UNIVERSITY OF DODOMA

SHOOL OF MEDICINE AND DENTISTRY

DEPARTMENT OF COMMUNITY MEDICINE

NUTRITIONAL FIELD RESEARCH REPORT

TITLE: PREVALENCE AND FACTORS ASSOCIATED WITH MALNUTRITION

(STUNTING, WASTING, UNDER WEIGHT) AMONG UNDER FIVE YEARS IN
MAKAMBAKO WARD JULY-AUGUST 2023.

COURSE INSTUCTOR: DR. MARIAM MUNYOGWA

COURSE NAME: COMMUNITY MEDICINE I

DEGREE PROGRAM: DOCTOR OF MEDICINE

NATURE OF ASSIGNMENT: INDIVIDUAL ASSIGNMENT

NAME OF STUDENT: ANGEL LUCAS PINDA

REGISTRATION NUMBER: T21-03-12664

SUPERVISOR NAME: DR. JAMES MASANYIWA.

Contents
1. INTRODUCTION...............................................................................................................................3
2. METHODOLOGY..............................................................................................................................4
2.1. Study area....................................................................................................................................4
2.2. Study design................................................................................................................................4
2.3. Study population..........................................................................................................................4
2.4. Sample size and sampling technique............................................................................................4
2.5. Data collection Technique...........................................................................................................4
2.6. Data measurement procedure.......................................................................................................4
2.7. Data collection tool......................................................................................................................5
2.8. Data processing and analysis.......................................................................................................5
3. RESEARCH FINDING.......................................................................................................................6
3.1. Demographic data of child...........................................................................................................6
3.2. Breast feeding and weaning.........................................................................................................6
3.3. Immunization and nutritional suppliments...................................................................................6
3.4. Prevalence of stunting, wasting, underweight..............................................................................7
5. STRENGTH OF THE STUDY...........................................................................................................9
6. LIMITATION OF THE STUDY.........................................................................................................9
7. CONCLUSION.................................................................................................................................10
 1. INTRODUCTION
Malnutrition occurs when an individual gets too few or too many nutrients, resulting in health
problems. Specifically, it is a deficiency, excess, or imbalance of energy, protein and other
nutrients which adversely affects the body's tissues and form. Malnutrition is a category of
diseases that includes undernutrition and overnutrition. Undernutrition is a lack of nutrients,
which can result in stunted growth, wasting, and underweight. A surplus of nutrients causes
overnutrition, which can result in obesity. In some developing countries, overnutrition in the
form of obesity is beginning to appear within the same communities as undernutrition.
Undernutrition remains one of the biggest health problems for developing countries. Recent
global estimates reported that 45% of all child deaths are due to various forms of undernutrition.
These rates are persistently higher in the Sub-Saharan Africa region. Tanzania southern
highlands regions are among the regions with malnutrition rates especially under nutrition,
higher than the national average, Njombe is among of the Tanzanian southern highlands regions
with 50.4% of children stunted, 12.2% were under weight and 14.1% were wasted.(Survey &
Indicators, 2022)
The causes for undernutrition in under-five children are complex and multifaceted. Poor socio-
economic conditions, food insecurity, poverty, and adverse conditions such as illness or
inadequate feeding practices can drastically alter the growth pattern of children. According to the
UNICEF conceptual framework, undernutrition can be caused by insufficient diet intake,
infections, poor breastfeeding or inadequate complementary foods. To date, numerous studies
have been conducted to examine the determinants of undernutrition in Tanzania. However,
available studies in the country have used conventional indices, rather than aggregated indicator
of CIAF. More studies are therefore needed to reveal the associated factors of anthropometric
failure particularly among children in Tanzania. This study aimed to determine the prevalence
(stunting, wasting, and underweight) and factors associated with malnutrition in Makambako
District, July 2023
 2. METHODOLOGY
2.1. Study area
This research was done in the street of Kivavi, Ward of Kivavi, Makambako Municipal in
Njombe region.
2.2. Study design
This study was conducted by using quantitative community research method based Cross-
sectional study, since it helps to assess both exposures and outcomes at the same time, it does not
consume a lot of time and it is less expensive. The quantitative methods helped to provide vital
information about the community examinations, surveys and records that no individual could
have obtained by observation. The field was conducted for five days starting from 28 th July 2023
to 1st August 2023 where the first day was a pilot day.
2.3. Study population
The study population in this research were children under five years of age and their parent/
guardians residing at Makambako ward in Makambako district, the population is more
vulnerable to malnutrition.
2.4. Sample size and sampling technique
The sample size in this study was 14 children which was obtained by simple random sampling
where children were selected randomly from Kivavi street households found in Kivavi Ward.
2.5. Data collection Technique.
Semi- structured questionnaire was used to collect data, questions listed in a questionnaire were
asked to the parents or guardians and their responses were recorded using an online data kit in
the mobile phone. The questions were based on demographic data, breast feeding habits, cultural
practice and environmental factors associated with malnutrition. Also weighing scale, MUAC
tape and length board was used to collect weight, MUAC and height/length respectively.
2.6. Data measurement procedure.
The anthropometric measurements used in our study include height, length and age. These were
used to determine anthropometric indices.
2.6.1. Measurement of age
The accurate child age was obtained by looking on RCH card, information from the parent or
guardian, or birth certificate of a child.
2.6.2. Measurement of height
For children aged from 6–24 months length was measured as follows: -
 • The mother or care-taker was assisted to take off shoes of a child and set hair properly so
that to avoid interference in measuring length
• Measuring board was placed on the flat surface to avoid errors then the child was laid on
the board, the assistant helps a measurer by supporting the back of the child head with
one hand and the trunk of the body with the other hand.
• Then after positioning the child well measurement was taken and recorded.
For children above 24 months measuring height was done as follows: -
• The measuring board was placed on the flat surface against the wall to avoid movement
of the board for correct measurement.
• The mother was asked to assist the child to take off the shoe and set the hair properly
during measuring height.
• Under the assistance of the parent or research assistance the child feet were placed
together at the center against the back and base of the board.
• Three body parts of the child was touch on the board head, shoulder and knees
• And the child was asked to look straight then measurement was recorded after child being
placed correctly.
2.7. Data collection tool
The instruments used to measure anthropometric measurements of children include;
• Measuring board for measuring height and length
• Weighing scale (SECA scale)
• MUAC Tape
• Mobile smart phone for recording answers of respondents and data obtained from
anthropometric measurements.
• RCH card or birth certificate to obtain age of a child.
2.8. Data processing and analysis.
Kobo toolbox software was used to collect data. The Statistical Packages for Social Science
software (SPSS) version 25 and ENA for smart was used to analyses data in order to classify the
nutritional status. SPSS used to process data concerning demographic data, breast feeding
practice, complementary breast feeding, cultural practice and environmental factors associated
with malnutrition. ENA used to process and analyses data concerning age, weight, height and
MUAC.
3. RESEARCH FINDING
Research finding have been presented according to the sections of interview schedules. Some
data have been grouped together to give an overall picture. Data have been presented using
frequency tables to communicate research findings. Table were used because they are easy to
understand and can be used for all types of data.
3.1. Demographic data of child
A total of 14 respondents were recruited in this study. Most of children were male equal to 57.1
%, females were 8 equals to 42.9%.
Criteria n %
Sex/Gender

Male 8 57.1
Female 6 42.9

3.2. Breast feeding and weaning

All the children were breastfed (100%). Also 78.6% of the children were complementary
breastfeed at the age of 6 months.
Exclusive breastfeeding
<6 months 3 21.4

>6 months 11 78.6

Complementary breastfeeding
<6 months 3 21.4
>6 months 11 78.6
Weaning
< 6 months 2 14.3
>6 months 12 85.7

3.3. Immunization and nutritional supplements

92.9% of the children got immunization as required by all children under five. And none missed
the Vitamin A drops.
Criteria n %
Immunized 13 92.9
Not immunized 1 7.1
Vitamin
 Given 14 100
Not given 0 0
Ant-helminths
Given 13 92.9
Not given 1 7.1

3.4. Prevalence of stunting, wasting, underweight.

This study shows that no one was underweight, 7.1% has wasting and 28.6% had stunting.
Criteria n %
Stunting
Normal 10 71.4
Stunting 4 28.6
Wasting
Normal 13 92.9
Moderate 1 7.1
Underweight
Normal 14 100
Underweight 0 0
4. CHALLENGES
 Lack of enough measuring instruments made a delay in measurements taking and hence
data collection took a long time.
 Lack of funds from the Government. Most of the students are beneficiaries of HESLB
(Loan’s board) and since HESLB did not provide research funds and accommodation fees
were a problem among students.
 Most of the parent not being at home made it hard to obtain the information required for
research hence losing a lot data
5. STRENGTH OF THE STUDY
 The study helped to determine the prevalence of malnutrition (stunting, wasting, and
underweight) at Kivavi ward in Njombe region.
 Also helped to assess factors contributing to malnutrition.

6. LIMITATION OF THE STUDY

 The sample size used 14 was too small to be representative of the population due to
limited time of conducting the study.
 The study relied on participants’ self-reported data, which is prone to recall bias and
social desirability bias.
 Some eligible participants were not available to participate in the study.
 RCH cards were missing especially for the children between 3 years old and 5 years old.
 A large sample of participants could not be obtained because of time constraints.
7. CONCLUSION
This study shows that 28.6% were stunted, none was underweight, and 7.1% was wasted.
Malnutrition among children aged 6 to 59 months remains a challenge which needs health
workers to sensitize the mothers and care- takers on the causes and prevention of malnutrition.
The study has revealed a lot of details about the characteristics of respondents. Most of the
respondents were found to unemployed with low level of income and low level of education. The
cause of malnutrition among this families was found to be multifactorial: inability to provide for
the child’s nutritional needs, poor breastfeeding practice, and presence of infectious disease such
malaria, diarrhea, pneumonia which lead to acute malnutrition.
Due to this finding’s education should be given to the parent on the importance of breastfeeding
and winning and also should be advised to have habit of taking their children to the health Centre
for early diagnosis and treatment of infectious disease.