1.1 Introduction
Protein Energy Malnutrition is a significant public health problem and it is an important cause of morbidity and mortality in children below 5 years of age. The proportion of this disease is much higher in sub-Saharan countries than in other geographical regions globally. Malnutrition can be caused by deficiencies, excesses, imbalances in an individual's consumption of nutrients (WHO, 2017). Malnutrition can be under nutrition or over nutrition (Sufiyan et al., 2012), but in this review, malnutrition solely refers to the deficiency of nutrition. One of the major health problem faced by children in developing countries today is under nutrition (Goon et al., 2011; Ubesie et al., 2012 and Mengistu et al., 2013). Under nutrition leads to diseases and death in children, especially in the low and middle income countries (WHO, 2018).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.
1.2 Background of Study
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 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 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.
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to carry out Knowledge and Practices of Mother toward Prevention of Protein Energy Malnutrition Among Children 0-5years.
1.3 Statement of Problems
Investigation revealed that about 50 percent of the citizens in Nigeria are low income earners; it is evident from World Bank found that, from 1970 to 2000, the number of malnourished children decreased by 20 percent in developing countries. Some the other problems discovered are in the areas of lack of iodine intake by pregnant mothers before child birth, lack of minerals, calcium vitamins has seen to be a major clog on the wheels of child growth and development. In Nigeria today, there has been lack of nutritional education in most of the hospitals to educate pregnant mothers on how to feed before child birth.
Mal-nutrition leads to diseases and death in children, especially in the low and middle income countries (WHO, 2018). Malnutrition causes Nigeria billions in lost revenue through reduced economic productivity, days away from work due to illness and money spent on treating ailments (World Bank, 2014). The negative impacts of malnutrition are seen in families and communities in various aspects such as economically, socially and medically (WHO, 2018).
1.4 Aim and Objectives of Study
The aim of the study is to examine the Knowledge and Practices of Mother toward Prevention of Protein Energy Malnutrition Among Children 0-5years. In achieving this aim, the following specific objectives were laid out as follows:
- To examine the knowledge level of protein energy malnutrition among children from Zero to Five years of age;
- To examine the relationship between protein energy malnutrition and child mortality rate in Nigeria;
- To examine the effect of parent income on child care and protein energy malnutrition among children from Zero to Five years old;
- To identify the strategies for reducing protein energy malnutrition in children from zero to five years; and
- To proffer solution to the above stated problems of protein energy malnutrition among children under five years in the area under study.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- Does parent income have any effect on child care and protein energy malnutrition among children from Zero to Five years old?
- What is the knowledge level of protein energy malnutrition among children from Zero to Five years of age?
- What is the relationship between protein energy malnutrition and child mortality rate in Nigeria?
- What are the strategies for reducing protein energy malnutrition in children from zero to five years?
