Level of Awareness on Prevalence of Malnutrition Among Children Under 5years
CHAPTER ONE
Objectives
The general objective of the study was to examine, the level of awareness of the prevalence of malnutrition among children aged 0-5 years old in the Borno state.
- To explore the relationship between the socio-economic characteristics of parents and the nutritional status of children less than five years in the study area.
- To examined the influences of maternal health seeking behaviour of matter and childhood morbidity among malnutrition children less than five years in the study area.
- To determine how household feeding practices, water sources and refuse disposal and how these relate to the nutritional status of children less than five years in the study area.
- To estimate the proportion of malnutrition forms among the children and the relation between it and their sex, and
- To make recommendation to stakeholders from the evidence gathered as to how malnutrition occurrence could be reduced in the study area.
CHAPTER TWO
LITERATURE REVIEW
Introduction
Child growth is internationally recognized as an important public health indicator for monitoring nutritional status and health in populations. Children who suffer from growth retardation as a result of poor diets and recurrent infection tend to have more frequent episodes of severe diarrhoea and are more susceptible to several infectious diseases such as malaria, meningitis and pneumonia. A number of studies (Brown, 1998 Ojeifeitimi and others., 2013; and Benson,and others.,2014) have demonstrated the association between increasing severity of anthropometric deficits and mortality. The substantial contribution to child mortality of all degrees of malnutrition is now widely accepted. In addition, there is strong evidence that impaired growth is associated with delayed mental development, poor school performance and reduced intellectual capacity (WFP, 2015). This chapter therefore reviews the concept of malnutrition, influences of social, economic, and health related factors affecting children less than five years.
Brief concept of malnutrition and causes
Malnutrition literally means “bad nutrition” and it entails both over- and under-nutrition. In relations to trends of malnutrition in nations, the later is much prevalent in developing countries including Nigeria. The World Food Programme (WFP) defines malnutrition as “a state in which the physical function of an individual is impaired to the point where he or she can no longer maintain adequate bodily performance process such as growth, pregnancy, lactation, physical work or resisting and recovering from disease” (WFP, 2015). Malnutrition can result from a lack of macronutrients (carbohydrates, protein and fat), micronutrients (vitamins and minerals), or both. Macronutrient deficiencies occur when the body adapts to a reduction in macronutrient intake by a corresponding decrease in activity and an increased use of reserves of energy (muscle and fat), or decreased growth. Consequently, malnourished individuals can be shorter (reduced growth over a prolonged period of time) and/or thinner than their well-nourished counterparts. ‘Hidden Hunger’, or micronutrient malnutrition, is widespread in developing countries. It occurs when essential vitamins and/or minerals are not present in adequate amounts in the diet. The most common micronutrient deficiencies are iron (anaemia), vitamin A (xerolphthalmia, blindness), and iodine (goiter and cretinism). Others, such as vitamin C (scurvy), niacin (pellagra), and thiamin or vitamin B1 (beriberi), also can occur during acute or prolonged emergencies when populations are dependent on a limited, unvaried food source.
CHAPTER THREE
METHODOLOGY
Study Design
The study was a descriptive study with an analytical cross-sectional design conducted to access the determinants of malnutrition in the Borno state. Data was collected during August 2019, the harvest season. The crop this year was good in comparison with that of 2016 and 2018, There were occasional outbreaks of malaria before and during the data collection period. For women, who are the main caretakers, the harvest season is one of the busiest periods of the year. Although the food security situation is usually good during harvesting, child care tends to suffer. Data was collected randomly on a section of the population. The already existing data at the health facility was also reviewed
Study Area
Borno, also known as Borno State, is a state in north-eastern Nigeria. Its capital and largest city is Maiduguri. The state was formed in 1976 from the split of the North-Eastern State. Until 1991 it contained what is now Yobe State. The motto or slogan of the state is “Home of Peace”. Borno is the homeland of the Kanuri people in Nigeria and several other ethnic groups. Borno has been the epicenter of the Islamist group Boko Haram since it began its insurgency in 2009. The conflict in Borno drew media attention in 2009 after clashes between Boko Haram and government security forces in which the founder of Boko Haram Mohammed Yusuf was reportedly captured alongside 300 of its members. Days later Mohammed Yusuf was announced dead after he reportedly attempted to escape from detention.
CHAPTER FOUR
RESULTS AND DISCUSSION
Introduction
This section of the study covers the findings. The findings are shown based on the pre- determined objectives as indicated in chapter one. They are presented in tables and graphs.
CHAPTER FIVE
CONCLUSION AND RECOMMENDATIONS
Conclusion
Influence of socio-economic characteristics on nutritional status of the child
- Maternal age is a significant indicator for determining the nutritional status of a child
- The number of children and dependants in a household has a corresponding effect on the nutritional status of children less than five years in the study area.
- Employment status even though has an implication of determination of the nutritional status does not result in earnings that actually determines the distribution of nutritional status among children less than five years in the study area.
Influence of Maternal and Child health seeking behaviour on nutritional status of the child
- The morbidity of children less than five years in the Borno state, affect their nutritional status and could explain the high malnutrition observed in this study.
- The time of ANC attendance does have a relationship with incidence of malnutrition in among children less than five years in the study area even though majority of those malnourished were of mothers who attended the ANC in the first
- Introduction of water and food before 6 months as a strong indicator of the nutritional status of children less than five years in the study area. Water and food sources used may be contaminated and account for morbidity among this group.
Influence of feeding practices, water source and sanitation on child malnutrition
Porridge and fufu with soup is the predominant food given to children less than five years. Most of the children are fed twice or more, the quality and quantity of these food sources is a factor for accounting for the malnutrition levels among this group of children in the study area.
Source of domestic water and toilet facilities in the household determines the nutritional status of the child. Crude dumping in the study area is a factor to the sanitations situation predisposes children to infection and hence malnutrition.
Malnutrition estimate among children in the study area
The malnutrition level among children less than five years in the study area is very high. It is significantly related the age of the children rather that their sex group. The younger the child the more likely they are susceptible to malnutrition.
Recommendation
Community and Opinion Leaders should:
- Educate and reinforce social services interventions and promotions on feeding children less than five years with adequately nutritious
- Should encourage parents to farm and use protein sources in addition with the readily available carbohydrate sources to complement the food given to children less than five years in the study area.
- Initiate a community action in the management of water sources so as to ensure that water used for domestic purposes particular for children less than five years are
- Create awareness and use community labour to ensure safe disposal of waste including faecal matter so as to prevent contamination of water
Area Health Administration should:
- Intensify education on proper nutritional practices especially during ANC services in health facilities and at outreach
- Give refresher training to public health nurses on the predictors of malnutrition among children less than five years. This should highlight risk of maternal age, employment status and dependants per
- Encourage mothers who attend ANC, to observe cleanliness during the preparation and feeding of children less than five
Area Assembly should:
- Provide social infrastructure including wholesome water and toilet services in each household in addition proper waste management
- Build and integrate community support for the prevention of diseases affecting children less than five years.
Parents should:
- Control the number of children they have as an increased number of children does not only pose a health risk to especially the mother, but more important, affect children less than five years in the household.
- Observe proper hygiene especially in the use of toilet facilities and water used for children less than five years
- Ensure that the use of preventive tools including Insecticide Treated Nets (ITN), Measles immunisation and malaria prophylaxis to prevent the incidence of illness that is a significant factor accounting for the malnutrition in the study area.
- Inform relatives who take care of their children in their absence not to give the child food and water which is a predictor for malnutrition among the children less than five years in the study area.
REFERENCE
Agnarsson I, Mpell, G. Gunnlaaugsson, Y. Hofuander, T. Greider(2001), Infant feeding practices during the first months of life in a rural area, Tanzania, East Africa Medical Journal. 78 (1) 9-13
Appoh, L.Y. and Krekling, S. (2015) Maternal nutritional knowledge and child nutritional status in the Volta Region of Nigeria Maternal and Child Nutrition pp. 100–11
Benson, T,and others. 2014.Crossing Boundaries to Reduce Malnutrition: An Institutional Study of Agriculture and Nutrition in Uganda, Mozambique, and Nigeria. Report submitted to ICRW under the Agriculture-Nutrition Advantage project. Washington, DC
Brown, K.H.,and others., 1998, Complementary feeding of young children in developing countries: A review of current scientific knowledge. Geneva: World Health Organisation.
Castle S., Yoder P.S. & Konate M.K. (2001) Introducing Complementary Foods to Infants in Central Mali. ORCMacro: Calverton, MD, USA.
Daelmans B & Saadeh R (2013). Global initiative to improve complementary feeding. SCN News 27, 10–18.
Area Health Administration, 2016, Annual Report. Borno state, Nigeria.
Gupta, A., Maathur G.P, and Jagdish C., (2012), World Health Assembly recommends exclusive breastfeeding for the first six months
Dewey, K G. Cohen, R.J.Brown, K.H. Vera, L.I (1999) Age of introduction of Complementary foods and Growth and Low-Birth-Weight, Breastfed Infants. American Journal of Clinical Nutrition (1) 2 pp 32-45.
Lartey, A. (2019) Maternal and child nutrition in Sub-Saharan Africa: challenges and interventions. Proceedings of the Nutrition Society (2019), 67, 105–108
