KNOWLEDGE AND ATTITUDE OF MOTHERS TOWARDS MALNUTRITION PREVENTION PRACTICE FOR CHILDREN WITHIN 5YEARS 

CHAPTER ONE

INTRODUCTION

1.1 Background Of Study

Malnutrition is a widespread problem in underdeveloped countries, which has a significant impact on the overall health of the population (Gómez, 2020). Malnutrition, as described by the World Food Programme (WFP), is a state in which a person's physical well-being is severely affected, hindering their ability to support essential bodily functions like growth, reproduction, immunity, and recovery from illnesses. Although malnutrition has become a pressing public health issue, it has had a particularly disproportionate impact on children. Young children under the age of five are often considered vulnerable in multiple ways, particularly when it comes to their health.  Malnutrition encompasses various forms of nutritional deficiencies, including undernutrition, micronutrient deficiencies, excessive weight, obesity, and diet-related non-communicable diseases. It is estimated that a staggering 149 million children under the age of five experience below-average weight, resulting in hindered growth. There were 45 million individuals who experienced undernourishment or stunted growth, while 38.9 million were classified as overweight or obese. In addition, it is worth noting that malnutrition in children is a significant factor in a staggering 45 percent of deaths among children under the age of five.

Child malnutrition, specifically, is a pressing concern in underdeveloped nations, especially in Africa (Smith, 2018). Child malnutrition, as defined by the World Health Organisation (2022), refers to an insufficient, excessive, or unbalanced consumption of calories and/or nutrients. According to the World Health Organisation (WHO, 2022), the countries facing the greatest impact are those with the highest levels of economic disadvantage and middle-income. According to the Global Nutritional Report (2021), Africa has a prevalence of 5.3 percent for overweight individuals and 30.7 percent for stunted growth. On the other hand, a significant portion of the African population, approximately 6.0 percent, is affected by waste. In addition, Nigeria has the second highest rate of stunted children worldwide, with 32 percent of children under the age of 5 suffering from impaired growth across the country. It is concerning that the treatment for malnutrition in Nigeria is only reaching a small fraction of the children in need, even though there are over two million children suffering from this condition. The citation is from UNICEF in 2021. Reports indicate that a concerning number of 124 young individuals out of the total of 21,265 admitted have unfortunately fallen victim to acute malnutrition. The government's support greatly improved the accessibility of high-quality malnutrition therapy across the state, although there is still room for further advancements. Malnutrition is a condition characterised by an imbalance or insufficiency of energy and nutrients in the diet. Malnutrition, excessive nutrition, and vitamin insufficiency are some of the indications that can be observed. In a study conducted by Kalu and Etim (2018), it was found that children who suffer from malnutrition are more likely to face long-term health issues.

When individuals experience moderate malnutrition, their immune system's functionality is compromised, making them more vulnerable to developing active Tuberculosis. Protein and calorie malnutrition, along with deficiencies in essential nutrients, have been documented (Adamu et al., 2021). The symptoms of malnutrition can have various negative impacts on the body, including skin rashes, hair loss, a weakened immune system, increased vulnerability to infections, digestive problems, difficulty seeing in low light, slower healing of wounds, and other related signs (Mohammadinia et al., 2016). In a recent study, Dipasquale et al. (2020) highlight the connection between insufficient protein or calorie intake and the development of acute malnutrition. Children experiencing primary acute malnutrition are widespread in low- and middle-income nations. The reason behind this problem is a lack of resources caused by various economic, political, and environmental factors. Secondary acute malnutrition can arise from various factors such as abnormal nutrient loss, increased energy expenditure, or decreased food intake. It is often noted in individuals with chronic illnesses like cystic fibrosis, chronic renal failure, chronic liver problems, and similar conditions (Gorver & Ee, 2019; Dipasquale et al., 2015). In addition, obesity is one of the two outcomes of malnutrition. Childhood obesity is characterised by a weight-to-height ratio that surpasses three standard deviations. Childhood obesity is a significant issue in impoverished nations, where the growth rate exceeds that of industrialised ones by more than 30%. In 2019, there was a significant increase in the number of overweight children between the ages of 0 and 5, reaching over thirty-eight million. 

In 2020, the World Health Organisation (WHO) released a report highlighting the alarming number of children under the age of five who were impacted by overweight or obesity. The figures revealed a staggering 39 million children affected by this issue. Malnutrition is linked to various factors including the size of the family, the mother's level of education, the monthly income, and the father's level of education (Nath & Kanniammal, 2017). As per the research conducted by Aljohani and Aljohani (2020), it has been established that insufficient maternal education is the primary risk factor. Mothers, who are entrusted with the well-being of their children, should have a deep understanding of child nutrition (Patali, 2018). Mothers who have a deep understanding of nutrition can create a healthier environment for their children (Khattak et al., 2017). As part of our research, we will be conducting a survey to evaluate the knowledge, attitude, and practices of mothers in the Ugbekun health centre regarding the prevention of malnutrition in children under the age of five.

1.2 Statement Of Problem

Young children in Nigeria, particularly those under the age of five, encounter a multitude of significant obstacles, including the prevalent issue of malnutrition. In 2022, the World Health Organisation (WHO) highlighted hunger and malnutrition as the most significant and serious risk to public health globally. Malnutrition has been associated with a significant number of deaths among children under the age of five in various impoverished nations, such as Nigeria. Malnutrition is responsible for a staggering 45 percent of fatalities among children under the age of five, whether it be through direct or indirect means. At the same time, there is a growing issue of childhood obesity and overweight in these countries. Malnutrition has far-reaching and long-lasting developmental, economic, social, and medical effects on individuals, families, communities, and governments across the globe. Dealing with malnutrition in children under the age of five remains a pressing concern in economically disadvantaged nations across the globe (UNICEF, 2021). Furthermore, a distressing number of 124 children, ranging from 9 months to 9 years old, tragically lost their lives as a result of severe malnutrition. This devastating situation also resulted in the hospitalisation of an alarming 21,265 additional children (KADSPHCDB, 2020). It's worth noting that the occurrence of malnutrition among children under the age of five in Nigeria differs greatly between rural and urban areas (Akombi et al., 2019). Hence, it is in the light of these that the study seeks to assess the knowledge and attitude of mothers towards malnutrition prevention practice for children within 5years.

1.3 Objective Of The Study

The main purpose of this study is to assess the knowledge and attitude of mothers towards malnutrition prevention practice for children within 5years. Specifically, the study will;

Assess the  knowledge of mothers towards malnutrition prevention for under-five children.

Assess the attitude of mothers towards the prevention of malnutrition for under-five children.

Assess the factors which influences mothers practices towards the prevention of malnutrition for under-five children.

1.4     Research Questions

The following questions have been prepared for the study:

What is the level of knowledge of mothers towards malnutrition prevention for under-five children?

What is the attitude of mothers towards the prevention of malnutrition for under-five children?

What factors influence mothers' practices towards the prevention of malnutrition for under-five children?

1.5 Research Hypothesis

Ho: Mothers' attitude does not significantly influence the prevention of malnutrition amongst under-five children in Ugbekun health center.

Ha: Mothers' attitude significantly influences the prevention of malnutrition amongst under-five children in Ugbekun health center.

1.6 Significance Of The Study

The Primary Health Care directorate at the Department of Health will utilize the findings to identify the educational needs of mothers on malnutrition in children under the age of five. Furthermore, the findings will serve as a benchmark for malnutrition awareness initiatives. It will also inform policy makers in the development of policies related to malnutrition.Furthermore, subsequent researchers will use it as a literature review. This means that other students who may decide to conduct studies in this area will have the opportunity to use this study as available literature that can be subjected to critical review. Invariably, the result of the study contributes immensely to the body of academic knowledge with regard to the knowledge and attitude of mothers towards malnutrition prevention practice for children within 5years.

1.7 Scope Of The Study

The scope of this study is boarded on an assessment the knowledge and attitude of mothers towards malnutrition prevention practice for children within 5years.  Empirically, this study will assess the  knowledge of mothers towards malnutrition prevention for under-five children, the attitude of mothers towards the prevention of malnutrition for under-five children and the factors which influences mothers practices towards the prevention of malnutrition for under-five children.

Geographically, the study will be delimited to residents of Ugbekun community.

1.8  Limitation Of The Study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. In addition, there was the element of researcher bias. Here, the researcher possessed some biases that may have been reflected in the way the data was collected, the type of people interviewed or sampled, and how the data gathered was interpreted thereafter. The potential for all this to influence the findings and conclusions could not be downplayed. 

More so, the findings of this study are limited to the sample population in the study area, hence they may not be suitable for use in comparison to other schools, local governments, states, and other countries in the world.

1.9 Definition Of Terms

Nutrition: This is the outcome of ingesting food and the absorption of nutrients by the body.

Nutrients: These are chemical substances, elements and compounds contained in food. They enable the body to grow, maintain itself, give it energy and keep it healthy. For all nutrients there are recommended daily allowances and specific safety levels. 

Malnutrition: This includes all forms of nutritional disorders, including both undernutrition and overnutrition. It is associated with disparities in the amount of calories consumed, the consumption of specific macronutrients and micronutrients, and the timing and frequency of meals. 

Child malnutrition: Child malnutrition, in all its forms, includes under nutrition (wasting, stunting, underweight), inadequate vitamins or minerals, overweight, obesity, and resulting diet-related non-communicable diseases (WHO, 2012).

Food: For some, this term refers to anything that is eaten, that which nourishes. For policy makers, it includes any substance intended for human consumption.