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1.1 BACKGROUND TO THE STUDY
Malnutrition in children also known as undernutrition is common
globally and results in both short and long term irreversible negative
health outcomes including stunted growth which may also be linked to
cognitive development deficits, underweigt and wasting. The World
Health Organization (WHO) estimates that malnutrition accounts for 54
percent of child mortality worldwide, about 1 million children. Another
estimate also by WHO states that childhood underweight is the cause for
about 35% of all deaths of children under the age of five years
worldwide. The main causes are unsafe water, inadequate sanitation or
insufficient hygiene, factors related to society and poverty, diseases,
maternal factors, gender issues and overall poverty (Bhutta et al,
There are three commonly used measures for detecting malnutrition
in children. They includes stunting (extremely low height for age),
underweight (extremely low weight for age), and wasting (extremely low
weight for height). These measures of malnutrition are interrelated,
but studies for the World Bank found that only 9 percent of children
exhibit stunting, underweight, and wasting. Children with severe acute
malnutrition are very thin, but they often also have swollen hands and
feet, making the internal problems more evident to health workers.
Children with severe malnutrition are very susceptible to infections
(World Bank, 2008).
Malnutrition in children causes direct structural damage to the
brain and impairs infant motor development and exploratory behavior.
Children who are undernourished before age two and gain weight quickly
later in childhood and in adolescence are at high risk of chronic
diseases related to nutrition. Studies have found a strong association
between malnutrition and child mortality (Duggan et al, 2008). Once
malnutrition is treated, adequate growth is an indication of health and
recovery. Even after recovering from severe malnutrition, children
often remain stunted for the rest of their lives. Even mild degrees of
malnutrition double the risk of mortality for respiratory and diarrheal
disease mortality and malaria. This risk is greatly increased in more
severe cases of malnutrition. Undernourished girls tend to grow into
short adults and are more likely to have small children.
Prenatal malnutrition and early life growth patterns can alter
metabolism and physiological patterns and have lifelong effects on the
risk of cardiovascular disease. Children who are undernourished are
more likely to be short in adulthood, have lower educational
achievement and economic status, and give birth to smaller infants
(Bhutta et al, 2008). Children often face malnutrition during the age
of rapid development, which can have long-lasting impacts on health.
The World Health Organisation estimated in 2008 that globally,
half of all cases of malnutrition in children under five were caused by
inadequate food intake, unsafe water, inadequate sanitation or
insufficient hygiene. This link is often due to repeated diarrhoea and
intestinal worm infections as a result of inadequate sanitation.
However, the relative contribution of diarrhea to malnutrition and in
turn stunting remains controversial. In almost all countries, the
poorest quintile of children has the highest rate of malnutrition.
However, inequalities in malnutrition between children of poor and rich
families vary from country to country, with studies finding large gaps
in Peru and very small gaps in Egypt. In 2000, rates of child
malnutrition were much higher in low income countries (36 percent)
compared to middle income countries (12 percent) and the United States
(1 percent). Studies in Bangladesh in 2009 found that the mother’s
literacy, low household income, higher number of siblings, less access
to mass media, less supplementation of diets, unhygienic water and
sanitation are associated with chronic and severe malnutrition in
Diarrhea and other infections can cause malnutrition through
decreased nutrient absorption, decreased intake of food, increased
metabolic requirements, and direct nutrient loss. Parasite infections,
in particular intestinal worm infections (helminthiasis), can also lead
to malnutrition. A leading cause of diarrhea and intestinal worm
infections in children in developing countries is lack of sanitation
and hygiene. Children with chronic diseases like HIV have a higher risk
of malnutrition, since their bodies cannot absorb nutrients as well.
Diseases such as measles are a major cause of malnutrition in children;
thus immunizations present a way to relieve the burden. The nutrition
of children 5 years and younger depends strongly on the nutrition level
of their mothers during pregnancy and breastfeeding.
Infants born to young mothers who are not fully developed are
found to have low birth weights. The level of maternal nutrition during
pregnancy can affect newborn body size and composition.
Iodine-deficiency in mothers usually causes brain damage in their
offspring, and some cases cause extreme physical and mental
retardation. This affects the children’s ability to achieve their full
potential (Wagstaff & Naoke, 1999). In 2011 UNICEF reported that
thirty percent of households in the developing world were not consuming
iodized salt, which accounted for 41 million infants and newborns in
whom iodine deficiency could still be prevented. Maternal body size is
strongly associated with the size of newborn children. Short stature of
the mother and poor maternal nutrition stores increase the risk of
intrauterine growth retardation (IUGR). However, measurements of a
child’s growth provide the key information for the presence of
malnutrition, but weight and height measurements alone can lead to
failure to recognize kwashiorkor and an underestimation of the severity
of malnutrition in children
1.2 STATEMENT OF THE PROBLEM
Measures have been taken to reduce child malnutrition. Studies for
the World Bank found that, from 1970 to 2000, the number of
malnourished children decreased by 20 percent in developing countries.
Iodine supplement trials in pregnant women have been shown to reduce
offspring deaths during infancy and early childhood by 29 percent.
However, universal salt iodization has largely replaced this
intervention. Nutritional education and micronutrient-fortified food
supplements has resulted in 10 percent reduction and the prevalence of
stunting in children 12–36 months old. Milk fortified with zinc and
iron reduced the incidence of diarrhea by 18 percent in children.
1.3 OBJECTIVES OF THE STUDY
The following are the objectives of this study:
- To examine the causes of malnutrition in children from zero to five years.
- To examine the prevalence of malnutrition in children from zero to five years.
- To identify the strategies for reducing malnutrition in children from zero to five years.
1.4 RESEARCH QUESTIONS
- What are the causes of malnutrition in children from zero to five years?
- What is the prevalence of malnutrition in children from zero to five years?
- What are the strategies for reducing malnutrition in children from zero to five years?
1.6 SIGNIFICANCE OF THE STUDY
The following are the significance of this study:
- The outcome of this study will educate on the causes, prevalence and strategies for reducing malnutrition in children from zero to five years.
- This research will be a contribution to the body of literature in the area of the effect of personality trait on student’s academic performance, thereby constituting the empirical literature for future research in the subject area.
1.7 SCOPE/LIMITATIONS OF THE STUDY
This study will cover the causes and the prevalence of
malnutrition in children. It will also cover the strategies for
reducing malnutrition in children from zero to five years of age.
LIMITATION OF STUDY
Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.
Duggan Christopher, Watkins John B., Allan W. (2008).
Nutrition in pediatrics: basic science, clinical application. Hamilton:
BC Decker. pp. 127–141. ISBN 978-1-55009-361-2.
Wagstaff Adam; Naoke Watanabe (1999). "Socioeconomic
Inequalities in Child Malnutrition in the Developing World". World Bank
Policy Research Working Paper No. 2434. Retrieved March 3, 2014.
Bhutta, Z. A.; Ahmed, T.; Black, R. E.; Cousens, S.;
Dewey, K.; Giugliani, E.; Haider, B. A.; Kirkwood, B.; Morris, S. S.;
Sachdev, H. P. S.; Shekar, M.; Maternal Child Undernutrition Study
Group (2008). "What works? Interventions for maternal and child
undernutrition and survival". The Lancet 371 (9610): 417–440.
doi:10.1016/S0140-6736(07)61693-6. PMID 18206226
World Bank (2008). Environmental health and child survival epidemiology, economics, experiences. Washington, DC: Environment Department of the World Bank. ISBN 978-0-8213-7237-1.
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