of vitamin A available in foods namely preformed vitamin A and Pro-vitamin A carotenoids (WHO/FAO, 2004). Preformed vitamin A is found almost exclusively in animal products, such as human milk, glandular meats, liver and fish liver oils (especially), egg yolk, whole milk, and other dairy products. Pro-vitamin A carotenoids are found in green leafy vegetables (e.g. Spinach, Amaranth, and young leaves from various sources), yellow vegetables (e.g. Pumpkins, Squash, and Carrots), and yellow and orange non-citrus fruits (e.g. Mangoes, Apricots and Papayas).

A study carried out in Aba South LGA in Abia State revealed that most of the food items produced and purchased for consumption by the respondents had good amounts of vitamin A retinol equivalent (Mbah et al., 2013). It was also revealed that only 11.0% of the respondents consumed palm oil a rich source of vitamin A daily (Mbah et al., 2013). This was lower when compared to a similar study done in Orba community in Enugu State where it was found that 41.0% of the respondents consumed palm oil daily (Nwamarah and Ifezie, 2011). This discrepancy in the limited data available on knowledge and utilization of vitamin A rich foods among households has further stressed the need to carry out this present study.

Substantial evidence that malnutrition, particularly micronutrient deficiencies, is a contributing factor in up to 35% of mortality in children less than 5 years of age and growing body of evidence exists that malnutrition plays a similar role in maternal mortality (Black et al., 2008). As a result of the food crisis, many households have been forced to adopt harmful coping strategies for survival, such as cutting back on food consumption, replacing micronutrient-rich foods with staple foods, selling household and agricultural assets, and increased borrowing, thereby putting many households in financial debt. These actions have long-term negative consequences for nutrition, health, child development and food security. Women and children, who have special nutritional needs, are particularly at risk with negative implications on maternal health and well-being and on the survival, growth and development of children (Victora et al., 2008). Food and Agriculture Organization’s food disappearance data reported that the supply of food vitamin A is generally high in industrialized countries, with most derived from the highly available retinyl esters. Conversely, for most of the developing countries such as Nigeria, the total supplies are appreciably lower. The major source is carotenoids, the utilization of which may be affected by dietary and other factors. Household level data mask problems of intra-household distribution. The Nigeria Demographic and Health Survey (2013) revealed that the South Eastern region had the highest percentage consumption of vitamin A rich foods by children 6-23 months (66.1%) as compared to other regions of the country, the distribution by State in the South Eastern region revealed that Enugu State had the highest percentage consumption of vitamin A (74.4%), followed by Anambra State (72.9%), Abia State (65.3%), Ebonyi State(62.0%) and Imo State (56.3%) (NPC and ICF, 2014). A study carried out in Aba South LGA in Abia State revealed that most of the vitamin A rich food sources were not grown but purchased in the area. This might have predisposed the respondents into low consumption of these foods because of poor purchasing power (Mbah et al., 2013). Until recently, projects that encourage households’ own production of food have focused on home gardens that often promote the production of plant source foods only, whereas limited data exist on the knowledge and utilization of these food sources. While plant foods are important sources of micronutrients, particularly vitamin A, it is now well known that the bioavailability of vitamin A and other micronutrients from plants is lower than originally thought (West et al., 2002). Therefore it is crucial to increase the consumption of animal foods, which are known to be rich sources of bioavailable vitamins and minerals, among micronutrient deficient populations. In Nigeria, however data on the knowledge and utilization of vitamin A rich foods among households are lacking making it of crucial importance to assess. 

The general objective of this study is to assess the knowledge and utilization of vitamin A rich foods among households in Umuahia North Local Government Area of Abia State.

The specific objectives includes to:

The result of this study will help bring to light the knowledge, attitude and practice of households in Umuahia North Local Government Area of Abia State towards vitamin A rich foods and thereby assist nutrition educators, policy makers, public and private agencies involved in the formulation and implementation of strategies to be able to assess the level of success recorded. It will also help reveal the level of utilization of vitamin A rich food sources in the study area thereby assisting in the timely identification of other areas prone to possible risk.