Background Information

Malnutrition in children is a serious global problem. It is estimated that around 195 million
children under five years are malnourished and more than 28 million suffer from severe acute
malnutrition(UNICEF 2009). The problem has ranked high on the global agenda for 50 years
with broad consensus to tackle it, still without leading to a satisfactory solution in the foreseeable
future. One reason is that malnutrition is not an isolated problem but caused by a series of
complex, multiple and interactive causes (Beaudry, 1999) and therefore must be treated in a
broad multisectoral approach. When a child is suffering from malnutrition it there may be
exhibited different manifestations. The child can suffer from acute malnutrition, and chronic
malnutrition, or both . To distinguish between acute and chronic malnutrition the measurements
weight‐for‐ height (W/H) and height‐for‐age (H/A) applies. Acute malnutrition is a sign of poor
feeding which may involve weight loss or excessive weight gain compared to height is a good
measure. , Therefore height compared to age is useful. A child is malnourished if the W/H or
H/A measures are more than ‐2 SD from the median(WHO Growth standards). Malnutrition is
measured as weight‐for‐age (W/A).
Problem Statement

Malnutrition refers to a pathological state resulting from a relative or absolute deficiency or

excess of one or more essential nutrients. It is a state of nutrition where the weight for age, height
for age and weight for height indices are below -2 Z-score of the NCHS reference. Malnutrition
continues to be a major public health problem in developing countries. It is the most important
risk factor for the burden of disease causing about 300, 000 deaths per year directly and
indirectly responsible for more than half of all deaths in children (Müller and Krawinkel, 2005).
Health and physical consequences of prolonged states of malnourishment among children are:
delay in their physical growth and motor development; lower intellectual quotient (IQ), greater
behavioral problems and deficient social skills; susceptibility to contracting diseases (Black,
Morris and Bryce, 2003)
Much of the burden of deaths resulting from malnutrition, estimated to be over half of childhood
deaths in developing countries, can be attributed to just mild and moderate malnutrition, varying
from 45% for deaths due to measles to 61% for deaths due to diarrhea (de Onis M et al, 2004).
The majority of studies on child nutritional status have described prevalence of malnutrition
among under-five children and analyzed socioeconomic, demographic and cultural factors
associated with child malnutrition in SSA(Reed, Habicht, Niameogo, 1996)
In Kenya survey result on nutrition indicate that global acute malnutrition levels have also raised
22.5% compared to 3% in 2000, Severe acute malnutrition is at 3.5% from 1.5% over the same
period. About 400 children below 5 years of age die every year while more than a third of the
children dying as a result of maternal and child inadequate nutrition, diarrhoea, pneumonia,
malaria and HIV/AIDS (KIdaki, 2008).