My Research Proposal

ASSESSING THE KNOWLEDGE OF NURSING MOTHERS ON THE PREVENTION AND MANAGEMENT OF
MALNUTRITION IN CHILDREN 0-5 YEARS OF AGE
CERTIFICATION
This is to certify that the research proposal entitle “ASSESSING THE KNOWLEDGE OF
MOTHERS ON THE PREVENTION AND MANAGEMENT OF MALNUTRITION IN
CHILDREN 0-5 YEARS at the Bonassama District HOSPITAL DOUALA’’ proposed by
EMADE GWENDOLINE NGEH MATRICULATED 20HNDNU205 a final year student in
Higher National Diploma nursing has been read by the authorities of ALPHA HIGHER
INSTITUTE DOUALA and meet the requirements for research authorization
SUPERVISOR: Mme, AJOH VALERIE
SIGN………………………………
DATE………………………………
DEAN OF STUDY: Mr. ATONGNO ASHU
SIGN……………………………………
DATE……………………………………
LIST OF ABBREVIATION
i
WRITTEN AND PRESENTED BY UKAH ERIC NGIEH
i WHO: World health organization
ii IWC; Infant welfare clinic
iii ANC: Antenatal care.
iv 0RS: 0ral rehydration salts.
v NS: Nasogastric tube.
vi FBC: Full blood count.
vii HIV Test: -Human immune virus test.
viii PEM: Protein energy malnutrition.
ix Urine MC&S: Urine for microscopy, culture and sensitivity.
x PEM-: Protein energy malnutrition
xi SDGs: Sustainable Development Goals
xii MUAC: Mid upper arm circumference
xiii UNICEF: United nation children emergency fund
xiv BMI: Body mass index
ABSTRACT
ii
Background: Malnutrition is a condition that develops when the body does not get the required
food nutrients in their correct proportions. Malnutrition is also a result of underfeeding or
overfeeding. Increased nutritional needs such as vitamins, minerals, carbohydrate protein
supplements in children can help reduce further complications. This study will be carried out at
the Bonassama District Hospital. Malnutrition has been a public problem since the existing of
man, many young children particularly those poor socio-cultural background in the developing
countries suffer from malnutrition deficiency and infection (Grantham-M et al 2019). The aim of
this study is to assess mothers on the prevention and management of malnutrition in children 0-5
years of age.
Methodology: This study will be carried out at the Bonassama District Hospital Douala. This
study will be a cross sectional study. The target population will include having children below
five years of age. A random sampling technique will be used to collect data. Questionnaires will
be given to the participants to respond to the various questions. A sample size of 106 mothers
will be evaluated. Data will be collected and presented using tables and chart.
Results: The result will be calculated using excel and presented in percentages and frequency in
tables and chart.
Discussion: This will be determined on the results gotten from the participants (nursing
mothers) on the prevention and management of malnutrition in children 0-5 years of age.
Conclusion: After collecting the data, the data will be analyzed and presented. Conclusion will
be based on responses of nursing mothers if they have adequate knowledge on the prevention of
malnutrition in children or not.
Recommendation: After collecting the data and presenting, if nursing mothers have inadequate
knowledge on the prevention and management of malnutrition, more teaching will be encourage
during ANC and IWC on the management, prevention, effects, causes of malnutrition in children
0-5 years of age especially with women with low educational level.
Keywords: Mothers, knowledge, prevention, management, malnutrition, children.
TABLE OF CONTENTS
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CERTIFICATION……………………………………………………………………….i
DEDICATION………………………………………………………………………….ii
ACKNOWLEDEMENT…………………………………………………………………….iii
LIST OF ABBREVIATION……………………………………………………………………..iv
ABSTRACT………………………………………………………………………………….v
LIST OF TABLES
2.1 F75 COMPOSITION………………………………………………………………….
2.2 F100 COMPOSITION……………………………………………………………………
CHAPTER ONE: GENERAL INTRODUCTION
1.1 BACKGROUND………………..……………………………………………………………
1.2 PROBLEM STATEMENT…………………………………………………………………
1.3: RESEARCH OBJECTIVE………………………………………………………………….
1.3.1GENERAL OBJECTIVES………………………………………………………………….
1.3.2 SPECIFIC OBJECTIVES…………………………………………………………………..
1.4 RESEARCH QUESTION………………………………………………………………….
1.5 HYPOYHESIS……………………………………………………………………………..
1.6 SIGNIFICANT OF THE STUDY………………………………………………………….
1.7: DEFINITION OF TERMS………………………………………………………………
CHAPTER TWO: LITERATURE REVIEW
2.1 MALTRITION IN CHILDHOOD……………………………………………………….
2.2 PREVALENCE…………………………………………………………………………….
2.3 CAUSES OF MALNUTRITION…………………………………………………………….
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2.4 PATHOPHYSIOLOGY OF MALNUTRITION………………………………………...
2.5 TYPES OF MALNUTRITION………………………………………………………………
2.5 GENERAL SIGNS AND SYMPTOMS………………………….……………………….
2.6 DIAGNOSIS AND MEASUREMENT…………………………………………………
2.7 MANAGEMENT…………………………………………………………………………
2.8 PREVENTION….…………………………………………………………………….
2.9 COMPLICATION…………………………………………………………………………
2.10 NUTRITIOPNAL THERAPY………………..……………………………………………
2.11 TREATMENT……………………………………………………………………………..
2.12 PROGNOSIS……………………………………………………………………………
CHAPTER THREE: METHODOLOGY
3.1 STUDY AREA…………………………………………………………………………..
3.2 STUDY DESIGN………………………………………………………………………
3.3 TARGET POPULUTION………………………………………………………………….
3.3.1 INCLUSIVE CRITERIA………………………………………………………………….
3.3.2 EXCLUSIVE CRITERIA……………………………………………………………….
3.4 SAMPLE TECHNIQUE OR METHOD…..…………………………………………….
3.5 VALIODATION OF INSTRUMENT……………………………………………………..
3.6 ADMINIWSTRATION OF INSTRUMENT……………………………………………
3.7 SAMPLE SIZE…………………………………………………………………………….
3.8 DATA COLLECTION……………………………………………………………………
3.9 DURATION OF STUIDY…………………………………………………………
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3.10 ETHICAL CONSIDERATION…………………………………………………………
3.9 LIMITATION OF STUDY……………………………………………………………….
CHAPTER FOUR
RESULT…………………………………………………………………………………
CHAPTER FIVE
5.1 DISCUSSION………………………………………………………………………….
5.1.1 KNOWLEDGE OF NURSING MOTHERS ON MALNUTRITION………………
5.1.2 NURSING MOTHERS KNOWLEDGE ON THE PREVENTION OF MALNUTRITION...
5.2 CONCLUSION……………………………………………………………………………
5.3 RECOMMENDATION………………………………………………………………
APPENDIX
REFERENCE……………………………………………………………………………….
QUESTIONNAIRE……………………………………………………………………………….
CURRICOLLUM VITAE…………………………………………………………………..
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CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND
One out of three people in the world suffer from malnutrition. Broadly speaking, malnutrition is
the lack of sufficient nutrients in the body; such nutrients include protein, fat, vitamin,
carbohydrate, minerals needed for growth (Dawit G, et al 2021). Malnutrition can also occur
when and individual diet does not provide him/her with adequate calories and protein needed for
maintenance and growth or when the body cannot fully utilize the food due to illness.
Consequently, the role of nutrition is to promote good health and the prevention of disease which
has always been of interest to consumers, scientist, the food industry and others stakeholder as
this information can be useful in developing new products. All this is to prevent nutritional
disease like marasmus and kwashiorkor which occur as a result of protein calories deficiency. A
review of the content of nutrition polices in different countries suggest that these polices have the
same generation mostly aiming at supporting children (Tahlramani, et al 2021). The main type of
malnutrition is protein energy malnutrition which is as a result of deficient micronutrients, which
is further divided into three which are acute, chronic, and wasting malnutrition. There is still
knowledge on the prevention and manage of malnutrition among mothers (Ragab Mahfouz,
Kanniammal Ch., 2017)
Many young children particularly those from poor socio-cultural environments in developing
countries suffer from nutritional deficiencies and infection. There is now evidence to indicate
that this deficiencies and infections may affect the children cognitive, motor, and behavioral
development, both in pre and postnatal (Megan A, et al, 2021). As described by WHO [2008],
nutrition is the foundation for health and development as good nutrition means stronger immune
system, less illness and better health for people at all ages. Healthy people are stronger and can
contribute better in the development of their societies. Nutritional status is considered an
indicator of nutritional development since nutrition is both an input into an output of the
development process (FAO, 2020). Malnutrition in children below 5 years can occur as a result
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of under nutrition which can be chronic (stunted) or acute and characterize by loss of weight,
known as wasting, there are about 1080000 under five with chronic under nutrition and 375000
of them are on the northern region of Cameroon and severe micronutrients deficiencies in a
person diet because they are critical for development, their absence for example vitamin A
deficiency (about 38.8% of children suffer from vitamin A deficiency) is a leading cause of
blindness in children according to WHO. For children 6-59 months and women of child bearing
age, 68.9% and 44% respectively are anemic (EDS, 2016).
The information available from various surveys (EDS, 2016 and 2019), for the past fifty years
shows that malnutrition remain a serious public health problem in Cameroon. It is a Major
contributor to the disease and death burden of the population. There are high child mortality rate
especially in northern regions. In 2004, the overall under five (<5) mortality rate in the country
was 144 deaths per 1000 live birth (e.g. 3 out of 20 children died before the age of five). It was
estimate that about 105000 child deaths occurs per year and 40000 of this are in northern
Cameroon. Under nutrition is the major cause of child mortality. Mild to moderate under
nutrition explain about 80% of the burden of child mortality is as a result of under nutrition.
The sustainable development goals (SDGs) adopted in 2015 was developed to end poverty by
2030 which is the leading cause of malnutrition. The SDGs reduce 40% of children who was
stunted and dropping childhood wasting less than 5% Progress on exclusive breastfeeding for 6
months was encourage which reduce the rate of malnutrition of about 50%. The WHO categories
exclusive breastfeeding as a Cornerstone of child survival and child health, because it provide
irreplaceable nutrition.
1.2 PROBLEM STATEMENT.
Malnutrition has been a public problem since the existence of man. many young children
particularly those of the poor socio-cultural environment in the developing countries suffer from
malnutrition deficiencies and infection (Jacent K, et al 2021).Despite all the available methods of
malnutrition and prevention techniques available, children from 0-5 years still suffer die of
malnutrition especially in the less develop countries like Cameroon and also the awareness raised
by public media and health problem. This explain why many children 0-5 years still die of
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malnutrition because of poor knowledge on it management (Ragah Mahfouz 2017). The

management of moderate acute malnutrition is inadequate (Reginal A, Patrick Webb 2020)
It is for this reason that the researcher want to go into the field and assess the knowledge of
mothers on the prevention and management of malnutrition in children 0-5years of age.
1.3 RESEARCH OBJECTIVES
1.3.1 General Objective
This study is aim at assessing the knowledge of mothers on the prevention and management of
malnutrition in children 0-5 years of age at the Bonassama District Hospital.
1.3.2 Specific Objective

i) To assess the knowledge of mothers on prevention of malnutrition in children 0-5 years of age
ii) To assess the knowledge of mothers on the management of malnutrition in children 0-5 years of
age.
1.4 RESEARCH QUESTION

i) How are mother’s knowledgeable on the prevention of malnutrition in children 0-5 years of age?
ii) How knowledgeable are mothers at the Bonassama District Hospital on the management of
malnutrition in children 0-5 years of age?
1.5 HYPOTHESIS.
i) Mothers have adequate (good) knowledge on the prevention of malnutrition in
children 0-5 years of age at the Bonassama District Hospital.
ii) Mothers at the Bonassama District Hospital have poor knowledge on the
management of malnutrition in children 0-5 years of age.
1.6 SIGNIFICANT OF THE STUDY
This study that will be carried out at the Bonassama District Hospital is a hospital based
research aim at raising awareness and providing adequate knowledge on the prevention and
management of malnutrition to the mothers in order to improve their knowledge on the
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prevention and management of malnutrition in children 0-5 years of age to prevent the
prevalence rate of malnutrition in their children. Data collection during this research will be
used to write a project which will serve as a partial fulfillment of the requirements for award of a
Higher National Diploma in nursing science and a copy deposited in school will serve as a
reference to other students who will desire to carry another research on the same topic.
1.7 DEFINITION OF TERMS.
i) Prevention; the act of stopping something from happening or stopping someone from doing
something
ii) Management: the process of administering and controlling the affairs of the organization
irrespective of its nature, type, structure and side.
iii) Nursing mothers: A mother who is breastfeeding her baby.
iv) Malnutrition: it is a condition in which nutrients Is defective in quantity or quality.
v) Food: Anything which when taken into the body, serves to nourish or build up the tissue or to
supply body heat.
vi) Nutrients: This are compounds in foods essential to life and health, providing us with energy,
the building blocks for repair and growth and substances necessary to regulate chemical process.
For example carbohydrate, protein, fats, water, minerals and vitamin,
vii) Diet: It is the customary amount and kind of food and drinks taken by a person from day to day
in a given locality.
viii) Balance diet: varied diet that contain all the nutritional element in their correct quantity
required for growth and repair of body tissue
vii) Calories: It is the amount of energy needed by the body to perform it daily activity and it is
gotten from food substances or nutrients.
xi) Malnutrition: it is a condition in which nutrients Is defective in quantity or quality.
x) Under nutrition: This is when a person does not ingest an adequate supply of nutrients.
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xi) Over nutrition: This is when a person consumes more food or nutrients supplements more than
the body needs. Any type of nutritional disorder may interfere with body process which can lead
to poor functioning of the body system.
Xii) Marasmus: It is a chronic undernourishment occurring especially in children and usually caused
by a diet deficient in calories and protein.
Xiii) Kwashiorkor: It is a severe condition that occurs as a result of inadequate amount of protein in
the diet.
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CHAPTER TWO
LITERATURE REVIEW
2.0 INTRODUCTION
Malnutrition is define as the insufficient, excessive or imbalance consumption of nutrients that

the body need for growth and maintenance of tissue functioning. Malnutrition is a broad term
that refers to all deviation from adequate and optimal nutritional status (Sri U, et al.2021
malnutrition), resulting from specific nutrients deficiency. Malnutrition is a condition that results
from either not enough nutrients or too much, such can cause health problem. It may involve
calories, protein, carbohydrate, vitamin or minerals. Individual suffer from under nutrition if
their diet does not provide them with adequate calories and protein for maintenance of growth or
it can be as a result of the body being unable to utilize the nutrients as a result of a disease
condition. Malnutrition is group into two that is under nutrition and over nutrition. Over nutrition
is hyper consumption of calories and nutrients beyond necessary for growth, development,
metabolic function. Over nutrition can lead to obesity. Under nutrition from inadequate intake of
dietary energy intake and can equally be caused by infection which limit absorption of key
nutrients (Ivan E, et al.2020)
Malnutrition results from a poor diet and lack of nutrients. It happen when the intake of nutrients
energy is too high, too low or poorly balance. Under nutrition can lead to delay growth or
wasting while diet that provide too much food, but not necessary balance lead to obesity.
According the WHO, malnutrition is a greatest threat to public health.
Malnutrition in children is a global problem and lead to irreversible negative health outcomes.
The WHO estimate that about 54% of child mortality worldwide (walker) edited by [Emily C, et
at 2021] about one million children. Another estimate also by WHO state that the childhood
underweight is the cause of about 35% of children under the age of five years worldwide (DawIt
G, et al 2021).
Chronic malnutrition occur as a result of inadequate nutrition over a long time and it is not
always visible as acute malnutrition. This kind can begin from the uterus as a result of poor
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maternal nutrition and persist through inadequate feeding practice and sub optimal food quality
(Predergast A, et al 2014). Further exposure to bacterial infection can worsen the condition.
2.1 MALNUTRITION INCHILDHOOD
Malnutrition is one the leading cause of child mortality in the world. In 2013, the WHO reported
about 45% of all childhood deaths. Malnutrition is one of the leading factor of death in most of
the children diagnose with diarrheal disease of about 60.7%, 57’2% associated with malaria,
52.3% associated with pneumonia, and 44.8% associated with measles (Tahiramanio G, et al
2021])
Children who are undernourished are said to be short in childhood, have low educational
achievement and economic status, Children mostly face with malnutrition during the age rapid
development which can have long lasting impact on health. This children are mostly vulnerable
during the first 1000 days following conception. Inadequate during this period can lead to
delayed and impaired cognitive and physical behavior. This malnutrition based damage is largely
irreversible and can increase risk for developing disease later in life [counter JBS 2014]. In 2019,
the International Child Development Steering Group found that children raise with limited access
to nutrition resources were less likely to be socially and economically productive adults (Rigah
M, et al 2017)
2.2. PREVALENCE OF MALNUTRITION
Globally, malnutrition remain one of the greatest factor of illness and death in children. It
children and pregnant women inversely. It is the direct cause of death of about 300000 per year
and indirectly responsible for about half of all death in children. For example malnutrition
increases the risk of death from diarrhea, malaria, lower respiratory tract infection and measles.
In 2015, the world Health Organization estimated the prevalence of malnutrition

worldwide of about 17.6% and most of the where from the developing countries in southern Asia
Sub Saharan Africa. And some of this population will be stunted growth due to poor nutrition.
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2.3 CAUSES OF MALNUTRITION
i) POVERTY
Poverty is one of the major cause of poverty and food prices, dietary practice and agricultural
productivity with many individual cases being a mixture of several factors. Clinical malnutrition
such as cachexia [ disease associated malnutrition which is a complex syndrome characterized by
the progressive deterioration of nutritional status leading to reduce appetite and food intake], is a
major burden also in the developed countries various scales of analysis also have to be
considered in order to determine the socio-political causes of malnutrition. For example a
community that have poor government may be at risk if the area lack health related services but
some individual may be at high risk due to differences in income level or level of education
(Ivan E, et al 2018).
ii) DISEASES.
Malnutrition can be a consequence of health issues such as gastroenteritis (Menduell G, et al

2019) principle and practice of infection disease chronic illness, especially thee HIV/AIDS
pandemic (Baro, M, et al 2006), perspective in vulnerability, famine and food in sub Saharan
Africa. Diarrhea and other infection can cause malnutrition through decrease nutrients
absorption, decrease intake of food, increase metabolic requirement, and direct nutrients loss
parasite infection, in particular intestinal worm infection (helminthiasis), can cause malnutrition.
Diarrhea and intestinal worm infection is as a result of lack of hygiene and sanitation. Some
people may become malnourished due to abnormal nutrients loss due to diarrhea and chronic
illness affecting bowel (Ragah et al 2017)
iii) OVER NUTRITION
It can be caused by overeating, it is also a form of malnutrition. In the United State more than
half of all adults are now overweight, a condition that increases the susceptibility to decrease and
lower life expectancy (Dawit G et al 2021). Many parts of the world have access to surplus non-
nutritive food in addition to increase sedentary lifestyle. Yale psychologist Kelly Bronell calls
this a “toxic food environment” where fat and sugar laden food have taken precedence over
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healthy nutritious food (Anas A, 2020). Overeating causes heart diseases and diabetes and even
death.
iii) LACK OF SAFY DRINKING WATER
Water is synonymous with life. Lack of potable water, poor sanitation, and poor hygiene
practice increased vulnerability to infectious and water borne disease, which are direct causes of
acute malnutrition.
Malnutrition is caused not only by food scarcity, but also by lack of access of safe toilet, clean
water, and awareness of good hygiene practices. This condition enables dirty water to transmit
diseases like diarrhea which can prevent children’s bodies from absorbing the nutrients in their
food. Malnutrition is both a cause and a consequence of ill health. We tend to visualize
malnutrition as solely affecting starving children in the developing world but it is common at
home particularly in elderly and hospitalized population and massively increase a patient’s
vulnerability to decreased.
v) CONFLICT
Conflict has a direct impact on food scarcity, drastically compromising access to food. Often
forced to flee as violence escalates, people uprooted by conflict lose access to their farms and
businesses, or other means of local food production and markets. Abandoned field and farms no
longer provide food broader distribution circuits. As a result, food supplies to distributors may
be cut off, and the many population dependent on them may be unable to obtain sufficient food.
vi) CLIMATE CHANGE
Climate change has increased substantially. The effects of climate change are often dramatic,
devastating. Infrastructure in this areas are often damaged or destroyed. Disease spread quickly;
people can no longer grow crops or raise livestock.
According to UN over 40 developing countries, has decline in agriculture production caused

either directly or indirectly by climate change could dramatically increase the number of people
suffering from hunger in the coming years.
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2.4 PATHOPHYSIOLOGY OF MALNUTRITION
Malnutrition result from an imbalance between intake and protein energy requirements resulting
in tissue losses with adverse functional consequences. Adaptation to nutrients deficiency aims at
establishing lasting saving conditions by promoting optimization of energy reserve utilization
while preserving protein pool. This is achieved by reducing basal metabolism (low T3), by
decreasing the secretion of anabolic factors and moderately increasing catabolic hormones.
Unlike the previous process, the metabolic response to injury and stress, which will sometime
induce major increase in requirements, will have an immediate purpose the defense of the
organism. The body will draw sometime substantially in it protein pool to produce the glucose
required for example by the immune cells. Stress response stems from both an endocrine
response, an immune-inflammatory one with the important role of pro-inflammatory cytokines
released in response to pathogens and more recently alarming in response to endogenous stress in
the inflammatory phenomena of the stress response and in the resulting malnutrition state.
Malnutrition can lead to various secondary health problems that impact mortality and morbidity.
Deficiencies of vitamin A, found in a variety of green vegetables, can lead to blindness and
increased rates of infection. Long term vitamin c deficiency can cause survey, micronutrients
disease whole symptoms begin with general malaise, anemia and gingivitis, but if left untreated
can cause loss of teeth, neuropathy, and even death. Other trace nutrient deficiencies such as
those from iron and iodine yield anemia and goiters, the enlargement of the thyroid gland. Under
nutrition affect almost every organ system, including the cardiovascular system, liver,
genitourinary system, gastrointestinal tract, immune system endocrine system, metabolism and
circulation, circular function, skin, and glands. Concurrent condition may exhibit themselves
differently in undernourished individualS
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2.5 MAIN SIGNS AND SYMPTOM OF MALNUTRITION
There are two main signs and symptoms
2.5.1 MARASMUS
Marasmus always results from a negative energy balance in all forms, including protein. Obvious
loss of weight with gross reduction in muscle mass especially from limbs girdles. Subcutaneous
fat virtually absent. Thin atrophic skin lies in folds.
-Pinched face has appearance of old man’s or monkey.
-Alopecia and brittle hair.
-Sometimes appearance of lanugos hair
2.5.2 KWASHIOKOR
(Often a sign that the tissues within the liver isn’t functioning properly) and pitting edema
Dry, dark skin which spits where stretched over usually occur in children age 1-2 years with
changing hair color to red, grey, or blonde.
- Protein deficiency with adequate energy intake.
- Moon faces, swollen abdomen (pot belly) hepatomegaly and pitting edema.
- Nutritional dwarfism.
2.6 GERERAL SIGNS AND SYMPTOMS OF MALNUTRITION
- Skin may be become thin, dry, inelastic, pale and cold
- Eventually as fat in the face is lost, the checks look sagged and the eyes sunken.
- Sometimes severe malnutrition may lead to unresponsiveness (stupor)
- If calories deficiency continues for long enough, there may be heart, liver and respiratory
failure
- Hair becomes dry and sparse, falling out easily.
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- Loss of fat
- Breathing difficulties, a high risk of respiratory failure
- High risk of complications after surgery
- High risk of hypothermia abnormally low both temperatures.
- High susceptible to feel cold
- Longer recovery from infection and illness.
- Diarrhea, fatigue.
- Face shape may be affected by side of teeth.
2.7 DIAGNOSIS AND MEASUREMENT
Most malnourished children are not diagnosed until a health crisis, such as an infection, leads
them to seek medical attention. Because malnutrition is a broad-spectrum disorder and not linked
to a specific pathogen, there is no single test to confirm a diagnosis. In 1999, the WHO
introduced a set of measurement guild line for the identification and treatment of acute
malnutrition based upon the practice of facilities with the lowest rates of mortality (picot J,
2018). There is form of SAM; Kwashiorkor caused by insufficient protein intake and
characterized by rapid deterioration in nutritional status and characterized by extreme wasting of
fat and muscle; and previous forms UNICEF
There are four methods of assess a person’s status; Anthropometry, biochemical assessment,
clinical assessment and dietary intake assessment. Anthropometric measurement is the most
common method; it compares an individual’s body composition and physical measurement
(example height, weight, mid upper arm circumference-MUAC) body mass index(BMI) to
expected values for a person of the same sex and age(United Nation System Standing Committee
on nutrition).
Anthropometric surveillance of a population can identifies major nutritional problems such as

famine and is the most efficient means to assess required nutritional intervention, such as
additional screening and supplementary or therapeutic feeding (Karaolis N, et al 2007).
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Clinical manifestation of malnutrition such as bilateral edema (fluid retention) and visible
wasting offer in sight to the health status of an individual and can aid in diagnosis. Biochemical
test, such as blood or urine test can identify lipid, vitamin, mineral and protein concentration
(United nation System Standing Committee on nutrition 2015).
Physical assessing the intake of an individual over a given period of time accurately identified
the quality and quantity of his or her diet. However, these assessments are very invasive,
expensive and time- consuming and they require substantial biochemical and laboratory
infrastructure (United Nation System Standing Committee on nutrition 2015).
2.8 MANAGEMENT
i) Complementary feeding and hygiene practices of mothers is very important in malnourished

children (Richard B Kajjura, Frederick J 2019)
ii) Check electrolyte level once daily for one week, and at least three times in the following week
iii) Any severely malnourished child should be stabilized and treated in an impatient
environment. Re-feeding should start at 100kcal/day, every 2 hours and is usually with milk –
formula called F75. Those with severe malnutrition without complications and who are able to
accept and tolerate therapeutic food can be monitored in outpatient and treatment in the
community. They should be re-fed at 175kcal/kg/day, usually with a therapeutic feed known as
F-100.
iii) In children, there is often co-existing infection. This has such a high prevalence that WHO
recommends use of empirical antibiotics for the first 7 days.
iv) Vitamin supplementation should be started immediately, before and for the first 10 days of
resending.
v) Hypoglycemia should be treated with IV glucose and/ or oral rehydration sucrose.
vi) Cases showing hypothermia require warming.
vii) Rehabilitation phase of treatment; starts as the child’s appetite return usually a week after
treatment is started. Many essential nutrients are still deficient. In the developing world, the use
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of fortified spread (such as peanut butter carrying proteins- rich milk powder and micronutrients
powders) have been used to treat acute moderate malnutrition in the community.
viii) Progress is monitored by regular weighting with weight gain target of 10-15g\kg\day. Return
visit to our patients can stop malnutrition. It is also our role to educate mothers to know the type
of diet for their children after weaning so as to meet up their nutritional demand and the times to
introduce the feedings to those children.
ix) Furthermore, it is also our duty to educate women breast feeding policy [introduce in 2015 by
SDGs] and the important of the first breast milk. This colostrum is yellowish in color and very
nutritive. But since some women ignorant, they squeeze the “colostrum “and throw. We should
insist on telling them or educating them to give these colostrum to their babies and breast feed
exclusively for six months to prevent malnutrition.
x) Again, it is also the role of the nurse to educate the women on the duration of breast feeding during
antenatal clinic and infant welfare clinic to managed and prevent malnutrition. Women should
breast feed their children for at least 10-15 minutes on one breast but since some women do not
have time, they spent less time to breast their children leading them to go malnourished.
xi) Another role of the nurse to managed and prevent malnutrition is too educate mothers with special
cases those cases include mother with human immune virus because their babies are forbidden
from breast milk for their babies to have enough to eat at all times than to go for expensive ones
which at all might not be available causing babies to starved and go malnourished.
xii) It is equally the role of the nurse to be taking weight curve of the child during infant welfare
clinic. This is because it is one the best index in accessing the state of health of an infant so as to
rapid decrease.
2.9 PREVENTION
The best way to prevent malnutrition is to eat a healthy, balanced diet and a nutritive diverse that
is you need to eat a variety of food from the main food groups, including plenty of fruits,
vegetables, plenty of bread, rice, potatoes, pasta and other starchy food. Immunization and
supplement any nutrients for children can also lower the burden of severe and moderate
malnutrition (Duggan MB 2014). In contexts where access to sufficient food is limited,
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malnutrition prevention initiatives are critical to identifying and reducing chronic and acute
malnutrition, especially among children. Mother’s knowledge should be upgraded on the
management and feeding of children under five years of age [Int j pharm clin Res 2018].
For the first six months of life, exclusive breast feeding is the best source of
nutrition for infants under six months. It enhances infant and maternal health by providing
essential antibiotics, enzymes and easily digestible nutrients. Breast fed infant are less likely to
suffer from infectious diseases, diarrhea and severe bacterial infections, reducing infant
morbidity and death. Exclusive breast feeding also contribute to women’s health by lowering
female producing offspring (fecundity) and increasing birth intervals, possible benefiting infants
for years to come (UNICEF 2015). United Nations International Children’s Emergency Fund.
Adoption of exclusive breastfeeding may require addressing colostrum cultural beliefs, training
health professional and Para professional, and providing educational support. In 2006, WHO, the
World Food Programmed (WFP), and the UN began promoting “community-based management
of acute malnutrition” to improve adoption of exclusive breast feeding and other preventives
strategy (WHO, UNICEF and SCN 2020). Community health workers (CHWs) meet with
mothers individually or in small groups at local health posts primary care clinic, or participant’s
homes to educate them about the practice and benefit of breast feeding (UNICEF)
Other factor associated with malnutrition include limited clean water access, low
maternal education and body mass index, low household calories intake, and the absence of a
toilet in the home (Babatune R, et al 2011).several studies indicate that female children tend to
be more underweight, stunted and wasted than male children. Some suggest that this is due to
part of gender discrimination in the allocation of the household food resources (Ndiku M, 2016).
2.10 COMPLICATION
The consequences of severe malnutrition
i Impaired immune response and increase of infection
ii Reduced muscle strength
iii Impaired wound healing
15
iv Impaired psycho social function including poor cognition and increased depending.
v Impaired recovery from illness and surgery
vi Proper health outcome in the weight will indicate malnutrition
2.11 NUTRITIONAL THERAPY
There are two types namely; F75 and F100
2.1 TABELE ONE: F75 COMPOSITION
35g protein 1 sachet of milk

Cereal 7 teaspoons
Sugar 30g (6 cubes)
Oil [vegetable oil] 20ml aspirated with a syringe
Multivitamin with micronutrient 20ml
2.2 TABLE TWO: F100 COMPOSITION
Water 1liter
Sugar 30g (6cubes)
Oil [vegetable oil] 20ml aspirated with syringe
Multivitamin and micronutrients 20ml
110 protein 3 sachet of milk
FEEDING ADMISSION
To avoid overloading the intestine, liver and kidneys, it is essential that food be given frequently
and in small amounts. Children who are unwilling to eat should be fed by NG tube (do not use
IV feeding.) children who can eat should be given the diet every 2, 3, or 4 hours, a day and night.
If vomiting occurs, both the amount given at each feed and intervals between feeds should be
reduces.
16
The F75 diet should be given to all children during the initial phase of treatment. The child
should be given at least 80kcal or 336kJ/kg, but no more than 100kcal or 420KJ/kg per day. If
less than 80 kcal or 336kJ/kg per day are given, the tissue will continue to be broken down and
the child will deteriorate. If more than 100kcal or 420Kj per day are given, the child may
develop a serious metabolic imbalance.
Nearly all malnourished children have poor appetite when first admitted to hospital. Patience and
coaxing are needed to encourage the child to complete each feed. The child should be fed from a
cup and spoon; feeding bottles should never be used, even for very young infants, as they are an
important source of infection. Children who are very weak may be fed using a dropper or a
syringe. While being fed, the child should always be held securely in a sitting position on the
attendant’s or mother’s lap. Children should never be left alone in to feed themselves.
NASOGASTRIC FEEDING
Despite coaxing and patience, many children will not take sufficient diet by mouth during the
first days of treatment. Common reasons include a very poor appetite, weakness and painful
stomatitis. Such children should be fed using a NG tube. However, NG feeding should end as
soon as possible. At each feed, the child should first be offered the diet orally. After the child has
taken as much as he or she wants, the remainder should be given by NG tube. The NG tube
should be removed when the child is taking three-quarter of the day’s diet orally, or takes two
consecutive feeds fully by mouth. If over the next 24 hours the child develops abdominal
distension during NG feeding, give 2ml of a 50% solution of magnesium sulfate IM.
The NG tube should always be aspirated before fluids are administered. It should also be
properly fixed so that it cannot move to the lungs during feeding. NG feeding should be done by
experienced staff.
FEEDING AFTER THE APPETITE IMPROVES
If the appetite improves, treatment has been successful. The initial phase of treatment ends when
the child becomes hungry. This indicates that the infections are coming under control, the liver is
able to metabolize the diet, and other metabolic abnormalities are improving. The child is now
ready to begin the rehabilitation phase. This usually occurs after 2-7 days. Some children with
17
complication may take longer, whereas other are hungry from the start and can be transferred
quickly to F-100.Nevertheless, the transition should be gradual to avoid the risk of heart failure
which can occur if the children consume large amount of feed. Replace the F75 diet with an
equal amount of F100 for 2 days before increasing the volume offer feed. It is important to note
that it is the child’s appetite and general condition that determine the phase of treatment and not
the length of time since admission.
ORAL REHYDRATION SALTS (ORS) SOLUTION FOR SEVERE

ALNOURISHED CHILDREN
Severe malnourished children are deficient in potassium and have abnormally high level of
sodium; the oral rehydration salts (ORS) solution should contain less sodium and more
potassium than the standard WHO- recommended solution. Magnesium, zinc and copper should
also be given to correct deficiencies of these minerals. The composition of the recommended
ORS solution for severely malnourished children.
ResoMal is available commercially. However, ReSoMal can also be made by diluting one packet
of the standard WHO- recommended ORS in 2 liters of water, instead of 1litre and adding 50g of
sucrose (25g/l) and 40 ml(20ml/l) of mineral mix solution.
AMOUNT OF RESOMAL TO GIVE
Between 70 and 100ml of resomal kg of the body weight is usually enough to restore normal
hydration. Give this amount over 12 hours, starting with 5ml/kg every 30minutes for the first 2
hours orally or by NG tube, and then 5-10ml/kg per hour. This rate is slower than for children
who are not severely malnourished. Reassess the child at least every hour. The exact amount to
give should be determined by how much the child will drink the amount of ongoing losses in the
stool, and whether the child is vomiting and has any signs of over hydration, especially signs of
heart failure. Resomal should be stopped if
-the respiratory and pulse rate increase
-the jugular veins become engorged; or
-there is increasing edema (example puffy eyelids).
18
Rehydration is complete when the child is no longer thirsty, urine is passed and any other signs
of dehydration have disappeared. Fluid given to maintain hydration should contain the mineral
salts needed to prepare Resomal standard WHO –recommended ORS solution. The same salt are
also added to the child’s food be based on the child’s willingness to drink and children under 2
years should be given 50-100ml (between one-quarter and one-half of a large cup) of Resomal
after each loose stool, while older children should receive 100-200 ml. continue this treatment
until diarrhea stops.
HOW TO GIVE RESOMAL
Children who can drink may be given the required amount by spoon every few minutes.
However, malnourished children are weak and quickly become exhausted, so they may not
continue to take enough fluid voluntarily. If this occurs, the solution should be given by NG tube
at the same rate. An NG tube should be used in the weak or exhausted children, and in those who
vomit, have fast breathing or painful stomatitis.
INTRAVENOUS REHYDRATION
The only indication for IV infusion in the severely malnourished child is circulating collapse
caused by severe dehydration or septic shock. Use one of the following solutions (in order of
preference);
-Half-strength Darrow’s solution with 5% glucose (dextrose)
-Ringer’s lactate solution with 5% glucose2.
- 0.45% (half-normal) saline with 5% glucose2.
Give 15ml/kg IV one hour and monitor the child carefully for signs of hydration. While the IV
drip is being set up, also insert an NG tube and give resomal through the tube (10ml/kg per
hour). Reassess the child after 1 hour. If the child is severely dehydration, there should be an
improvement with IV treatment and him or her respiratory and pulse rates should fall. In this
case, repeat the IV treatment (10ml/kg per hour) for up to 10 hours. If the child fails to improve
after the first IV treatment and his or her radial pulse is still absent, then assume that the child
has septic shock and treat accordingly (still to number).
19
2.12 TREATMENT
There is no” silver bullet” or instant cure for malnutrition. The most apparent solution, giving an
individual’s more to eat, can cause harm and lead to re-feeding syndrome- a rapid shift in
electrolyte and fluid level that can lead to death (Mehanna H, et al 2018). The WHO, WEP,
United Nations High Commission for Refugees (UNHCR) and UNICEF have outline specific
interventions for the safe and efficient reduction of malnutrition in both emergency and endemic
setting through phased therapeutic feeding programs.
i) Regular visit to the pediatric unit for assessment of adequate growth in the height and weight.
ii) Children with protein energy malnutrition (PEM) need to be identified. This includes children
with marasmus and kwashiorkor. These children require aggressive therapy.
Children with long term disease need therapy for malnutrition as a prophylactic measure. This
includes additional nutrients, vitamins and mineral supplement etc. The underlying disease so
needs to treated with adequately to prevent malnutrition.
iii) Children with severe malnutrition need therapy in the hospital. This includes oral parenteral
nutrition and slow introduction of nutrients by mouth. Once their condition stabilizes then they
can gradually be introduced to a normal diet. Children who are malnourish should be effectively
manage to prevent the effect that may occur [S Nambile C, N Ankraleh, 2016]
2.13 PROGNOSIS OF MANAGEMENT
Up to 10% of body weight can be lost without side effects, but if more than 40% is lost, the
situation is almost always fetal. Death usually occur from heart failure, electrolyte imbalance or
low body temperature.
20
CHAPTER THREE
RESEARCH METHODOLOGY
3.1 STUDY AREA AND SITE
This research will be carried out in Douala in the Littoral region of Cameroon precisely at the
Bonassama District Hospital Douala located at the north of Wouri River .This structure lie in the
surface 11/12 hecter and covers with others 41 sanitary institution a total population of 293561
inhabitant under it care.
This will be the choice of study site because it is accessible and well equipped with materials,
staff and patients suitable for this study.
3.2 STUDY DESIGN
This study will a cross -sectional study aimed at assessing mother’s knowledge on the prevention
and management of malnutrition in children of age 0-5years. The data will be collected at a
particular period of time.
3.3 TARGET OR STUDY POPULATION
The target or study in this research will include mothers with children 0-5 years at the
Bonasama District Hospital Douala.
3.3.1 INCLUSIVE CRITERIA
The respondent in this research will be mother having children of age 0-5 years, women who
came for antenatal clinic (ANC) and vaccination and those on the sick bed.
3.3.2 EXCLUSIVE CRITERIA
Mothers that did not accept to participate in the research for some certain reasons known to
them.
21
3.4 SAMPLE TECHNIQUES OR METHODS
A simple random sampling will be used to select those who will accept to participate in the
collection of data.
3.5 VALIDATION OF INSTRUMENT
After structuring this work, my supervisor will crosscheck my work and questionnaire and
approve it before I will it into the field.
3.6 ADMINISTRATION OF INSTRUMENT
Questionnaire will be given to the respondents personally for them to fill depending on their
knowledge about malnutrition in children.
3.7 SAMPLE SIZE
The sample size of 106 women (responders) will be evaluated on the prevention and management of
malnutrition in children 0-5 years of age during this course of this study. The Lorenz formula was used to
input this sample size. N=[z2p(1-p)]/d2
=(1.96)2(0.5)(0.5) =3.842x0.5x0.5 =0.96 =96

(0.18)2 0.0064 0.01
Non Response=10% 10% of 96 96+10=106 Participants
Here
N=is the minimum sample size,

Z=is estimated from the Fisher and Yates tables at 1.96, (95% confidence level)
D=precision limit or proportion of the sample error (0.10)
P=prevalence estimated (50% or .5) as no study found.
3.8 DATA COLLECTION
Data will be collected with the use of questionnaire which will be made up of opened and
closed ended questions. The questionnaires will administered by the researcher to mothers.
22
Others materials which might be use include pens, pencils, books, internet and past research
work. Data collected will be entered in Microsoft excel.
3.10 DATA ANALYSIS TECHNIQUES AND PRESENTATION
The data that will be collected or obtained from the respondents or mothers will be studied and
analyzed using frequency and percentages and presented using tables and chart, using excel and
statistical package for social science (SPSS)
3.11 DURATION OF STUDY
This research will began from 6th of February to the 28th of March 2022.
3.12 ETHICAL CONSIDERATION
An authorization letter will give by the institution [Alpha Higher Institute Douala) to carry out
this research.
An authorization to collect data will be issued by the Regional Delegate of Higher

Education Littoral and another letter (authorization) to collect data from mothers by the Director
of the Bonassama District Hospital.
An informed consent will be attached to the questionnaire to assure the respondents on the
respect of the following ethical principles.
- respect principle
- Non malfeasance
- Beneficence
- Justice
- Confidentiality.
3.13 STUDY LIMITATION
One of the problems likely to be face is language barrier because understanding French is still
actually a problem to me
23
Also, financial strength will actually post as one of my limitation since during this research I
will need to be paying transport to the hospital and to be downloading articles and printing of the
research. Data collection will only be limited at the hospital.
CALENDAR OF ACTIVITY
December January February March April

Preparation x x x x x
of research
proposal
Writing of x x x
literature
review
Submission x
of research
proposal
Start of x
internship
at the LHD
Clinical x x x x x x x x
work
End of x
internship
Binding of x
results
Printing of x
research
work
Defense x
24
TABLE 3. 1 RESEARCH FINANCIAL BUDGET
Items Cost Number Total cost

Questionnaires 200 100 20000
Research proposal 3000 2 6000
Transport 20000 - 20000
Data collection 40000 - 40000
Data analysis 30000 - 30000
Internet fee per month 3000 4 12000
Research booklet Editing 5000 - 5000
Printing 7000 4 28000
Binding 1000 4 4000
Total budget 165000 Fcfa
25
CHAPETER FOUR
PRESENTATION OF FINDING OF DATA ANALYSIS

This chapter will present the result analysis of responses that will be collected by the use of
questionnaire given to respondents on the mothers knowledge on the prevention and
management of malnutrition in children 0-5years of age.
The results will be presented using tables and chart.

4.1. SOCIO -DEMOGRAPHIC DATA OF THE RESPONDENT
4.1.1 AGE;
Table 1: The various age of the respondent will be presented using a table which will include
the variation in age, the frequency and percentages will be interpreted.
4.1.2 Table 2: Distribution of respondents according on their marital status.
This table will be talking on the marital status of the nursing mothers, which will contain the
variation, the frequency and the percentage of married women which will be interpreted.
4.1.3 Table 3: Distribution of respondents according to their level of education
The level of education will equally be assessed through the use of questionnaire which will be
presented on a table and interpreted.
4.1.4 Table 4; Distribution of participants relative to occupational status:
The occupation of all the will be indicated on the table showing the number of employed and
unemployed women and also nursing mothers who are only housewife, will be presented on a
three sectional table that is the variation, frequency and percentages.
4.1.5 Table 5: Knowledge of participants on the definition of malnutrition.
Here, the knowledge on mothers on the definition of malnutrition will be assessed by

administering questionnaire which already has all the options on the definition of malnutrition,
and this will be presented using a table to see the percentage of all the nursing mothers’
knowledge.
26
4.2.1 Figure 1: participant’s response with respect to causes of malnutrition.
In this figure, data will be presented using a pie chart to indicate the different knowledge of
mothers on the causes on malnutrition which can be poverty, disease, conflict etc.
4.2.2 Figure 2: Knowledge of mother’s on the source of water they give to their children.
All this this will be present in the questionnaire that will be administer to the participants. And
will be presented and interpreted to come out the result.
4.2.3 Figure 3: Distribution of respondents on the various types of food they give to their children
after six months of delivery.
This result will only be known after the responder has answer the questions provider to them,
either soya beans, fish, rice, eatable food. All this will be presented in a pie chart and interpreted.
4.2.4 Figure 4: Distribution of respondents whether they give drinking water to their children
regularly.
All the participant will be in charged to answer all this question which then be process and
interpreted then present in a chart.
4.2.5 Distribution of respondents knowledge based on the importance of adding artificial milk to
breast milk in children below six months if the breast milk is not producing.
A YES or NO question will be provided to the responder as already in the questionnaire to assess
their knowledge.
27
CHAPTER FIVE
DISCUSSION, CONLUSION ANDRECOMMENDATION
This chapter is concern with the summary of the entire work and conclusions drawn based on the
finding in chapter 4. Recommendations will also be made.
5.1 DISCUSSION
The result of this study table 1 above, shows the distribution of respondents according to age
which will be divided in to different groups. After administering of the questionnaire, the exact
age group who will be participating in this project will be known and the researcher will
determine the highest frequency of the age group that will participate he the research.
In table 2, the proportion of the women that attended primary school, secondary school and
university will be known to determine those who can read and write, and the highest proportion
will easily be notice and it will be graded in percentages.
In table3 above, the number of married women will be known and unmarried women and those
that are going to school, this will help determine the rate at which this different women can have
time to respective prepare their children diet.
5.1.1 KNOWLEDGE OF MOTHERS ON MALNUTRITION
Here, the knowledge of mothers will be assessed using questionnaire to see the proportion of
nursing mothers that can identify the definition of malnutrition, causes of malnutrition, how the
prevent it and how to manage malnutrition in children and equally the type of food, water they
give to their children.
Also, mothers will equally be assessed on how frequent they feed their children, to see if it is
three times per day, two times or one time per day or to see if it is regularly whenever the child
need food
28
Concerning the type of additional food that the mothers give to their children after six months
will equally be known to see if the food balance or not to enhance the child growth.
With regard to the type of drinking water the mother give to the child will equally be
known to see if the is from a good source or not. Some mothers may give any kind of drinking
water to their children may be because of financial issues. The exact proportion of mother and
the type of water the give to their children will be known.
We will equally see the proportion of mothers who give regular drinking water to their
children and their percentages.
5.1.3 KNOWLEDGE OF MOTHERS ON THE PREVENTION OF MALNUTRITION.
The knowledge on the prevention of malnutrition among mothers will be known after this this
project will be completed and the exact percentage will be presented to determine the proportion
of nursing that have knowledge on the prevention of malnutrition and to know which proportion
is greater than which.
5.2 CONCLUSION
The data that will be collected and analyzed, it will show the age group of the mothers that take
part during the interview, and the knowledge of women concerning malnutrition in children 0-5
years of age will collected and analyze. The percentages of mothers who have knowledge on the
causes of malnutrition will be analyze, the percentage of those having knowledge on the
prevention of malnutrition in children below five years will be analyze and the percentage on the
knowledge of mothers on how to manage malnutrition in children below five years will be
analyze, all this will be based on interview of mothers.
5.3 RECOMMENDATIONS
The proportion of the population of mothers who will take part in this interview on malnutrition,
will determine if they have enough knowledge on the prevention and management of
malnutrition in children below the age of five. Their knowledge will be assessed and result will
be presented in percentages.
29
After realizing the percentage of the result on the knowledge of mother on the
prevention and management of malnutrition in children, and if they have inadequate knowledge
on it, more teaching should be taught about effect of malnutrition during ANC to reduce the
negative behavior of mothers on malnutrition.
The ministry of public health should implement new technique in other to educate the
population. Health education on the consequences of malnutrition in children below the age of
five should be explain to the mothers during their ANC visit.
Lastly, the ministry of public health should train health personnel that are specialize in the
prevention, management, treatment and education of mothers on malnutrition.
30
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Countries
iii) Ivan Elisabeth Purba, Agnes Purba, Rinawati Sembiring, Paginas 140-143(Junio 2020). DOL:
10.1016/j,enfcli.2019.11.040
iv) Sri Umijati, Sri Kardjati, Senator. Eectronic Journal of General Medicine 2021, 18(6) em3507. Pubic
16 Oct 2021
v) Jacent Kamuntu Asilmwe, Joweria Nambooze, George Wilson Concho, James Wakened. Home
journal Article June 2021. DOL 10.4236/fan’s 2021.126038
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July 2021
vii) Tahilramani G, Wed ad M. Almutairi, Fatmah Alsharif, Fathia Khamis. Nutritionalist. Nutritional
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xvi) BS Nayak, B Unnikrishnan, A George….Indian journal of nutritional importance 2018-

sereach.ebscohost.com
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severe acute malnutrition in Kenyan children: a prospective descriptive study of risk factors and
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(2014).http:// www.unicef.org/emergencies/mali-73505.html. Accessed October6, 2015.
xxxvi)-United Nation System Standing Committee on Nutrition. Module 6 measuring

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xxxvii)-WHO. Comprehensive implementation plans on maternal, infants and young child

nutrition.2014.
xxxiii)-WHO. Global target 2025 to improve maternal, infant and young children nutrition
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www.who.int (/nutrition/publication/emergencies/ WHO-NHD-99.11/en/. Accessed July 3, 2014.
33
RESEARCH QUSTIONNAIRE
CONSENT FORM
Dear participant,
My name is EMADE GWENDOLINE NGEH, a student in the nursing department

of Alpha Higher Institute Douala, level three, I am carrying out a research on the topic
ASSESSIN THE KNOWLEDGE OF MOTHERS ON THE PREVENTION AND
MANANAGEMENT OF MALNUTRITION IN CHILDREN 0-5 years of age at Bonassama
District Hospital from the 6th of February to the 28th Match 2023 under the supervision of Mme,
AJOH VALERIE. This is to fulfill part of my HND (Higher National Diploma) requirement in
nursing. Data collected will be used to write a project and will be kept confidential. Only the
investigators and the team of supervision will have access to the data.
If u agree to participate in this study, please answer all the questions attached to this
form.
SUPERVISOR STUDENT
Mme, AJOH VALERIE EMADE GWENDOLINE NGEH
34
APPENDIX II: QUESTIONAIRE
IDENTIFICATION OF STUDY PARTICIPANTS
SECTION A: SOCIO DEMOGRAPHIC DATA
Tick the right answer
1. Age: a) 18-30 b) 31-40 c) 41-50
2) Marital status: a) Widow b) Divorce c) Married d) Single
3. Occupation: a) Employed b) Housewife c) Student d) others
4. Level of education: a)Secondary school b)Primary school c)University d)Non
5- Religion: a) Christianity b) Islamism c) Traditional religion d) Non
SECTION B: PREVENTION OF MALNUTRITION.
1-What is malnutrition: a) when the body takes all the balance diet b) When an individual
does not take food rich in all the body nutrient in their appropriate amount.
c) When we eat too much and drink too much d) No idea
2- What is the main cause of malnutrition?
a) Diseases b) Over nutrition c) Age and sex d) Poverty
3-Do you think malnutrition can be prevented in children?
a) Yes b) No
4- If yes how? If No skip to the next question
a) Feeding the baby with food b) Giving much water c)Proper hygiene
d) Balance diet
6- Do you think adding extra milk to breast milk is important below six months if the breast milk
is not producing? a) Yes b) No
35
7- Do you think good proper hygienic condition can actually prevent the child from being
malnourished? a) Yes b) No
SECTION C: MOTHERS KNOWLEDGE ON THE MANAGEMENT OF

MALNUTRITION
1- As any of your child suffer from this condition? a) Yes b) No
2- If yes what are the measures you took to managed this condition
a) Balance diet b) Soya bean milk c) Parenteral feeding d) Non
4- How many times do you feed your child a day?
a) 4 times b) 3 times c) It depend how the child cries d) 2 times
5- Which food do you add to your babies during breast feeding after six months of delivery?
a) Soya bean pop only b) Any food eatable c) Balance diet rich with vitamins d)
Fish only
6-Do you give clean portable drinking water to your child regularly? a) Yes b) No
7- What is the source of your child drinking water?
a) Mineral water
b) Hand dug water
c) Stream pond
d) Any water drinkable
9- Do you normally add fruits to your baby’s food after six months? a) Yes
b) No
36
APPENDIX III
CURRICULLUM VITAE
PERSONAL INFORMATIOM
Name; EMADE GWENDOLINE NGEH Date of birth;17 April 1992
Place of birth; Nyasoso Sex; Female
Marital status; Single Tel; 670400877
Profession; Student
ACADEMIC PROFILE
Year School attended Certificate obtain

2022-2023 Alpha Higher Institute Douala
2014-2015 G.B.H.S Mabanda G.C.E Advance level certificate.
2007-2008 P..H.S Kumba G.C.E Ordinary level certificate.
2001-2002 P.S TOMBEL First school living certificate
INTENSHIP EXPERIENCE.
HOSPITAL PERIOD SKILLS ACQUIRED

Biamasi District June to August -Obtain skills on accurately taking and recording vital
hospital yaounde 2019 signs
-Acquired skills in drug administration
Presbyterian January to -Obtain skills to develop and deliver health talk.
generahos,nyasoso March 2020 -Acquired research skills in the community
Bonassama June to augus -Obtain skill on drawing and implementing patients
District Hospital 2021 care plan
Douala -Acquired skills on patient preparation in last office
Acquired skill in conducting delivery
-Also skills on carrying out wound dressing
37
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ASSESSING THE KNOWLEDGE OF NURSING MOTHERS ON THE PREVENTION AND MANAGEMENT OF

MALNUTRITION IN CHILDREN 0-5 YEARS OF AGE

SUPERVISOR: Mme, AJOH VALERIE

DEAN OF STUDY: Mr. ATONGNO ASHU

i WHO: World health organization

ii IWC; Infant welfare clinic

iii ANC: Antenatal care.

iv 0RS: 0ral rehydration salts.

v NS: Nasogastric tube.

vi FBC: Full blood count.

vii HIV Test: -Human immune virus test.

viii PEM: Protein energy malnutrition.

ix Urine MC&S: Urine for microscopy, culture and sensitivity.

x PEM-: Protein energy malnutrition

xi SDGs: Sustainable Development Goals

xii MUAC: Mid upper arm circumference

xiii UNICEF: United nation children emergency fund

xiv BMI: Body mass index

Keywords: Mothers, knowledge, prevention, management, malnutrition, children.

2.1 F75 COMPOSITION………………………………………………………………….

2.2 F100 COMPOSITION……………………………………………………………………

CHAPTER ONE: GENERAL INTRODUCTION

1.2 PROBLEM STATEMENT…………………………………………………………………

1.3: RESEARCH OBJECTIVE………………………………………………………………….

1.3.2 SPECIFIC OBJECTIVES…………………………………………………………………..

1.4 RESEARCH QUESTION………………………………………………………………….

1.6 SIGNIFICANT OF THE STUDY………………………………………………………….

1.7: DEFINITION OF TERMS………………………………………………………………

CHAPTER TWO: LITERATURE REVIEW

2.1 MALTRITION IN CHILDHOOD……………………………………………………….

2.3 CAUSES OF MALNUTRITION…………………………………………………………….

2.4 PATHOPHYSIOLOGY OF MALNUTRITION………………………………………...

2.5 TYPES OF MALNUTRITION………………………………………………………………

2.5 GENERAL SIGNS AND SYMPTOMS………………………….……………………….

2.6 DIAGNOSIS AND MEASUREMENT…………………………………………………

2.10 NUTRITIOPNAL THERAPY………………..……………………………………………

CHAPTER THREE: METHODOLOGY

3.1 STUDY AREA…………………………………………………………………………..

3.2 STUDY DESIGN………………………………………………………………………

3.3 TARGET POPULUTION………………………………………………………………….

3.3.1 INCLUSIVE CRITERIA………………………………………………………………….

3.3.2 EXCLUSIVE CRITERIA……………………………………………………………….

3.4 SAMPLE TECHNIQUE OR METHOD…..…………………………………………….

3.5 VALIODATION OF INSTRUMENT……………………………………………………..

3.6 ADMINIWSTRATION OF INSTRUMENT……………………………………………

3.7 SAMPLE SIZE…………………………………………………………………………….

3.8 DATA COLLECTION……………………………………………………………………

3.9 DURATION OF STUIDY…………………………………………………………

3.10 ETHICAL CONSIDERATION…………………………………………………………

3.9 LIMITATION OF STUDY……………………………………………………………….

5.1.1 KNOWLEDGE OF NURSING MOTHERS ON MALNUTRITION………………

5.1.2 NURSING MOTHERS KNOWLEDGE ON THE PREVENTION OF MALNUTRITION...

1.2 PROBLEM STATEMENT.

malnutrition because of poor knowledge on it management (Ragah Mahfouz 2017). The

1.3 RESEARCH OBJECTIVES

1.3.1 General Objective

1.3.2 Specific Objective

1.4 RESEARCH QUESTION

1.6 SIGNIFICANT OF THE STUDY

1.7 DEFINITION OF TERMS.

iii) Nursing mothers: A mother who is breastfeeding her baby.

iv) Malnutrition: it is a condition in which nutrients Is defective in quantity or quality.

xi) Malnutrition: it is a condition in which nutrients Is defective in quantity or quality.