Factors That Influence The Nutritional Status Of Primary School Pupils

Project and Seminar Material for Public Health

Factors That Influence The Nutritional Status Of Primary School Pupils


The purpose of this study was to assess the factors that influence the nutritional status of primary school pupils in Enugu state, Nigeria. This descriptive research study was conducted with a sample of 200 pupils in Enugu state, who were randomly selected for the study. A self-developed structured questionnaire was used to gather data from the respondents. Frequency distribution and percentages were used in the analysis of data which were then presented in tables. Results revealed that that the majority of pupils agreed that their weight determines their nutritional status (90.5%); Proper dieting promotes healthy growth (85.0%); The type of food consumed affects the nutritional status of the student (66.4%); Pupils should only eat when hungry (90.9%); Under nutrition is the only form of malnutrition that can affect pupils (78.7%); Swollen legs can be a sign of nutritional deficiency (62.5%); Sickness does not allow the pupils to grow very well (70.5%); and Nutritional status is easily monitored through a growth chart (64.4%). Results showed the factors that influence the nutritional status of the pupils to include I am not aware of how to feed myself properly (90%); I do not tolerate my food properly (68.6%); I do not know what type of food to feed myself with (93.7%); I often have diarrhea or cough (92.1%); Nutritious foods are not readily available (86.9%); Tight academic schedule does not allow me to take care of myself as I wish (62.2%); There is no money to buy the needed foods (63.4%); My parents are the only people that bring in income into the family (66.8%); I do not have a good water supply (73.9%); I do not have a good toilet facility (72.9%); and I do not have constant electricity supply (69.8%).


Table of Content

Preliminary Page(s)

  • Title Page
  • Declaration
  • Approval
  • Dedication
  • Acknowledgement
  • Abstract
  • Table of Content

Chapter One

1.0 Introduction

  • 1.1 Background to the Study
  • 1.2 Statement of Problem
  • 1.3 Objectives of the Study
  • 1.4 Research Questions
  • 1.5 Hypothesis
  • 1.6 Significance of the Study
  • 1.7 Definition of Terms
  • 1.8 Organization of Study

Chapter Two

2.0 Literature Review

  • 2.1 Conceptual Review
  • 2.2 Determinants of Nutritional Status
  • 2.3 Theoretical Review
  • 2.3.1 Health Belief Model

Chapter Three

3.0 Methodology

  • 3.1 Research Design
  • 3.2 Study Area
  • 3.3 Target Population
  • 3.4 Sampling Technique
  • 3.5 Instruments for Data Collection
  • 3.6 Method of Data Collection
  • 3.7 Method of Data Analysis

Chapter Four

4.0 Results and Discussion

  • 4.1 Results
  • 4.2 Discussion

Chapter Five

5.0 Conclusion and Recommendation

  • 5.1 Conclusion
  • 5.2 Recommendations
  • References
  • Appendix

Chapter One

1.0 Introduction

1.1 Background to the Study

The difference between food intake and utilization determines the nutritional status of the individual. Change in food consumption and the biological utilization will directly or indirectly reflect in the nutritional status. The nutritional status can be normal, under nutrition or over nutrition. The under and over nutrition are considered as malnutrition. The nutritional status of the individual might be affected by some factors ranging from busy schedule of the primary care giver to inability to provide enough food and needed health care to maintain normal nutritional status. The determinants of the nutritional status may differ based on regions, communities, or even over time. To proffer necessary recommendations or solve any nutritional problem in an area, it will be important to determine the nutritional status and the associated factors.

Efforts have been made both nationally and internationally by governmental and non-governmental organizations to maintain normal nutritional status but poor nutrition remains a major link to diseases and reduced life-span (Tette, Sifah& Nartey, 2015). According to Mamulwar, Rathod, Jethani, Dhone, Bakshi, Lanjewar et al. (2014), one quarter of the pupils children are stunted. Many factors have been implicated to influence the nutritional status. Poor diet and disease are considered as immediate factors but there are underlying factors like food security, caring practices of the caregiver, healthy environment and assessment of health facilities. The underlying causes are also considered to have basic causes which are seen as socio-economic and political conditions (Asegedech, 2014).

Nutritional status of the individuals is of great importance as it contributes to adequate growth and development (Badake, Maina, Mboganie, Muchemi, Kihoro, Chelimo, &Mutea, 2014). Under-nutrition could be described as weighty medical condition characterized by a deficient bodily nutrition (energy, essential proteins, fats, vitamins, and minerals in a diet) as a result of inadequate food intake or faulty assimilation. Over 10 million children and adolescents are lost annually due to diseases that can be prevented and even easily treated. Most of these illnesses and majority of these deaths occur in developing countries because of the poor economy of such Countries (Black, Morris & Bryce, 2013). Malnutrition causes more over 30% of all children and adolescent deaths (United Nations Children’s Fund (UNICEF), 2013). According to Badake et al., (2014), assessing the growth of individuals is a good parameter to look at the development of the individual and this also gives insight about food security in the area and assess to good health services.

Poor nutritional status has called for different programmes and interventions in different sectors in order to improve the nutrition status. Sequel to this, experts from different fields are strategizing and evaluating various interventions that have nutrition components (Macias &Glasauer, 2014). Assessing nutritional status is the easiest indicators for assessing the impact of interventions that are nutrition focused and this can be done using various methods. Assessing nutritional status entails a deep understanding of what people consume and the determinants of people’s nutritional habits. The nutritional status can then be traced to have a myriad of determinants. Different factors have been implicated to affect the nutritional status and there are repeated episodes of diseases that are often seen among these individuals. Some of the factors include inadequate food availability, poor caring capacity of the caregiver, and lack of basic education, poor health systems, poor housing and environmental conditions. Communities that are unable to satisfy the basic needs of its citizens are likely to generate more individuals with poor anthropometric indices.

The need for food by mankind most especially the growing up children and youths has been emphasized over the years (Adegun, Ajayi-Vincent, &Alebiosu, 2013). The nutritional status is solely dependent on the adequate and right consumption of nutrients from foods and the body’s ability to make use of them adequately to meet its metabolic needs of health and fitness. At early stage of growth, several biochemical activities that affect growth and development are going on in the body and these require nutrition. When there are inadequate nutrients available for these activities then there is likelihood of developing stunted growth and development (Adegun, Ajayi-Vincent, &Alebiosu, 2013). To find solutions to the nutritional related problems that are common, it is very necessary to determine the nature, magnitude and determinants of malnutrition.

According to Hunger Facts (2015), globally about 795 million individuals are undernourished. The vast majority (98%) of these undernourished reside in the developing countries. Under-nutrition among the pupils remains a problem faced by different parts of the world. Close to 50% of all deaths are attributable to under nutrition. This implies that there is unnecessary loss of about 3 million young lives every year (Hunger Facts, 2015). In Sub-Saharan Africa, close to 50% of children and youths are malnourished and deaths from such nutrition related condition is on the increase (FAO, 2018). Nutrition related problem in Sub-Saharan Africa has added more to the burden of morbidity and mortality. However, the information available on the nutritional status of the individuals in informal settlements or grouped settings such as in schools can be considered as little and inadequate (Olack, Burke, Cosmas, Bamrah, Dooling, Feikin&Breiman, 2011).

Reducing nutritional related problems among individuals is a huge challenge that is being faced by different countries particularly the underdeveloped and the developing countries. In Kenya, the percentage of stunted children and adolescents is 35%, 14% were considered to be severely stunted while underweight was 16% (low weight-for age) and severely underweight was 4%. The core factor responsible for all these nutrition related health challenges as conceived by different researchers can be linked to food access issue, infections of various degrees and forms, maternal/paternal factor, socio-economic factors and other related factors.

Nigeria (especially the rural areas) is one of the developing countries that are affected by this nutrition-related problem. This might be related to causes that are found in other regions of the world like poor access to food, primary care giver factor, socio-economic factor, area of abode and other related factors. The Nigeria Demographic and Health Survey (2013) put the rate of stunted growth among the pupils years to be 38%, underweight to be 29% while wasting was 9.2%. Several factors can be considered to have caused these nutritional deficiencies. According to the Federal Ministry of Health (FMOH) Nigeria (2017), 7% is the rate of compliance of mothers to exclusive breastfeeding of their children who are less than 6 months.

According to Adegun, Ajayi-Vincent, and Alebiosu (2013) there are not enough supporting data on under-nutrition among pupils in schools in Enugu State which can easily be generalized but a closer look at the pupils in schools by different investigators suggests the prevalence of nutritional related problems among children in Enugu. Common nutritional problems as faced by the pupils are protein energy malnutrition (PEM), anemia due to iron deficiency, vitamin A and iodine deficiency respectively (Babatunde, 2013).

Factors including biologic, economic, cultural, environmental and of disease origin have been found to affect nutritional status. Inadequate food intake, food insecurity, poor distribution of food in the household, poor storage pattern of the available food, wrong food handling, nutritional taboos/ harmful traditional practices and different types of infections among pupils might make them to be most vulnerable to nutritional related problems. These factors might be seen to have immediate, underlying biological and behavioural, underlying social and economic, and basic influences on the pupils (Degarege, Degarege & Animut, 2015). Understanding the causes and the effects of different nutritional status will help proffer necessary recommendations.

1.2 Statement of Problem

Nutrition related problems affect the populace but the pupils and women are most susceptible to this condition. The unique physiology of the under-five, socioeconomic factor, and other related factors in the society might be implicated. Available data shows that more than 2billion individuals are affected with different degrees of nutritional related problems. Children that are up to 2.6million die yearly following nutrition related problem. This accounts for about one third of children’s deaths globally. Stunted children are highest in number in Nigeria which makes Nigeria to have the highest stunted rate in Africa and third globally having above 10 million citizens who are stunted. Within the first 1,000days of life, malnutrition accounts for over one-third of deaths among the pupils’ years and half of all child deaths worldwide (Malnutrition and Child Survival in Nigeria, 2016).

Managing the incessant illnesses of pupils places economic burden on the family and government because the money spent on these nutritional-related diseases (which would have been prevented) could be used for other developmental projects (Kitinya, 2013). Poor school performance and lower productivity could also be the impact of poor nutritional status on the society. As a result of the magnitude of the identified problem, the researcher is set to assess the factors that influence the nutritional status of primary school pupils in Enugu state, Nigeria.

1.3 Objectives of the Study

The main purpose of this study is to assess the factors that influence the nutritional status of primary school pupils in Enugu state, Nigeria.

Specifically, the study has the following objectives;

  1. To find out the level of awareness of pupils about their nutritional status in Enugu State;
  2. To assess the factors that influence the nutritional status of the pupils in Enugu State;
  3. To find out the feeding practices engaged in by pupils in Enugu state.

1.4 Research Questions

The following research questions were formulated based on the objectives of the study;

  1. What is the level of awareness of pupils about their nutritional status in Enugu State?
  2. What are the factors that influence the nutritional status of the pupils in Enugu State?
  3. What are the feeding practices engaged in by pupils in Enugu State?

1.5 Hypothesis

The null hypothesis for this study is stated below;

  • HO1: There is no significant relationship between the nutritional status of pupils and their socio-economic factors.

1.6 Significance of the Study

Findings from this study will provide data which will reflect the nutritional status of the pupils and this would help in decision or policy making process. This study would also help in early recognition of nutritional related problems of the pupils which would encouragement for healthy promotion and adequate counseling. Findings would also show the pattern/prevalence of nutritional related problems among the pupils as revealed by findings. Also, the study will serve as an empirical literature for future researchers to develop further research in future studies. Recommendations from this work, when published, would serve as assistance to the governments in making policies that might reduce the burdens of nutrition related problems in the society especially among the pupils, adolescents, and youths.

1.7 Definition of Terms

Nutritional status:

This is the health status of the pupils as determined by certain measurements in Madonna Primary school of Enugu state.

Associated factors:

These are the determinants of the nutritional status of the pupils in Madonna Primary school of Enugu state.


These are the nursing pupils in Madonna Primary school who were in their third, fourth and fifth year of study, and who were used as the respondents for the study.

1.8 Organization oOf Study

The study comprises of 5 chapters. In chapter one, the concepts are introduced and the problem of the study is established with the research objectives and questions. Chapter two presents the literature review while chapter three presents the research methodology. The fourth chapter presents the results and discussion, and the last chapter presents the conclusion and recommendation.

Chapter Five

5.0 Conclusion and Recommendation

5.1 Conclusion

The findings of the study implied that nutrition education makes a difference in making healthy eating choices. Pupils at all levels should receive nutrition education that will teach them the skills to make healthy choices not only at school but at home as well. Families should also receive nutrition bulletins throughout the school year to help them reinforce what is being learned at school. Making healthy food choices available to pupils is important as is educating pupils, parents, teachers, food service staff, administrators, and the community. Schools need to promote a healthy eating environment and seek out student input to be used when planning a healthy menu. The goal is to meet the dietary needs so that pupils are able to reach their potential physically and cognitively. Due to the considerable amount of time pupils spend at school more attention needs to be paid to the food options that are available if we want healthy eating to become a normal lifelong behavior. More research needs to be done to gather more information to show a correlation between nutrition and cognitive function and academic performance.

5.2 Recommendations

  1. There is need for mass education on healthy lifestyle with a focus on proper nutrition by the school authorities and health stakeholders.
  2. Also, there is need for pupils to receive nutrition education that will teach them the skills to make healthy choices not only at school but at home as well.
  3. Families should also receive nutrition bulletins throughout the school year to help them reinforce what is being learned at school.

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