CHAPTER ONE

1.0 INTRODUCTION

1.1 BACKGROUND OF STUDY

The issue of malnutrition has become a household name among families with children from zero to five years. It is evident that the nutritional status of children is widely regarded as one of the well-known indicators of economic development of that particular region in question.

There has been high level of neglect of children by most parents’ reason being as a result of low family income, lack of parent exposure and poor implementation of infrastructural facilities such as good hospital that sees for children like of pipe borne water etc.

The World Health Organization (WHO) estimates that malnutrition accounts for 54 percent of child mortality worldwide, about 1 million children. Another estimate also by WHO states that childhood underweight is the cause for about 35% of all deaths of children under the age of five years worldwide. The main causes are unsafe water, inadequate sanitation or insufficient hygiene, factors related to society and poverty, diseases, maternal factors, gender issues and overall poverty (Bhutta et al, 2008). The nutritional status of children under five (5) years of age is usually measured as weight-for-age, weight for height and height for age indexes. The common nutritional status of children under 5 years old in each region such as underweight, stunning and wasting are considered as nutritional disorders.

The evaluation of these criteria reflects the general health status of that region. Malnutrition is a clinical syndrome which the infant or child deviates from the main pattern of growth, the growth curve is downward and constantly locates under the curve of 3% of the height and weight (Nakhshab M, Nasiri H, 2009).

The malnutrition often occurs in the first years of life when the caloric intake is not able to provide the metabolic needs of the body. Consequently, the stored nutrients in the tissues will be consumed to preserve the life (Arezomaniance S, 2005). In children, protein-energy malnutrition is defined by measurements that fall below 2 standard deviations under the normal weight for age (underweight), height for age (stunting) and weight for height (wasting). Wasting indicates recent weight loss, whereas stunting usually results from chronic weight loss.

The primary malnutrition in children occurs due to socioeconomic factors and lack of food. The secondary malnutrition is associated with the diseases with increased need for calories, calorie loss, and reduction of calorie intake or a combination of these three modes. It may be caused by low food intake or impaired absorption of nutrients.

Prenatal malnutrition and early life growth patterns can alter metabolism and physiological patterns and have lifelong effects on the risk of cardiovascular disease. Children who are undernourished are more likely to be short in adulthood, have lower educational achievement and economic status, and give birth to smaller infants (Bhutta et al, 2008). Children often face malnutrition during the age of rapid development, which can have long-lasting impacts on health.

The World Health Organisation estimated in 2008 that globally, half of all cases of malnutrition in children under five were caused by inadequate food intake, unsafe water, inadequate sanitation or insufficient hygiene. This link is often due to repeated diarrhoea and intestinal worm infections as a result of inadequate sanitation. However, the relative contribution of diarrhea to malnutrition and in turn stunting remains controversial. In almost all countries, the poorest quintile of children has the highest rate of malnutrition. However, inequalities in malnutrition between children of poor and rich families vary from country to country, with studies finding large gaps in Peru and very small gaps in Egypt. In 2000, rates of child malnutrition were much higher in low income countries (36 percent) compared to middle income countries (12 percent) and the United States (1 percent). Studies in Bangladesh in 2009 found that the mother’s literacy, low household income, higher number of siblings, less access to mass media, less supplementation of diets, unhygienic water and sanitation are associated with chronic and severe malnutrition in children.

1.2 STATEMENT OF RESEARCH PROBLEM

What really instigated the study was the increased mortality of children under the ages of five (5) as a result of malnutrition; about 50 percent of the citizens in Nigeria are low income earners, it is evident from World Bank found that, from 1970 to 2000, the number of malnourished children decreased by 20 percent in developing countries. Some the other problems discovered are in the areas of lack of iodine intake by pregnant mothers before child birth, lack of minerals, calcium vitamins has seen to be a major clog on the wheels of child growth and development. In Nigeria today, there has been lack of nutritional education in most of the hospitals to educate pregnant mothers on how to feed before child birth.

1.3 AIMS AND OBJECTIVES OF STUDY

The main aim of the research work is to carry out a statistical analysis of the prevalence of malnutrition on children Zero to five years. Other specific aims of the study include:

1. To examine the effect and causes of malnutrition among children from Zero to Five years of age
2. To examine the relationship between malnutrition and child mortality rate in Nigeria
3. To identify the strategies for reducing malnutrition in children from zero to five years
4. To examine the effect of parent income on child care and malnutrition among children from Zero to Five years old
5. To proffer solution to the above stated problems

1.4 RESEARCH QUESTIONS

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions are stated below as follows:

1. What is the effect and causes of malnutrition among children from Zero to Five years of age?
2. What is the relationship between malnutrition and child mortality rate in Nigeria?
3. What are the strategies for reducing malnutrition in children from zero to five years?
4. Does parent income have any effect on child care and malnutrition among children from Zero to Five years old?

1.5 STATEMENT OF RESEARCH HYPOTHESIS

H0: there is no significant relationship between malnutrition and child mortality rate in Nigeria

H1: there is significant relationship between malnutrition and child mortality rate in Nigeria

H0: length for age and weight for age does not influence mortality rate among children from Zero to Five years as a result of malnutrition

H1: length for age and weight for age influences mortality rate among children from Zero to Five years as a result of malnutrition

1.6 SIGNIFICANCE OF STUDY

The study on the prevalence of malnutrition on children Zero to five years will be of immense benefit to the entire pregnant mothers in Nigeria as it will educate them on the effect of malnutrition on child mortality rate. The study will also educate them on how to take care of their child at the early age of growth and development. The study will educate on the causes, prevalence and strategies for reducing malnutrition in children from zero to five years. Finally the study will be a contribution to the body of literature in the area of the effect of personality trait on student’s academic performance, thereby constituting the empirical literature for future research in the subject area.

1.7 SCOPE OF STUDY

The study on prevalence of malnutrition on children Zero to five years will cover areas on the causes and the prevalence of malnutrition in children. It will also cover the strategies for reducing malnutrition in children from zero to five years of age

1.8 LIMITATION OF STUDY

Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.

1.9 DEFINITION OF TERMS

MALNUTRITION: lack of proper nutrition, caused by not having enough to eat, not eating enough of the right things, or being unable to use the food that one does eat

MORTALITY RATE: death, especially on a large scale

PREVALENCE: the fact or condition of being prevalent; commonness

REFERNCES

WHO. Physical status : the use and interpretation of anthropometry. report of a WHO Expert Committee. World Health Orqan Tech Rep Ser 1995; 854:1-452. 2. Nakhshab M, Nasiri H. A study on the prevalence rate of malnutrition and it’s effective factors in children under two years in sari township 1999-2000. J Mazandaran Univ Med Sci 2002; 12 (34):47-58. 3. Arezomaniance. S. (2005) Marllow infants nursing. 13 ed. Tehran: Boshra publication, p291-4.

Taheri. F, Sharif zadeh. Gh, and Nasiri. Prevalence of malnutrition in 1-36 month old children hospitalized in Valiyy-e-Asr Hospital of Birjand. Journal of Birjand University of Medical Sciences 2006; 13(2):9-15. 5. Nojoomi N, Kafashi A, Najmabadi S. Study of frequency of malnutrition risk factors in under 5 years children in Karaj, 2001-2002. RJMS 2003; 10(33):123-30. 6. World Bank. (1993) World development report. New York: Oxford University press: p36-42. 7. Word Health Organization (WHO). Global Database on Child Growth and Malnutrition [Internet]. 2011 [updated 2011 January 14]. Available from: http://www.who.int/nutgrowthdb. January 14, 2011]