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Strategies
for Reducing Malnutrition on Children’s Zero to Five Years
CHAPTER ONE
INTRODUCTION
1.1
BACKGROUND TO THE STUDY
Malnutrition
in children also known as undernutrition is common globally and results in both
short and long term irreversible negative health outcomes including stunted
growth which may also be linked to cognitive development deficits, underweight
and wasting. 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).
There are
three commonly used measures for detecting malnutrition in children. They
includes stunting (extremely low height for age), underweight (extremely low
weight for age), and wasting (extremely low weight for height). These measures
of malnutrition are interrelated, but studies for the World Bank found that
only 9 percent of children exhibit stunting, underweight, and wasting. Children
with severe acute malnutrition are very thin, but they often also have swollen
hands and feet, making the internal problems more evident to health workers.
Children with severe malnutrition are very susceptible to infections (World
Bank, 2008).
Malnutrition
in children causes direct structural damage to the brain and impairs infant
motor development and exploratory behavior. Children who are undernourished
before age two and gain weight quickly later in childhood and in adolescence
are at high risk of chronic diseases related to nutrition. Studies have found a
strong association between malnutrition and child mortality (Duggan et al,
2008). Once malnutrition is treated, adequate growth is an indication of health
and recovery. Even after recovering from severe malnutrition, children often
remain stunted for the rest of their lives. Even mild degrees of malnutrition
double the risk of mortality for respiratory and diarrheal disease mortality
and malaria. This risk is greatly increased in more severe cases of
malnutrition. Undernourished girls tend to grow into short adults and are more
likely to have small children. 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 diarrhea 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.
Diarrhea and
other infections can cause malnutrition through decreased nutrient absorption,
decreased intake of food, increased metabolic requirements, and direct nutrient
loss. Parasite infections, in particular intestinal worm infections
(helminthiasis), can also lead to malnutrition. A leading cause of diarrhea and
intestinal worm infections in children in developing countries is lack of
sanitation and hygiene. Children with chronic diseases like HIV have a higher
risk of malnutrition, since their bodies cannot absorb nutrients as well.
Diseases such as measles are a major cause of malnutrition in children; thus
immunizations present a way to relieve the burden. The nutrition of children 5
years and younger depends strongly on the nutrition level of their mothers
during pregnancy and breastfeeding.
Infants born
to young mothers who are not fully developed are found to have low birth
weights. The level of maternal nutrition during pregnancy can affect newborn
body size and composition. Iodine-deficiency in mothers usually causes brain
damage in their offspring, and some cases cause extreme physical and mental
retardation. This affects the children’s ability to achieve their full
potential (Wagstaff & Naoke, 1999). In 2011 UNICEF reported that thirty
percent of households in the developing world were not consuming iodized salt,
which accounted for 41 million infants and newborns in whom iodine deficiency
could still be prevented. Maternal body size is strongly associated with the
size of newborn children. Short stature of the mother and poor maternal
nutrition stores increase the risk of intrauterine growth retardation (IUGR).
However, measurements of a child’s growth provide the key information for the
presence of malnutrition, but weight and height measurements alone can lead to
failure to recognize kwashiorkor and an underestimation of the severity of
malnutrition in children.
1.2
STATEMENT OF THE PROBLEM
Measures
have been taken to reduce child malnutrition. Studies for the World Bank found
that, from 1970 to 2000, the number of malnourished children decreased by 20
percent in developing countries. Iodine supplement trials in pregnant women
have been shown to reduce offspring deaths during infancy and early childhood
by 29 percent. However, universal salt iodization has largely replaced this
intervention. Nutritional education and micronutrient-fortified food
supplements has resulted in 10 percent reduction and the prevalence of stunting
in children 12–36 months old. Milk fortified with zinc and iron reduced the
incidence of diarrhea by 18 percent in children.
1.3
OBJECTIVES OF THE STUDY
The
following are the objectives of this study:
To examine
the causes of malnutrition in children from zero to five years.
To examine
the prevalence of malnutrition in children from zero to five years.
To identify
the strategies for reducing malnutrition in children from zero to five years.
1.4 RESEARCH
QUESTIONS
What are the
causes of malnutrition in children from zero to five years?
What is the
prevalence of malnutrition in children from zero to five years?
What are the
strategies for reducing malnutrition in children from zero to five years?
1.6
SIGNIFICANCE OF THE STUDY
The
following are the significance of this study:
The outcome
of this study will educate on the causes, prevalence and strategies for
reducing malnutrition in children from zero to five years.
This
research 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/LIMITATIONS OF THE STUDY
This study
will cover 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.
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.
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