ASSESSMENT OF NUTRITIONAL STATUS OF UNDER FIVE CHILDREN

ATTENDING POST NATAL CLINIC AT OJA-TIMI PRIMARY HEALTH CENTRE,

EDE NORTH, OSUN STATE.

COMPILED BY:

RAJI MUIBAT ENIOLA ND201603190

OKUNRINTINRIN SADIAT ADEOLA ND201603337

SALAUDEEN SHAIDAT FOLASADE ND201603767

BEING A PROJECT WORK SUBMITTED TO THE DEPARTMENT OF NUTRITION

AND DIETETICS

SCHOOL OF APPLIED OF SCIENCES

FEDERAL POLYTECHNIC EDE, OSUN STATE

IN PARTIAL FULFILMENT OF THE REQUIREMENT FOR THE AWARD OF

NATIONAL DIPLOMA IN NUTRITION AND DIETETICS

SUPERVISED BY

MR. NNOKA KINGSLEY O. (RD)

SEPTEMBER 2018
 CERTIFICATION

This is to certify that the project was carried out by

RAJI MUIBAT ENIOLA ND201603190

OKUNRINTINRIN SADIAT ADEOLA ND201603337

SALAUDEEN SHAIDAT FOLASADE ND201603767

In the department of Nutrition and Dietetics Department under the supervisor of

_______________________ ________________________

MR NNOKA KINGSLEY O. (RD) DATE

PROJECT SUPERVISOR

________________________ ________________________

DR. MRS ATTAH DATE

HEAD OF DEPARTMENT

_______________________ ________________________

MRS. FAKUNLE (RD) DATE

EXTERNAR SUPERVISOR
 DEDICATION

This project is dedicated to God Almighty, the beginning and the end who has been guiding us

throughout the project. Also to our parents and guardians we pray God Almighty reward them

bountifully. (AMEN)
 ACKNOWLEDGMENT

All praises, adoration and glorification to the supreme being, the comforter, supporter, helper and

deliverer for guiding us through. We also appreciate so much the effort of our able supervisor.

MR. NNOKA KINGSLEY(RD) for guiding us throughout this project and also went through our

work and made vital corrections, May God in his infinite mercy continue to reward you and

family abundantly.

Our thanks also goes to our lecturers; Mr. Gbenga Abata, Mr. Hammed, Mrs. Mosimabale,

Mr. Oyinloye, Mrs. Adedoyin, Miss Akande and the entire non-teaching staffs for their advices,

support and encouragement in making our programmes successful. May God bless you all.

Our sincere appreciation goes to our family and friends for their moral, spiritual and financial

support given to us. We are sincerely indebted to you for your understanding and care directed

towards our lives

 ABSTRACT

This descriptive cross-sectional study was conducted to assess nutritional status of under five

children attending postnatal clinic at Primary health Centre Oja Timi hospital. The data was

collected using semi-structured validated questionnaire. A total of 340 respondents participated

in the study. Data was analyzed using descriptive statistics (frequency, percentage, x + S.D). the

result shows that prevalence of stunting, wasting % underweight were 20.0%, 14.7%, 21.4%

respectively. Prevalence of childhood obesity was 12.6%. Average monthly income and

educational background of the parents had reverse relationship with prevalence of under

nutrition.
 TABLE OF CONTENT

Front Page i

Certification ii

Dedication iii

Acknowledgement iv

Abstract v

Table of Content vi

CHAPTER ONE

1.0 INTRODUCTION 1

1.1 THE PROBLEM STATEMENT 3

1.2 AIM AND OBJCTIVES 4

1.2.2 SPECIFIC OBJECTIVES 4

1.3 JUSTIFICATION OF THE STUDY 5

CHAPTER TWO

2.0 LITERATURE REVIEW 6

CHAPTER THREE

3.0 METHODOLOGY 13

3.1 STUDY AREA 14

3.2 STUDY POPULATION 14

3.3 STUDY DESIGN 14

3.4 SAMPLING TECHNIQUE 14

3.5 SAMPLING SIZE DETERMINATION 14

3.6 DATA COLLECTION 15

3.7 DATA ANALYSIS 15

CHAPTER FOUR

4.0 RESULTS AND DISCUSSION 16

4.1 AGE DISTRIBUTION OF THE RESPONDENTS BASED ON GENDER 16

DISCUSSION 24

CHAPTER FIVE

5.0 RECOMMENDATION 27

5.1 CONCLUSION 27

REFERENCES 28
 CHAPTER ONE

1.0 INTRODUCTION

Malnutrition is a condition that results from eating a diet in which one or more nutrients

are not enough or are too much such that the diet causes health problem. It may involve protein,

carbohydrates, vitamins and minerals. Not enough nutrients are called under nutrition or

undernourishment while too much is called over nutrition. (WHO,2016)

Malnutrition is one of the biggest health problems that the world currently faces and is

associated with more than 41% of the deaths that occur annually in children from 6 to 24 months

of age in developing countries which totally approximately 2.3 million. 1 World Health

Organization in 2001 reported that 54% of all childhood mortality was attributable, directly or

indirectly to malnutrition Sub-Saharan Africa has a high prevalence of different types of

malnutrition namely; stunting, wasting and underweight.2feeding practices during infancy are

critical for growth, development and health of a child during the first two years of life and of

importance for the early prevention of chronic degenerative diseases. Progress in improving

infant and young child feeding practices in the developing world has been remarkably slow due

to several factors like poverty and poor hygienic conditions. (The Nigerian Food Consumption

and Nutrition survey of 2001-2003) observed similar trends among this age group with 42

percent stunted, 25 percent underweight, and 9 percent wasted.6 It will be of greater help if a

comprehensive study on the food consumption is conducted which will help to identify current

good consumption is conducted which will help to identify current good practices to be

supported for improving the feeding practices of the children as effective strategies for solving

childhood malnutrition. Such a study will be a contribution to knowledge on food consumption

and nutritional status of under five children in Nigeria. Malnutrition contributes to Nigeria
current health problems (morbidity and mortality) in several ways. Under nutrition remains a

devastating problem in many developing countries affecting over 815 million people causing

more than one-half of child death.10, 11 Although, WHO, UNICEF and Nigeria’s National

breast feeding policy recommended that infants be exclusively breast fed from birth to 6 months

and continue breastfeeding to 24months and beyond for optimal survival, growth development

unfortunately only 17% of infants under six months of age are exclusively breast fed in Nigeria.

The poor breastfeeding and inadequate complementary feeding explained the protein energy

malnutrition level in children as they grow older. The nutritional status of under five-year-old

children is an outcome measure of children’s health. Malnutrition is one of the most important

causes of children’s abnormal physical and mental development. The study aims to find the

prevalence and determinants of malnutrition in terms of wasting, stunting, and underweight, in

addition to obesity in a sample of under five-year-old Iraqi children. A cross sectional study was

conducted in three health care center in Baghdad for the period from 3 rd January to 31st march

2012. A sample of 606 under 5-year-old children (2-59months) of both genders was included in

the study. Data were gathered by direct interviews with the children’s parents, and the weight,

height and BMI measurements of each child were taken. The prevalence of different under

nutrition problems among under five-year-old children were: 5.28% for wasting, 16.17% for

stunting, and 7.43% for underweight. The highest prevalence was that of being obese; 17.5% by

weight to height and 15.35% by BMI to age. Malnutrition levels were higher in rural than in

urban areas. A significant association was estimated between; the age of a child and being

underweight, lower levels of parental education and stunting, and between extended families and

stunting. The rates of being obese were higher than that of those of under nutrition. The factors

associated with under nutrition in under five-year-old children are especially related to lower
socio economic status such as rural residence, lower levels of maternal education, unemployed

mothers, and extended larger families.

1.1 THE PROBLEM STATEMENT

Malnutrition is one of the biggest health problems that the world currently faces and is

associated with more than 41% of the deaths that occur annually in children from 6 to 24 months

of age in developing countries which totally approximately 2.3 million. 1 World Health

Organization in 2001 reported that 54% of all childhood mortality was attributable, directly or

indirectly to malnutrition Sub-Saharan Africa has a high prevalence of different types of

malnutrition namely; stunting, wasting and underweight. feeding practices during infancy are

critical for growth, development and health of a child during the first two years of life and of

importance for the early prevention of chronic degenerative diseases. Progress in improving

infant and young child feeding practices in the developing world has been remarkably slow due

to several factors like poverty and poor hygienic conditions.

1.2 AIM AND OBJCTIVES

1.2.1 AIM

To assess the nutritional status of under 5 children attending Post Natal Clinic at Primary Health

Centre Oja-Timi.

1.2.2 SPECIFIC OBJECTIVES

1. To assess anthropometric parameters of under five children

2. To assess the prevalence of wasting, stunting, overweight and underweight.

3. To assess factors that predispose under five children to malnutrition

i. The method of breast feeding

ii. Mother’s income

iii. Mother nutritional education

iv. To evaluate relationship between parent average monthly income and educational

qualification on the nutritional status of under 5 children.

1.3 JUSTIFICATION OF THE STUDY

Vulnerable groups are group in which their nutritional requirements are likely to be

misunderstood or taken for granted. These group of people are higher risk of nutritional

deficiency. The vulnerable group are easily identifiable in any community, individuals in this

categories are likely to suffer from various forms of malnutrition dues to ignorance. Nutrition is a

critical determinant of human health and good health becomes all the more elusive in the

presence of malnutrition. Low birth weight is influenced by three major mechanisms-duration of

gestation.

However, there still remains a resistant core of child mortality where under nutrition is an

underlying cause. Several deficiency syndromes in woman and children are still prevalent and

are of public health significance contributing to 3.4% of the global burden of total diseases and

affecting the quality of life. Children born with low birth weight are at increased cycle of

infection and malnutrition will be seriously stunted and will carry its growth deficiency and often

its impaired learning ability.

 CHAPTER TWO

2.0 LITERATURE REVIEW

Malnutrition is a condition that results from a diet in which one or more nutrients are

either not enough or too much such that the diet causes health problems. It may involves protein,

carbohydrate, vitamins or minerals. -Cited by 304 Frongillo Jr.

It also refers to deficiencies, excesses, or imbalances in a person intake of energy

nutrients. The term nutrition is in three broad groups of under nutrition, which includes wasting

(low weight-for-height), stunting (low height-for-age) and underweight (low weight-for-age).

ANTHROPOMETRIC DEFINITIONS OF MALNUTRITION.

1. STUNTING; This refers to low height-for-age when a child is shorter than normal for his or

her age, is a reduced growth in human development, which is also manifestation of

malnutrition or under nutrition and recurrent infections such as diarrhea and helminthiasis in

early childhood and even before birth due to malnutrition during fetal development brought

on by the malnourished mother.

Stunted growth in children has the following public health impacts apart from the obvious

impacts of shorter stature of the person affected;

 Greater risks for illness and premature death.

 It may result in delayed mental development and therefore poorer school performance and

later on reduced productivity in the work force.

 Women of shorter stature have a greater risk for complications during child birth due to their

smaller pelvis and are at risk of delivering a baby with low birth weight.

2. WASTING; this is referred to as wasting syndrome which refers to a process by which

debilitating disease causes muscle and fat tissue to waste away it is sometimes referred to as
 acute malnutrition because it is believed that period of wasting have a short duration.

According to the latest UN estimates an estimated 52 million children under 5 years of age,

or 8% were wasted. the vast majority about 70%, of the world wasted children live in Asia,

most in South-central Asia.

3. UNDERWEIGHT; also refers to low weight-for-age, also considered a weight too low for

good health. An underweight person is a person whose body weight is considered too low to be

healthy. Underweight people have a body mass index (BMI) of under 18.5kg/m 2 or a weight

15% to 20% below that normal for their age and height group. Ranges for BMI include;

Underweight; less than 18.5

Normal/healthy weight;18.5-24.9

Overweight;25.0-29.9

Obese;30 and above

The vulnerable groups; (neonates, pregnant women, lactating women and infants) are the

groups in which their nutritional requirements are likely to be misunderstood or taken for

granted. These groups of people are at higher risk of nutritional deficiency. The vulnerable

groups are easily identifiable in any community; individuals in this categories are likely to

suffer from various forms of malnutrition due to ignorance. Every individual needs nutrient

which can be obtained from the food we eat. However, nutritional needs vary from one

individual to another depending on age, gender, activity levels and physiological stage. MISS

Akande, 2018

NUTRITIONAL NEEDS OF INFANTS (0-6) MONTHS

The first six months after the birth of the baby is the period of rapid growth in the life of the

baby. The growth of infants and children directly reflects in their nutritional well-being and it
 is an important parameter in accessing their nutritional status. The baby should also be on

exclusive breastfeeding for the first six months of the infant.

 Breast feeding should start immediately after birth

 Breast feed low birth weight babies (2.3-2.5 kg) more frequently

Breast milk is a unique secretion with many differences from milk of other sources. The

composition of breast milk is enough to sustain the infants for six months with the exception

of vitamin D. which has some advantages which include;

1. Nutrition

2. Anti-infection

3. Bifudus factor

4. Bonding

5. Mother health (natural child spacing)

6. Convenience

7. Intake of colostrum.

NUTRITIONAL NEEDS OF INFANT (7-12) MONTHS

The child is still within the intensive growth period, however the infant is ready for the addition

of other foods to complement the breast milk, since the nutrients quantity of milk produced will

not sustain the child any longer. Complementary food should be based on food available at home

or in market.

According to World Health Organization, the recommendation for ideal complementary food

must meet the following standards;

 A-Adequacy

F-Feasibility i.e practicable

A-Accessibility

A-Affordability

S-Safe

NUTRITION INTERVENTION PROGRAMMES FOR THE SPECIAL GROUPS

The different types of nutrition intervention programmes are into four major categories;

1. Nutrition education and counselling

2. Special feeding programmes

3. Promotion of breast feeding and formulation of homemade complementary foods

4. Food fortification and administration of specific nutrient supplements.

ANTHROPOMETRIC INDICES

Measurements by themselves are incomplete, unless they are associated with other

measurements. Thus anthropometric indices are derived from combination of raw

measurement. Examples of anthropometric indices are weight for age, height for age, weight

for height, BMI for age etc.

These indices are essential for the interpretation of measurements as it is evident that a value of

body weight alone has no meaning unless it is related to an individual age or height. These

indices are expressed as Z scores, percentiles or percentage of the median. Further, these indices

are used to compare an individual or a group with a reference population.

1. WEIGHT FOR AGE

Weight for age reflects the body mass relative to chronological age. The advantage of this

index is that it reflects both past (chronic) and present (acute) Under nutrition. It is

commonly used for monitoring growth and to assess changes in the magnitude of

malnutrition over a period of time.

A major limitation of using weight for age is that it reflects both weight for height and height

for age.

Nutritional terms for weight for age;

Low weight for age; Underweight; The term ’underweight’ is commonly used to refer to the

underlying pathological processes of low weight for age (WHO 1995). It is described as

gaining insufficient weight relative to age or losing weight and is obtaining as weight < 2 SD

of sex specific references data relative to age.

2. HEIGHT FOR AGE

Height for age reflects the achieved linear growth and its deficits indicate long term

cumulative inadequacy of human health and nutrition. It cannot measure shot term changes in

malnutrition. Height for age is primarily used as a population indicator rather than for

individual growth monitoring.

Nutritional condition identified for age

Low height for age: Stunting of shortness

The term stunting is commonly used to refer to the underlying pathological processes for low

height for age (WHO 1995). It is described as gaining insufficient height relative to age and

is obtained as height <-2SD of the sex specific references data relative to age.

3. WEIGHT FOR HEIGHT

Weight for height measures the body weight relative to height and helps to identify current

or acute under nutrition. It is normally used as an indicator of current nutritional status and

can be useful for screening children at risk and for measuring short term effects such as

nutritional stress brought by illness. It is important to note that weight for height is not a

substitute for weight for age or height for age, since each index reflects a different

combination of biological processes.

Nutritional condition identified from weight for height

Low weight for height: wasting

The term wasting is commonly used to refer to the underlying pathological processes of

low weight for height (WHO1995).It is described as gaining insufficient weight relative to

height. It indicates current or acute malnutrition resulting from failure to gain weight or

actual weight loss .Causes of wasting include inadequate food intake, infection etc. Wasting

in individual children and population group can change rapidly and shows marked seasonal

patterns associated with changes in food availability or diseases prevalence, to which it is

very sensitive.

4. BMI for age

Body mass index(BMI) is calculated from a persons’s weight and height and is obtained

as the individual’s body weight (in Kgs) divided by the square of his or her height (in

meters). It is the only indicator that includes all the three measurements of height, weight and

age. In recent years, it has become the most widely used diagnostic tool for screening and

identifying underweight, overweight and obesity in population for both adults and children.

WHO BMI age reference (1995) reported BMI for age percentile for male and female

adolescents 9-24 years of age (Must et al 1991; WHO 1995). The CDC 2000 references
provide age an d sex specific BMI for age data for children between 2-20 years (Kuczmarski

et al 2000,2002).WHO 2007 provides BMI for age data for children between 5-19 years (De

onis et al 2007: WHO 2007).

 CHAPTER THREE

3.0 METHODOLOGY

This chapter presents the methodology use in the study. It describes the research design,

population and sample, research instrument, method of data collection and method of data

analysis. The purpose of this study, which was to assess the nutritional status of under five

children attending post natal clinic at primary health centre Ede, Osun state specifically, the

study was to assess the nutritional status of under five children in Ede.

3.1 STUDY AREA;

The study was conducted at the postnatal clinic at primary health Centre at oja-timi in Ede,

Ede North.

Primary Health Centre refers to essential health care that is based on scientifically sound and

socially acceptable methods and technology, which make universal health care accessible to

all individuals and families in a community.

The original concept of a primary health centre oja-timi, Ede was a small rural building

which has several beds. The advantages of such a hospital in villages were the provision of

care which avoided long journey to county or voluntary hospitals, facilities to deal more

immediately with emergencies and familiarity the local physician might have with their

patients that may affect their treatment.

A postnatal period begins immediately after the birth of a child as the mother body including

hormone levels and uterus size, returns to a non-pregnant state.

 3.2 STUDY POPULATION;

The study population was conducted using postnatal mothers, neonates and infants under the

age of 5.

3.3 STUDY DESIGN;

The study was a descriptive cross sectional study.

3.4 SAMPLING TECHNIQUE;

A systematic random sampling was used i.e where everybody was given a equal opportunity

of been selected.

3.5 SAMPLING SIZE DETERMINATION;

We determined the sampling size using Fischer formula

n = Z2 x/2 P(1 - P)

W2

Where n is the sampling size

Z is the z score (which has the value of 1.96)

P is the prevalence of under 5 malnutrition

W2 is the standard error (0.05)

Whereby, prevalence=27%

=1.962×0.27(1-0.27)

W2

=3.84×0.27×0.73
 0.052

=3.84×0.20

0.0025

= 0.77

0.0025

= 308 0f 10%

= 10 × 308=30.8

100

=30.8 +308

=340

3.8 DATA COLLECTION;

The data was collected using semi-structured validated questionnaire.

3.9 DATA ANALYSIS;

Data was analyzed using descriptive statistics such as frequency, percentage, mean +/- ( )

and significant differences will be determined.

CHAPTER FOUR

4.0 RESULTS AND DISCUSSION

4.1 Age distribution of the respondents based on gender

Age(months) Male Female

Frequency percentage(%) Frequency percentage(%)

1-10 months 18 14.4 27 12.6

11-20months 15 12.0 51 23.7

21-30months 21 16.8 37 17.2

31-40months 19 15.2 43 20.0

41-50months 35 28.0 29 13.5

51-60months 17 13.6 28 13.0

Total 125 (100) 215 (100)

41-50 months has the highest percentage(28.0) in the male’s table, while 11-20months has the lowest

percentage of (12.0). 11-20 months has the highest percentage (23.0) in the female’s while 1-10 months

has lowest percentage of (12.6)

Table 4.2 Position in the family

position Male Female

frequency percentage(%) frequency percentage

1st 55 44.0 53 24.7

2nd 31 24.8 43 20.0

3rd 28 22.4 84 39.0

Others 11 8.8 35 16.3

Total 125 (100) 215 (100)

In male 1st position has the highest percentage of (44.0) while others has the lowest percentage of (8.8)

In female 3rd position has the highest percentage of (39.0) while others has the lowest percentage of
(16.3)
Table 4.3 The baby currently on exclusive breast-feeding

Frequency Percentage(%)

The baby currently on exclusive on 203 59.7

Breastfeeding

The baby not currently on 137 40.3

exclusive breastfeeding

TOTAL 340 (100)

The baby not currently on exclusive on Breastfeeding has the highest percentage of (40.3), while The

baby currently on exclusive on Breastfeeding has lowest percentage of (59.7)

Table 4.4 Stage of introducing complementary feeding

Frequency Percentage (%)

Less than 3 months 53 15.6

4-6 months 89 26.2

More than 6 months 198 58.2

TOTAL 340 (100)

More than 6months has the highest percentage of (58.2) while less than 3 months has the lowest
percentage of (15.6)

TABLE 4.5 children that continued breastfeeding after complementary food was introduced.
 Frequency Percentage(%)

Children that continued breastfeeding after

complementary food was introduced. 221 65

children that didn’t continue breastfeeding after

complementary food was introduced. 119 35

TOTAL 340 (100)

Children that continued breastfeeding after complementary food was introduced has the highest

percentage of (65) while children that didn’t continue breastfeeding after complementary food was

introduced has the lowest percentage of (35)

Table 4.6 Source of drinking water

Frequency Percentage(%)

Borehole 34 10.0

Sachet water 65 19.1

Bottle water 201 59.1

Rain water 21 6.2

Stream water 8 2.4

Others 11 3.2

TOTAL 340 (100)

Bottle water has the highest percentage of (59.1) while stream water has the lowest percentage of (2.4)

Table 4.7 Average monthly income

Frequency Percentage%
1000-4000 165 48.5

5000-9000 37 10.9

10000-14000 73 21.5

15000-30000 25 7.4

31000-50000 27 7.9

More than 50000 13 3.8

TOTAL 340 (100)

1000-4000 has the highest percentage of (48.5) while more than 50000 has the lowest percentage of
(3.8)

Table 4.8 Highest educational qualification of mother

Frequency Percentage (%)

FSLC 81 23.8

SSCE 93 27.8

ND 125 37.8

HND/BSC 14 4.1

M.SC 17 5.0

PhD 10 2.9

TOTAL 340 (100)

ND has the highest percentage of (37.8) while PhD has the lowest percentage of (2.9)

Table 4.9 Types of excretory system used

Frequency Percentage (%)

 Bush 27 7.9

Pit latrine 262 77.1

Water closet 51 15.0

TOTAL 340 (100)

Pit latrine has the highest percentage of (77.1) while Bush has the lowest percentage of (7.9s)

Table 4.10Nutritional Status Of The Under-5 Children

Nutritional status Gender

Male Female TOTAL

Frequency (%) Frequency (%) Frequency (%)

Normal 25 20.0 37 17.20 62 18.2

Stunting 17 13.6 51 23.72 68 20.0

Wasting 21 16.8 29 13.48 50 14.7

Underweight 30 24.0 43 20.00 73 21.4

Overweight 15 12.0 29 13.48 44 12.9

Obesity 17 13.6 26 12.09 43 12.6

TOTAL 125 (100) 215 (100) 340 (100)

Underweight has the highest percentage 24.0 while overweight has the lowest percentage 12.0 in male.

Stunting has the highest percentage 23.72 while obesity has the lowest percentage 12.09 in female.

Table 4.10.1 Severity of chronic malnutrition (stunting) among the under-5 children.

Stunting Male Female Total

 Frequency (%) Frequency (%) Frequency %

Mild Stunting 8 47.05 32 62.74 40 58.8

Severe 9 55.94 19 37.25 28 41.1

TOTAL 17 (100) 51 (100) 68 (100)

Severe stunting has the highest percentage 55.94 while mild stunting has the lowest percentage 47.05 in

male. Mild stunting has the highest percentage 62.74 while severe stunting has the lowest percentage

37.25 in female.

Table 4.10.2 Severity of acute malnutrition(wasting) among the under-5 children

Wasting Male Female Total

Frequency (%) Frequency (%) Frequency %

Mild Wasting 13 61.90 19 65.51 32 64.0

Severe 8 38.09 10 34.48 18 36.0

TOTAL 21 (100) 29 (100) 50 (100)

Mild wasting has the highest percentage 61.90 while severe wasting has the lowest percentage 38.09 in

male. Mild wasting has the highest percentage 65.51 while severe wasting has the lowest percentage

34.48 in female.

Table 4.10.3Severity of Underweight among the under 5 children

Underweight Male Female Total

Frequency (%) Frequency (%) Frequency %

Mild Underweight 20 66.67 25 58.13 45 61.6

Severe 10 33.33 18 41.86 28 38.3

TOTAL 30 (100) 43 (100) 73 (100)

Mild underweight has the highest percentage 66.67 while severe underweight has the lowest

percentage 33.33 in male. Mild underweight has the highest percentage 58.13 while severe

underweight has the lowest percentage 41.86 in female.

Table 4.10.4 Anthropometric parameters of the infants

Parameters male female

X± S.D X± S.D

Weight/kg 15.4± 7.3 12.1±1.24

Height/m 1.50±1.46 1.10±1.14

BMI Kg/m2 13.4±1.97 15.2±2.40

Table 4.10.5 Impact Of Mother’s income on the baby nutritional status

Income Normal Stunting wasting underweight obese overweight

 (F) (%) (F) (%) (F) (%) (F) (%) (F) (%) (F) (%)

1-4000 9 8.73 18 30.00 8 15.38 4 13.33 1 3.12 3 4.26

5000-9000 23 22.33 15 25.00 21 40.38 12 40.00 9 28.12 18

28.57

10000-14000 28 27.18 17 28.33 10 19.23 7 23.33 9 28.12 13

20.63

15000-30000 18 17.47 4 6.66 3 5.76 2 6.66 4 12.50 6 9.52

31000-50000 21 20.38 5 8.33 7 13.46 5 16.66 0 0.00 11

17.46

More than

50000 4 3.88 1 1.66 3 5.76 0 0.00 9 28.12 12

19.04

TOTAL 103 (100) 60 (100) 52 (100) 30 (100) 32 (100) 63 (100)

Table 4.10.6 Impact Of Mother’s income on the baby nutritional status

Education Normal Stunting Wasting Underweight Obese Overweight

(F) (%) (F) (%) (F) (%) (F) (%) (F) (%) (F) (%)

FSLC 6 8.57 13 16.33 18 26.47 23 30.00 4 28.57 5 14.70

SSCE 9 12.85 28 35.89 21 30.88 26 34.21 0 0.00 1 2.94

ND 21 30.00 34 43.58 28 41.17 26 34.21 5 35.71 13 38.23

HND/BsC 18 25.71 3 3.84 0 0.00 1 1.31 2 14.28 0 0.00

MsC 10 14.28 0 0.00 1 1.14 0 0.00 1 7.14 7 20.58

PhD 6 8.71 0 0.00 0 0.00 0 0.00 2 14.28 0 0.00

TOTAL 70 (100) 78 (100) 68 (100) 76 (100) 14 (100) 34 (100)

DISCUSSION
Table 1: Shows the age distribution of the respondent base on gender which revealed that 14.4%

were within 1-10 months, 12.0% within 11-20n months, 16.8% within 21-30 m0nth, 15.2%

within 31-40 months, 28.0% within 41-50 months while 13.6% within 51-60 months for male

also 12.6%, 23.7% 17.2%, 20.0% and 13.5%,13.0 were with the age range of 1-10, 11-20, 21-30,

41-50 and 51-60 months respondent for female.

Table 2: Revealed the respondent position in the family in which 44.0%, 24.8%, 22.4%,8.8% fell

within the 1st, 2nd, 3rd, and others born for male which 24.7%, 20.00%,39.0% and 16.3% fell

within 1st, 2nd, 3rd and 4th born above for female in the family

Table 3: Shows if the baby are currently on exclusive breastfeeding which revealed that 59.7%

said their baby were currently on exclusive breastfeeding while 40.3% said they didn’t practice

exclusive breastfeeding

Table 4: Shows the stage at which they introduce complementary feeding to their children in

which 15.6% said they introduce it to their child at the age less than 3 months, 26.2% introduce

within 4-6 months while 58.2% said they introduce it at more than 6 months of age

Table 5: Revealed that 65% of their mother continue breastfeeding after introducing

complementary food while 35% said they didn’t continue breastfeeding their baby when

complementary was introduced

Table 6: Shows that 10.0%, 19.1%, 59.1%, 6.2%, 2.4% and 3.2% gave this baby borehole water,

sachet water, bottle water, rain water, stream water and others source of water respectively.

Table 7: Shows the average monthly income of the parents which revealed that 48.5%, 10.9%,

21.5%, 7.4%, 7.9% and 3.8% received within the amount of N1000-4000, N5000-9000, N10000-

14000, N15000-30000, N31000-50000 and N50000 above respectively.

Table 8: Shows the educational level of their mothers in which 23.8%, 27.8%, 37.8%, 4.1%,

5.0% and 2.9% had FSLC, SSCE, ND, HND/BSc, MBs and PHD respectively.

Table 9: Revealed the types of excretory system they used in which 7.9%, 77.1%, and 15.0%

said the used bush, pit latrine and water closet respectively as their ways of excretory system.

Table 10: Shows the nutritional status of the under five children in which revealed that 17.20%,

23.72%, 13.48%, 20.0%, 13.48% and 12.09% were Normal, Stunting, Wasting, Underweight,

Overweight and Obese for male while 20.0%, 13.6%, 16.8%, 24.0%. 12.0% and 13.6% were

Normal, Stunting, Wasting, Underweight, Overweight and Obese for female respectively.

Table 11: Revealed the level of the severity of stunting of the children in which 47.05% and

55.94% were mildly stunted and severity stunted for male also 58.8% and 41.1% were mildly

stunted and severity stunted for female.

Table 12: Revealed the level of wasted among the under five children in which 61.90%, and

38.09% were mildly wasted and severity wasted for male while 64.0% were mildly wasted,

36.0% were severity wasted for female respectively.

Table 13: Shows the level of the severity of underweight among the children in which 66.67%,

33.33% were mildly underweight and severity underweight for male while 61.6% and 38.3%

were mildly underweight and severity underweight for female.

Table 14: Revealed the mean and standard deviation for Anthropometric parameter of the infants

in which 15.4± 7.3, 1.50 ± 1.46, 13.4 ± 1.97 had the male and standard deviation value above for

weight, height and BMI for male while 12.1 ± 1.24, 1.10 ± 1.14 and 15.2 ± 2.40 for weight,

height and BMI for female respectively and the significant value for weight was 5.014, height

2.629, BMI 7.5 in which for weight there is significant difference for weight P ˂ 0.05, for height

P ˃ 0.05 that is significant difference, for BMI.

In order to assess the nutritional status of under five children anthropometric indices were used

and compare with past literature and WHO’s reference growth chart. Deviation of the

anthropometric indices from the standard value is regarded as an evidence of malnutrition. In this

study it was revealed that (16.76%) of the children were stunted, and is lower than the result of a

survey conducted in Nepal Medical College Teaching Hospital (41%) and in line with NDHS

2011 which said that children in rural areas are more likely to be stunted than those in urban

areas.

A total of 98% of the under five children were underweight among which girls (98%) among

male which was lower than 21.4% and 16.8% reported for male and female NDHS 2011 and this

study also oppose the other study that boys are more underweight that girls. NDHS 2011.

Under nutrition and weak immunological status can raise the chance of susceptibility and

vulnerability to infections in under five children main causes of malnutrition and inadequate

dietary intake and frequent episodes of diarrhea and respiratory disease. In addition to severe

malnutrition, even mild to moderate malnutrition lead to various infections and the risk of child

health (Urban J, 1997 ) the anthropometric indices in this study reveal that the percentage of

child affected with malnutrition was higher than those with normal for their nutritional status.
 CHAPTER FIVE

5.0 RECOMMENDATION

 Federal government, nutrition society association and Nigeria should organize a program to

enlighten the mother on the importance of exclusive breast feeding.

 Parents should be encouraged to practice home grown gardens that will enable them to have

access to foods.

 Federal government, state government, local government should start giving pregnant and

lactating mothers allowance and feeding program.

5.1 CONCLUSION

In conclusion, the study revealed that 20.0%, 13.6%, 16.8%, 24.0%, 12.0% and 13.6% were

Normal, Stunting, Wasting, Underweight, Overweight and Obese for male while 17.20%,

23.72%, 13.48%, 20.0%. 13.48% and 12.09% were Normal, Stunting, Wasting, Underweight,

Overweight and Obese for female respectively. The rate of being stunting were higher than

that of those under nutrition due to some factors associated with stunting such as lower levels

of maternal education, lack of knowledge, low level of income, unemployment mothers,

hygiene and type of excretory system used which lead to double bonding malnutrition
 REFERENCES

Mengistu K, Destaw B. Prevalence of Malnutrition and Associated Factor Among Children Aged

0-5 years at HidabuAbote District, North Shewa, Oromia Regional State. J Nutr Disorders

Ther TI. 2013. 001. Doi:10.41712/-0509.T1-001’.

SIDDIQI NA,Haque N, Goni MA Malnutrition of under five children; evidence from

bangaladesh, Asian Journal of Medical Sciences,2011.

Francis bolma. 2014 http//www.wfp.org/stories/sierra leone-food-wfp-vital-fight-against-child-

malnutrition accessed on 11/02/2017.

Black RE, Victoria CG,Walker SP et al.Maternal and child nutrition;maternal and children

undernutrition and overweight in low-income and middle-income countries.LANCET 2013.

UNICEF.Sierra Leone national survey 2014

Khan MM, Kraemer A. factors associated with being underweight, overweight and obese.

World Health Organisation, Global database on child growth and malnutrition.2016.

Frongillojunior,cited by 304,Mercedes 2009

Scholl et al 1994, story et al 1999-Must et al 1999

De onis et al 2007:WHO 2007-Kuczmarski et al 2000