Nutritional Status of Under-Five Children and Associated Factors
Chapter One
Study Aim
The study aimed to contribute towards the improvement of the nutrition status of children in Kaduna.
Study Purpose
The purpose of the study was to generate information on risk factors associated with the nutrition status of children under five years, to provide baseline data for an intervention program planned for Kaduna state.
Study Objective
The main objective of the study was to determine the nutritional status of children under five years and associated factors in Kaduna State.
Specific objectives of the studies included:-
- To determine demographic, socio-economic characteristics, food production, and utilization of households in Kaduna state
- To determine the nutritional status of children under five years in the study area
- To determine infant and young child feeding (IYCF) practices for children (0-24 months old) in Kaduna state.
- To determine immunization (12-35 months) and morbidity status of children under five years in Kaduna state.
CHAPTER TWO
LITERATURE REVIEW
Overview of Malnutrition
Malnutrition is defined as “a state in which the physical function of an individual is impaired to the point where he/she can no longer maintain adequate bodily performance processes such as growth, pregnancy, lactation, physical work, resting and recovering from disease (MMS/MPHS, 2009).
Malnutrition commonly affects all groups in a community, but infants and young children are the most vulnerable because of their high nutritional requirements for growth and development (Blössner et al., 2005). Globally, an estimated 165 million children under-five years of age, or 26%, were stunted, 16%, were underweight, 8% were wasted and 7% were overweight. High prevalence levels of stunting among children under-five years of age in Africa (36%) and Asia (27%) remain a public health problem, one which often goes unrecognized. More than 90% of the world’s stunted children live in Africa and Asia (UNICEF et.al, 2012).
In Nigeria, 35 percent of children under five are stunted, while the proportion severely stunted is 14 percent, 16 % are underweight (low weight-for-age) and 4 % are severely underweight (KNBS and ICF Macro 2010). Malnutrition observed in children under five years in Northern region where Kaduna state is located is high, estimated at 41.9% stunting, 7.3% wasting and 19.8 % underweight (KNBS and ICF Macro 2010).
Causes of malnutrition
There has been agreement among researchers on factors contributing to malnutrition. The primary determinants as conceptualized by several authors relate to unsatisfactory food intake, severe and repeated infections, or a combination of the two (UNICEF, 1998 and Rowland et al., 1988).
Immediate causes of malnutrition
Inadequate food intake and disease are immediate causes of malnutrition and create a vicious cycle in which diseases and malnutrition exacerbate each other. Malnutrition lowers the body’s ability to resist infection resulting to longer, more severe and more frequent episodes of illness.
Thus inadequate food intake and diseases must be both addressed to support recovery from malnutrition (UNICEF, 1998).
Underlying causes of malnutrition
The underlying causes are those that give way to immediate causes. The three major underlying causes of malnutrition include inadequate household food security, limited access to adequate health services and/or inadequate environmental health conditions and inadequate care in the households and at community level especially with regards to women and children (UNICEF, 1998).
Basic causes of malnutrition
The basic causes of malnutrition in a community originate at the regional and national level where strategies and policies that affect the allocation of resources (human and, economic, political and cultural) influence what happens at community level. Geographical isolation and lack of access to market due to poor infrastructure can have a huge negative impact on food security (MMS/MPHS, 2009), access to healthcare services as well as healthy environment. The above model characterizes the correlates of malnutrition as factors that impair access to food, maternal and child care, and health care. It is these very factors that impact the growth of children. Consequently, the assessment of children’s growth is a suitable indicator for investigating the wellbeing of children, and for examining households’ access to food, health and care (UNICEF, 1998).
CHAPTER THREE
METHODOLOGY
Study Setting
The study was conducted in Kaduna state in Northern region of Nigeria.
The site was selected because this study was part of on-going project in Kaduna state. Objective of the project was to stimulate the adaptation of pro- poor Agri-food systems innovations as a contribution to improving food security and sustainable natural resource management. In addition, the project sought to understand household nutrition, current socio-economic status of the community as well as issues around food production.
Study Design
The study was cross-sectional both descriptive and analytical in nature, designed to assess the nutrition status of children under five years and its association with demographic and socio- economic characteristics, household food security, water availability, hygiene and sanitation, Infant and young child feeding practices (IYCF) as well as immunization and morbidity status of children under five years old.
Study Population
The sampling unit for this study was the household with children below five years and the respondent were the principle care giver of the index child.
CHAPTER FOUR
RESULTS
Characteristic of Study Population
Table 2 describes the demographic characteristics of the study population. The survey was conducted among 145 households but one was dropped due to extreme outlier on some variables. The mean household size was 4.73 ±0.743. Age distributions of the household members were highly varied. The proportion of children aged between 6-17 years was comparatively higher (27.8%). The children under five years (target population) comprised of 26.9% of the total population. The ratio of male to female in the study population was approximately 1: 1.1. The dependency ratio of the population was 1.02.
The majority of the study population had attended primary school or was in primary school (71%). About 23.5% had attended secondary school while only 2.0% had attained above this level. The main occupation of population over 18 years was farming (64.1%). Only a very small proportion (4.9%) of the study population had salaried employment. Population in different occupation were significantly different (χ2, p<0.000). Most occupations were dominated by male except farming. More women were unemployed than their male counterparts.
CHAPTER FIVE
CONCLUSION AND RECOMMENDATION
Conclusion
The study established that malnutrition is high among children under five years, with risk being highest among those who were between the ages of 12-36 months of life. These high levels qualify the area to be classified as chronic food insecure area. The high self-reported level of exclusive breast feeding does not translate into improved nutritional status in older children.
There is high morbidity experience, generally due to poor sanitation and high incidence of use of unsafe water in the area. Food production among the study household is inadequate, due to farming on small pieces of land (2 acres) and low rainfall, limit their capacity to produce enough food. Diet diversity is poor comprising mainly starchy food followed by legumes. Households depend on market supply for their vegetable and fruits and therefore ability to acquire them entirely depends on purchasing power. Therefore, malnutrition among children under five years in Kaduna is indicative of chronic food insecurity situation. Large households size and morbidity experience are important associated factors.
Recommendation
Since most households complement their diet largely by purchased food, the types and the amount of food purchased for consumption and their contribution to the family dietary requirement need to be established. There is also need to explore the seasonality changes in energy and protein availability from farm produce and food purchase to get real food security situation in the area.
The problem of food insecurity could be tackled through multisectoral approaches that address different household dynamics including food security, health, nutrition and water/sanitation. Agricultural projects should therefore integrate health and nutrition components during planning to develop focused interventions aimed at improving nutrition, health and food security of the households. It is therefore recommended that the planned project/programme for Kaduna state should make provision for such integration and collaboration with the relevant sectors including health and water. Provision of nutritional education to the community members is also essential to address malnutrition.
REFERENCES
- Adeladza, A. (2009). The influence of socio-economic and nutritional characteristics on child growth in Kwale District of Nigeria. African Journal of Food, Agriculture, Nutrition and Development, 9(7).
- Ajao, K. O., Ojofeitimi, E. O., Adebayo, A. A., Fatusi, A. O., & Afolabi, O. T. (2011). Influence of family size, household food security status, and child care practices on the nutritional status of under-five children in Ile-Ife, Nigeria. African journal of reproductive health, 14(4).
- Arroyo, M., Freire, M., Ansotegui, L., & Rocandio, A. M. (2010). Intraobserver error associated with anthropometric measurements made by dietitians. Nutr Hosp, 25(6), 1053-1056.
- Aweke, K. A., Habtamu, F., & Akalu, G. (2012). Nutritional status of children in food insecure households in two districts of north Showa zone, Ethiopia. African Journal of Food, Agriculture, Nutrition and Development, 12(2), 5915-5927.
- Bhutta, Z. A., Ahmed, T., Black, R. E., Cousens, S., Dewey, K., Giugliani, E & Shekar, M. (2008). What works? Interventions for maternal and child undernutrition and survival. The Lancet, 371(9610), 417-440.
- Blössner, M., De Onis, M., Prüss-Üstün, A., Campbell-Lendrum, D., Corvalán, C., & Woodward, A. (2005). Quantifying the health impact at national and local levels.
- Bronte-Tinkew, J., & Dejong, G. F. (2005). Do household structure and household economic resources predict childhood immunization? Evidence from Jamaica and Trinidad and Tobago. Population Research and Policy Review, 24(1), 27-57.
- Cashat-Cruz, M., Morales-Aguirre, J. J., & Mendoza-Azpiri, M. (2005, April). Respiratory tract infections in children in developing countries. In Seminars in pediatric infectious diseases (Vol. 16, No. 2, pp. 84-92). WB Saunders.
