PERCEIVED CAUSES AND PREVENTION OF MALNUTRITION AMONG PRIMARY SCHOOL PUPILS (ILORIN EAST LOCAL GOVERNMENT, KWARA STATE AS A CASE STUDY)
ABSTRACT
The study examined the incidence of malnutrition among children in Ilorin East Local Government area of Kwara State. The objective of the study is to explore sickness as a result of malnutrition among children, investigate the majority of children as a result of the malnutrition among children, low body resistance to diseases, stunted growth as a result of malnutrition among children and succumb to infections as a result of malnutrition among children in Ilorin East Local Government Area.
Descriptive research design was adopted in the study that consisted of the population of households that have children of age between 5 to 12 years old in Ilorin East Local Government Area of Kwara State. A sample two hundred (200) respondents were selected from low income households in because that is where poverty can be found most which brings about malnutrition of children. Structured questionnaire titled incidence of Malnutrition among Children’s Questionnaire (IMCQ) validated by three (3) experts in the Department of Health Promotion and Environmental Health Education and yielded reliability coefficient ‘r’ of 0.64 tested with Pearson product – moment Correlation. Chi – square square (x2) statistical tool was employed in the study to test two (2) hypotheses formulated at 0.05 level of significance.
The findings of the study revealed that sickness is a significant result of malnutrition among children in Ilorin East Local Government Area since the calculated value (71.86) > table value (16.92), mortality of children is a significant result of malnutrition among children since the calculated value (55.84) > table value (16.92). Indicated that low body resistance to diseases is a significant result of malnutrition since calculated value (40.67) > table value (16.92), stunted growth is a significant result of lastly, succumb to infections is a significant result of malnutrition among children in Ilorin East Local Government Area since calculated value (82.13) > table value (16.92) at 0.05 level of significance.
The study concluded that, malnutrition can significantly lead to sickness among children; mortality of children resulted as a consequence of malnutrition among children, stunted growth was as a result of malnutrition among children, low body resistance to diseases is caused by malnutrition and succumb to infections is a significant result of malnutrition among children in Ilorin East Local Government area. The recommendation was therefore made that it other to curtail the occurrence of sickness and stunted growth among infants, balance diet should be take into consideration while feeding children and also, infants should be fed orally using a cup, spoon or syrings and nasogastric tube if there is impaired consciousness or there is vomiting, tachypnea, or painful stomatitis which can avoid morality of children.
TABLE OF CONTENT
Contents Page
Title page i
Certification ii
Dedication iii
Acknowledgement iv
Abstract v
Chapter One INTRODUCTION 1
Background of the Study 1
Statement of the Problem 5
Purpose of the Study 6
Research Questions 7
Research Hypothesis 7
Significance of the Study 8
Delimitations of the Study 8
Operational Definition of Term 8
Chapter Two INTRODUCTION 11
Introduction 11
Definition of the Concept Malnutrition 12
Malnutrition in Africa 13
Malnutrition among children and its Influence on Body 15
Reducing Malnutrition among Children 16
Prevalence and Determinants of Malnutrition among Pre – School children 20
Risk Factors of Malnutrition 21
Classifications of Malnutrition 21
Child Malnutrition and Cognitive Development 22
Management of Severe Malnutrition 23
Malnutrition with Co-Morbidities 25
Outcomes of Malnutrition 27
Appraisal of Literature Reviewed 27
Chapter Three RESEARCH METHOD 31
Introduction 31
Research Design 31
Population of the Study 32
Sample and Sampling Procedure 32
Instrument for Data Collection 32
Validity of the instrument 33
Reliability of the instrument 33
Procedure for Data Collection 34
Method of Data Analysis 34
Chapter Four DATA PRESENTATION AND ANALYSIS 35
Presentation of Data
CHAPTER ONE
INTRODUCTION
Background of Study
Reducing malnutrition among children under the age of five remains a huge challenge in developing countries of the World. An estimated 30 million under – five children are believed to be chronically malnourished in developing countries (Van de Poel, Hosseinpoor, Jehu – Appiah & Speybroeck, 2008). Similarly, about 54% of deaths among children of this age group are believed to be associated with malnutrition in developing countries (FAO, 2008). In Sub-Saharam Africa, 41% of under – five children are malnourished and deaths from malnutrition are increasing on daily basis in the region (FAO, 2008). Malnutrition is widespread in Nigeria, especially in the rural areas. This is partly due to inadequate food and nutrient supply. The 2003 Nigeria Demographic and Health Survey revealed that 38% of under – five children in Nigeria are stunted, 29% underweight and 9.2% wasted (Ajieroh, 2010). These surveys indicated significant variation between the rural and urban areas with children from rural areas worse affected by malnutrition.
Most common form of malnutrition in Africa is protein energy deficiency affecting over 100 million people; especially 30-50 million children under 5 years of age (Maletnlema, 1992) and almost additional 200 in a retrospective semi – rural – community based study of million are at risk (Maletnlema, 1992). Up till now, children with PEM at Ile – Ife and Ilorin. Nigeria, we protein energy malnutrition (PEM), a known sequel of analyzed the demographics, weaning food insufficiency and poor social – economic conditions diets, weight – for – age deficits, family size as (Dulger et al., 2002) continues to be a major public well as parental socio – economic conditions, literacy health problem and a source of major concern in levels and annual per capita income. Employing the developing third world countries including Nigeria Modified, Welcome classification of PEM, based on various authors have identified the impact of a number weight – for – age (WA) deficits and presence or absence of risk factors underlying PEM. Involvement of the oedema, the children were categorized into the four nervous system by PEM is thought to result from the not only clinical syndromes of PEM including kwashiorkor, deficiencies of protein and energy alone but from marasmic – Kwashiorkor maramus and underweight.
Simultaneous deficiency of micronutrient related to their parents was categorized into social classes’ brain growth and development. Malnutrition is one of the biggest health problems that the world currently faces and is associated with more than 41% of the deaths that occur annually in children from 6 to 24 months of age in developing countries which total approximately 2.3 million, (Sandoval – Priego, Reyes – Morals, Perez – Cuevas, Abrego – Blass & Orrico – Torres, 2002). World Health Organization in 2001 reported that 54% of all childhood mortality was attributable, directly or indirectly, to malnutrition. Sub-Saharam Africa has a high prevalence of the different types of malnutrition, namely stunting, wasting and underweight, (Lutter & Rivers, 2003).
The United States is currently characterized by the coexistence of two forms of childhood malnutrition. On the one hand, the prevalence of overweight children has increased dramatically over the past two decades 1 (Hedley, Allison, Cynthia Ogben, Clifford L. Johnson, Margaret D. Carroll, Lester R. Curtin, and Katherine M. Flegal 2004). On the other hand, the degree of underweight among children has been unacceptably high for such a wealthy country (Polhamus, Delenius, Thompson, Scanlon, Borland, Smith, & Grummer – strawn 2003). Both forms of malnutrition create public health problems. For example, an overweight child is more likely to be obese as an adult and has a higher probability of suffering from Type 2 – diabetes, high cholesterol, high blood pressure, some types of cancer, and heart disease than is a child who is not overweight (Schwimmer, Jeffrey, Tasha, Burwinkle, James & Varni, 2003). Furthermore, the Surgeon General has linked childhood overweight to social discrimination and depression (U.S. Office of the Surgeon General 2001).
Malnutrition in all its forms amounts to an intolerable burden not only on the health systems, but the entire socio – cultural and economic fabric of the society and is the greatest obstacle to the fulfillment of human potentials. Child malnutrition is a huge public health problem in Africa that is not properly given the priority that it deserves. Malnutrition is largely a preventable and treatable cause of childhood morbidity and mortality that can be dealt with for less that USD 20 per child per year (Chiabi et al., 2008). According to WHO malnutrition accounts for 6.6 million out of 12.2 million deaths among children under 5 (54% of child mortality) in developing countries. In Nigerian and elsewhere about 35.7% and 47.5% of children under 5 years of age are moderately to severely undernourished respectively (Solomon, 1985; Roy et al., 2007). It known that almost any illness will impair a child’s growth. However in practice in developing countries, growth deficits are caused by interplay of two preventable factors: adequate food and infections.
Infections influence body size and growth through their effects on metabolism and nutrition. Additionally, UNICEF conceptual framework also recognize poor caring practices as equally important cause of malnutrition (UNICEF, 1990). Environmental factors have a profound effect on health and can make nutritional problems worse. A child who is well fed but drinks contaminated water and lives in polluted environment will not grow up healthy (UN, 2004). Studies have shown the association between increasing severity of anthropometric deficits and mortality (Pelletier et al., 1993; Schroeder and Brown, 1994; Pelletier et al., 1995; Mendez and Adair, 1999; Onis et al.; 2000). Strong evidence exists that poor growth is associated with delayed mental development and that there is a relationship between impaired growth status and both poor school performance and reduced intellectual performance, thus compromising the efforts to achieve universal education (MDG -1) (Martorell et al., 1992; PAHO, 1998; UN, 2004; Cesar et al., 2008). Nutritional status is the best global indicator of growth and well – being in children.
Anthropometric assessment thus remains the most practically useful means of evaluating the health and nutritional status of children, just as it provides an indirect measurement of the quality of life of an entire population. Thus the objective of this study was to determine the nutritional status of pre – school children in a rural community of Kaura Local Government (District) of Kaduna State, Northern Nigeria. This is with a view to increase awareness of the magnitude of all forms of malnutrition so as to mobilize both human and financial resources to prevent the problem.
Statement of the Problems
Nigeria ranked 8th in the World in the prevalence of morality rates of under – fives, with a staggering figure of 189/1000 in 2008, WHO (2007). Malnutrition is the underlying cause is more than 50% of these deaths. The World Health Organization estimates that approximately 150 million children younger than 5 years in developing countries are underweight and an additional 200 million children are stunted, (Laura, 2004).
Malnutrition contributes to Nigeria’s current health problems (morbidity) and (mortality) in several ways. Under nutrition remains a devastating problem in many developing countries affecting over 815 million people causing more than one – half of child death (Ruel, 2003), Ukegbu et al, (2007), Although, WHO, UNICEF and Nigeria’s
Research Questions
The following questions were raised to help in eliciting information on the objectives of the study as follow:
1. Is sickness a result of malnutrition among children in Ilorin East Local Government Area?
2. Is mortality of children a result of malnutrition among children in Ilorin East Local Government Area?
3. Is low immunity to diseases a result of malnutrition in Ilorin East Local Government Area?
4. Is stunted growth a result of malnutrition among children in Ilorin East Local Government?
5. Is succumb to infections a result of malnutrition among children in Ilorin East Local Government Area?
Research Hypotheses
The following hypotheses were formulated to guide the study in making valid decision about the objectives of the research.
1. H01: sickness is not a significant result of malnutrition among children in Ilorin East Local Government Area
2. H02: mortality of children is not a significant result of malnutrition among children in Ilorin East Local Government Area
3. H03: low body immunity to disease is not a significant result of malnutrition in Ilorin East Local Government Area
4. H04: stunted growth is not a significant result of malnutrition among children in Ilorin East Local Government Area
5. H05: contract of infections is not a significant result of malnutrition among children in Ilorin East local Government Area
Significance of the Study
The research will enable the parent/guidance to know the incidence of malnutrition on children in order for them to inculcate the habit of giving adequate dietary intake to enable to mental development of children as needed at early stage. It will also show the likely effect this malnutrition on children such as low intelligent quotient, underweight, cognition level and growth rate. Lastly, the study will be of contribution to academic research and to researchers in the same or related line of study.
Delimitations of the Study
The study covered the households in Ilorin West Local Government Area of Ilorin to study the incidence of malnutrition on children which limited the study to two hundred (200) respondents were selected in the Local Government Area which also restricted the study to only the local government area in Ilorin. Questionnaire developed by the researcher was used to elicit information from the respondents while descriptive statistics was used to present the result of the analysis and chi – square statistical tool will be used to test the hypotheses formulated.
Operational Definition of Terms
Child Growth Rate: the speed with which normal growth occurs in length before birth and in height after birth. Fetal growth is critical to a person’s eventual height. Before birth, the key measure is the crown – rump length – the distance from the top of the head (the crown) to the buttocks (the rump). The fastest growth rate for a human is during embryonic life. If sustained, it would provide 50-60cm (close to 2 feet) of growth per year.
Child Malnutrition: this is the situation whereby nutrition is insufficient, excessive or imbalance consumption of dietary energy and nutrients by children.
Children: Biologically, children of children are generally human between the stages of birth and puberty. The legal definition of children generally refers to minors, otherwise known as people younger than the age of majority.
Cognition: cognition is the set of all mental abilities and processes related to knowledge: attention, memory & working memory, judgment & evaluation, reasoning & “computation”, problem solving & decision making, comprehension & production of language, etc.
Households: A household consists of one or more people who live in the same dwelling and also share at meals or living accommodation, and may consist of a single family or some other grouping of people.
Malnutrition: Malnutrition is insufficient, excessive or imbalance consumption of dietary energy and nutrients. It manifests in different forms, such as under nutrition, over nutrition and micronutrients (Smith and Haddad, 1999).
Nutrition: Nutrition is the intake of food, consisted in relation to the body’s dietary needs. Good nutrition – an adequate, well balanced diet combined with regular physical activity – is a cornerstone of good health. Poor nutrition can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced productivity.
Nutritional status: the state of the body with respect to each nutrient and the overall state of the body weight and condition. Nutritional status is the result of complex interactions between food consumption and the overall status of health and health care practices.
Usual Dictary Intakes: usual dietary intake is the long – run average daily intake of a nutrient or food. The concept of long – term average daily intake, or “usual intake”, is important because dietary recommendations are intended to be met over time and diet health hypotheses are based on Dictary intakes over the long term.
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