CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
The difference between food intake and utilization determines the nutritional status of the individual. Change in food consumption and the biological utilization will directly or indirectly reflect in the nutritional status. The nutritional status can be normal, under nutrition or over nutrition. The under and over nutrition are considered as malnutrition. The nutritional status of the under-five might be affected by some factors ranging from busy schedule of the primary care giver to inability to provide enough food and needed health care to maintain normal nutritional status. The determinants of the nutritional status may differ based on regions, communities, or even over time. To proffer necessary recommendations or solve any nutritional problem in an area, it will be important to determine the nutritional status and the underlying causes.
Efforts have been made both nationally and internationally by governmental and non-governmental organizations to maintain normal nutritional status but poor nutrition remains a major link to diseases and reduced life-span. According to Mamulwar, Rathod, Jethani,  Dhone,  Bakshi, Lanjewar et al. (2014), one quarter of the under-five children are stunted. Many factors have been implicated to influence the nutritional status. Poor diet and disease are considered as immediate factors but there are underlying factors like food security, caring practices of the mother, healthy environment and assessment of health facilities. The underlying causes are also considered to have basic causes which are seen as socio-economic and political conditions (Asegedech, 2014).
Nutritional status of the under-five is of great importance since this period of life is considered as pivotal for adequate growth (Badake, Maina, Mboganie, Muchemi, Kihoro, Chelimo, & Mutea, 2014). Under-nutrition could be described as weighty medical condition characterized by a deficient bodily nutrition (energy, essential proteins, fats, vitamins, and minerals in a diet) as a result of inadequate food intake or faulty assimilation. Over 10 million children of under-five are lost annually due to diseases that can be prevented and even easily treated. Most of these illnesses and majority of these deaths occur in developing countries because of the poor economy of such Countries (Black, Morris & Bryce, 2003). Malnutrition cause more over 30% of all children’s deaths who are under-five(United Nations Children’s Fund (UNICEF), 2009). According to Badake, Maina, Mboganie, Muchemi, Kihoro, Chelimo and Mutea, (2014), assessing the growth of children is a good parameter to look at the development of the children and this also gives insight about food security in the area and assess to good health services.
Poor nutritional status has called for different programmes and interventions in different sectors in order to improve the nutrition status. Sequel to this, experts from different fields are strategizing and evaluating various interventions that have nutrition components (Macias & Glasauer, 2014). Assessing nutritional status is the easiest indicators for assessing the impact of interventions that are nutrition focused and this can be done using various methods. Assessing nutritional status entails a deep understanding of what people consume and the determinants of people’s nutritional habits. The nutritional status can then be traced to have a myriad of determinants.
Different factors have been implicated to affect the nutritional status of the under-five and there are repeated episodes of diseases that are often seen among these children. Some of the factors include inadequate food availability, poor caring capacity of the caregiver, lack of basic education, poor health systems, poor housing and environmental conditions. Communities that are unable to satisfy the basic needs of its citizens are likely to generate more individuals with poor anthropometric indices.