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 LITERATURE REVIEW 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
FIVE
SUMMARY,
CONCLUSION AND RECOMMENDATION
Summary
Conclusion
Recommendation
REFERENCES
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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