CHAPTER ONE
1.0 INTRODUCTION
1.1 BACKGROUND OF STUDY
The issue of malnutrition has become a household name among families with children from zero to five years. It is evident that the nutritional status of children is widely regarded as one of the well-known indicators of economic development of that particular region in question.
There has been high level of neglect of children by most parents’ reason being as a result of low family income, lack of parent exposure and poor implementation of infrastructural facilities such as good hospital that sees for children like of pipe borne water etc.
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, 2008). The nutritional status of children under five (5) years of age is usually measured as weight-for-age, weight for height and height for age indexes. The common nutritional status of children under 5 years old in each region such as underweight, stunning and wasting are considered as nutritional disorders.
The evaluation of these criteria reflects the general health status of that region. Malnutrition is a clinical syndrome which the infant or child deviates from the main pattern of growth, the growth curve is downward and constantly locates under the curve of 3% of the height and weight (Nakhshab M, Nasiri H, 2009).
The malnutrition often occurs in the first years of life when the caloric intake is not able to provide the metabolic needs of the body. Consequently, the stored nutrients in the tissues will be consumed to preserve the life (Arezomaniance S, 2005). In children, protein-energy malnutrition is defined by measurements that fall below 2 standard deviations under the normal weight for age (underweight), height for age (stunting) and weight for height (wasting). Wasting indicates recent weight loss, whereas stunting usually results from chronic weight loss.
The primary malnutrition in children occurs due to socioeconomic factors and lack of food. The secondary malnutrition is associated with the diseases with increased need for calories, calorie loss, and reduction of calorie intake or a combination of these three modes. It may be caused by low food intake or impaired absorption of nutrients.
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 children.