Predisposing Factor To Protein Energy Malnutrition Among Children Of 0-5Year In Mallum Community Ardo-Kola Local Government Area Of Taraba State

Project and Seminar Material for Public Health

Predisposing Factor To Protein Energy Malnutrition Among Children Of 0-5Year In Mallum Community Ardo-Kola Local Government Area Of Taraba State


Abstract


This non-experimental, cross-sectional descriptive study assessed the predisposing factor to protein energy malnutrition among children of 0-5year in Mallum community Ardo-Kola local government area of Taraba State. The target population comprised all the mothers in um community Ardo-Kola local government area of Taraba Statewho has children (0-5years). The sample size consisted of 150 respondents who were selected using the convenient sampling technique after stratified sampling method. Data was collected from the mothers through self-structured and validated questionnaires. Data collected were presented in frequency and percentage. Mean scores were used to analyse the data. 2.50 was chosen as the bench mark (≥2.5 as criteria of acceptance). Inferential statistics (chi-square) (x2) was used to test the hypothesis at 0.05 level of significance. Findings revealed that the mothers do not have very good knowledge of protein-energy malnutrition, that ignorance on food nutrition, non-practice of exclusive breastfeeding and poor weaning methods were the major factors that predispose children to protein energy malnutrition. Result also shows that proper nutrition, exclusive breastfeeding and proper weaning can be an effective tool in reducing PEM among under five children. Based on the results, the researchers recommended that enhancement in both knowledge and practice is greatly required on the following areas of exclusive breast milk, initiation of breast milk, continuous feeding of breast milk and good dietary practices.

 


Table of Content


Preliminary Page(s)

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

Chapter One

1.0 Introduction

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

Chapter Two

2.0 Literature Review

  • 2.1 Conceptual Review
  • 2.2 Causes of Protein Energy Malnutrition
  • 2.3 Nutritional Requirement for Infancy and Early Childhood
  • 2.4 Factors Affecting Nutritional Status of Children
  • 2.5 Socio-Economic / Household Factors

Chapter Three

3.0 Methodology

  • 3.1 Design of Study
  • 3.2 Target Population
  • 3.3 Determination of Sample Size
  • 3.4 Sample / Sampling Technique
  • 3.5 Instrument for Data Collection
  • 3.6 Method for 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 of the Study

Nutrition is directly or indirectly linked to the seventeen Sustainable Development Goals (SDG) (National Population Commission, 2014), and it is critical in the overall development of individuals and the nation at large. On the other hand, malnutrition remains a major health problem and is responsible for one-third of all infant and child mortality especially in third world countries(Bryce et al., 2005; Muller et al., 2005; UNICEF/WHO/World Bank, 2012; WHO, 2013).

Malnutrition is the consumption of dietary nutrient either insufficiently or exclusively (Etim et al., 2017). In most countries, it is often observed that child mortality arises from the synergistic impact of effect of under-nutrition and infection(Black et al., 2008). Children who are severely malnourished are susceptible to impaired cognitive growth and development which consequently affect them later in life as they grow older(Black et al., 2008). Long-term malnutrition among children under five years of age results from poor dietary intake which can adversely lead to dysfunction of the physical and mental health(Victoria et al., 2008; WHO, 2013).

The burden of malnutrition commonly occurs within the African and Asian countries of the world. Evidence-based studies have shown that, of the 162 million children under five years who were stunted, 36% of them resided in Africa while 56% were found in Asia(UNICEF/WHO/World Bank, 2012). Victoria et al.(2008) reported that an estimated 60 million under- five children were found to be stunted out of which 11 million were Nigerian children. In Nigeria, the pattern and severity of childhood malnutrition has steadily increased from 11% in 2003 to 18% in 2013 for wasting; 24% in 2003 to 29% in 2013 for underweight, although there was a decline from 42% in 2003 to 37% in 2013 for children who were stunted(National Population Commission, 2013). Malnourished children are more likely to suffer from impaired physical and intellectual growth which makes them less productive during adulthood(Smith et al., 1999). Glewwe et al.(2001) have reported that poor school performance, increased school absenteeism, reduced intellectual achievement, delayed cognitive development and increased disease morbidity and mortality are common effects of malnutrition among under-five children. In low and middle income countries (LMICs), it is estimated that about 10 million children die from treatable and preventable illnesses annually(UNICEF, 2009; Etim, 2016; Etim et al., 2017).

High rates of child mortality in Sub-saharan Africa results from factors such as low intake of calories, high rates of HIV/AIDS, political instability, poor implementation of government policies, conflicts among groups, etc. (Etim, 2016). For instance, 50% of the children of Malawi, Burundi and Madagascar are stunted as a result of poor dietary intake or poor consumption of vital nutrients (UNICEF, 2009). Also, malnutrition accounts for 49% school absenteeism in 42% of Nigerian children (Yanusa et al., 2012). Factors such as poverty, failure to breastfeed exclusively, maternal factors such as poor nutrition during pregnancy, lack of appropriate weight gain, illnesses like diarrhea, acute respiratory infection, poor consumption of vitamin supplements or fortified foods, large family size, poor sanitation, lack of education and information about good or adequate nutrition and food insecurity and safety have been identified as factors that affect under-five children’s nutritional status(Babatunde et al., 2007; Aliyu et al., 2012; WHO, 2011; Ejemot et al., 2015; Hernel et al., 2015). A lot of studies on malnutrition as it affects the children of Sub-saharan Africa has been carried out.

Kwashiorkor is a form of malnutrition most often found in children. It is caused by not eating enough protein, despite a reasonable intake of calories. It is common in areas of drought and famine. Symptoms may include irritability and fatigue followed by slowed growth, weight loss and muscle wasting, generalized swelling, skin change, enlargement of liver and abdomen and weakening of the immune system, leading to frequent infection.1 Children are affected by kwashiorkor more frequently than adults. It typically starts after the child has been weaned and breast milk has been replaced with a diet low in protein, although it can occur in infant if the mother is protein deprive.2 Kwashiorkor can also occur due to parasite and infections that can interfere with nutritional status. Left untreated, kwashiorkor can cause life threatening shock and coma. Treatment of kwashiorkor depends upon its severity. Fluid and electrolyte imbalances may need to be corrected with intravenous fluids, and infections may require treatment with antibiotics.

Marasmus is a severe form of malnutrition that consists of the chronic wasting away of fat, muscle, and other tissues in the body. Marasmus symptoms will vary depending on the severity and whether associated infections or other conditions are present. General symptoms of marasmus include chronic diarrhea, dizziness, fatigue and rapid weight loss. Marasmus is caused by inadequate amount of both protein and calories that are consumed, resulting in an energy deficit in the body. Treatment is based on nutritious, well balanced diet with lots of fresh fruits and vegetables, grains and protein.3,4


1.2 Statement of Problem

Nutrition is one of the cornerstones of maintaining health and preventing illness. According to Basavanthappa (2011), nutrition is the sum of all the interactions between an organism and the food it consumes. In other words, nutrition is what a person eats and how the body uses it. Nutrition is an essential principle which must be applied throughout the life cycle. Periods of nutrition emphases include during pregnancy, infancy, childhood, adolescence, adulthood and the “older” adult. The relationship between diet and health is strong. Protein energy malnutrition (PEM) is the term given to a group of clinical conditions which occur due to inadequate protein and calorie intake, especially in children. Protein energy malnutrition is a grave problem in developing countries as pregnant mothers do not eat enough nutrition and healthy food, which puts the baby at a disadvantage even before he/she is born. PEM has been classified in many ways, two important types are; Kwashiorkor and, Marasmus.

The aim of this study was to carry out a review of the factors which are associated with malnutrition of children in developing countries.


1.3 Objectives of the Study

  1. To determine the level of knowledge of mothers in Mallum community Ardo-Kola local government area of Taraba Stateon protein energy malnutrition.
  2. To assess the predisposing factors to PEM in Mallum community Ardo-Kola local government area of Taraba State.
  3. To determine possible preventive measures of Protein energy Malnutrition (PEM) in Mallum community Ardo-Kola local government area of Taraba State

1.4 Research Questions

  1. What is the level of knowledge of mothers in Mallum community Ardo-Kola local government area of Taraba Stateon protein energy malnutrition?
  2. What are the predisposing factors to PEM in Mallum community Ardo-Kola local government area of Taraba State?
  3. What are the possible preventive measures of Protein energy Malnutrition (PEM) in Mallum community Ardo-Kola local government area of Taraba State?

1.5 Study Hypotheses

  • HO1: Mothers have no knowledge on protein energy malnutrition
  • HO2: There are no predisposing factors to protein energy malnutrition
  • HO3: There are no possible preventive measures to protein energy malnutrition

1.6 Significance of Study

Providing optimum health to children in terms of physical, social, and intellectual development should be a priority concern of the society. Malnutrition has been a problem worldwide which has been tackled in various ways but the problem still thrives. In fact it continues to kill millions of children regularly. There continue to be several challenges in unraveling the intervention barriers in terms of caregivers’ attitude, perception about the nutritional status of their children and strategies for reduction and control of malnutrition. More complex understanding is the behavioral or socio-demographic influences of the caregiver that affect the child. The consequence of the negligence of caregivers in ensuring better nutritional care of the children is obvious.

The findings of this study would inform better contextual planning and management of malnutrition generally, and that related to children 0-5 years in particular. It would provide the framework by which specific indicators could be used by health managers and stakeholders to assess the risk of malnutrition for a child thereby implementing the appropriate measures and strategies to control it. The findings of the study would also inform policy makers and health care professionals generally, as to possible markers that can guide the design and implementation of intervention to prevent malnutrition among children 0-5 years.


1.7 Definition of Terms

Malnutrition:

Is all forms of bad nutrition which includes both under nutrition and over nutrition

Protein Energy Malnutrition:

Is a form of malnutrition that is defined as a range of conditions arising from coincident lack of dietary protein and/or energy (calories) in varying proportions. The condition has mild, moderate, and severe degrees.

Predisposing Factors:

Are those that put a child at risk of developing a problem (in this case, high anticipatory distress). These may include genetics, life events, or temperament. Precipitating factors refer to a specific event or trigger to the onset of the current problem.


1.8 Organization of 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 purpose of this research work is to determine the predisposing factors to protein energy malnutrition among children (0-5) in Mallum community Ardo-Kola local government area of Taraba State in Obowo L.G.A of Imo State.

The objectives of the study are: To determine the level of knowledge of mothers in Obowo community on Protein Energy malnutrition, to identify the predisposing factors to protein energy malnutrition in the community, to determine the preventive measure of protein energy malnutrition in the community. Literature review was carried out in chapter two to review different opinions of other authors about protein energy malnutrition. Research method used was systematic and simple random sampling technique and data was collected using questionnaires.

The data were analyzed using the following statistical tools: figure (bar chart and histograms) and tables. The results were then discussed. The findings revealed that ignorance, food taboo, non-practice of exclusive breastfeeding and poor weaning by mothers constitutes are major factors that predispose children to suffer protein energy malnutrition in the community.

It was revealed during the study that ignorance, food taboo & poor weaning of children by the mothers predispose their children to suffer protein energy malnutrition in Mallum community Ardo-Kola local government area of Taraba State.


5.2 Recommendations

It is a statement of fact that the successful prevention of protein energy malnutrition among children will go a long way to promote healthy development. Based on the finding of this research, the researcher makes the following recommendations;

  1. The public should as a matter of urgency be educated on the implications of protein energy malnutrition on child’s growth and development, awareness programmes/campaigns on the need for proper selection of food by government/food agencies and all concerned.
  2. More effort should be made on poverty alleviation, means of production of food can be made available and also mothers should be properly educated on the importance of exclusive breastfeeding, also an acceptable and affordable health service should be provided to the mothers and children.
  3. Another area is, government should provide equipment and facilities in our clinics, health centers, and hospital for more effective treatment of children with protein energy malnutrition.

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