Public Health Project Topics

Prevalence of Malnutrition Among Children Under Five

Prevalence of Malnutrition Among Children Under Five

Prevalence of Malnutrition Among Children Under Five

CHAPTER ONE

General Objectives:

To determine the prevalence of malnutrition among children under five of age in the Pastoralist community of Barkin Ladi LGA, Plateau state.

Specific Objectives

  1. Whatare the major contributing factors for malnutrition in community under study?
  2. To determine prevalence ofstunting of under five children in the study area
  3. Toestimate prevalence of wasting of under five children in the study area
  4. To assess the knowledge and practice of mothers/caretakers on complementary andsupplementary feeding of the child

CHAPTER TWO

LITERATURE REVIEW

GeneralBackground

Adequate food and nutrition are essential for proper growth and physical development to ensure optimal work capacity, normal reproductive performance, adequate immune mechanism, and resistance to infection. Inadequate diet may produce several forms of malnutrition in children, the most important being protein energy malnutrition (PEM), Nutritional anemia, Vitamin A deficiency and Iodine deficiency disorder. These and other nutritional disorders may also serve as predisposing factors for several chronic and crippling diets related non- communicable diseases and have lasting effects throughout the life span (17).

Deficiencies of key vitamins and minerals continue to be pervasive, and they overlap considerably with problems of general under nutrition (underweight and stunting). A recent global progress report states that 35 percent of people in the world lack adequate iodine, 40 percent of people in the developing world suffer from iron deficiency, and more than 40 percent of children are vitamin A deficient (18).

The three commonly used indicators of malnutrition are height-for age, weight-for-age, and weight-for height. Children whose measurements fall below two standards deviations from the reference median are generally considered malnourished. Each indicator captures different aspects of malnutrition (19).

Magnitude of Malnutrition

Stunting, or low height for age, is considered an indicator of chronic malnutrition. Height for age measures linear growth and therefore a low score is indicative of a cumulative growth deficit. Stunting is often the result of inadequate feeding practices over a long period and/or repeated illness. It is likely to persist even after these conditions are eliminated. Wasting, or low weight-for-height, measures body mass in relation to body length and is generally considered to reflect acute malnutrition. As an indicator, wasting is likely to vary over short periods of time due to food availability and disease prevalence. Underweight, or low weight for age, is a composite of height for age and weight for height. It is generally considered a general indicator of malnutrition, since a child that is underweight could be stunted or wasted, or both stunted and wasted (19).

Understanding the problem of nutrition in a developing country like Nigeria and arriving at a consensus on the synergies and the integration of various causes of malnutrition are deemed essential as a background for the development of a National Nutrition Strategy (NNS). Three clusters of causes of malnutrition are identified as key sets of determinants for the process of developing the NNS. These include the immediate causes, the underlying causes, and the basic or root causes.

 

CHAPTER THREE

Research Methodology

Study Design

Five Homes were selected randomly from Barkin Ladi. Selected under five of age children in the selected villages were the study population.

The study assessed the nutritional status of children by using height and weight scale. The source population was all children 6-59 month of age in pastoralist community of Barkin Ladi and Community based Descriptive method design will be used.

Study Population

From the total 14 homes of Barkin Ladi five homes were selected randomly by using lottery method. The total sample was distributed for each homes by using proportional to size allocation. From this homes eligible sample of households were selected using simple random sampling technique. Data of 3112 households with children in the age group under five of age were taken from health extension workers. Depending on the data obtained from HEWs, sampling frame was prepared. For the family that had more than one child within this age the youngest child was selected.

A total of 816 children participated making the response rate 99.7%, with mean age and standard deviation of children 22 ± 12 months. The list of households those who have under five of age children were obtained from health extension workers. By using the list as a sampling frame a total of 816 children participated in this study.

CHAPTER FOUR

DATA PRESENTATIONS AND RESULTS

Socio Demographic Characteristics

The age ranges of children considered in the study were under five of age. Majority of children, which accounted for 673(82.5), were aged 6- 36 months. From the total study participants 442(54.2%) were males and 374(45.8%) were females respectively (Table 4.1).

Table 1 shows that 582(71.3%), of mothers were below the age of 36 years. Regarding family size 737(90.3%) of the respondents had greater than or equal to four family members. Of the total respondents 621(71.6%) of them had more than one under five of children. And 653(80%) mothers reported that, they had given birth for three or more children.

In the majority of the respondents, 812(99.5%), of them the head of the house hold were male. Regarding education status 754(92.4%) of mothers were illiterate. Of all interviewed Mothers, 797(97.7%) of them were married, 10(1.2%) of them were Divorced, and the rest of them were widowed. When we see the ownership of the house about 792(97.1%) of the house was owned by the respondent. Around half of the respondents, 398(48.8%), reside in the house which had only one room.

CHAPTER FIVE

SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

Summary

Descriptive survey research design was employed to undertake the study. From the total 114 homes of Barkin Ladi LGA, five homes were selected randomly by using lottery method. The total sample was distributed for each homes by using proportional to size allocation. From the 3112 households residing in the LGA, the list of households that have under five of age children were taken as a sampling frame and 816 children within the age of 6 -59 months were selected as study participants.

The findings in the research indicate that the morbidity rate identified in the study subjects using symptom complex such as: diarrhea, fever and chills, and cough and difficulty to breathe in the last two weeks. During bi variant analysis febrile illness shows significant association with wasting. But in multivariate analysis no significant different was observed in stunting and morbidity. Age at first marriage had significant association with stunting. Children from those mothers who got marriage before the age of eighteen were 2.3 times more likely to be stunted than children from those mothers who married after the age of eighteen.

Magnitude of Stunting was found to be very high with 35.8%, underweight 11.6% and wasting 9.2%, among children of Barkin Ladi

Generally in this study, it was observed that childhood malnutrition was among the main nutritional related problems of the population of Barkin Ladi and different factors were interrelated to cause child malnutrition. The effect of nutritional problems affects survival of individuals and development at the family, society and even at the national level.

Moreover, Health, food security, child care require special attentions to achieve rapid reduction in child malnutrition. Access to education, healthcare, safe water, and environmental sanitation are the key elements to alleviate this problem.

Conclusion

  • Based on the study findings, Maternal educational status , income, Water source,Number of under five children in the house hold, breast feeding, age at first marriage were found to be a major associated factors for chronic malnutrition or
  • Using unprotected water source, breast feeding and income were variables whichshow association with  So, they are the major predictors of wasting.
  • Childmorbidity can aggravate malnutrition; another key association was identified between having diarrheal disease and  And income was also found the main predictor of underweight.
  • Income was the variable which show significant association with all nutritionalproblems, (Stunting, wasting and underweight), breast feeding were found the predictor for both stunting and
  • Breast feeding was one of the variable which shows significant association with Children those ever not breast feed had great chance to be stunted.
  • Feeding the children for less than six times per day will increase the chance to be
  • Child Immunization, the sex of the head of the House Hold, and sex of the childwere not significantly associated with stunting

Recommendations

The multi-faceted nature of the causes of malnutrition can effectively be alleviated by multispectral approach in order to co-ordinate and prevent duplicating and contradicting each other during planning and implementation.  Therefore,

  • To that end Food and nutrition policy will be an important tool for bringing thisharmony both conceptually and practically. Consequently there is a need for regional health bureau to develop regional food and nutrition policy in harmony with participation of community and other
  • Zonal Health Departmentsshould go to the grass root level and undertake continuous supportive supervision especially to alleviate the root cause of nutritional problem in that area. And also should support Barkin Ladi by providing financial as well material
  • Barkin Ladi Health office should give due attention in tackling this problem by givingtraining for health workers, by educating the community on feeding frequency, exclusive breast feeding, family planning and on environmental sanitation. And also income generating conditions should have to be facilitated for communities in harmony with other stakeholders. They have to work hard in improving water supply in harmony with different governmental and nongovernmental stake holders so as to decrease water born disease and for the improvement of child. Additionally, they have to facilitate the condition and open their door for different nongovernmental organizations those who work on nutrition.
  • Health Extension workers shouldwork hard in tackling nutritional problem due to lack of awareness by educating the community on proper breast feeding of the child, feeding frequency of the child, encouraging programs to improve women role and education, combined with child feeding practice.

References

  • Centralstatistical agency (2007) ‘Compilation of Economic Statistics in  Addis Ababa.
  • Central statistical agency (2008) ‘Nigerian Consumer Price Index Methodology and DataCollection  Addis Ababa.
  • CareNigeria (2009) ‘Community based emergency response to reduce acute malnutrition and improved access to nutritional support and care.
  • BerukYemane (2003) Food Security Situation in the Pastoral Areas of  Oxfam GB
  • HPG(2008) ‘Improving drought response in pastoral areas of Nigeria, Somali and Afar Regions and Plateau state of Oromiya
  • UnitedNations (2008) ‘Health Situation report: Extended dry season in Plateau state,
  • SolomonBellete (2005). ‘The basic causes of malnutrition in Nigeria’ International Food Policy Research Institute Washington DC, USA
  • UNICEF,WHO, UNESCO, et al (2010) Facts for Life, fourth edition
  • World health organization (2004)‘Serious childhood problems in countries with limited resources’;Geneva
  • FAO(2010) Economic and Social Development Department
  • WHO, UNICEF(2004) Nutrition Essentials: A Guide for Health Managers
  • Departmentof Economic and Social Affairs (2005) Progress towards the Millennium Development Goals
  • MOH,UNICCEF (2004) Guidelines for the management of severe acute malnutrition: Nigeria
  • CentralStatistical Agency (2005) Nigerian Demographic and Health  ORC Macro Calverton, Maryland, USA
  • MelkieEdris (2007) ’Asessment of nutritional status of preschool children of Gumbrit’. North West Nigeria, Ethiop.J.Health Dev; 21(2).
  • Savethe Children UK (2007) ‘The causes of malnutrition in children under 3 in the Somali region of Nigeria related to household caring practices’.
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