FOOD CONSUMPTION PATTERN, ANTHROPOMETRIC INDICES AND MICRONUTRIENT STATUS OF CHILDREN AGED 6 - 59 MONTHS

1.1 Introduction

Malnutrition refers to deficiencies, imbalances or excesses in a person’s intake of energy and/ or nutrients (World Health Organisation, 2016), it is a problem that weakens the body’s immunity and causes illness. According to Ismail et al., (2013), malnutrition is the underlying cause of more than half the deaths of children under five. It accounts for approximately 1 million deaths of 20 million children under the age of five suffering from severe malnutrition annually. Nutritional status is defined as the evident state of nutrition of an individual (Akinlosotu and Hussain, 1985; Uppal et al., 2005). Children in this age group require a high supply of nutrients since they are usually very active and their growth is rapid (Ene-Obong, 2001).

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, Limitations of the Study and Definition of technical terms.

1.2 Background of Study

The World Development Report (WDR, 2007/2008) ranks Nigeria as the largest territorial unit in West Africa that has over one hundred and forty-seven million people (147,000.000). Approximately, 75% of the population is women and children. Over 70% are residing and securing their livelihoods in the rural areas. Within this huge rural population, particularly among the urban poor, Nigeria infant and child mortality rates are alarming. The rate is 100 per 1,000 births and mortality of 1,100 per 100,000 live births. Most of these deaths are due to lack of adequate intake of food or inappropriate combinations of food (Nigeria Demographic and Health Survey (NDHS) (2008). Akinyele (2009) reported a high level of malnutrition among children in rural Nigeria. The figures differed with geopolitical zones, 56 percent was reported in a rural area of South West and 84.3 percent in three rural communities in the northern part of Nigeria.

High level Task Force on Global Food Crisis (HTFGFC, 2008) reported that inadequate diet and malnutrition are the major cause of death of over 3.5 million children, every year at a rate of more than 10,000 children per day. Inadequate dietary pattern is a threat to health and under-nutrition, mainly in young children. Inappropriate and inadequate dietary patterns have emerged as a major development crisis facing Nigeria today. Inadequate dietary patterns have serious implication on the growth and health of individuals and have a huge effect on the country’s productivity.

Nutritional status of children has become a worldwide public health issue and its assessment has been adjudged the best global indicator of well-being in children. One in three children under the age of five (178 million children) in developing countries are stunted due to chronic under-nutrition and poor quality diets. Without addressing malnutrition, the Sustainable Development Goal 2 of ending hunger, achieving food security and improved nutrition may not be attained.

The United Nations Development Programme Report (UNDP) (2007) states that, adequate diet and health of the people are indicators of the country’s socio-economic situation; apart from shelter and clothing as the basic needs of life, food remains the core or apex in the hierarchy of human needs. This is because of its importance not just to children but to the entire human existence. Over two thirds of child’s deaths are associated with inappropriate feeding practices that occur within the first year of life. Malnourished children who survive are more frequently sick and suffer the lifelong consequences of impaired development (Hatloy, Hallund, Diarra & Oshaug, 2000).

Inadequate intake of food will continue to affect the nutritional status of households leading to malnutrition and consequently to poor health, poor livelihoods and poor productivity. This is very important and critical to life, adequate and appropriate dietary pattern should be the right of every individual. However, monotonous diet, inadequate food and poor feeding behavior have persisted. These constitute a major threat to the health and wellbeing of children. Again, for any country to thrive and be productive, it must have a healthy population as a malnourished population leads to reduced productivity, hampering economic growth and the full realization of potential of citizens. Adequate nutrition is very crucial to the growth and the economic development of any country. Dietary pattern or habits become established in children from infancy and to a greater extent persist throughout life. Nutrition affects health throughout the life cycle and it is best to prevent malnutrition early in life. So it is very important to monitor the nutritional status of any country to determine the productive rate of that nation.

The importance of good diet cannot be overlooked because food and eating well can make the difference between being alive or dead and being well or sick. Some researchers have shown (Caulfield, de Onis, Blossner & Robert, 2004; Bryce, Coltinho, Darnton-Hill, Pelletier & Pinstrup-Anderson, 2008) that food or good diet can prolong life, well being and promote human development. This is because a healthy population means healthy productive force. The Food and Agriculture Organization (FAO, 2000) reports that about 854 million people were under-nourished worldwide in 2001-2003 Nigeria inclusive and by 2008, the number had increased from 854 million to 925 million. The FAO report also shows clearly that a large percentage of this under-nourished number is located in Africa where one in three people are deprived of sufficient food.

United Nations Children’s Fund (UNICEF, 2006) indicates that infant mortality rate is 75 deaths per 1,000 births. The under-five mortality rate is 157 per 1,000 live births. The neo-natal mortality rate is 40 per 1,000 live births. This translates to about one in every six children born in Nigeria dying before their fifth birthday. The report shows that almost half of childhood deaths occurred during infancy and first few months of life. There are variations in mortality levels across the country. Infant mortality and under-five mortality rates are higher in the northern areas of Nigeria. Child mortality rate in the north-west (which comprises of Sokoto, Sokoto, Kastina, Zamfara and Kebbi) according to NDHS (2008) is 109 deaths per 1,000 births compared to south-west which is 89 deaths per 1,000 births. All evidence points to the fact that almost all the deaths are dietary and nutrition related (NDHS, 2008).

Adequate dietary pattern is the fundamental challenge to children’s health status and welfare in Nigeria and Sokoto State in particular. Nutrition is not just eating and drinking but eating adequate food to get a good supply of all the key nutrients. Individual nutritional status is dependent on the interaction between food that is eaten, the state of health and the physical environment. Many childhood deaths can be prevented if there is timely intervention for example; ensuring appropriate dietary pattern from birth, immunizing children against preventable diseases and making sure that children receive prompt and appropriate treatment when they become ill. A child that is born without any abnormalities and given the best environment including adequate care and protection against infection will grow well and develop to his or her full potential. Nutrition plays a major role in shaping a child’s life towards attaining or the attainment of his potential. The nutritional assessment of an individual or community is very important because it could be used to identify populations or population segments at risk for nutrition-related diseases and provide critical information for intervention.

Malnutrition is associated with an inadequate diet, poor health and sanitation services as well as inadequate care given to children. Malnutrition (poor nutritional status) constitutes a major public health problem in most developing countries including Nigeria. A lot of the population cannot afford enough to eat and most of them live in very poor environment. Vulnerable children with high nutritional needs and weak immune systems fall victims to diseases and subsequently to malnutrition.

Eliminating hunger and malnutrition is one of the most fundamental challenges facing humanity. Malnutrition and its associated disease conditions can be caused by eating too little, eating too much or eating inadequate diet that lacks necessary nutrients. Malnutrition is one of the most devastating problems worldwide. It is inextricably linked with ignorance, illiteracy, poverty and lack of development.

Creating awareness and appropriate knowledge of food combination (adequate diet) will contribute to reducing the incidence of malnutrition. Dietary pattern becomes established in children from infancy and to a greater extent persist throughout life. Nutrition affects health throughout the life cycle and it is best to prevent malnutrition early in life. For any country to thrive and be productive, it must have a healthy population as a malnourished population leads to reduced productivity, hampered economic growth and inability of citizen to realize their potentials. A healthy population with adequate nutritional status is very crucial to the growth and the economic development of any country. It is very important to monitor the nutritional status of any country because this will determine the productive rate of that nation.

Therefore, in Sokoto State, Nigeria where the research was carried out, the activities that was conducted is to know the Food Consumption Pattern, Anthropometric Indices and Micronutrient Status of Children Aged 6 - 59 Months.

1.3 Statement of Problems

Investigation revealed the malnutrition is a pathological condition brought about by the inadequacy or over consumption of one or more of the essential nutrients necessary for survival, growth, reproduction as well as productivity at work (UNICEF and FGN, 2001).

The inadequate or excessive intake of nutrients may result from disease factors that affect digestion, absorption, transport, and utilization of nutrients (UNICEF, 1990). Malabsorption of nutrients may result from genetic cum environmental conditions or illness. The most critically vulnerable groups are the developing foetus, preschool children, women before and during pregnancy, and lactating women (UNICEF, 1998).

Malnutrition affects all levels of development physically, mentally, socially, psychologically and physiologically. It thus multiplies the effect of prevailing disease or mortality in children and infants (Huffman and Marlin, 1994).

1.4 Aim and Objectives of Study

The aim of the study is to assess the Food Consumption Pattern, Anthropometric Indices and Micronutrient Status of Children Aged 6 - 59 Months in Sokoto State, Nigeria. In achieving this aim, the following specific objectives were laid out as follows:

1. To determine the food consumption pattern of under-five children in Sokoto State.
2. To assess the feeding practices of the under five children in Sokoto State.
3. To assess the anthropometric indices of the under five children in Sokoto State.
4. To assess the vitamin A, iron and iodine status of the under five children in Sokoto State.
5. To ascertain the relationship between the feeding practices of under five children and their nutritional status.
6. To determine the relationship between socio-economic status of the parent and their nutritional status(children).

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:

• Is there any relationship between the feeding practices of under five children and their nutritional status?
• What is the food consumption pattern of under-five children in Sokoto State?
• What are the feeding practices of the under five children in Sokoto State?
• What are the anthropometric indices of the under five children in Sokoto State?
• What is the vitamin A, iron and iodine status of the under five children in Sokoto State?
• What is the relationship between socio-economic status of the parent and their nutritional status (children)?

1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There is no significant relationship between socio-economic status of the parent and their nutritional status (children) in the area under study
• H1: There is significant relationship between socio-economic status of the parent and their nutritional status (children) in the area under study

1.7 Significance of Study

The study would provide much more detailed nutritional guide for use to educate women or mothers who attend ante-natal’s on major food crops in Sokoto State as well as relationship between dietary patterns of children and their anthropometric status. Nutritionists, Home Economic Teachers, Extension workers and other health workers in the state would benefit from the study because it would provided a tool for knowledge in the class rooms and in the field. The food and agricultural sectors will be spurred to focus attention in producing and promoting high quality food crops to reduce the global burden of malnutrition. The result would provide data for regional food policy change as well as spur research work on the vulnerable groups (women and children).

There is high prevalence rate of malnutrition and infant mortality in northern states of Nigeria. There are less extensive research to document dietary pattern and anthropometric status of children in Sokoto State. The study would highlight the consumption pattern and the nutritional status of under- five children in Sokoto State.

The result of the study would x-ray the relationship between the consumption pattern of the children and their anthropometric status. The documented results when published would serve as a guide to both senatorial districts, local government, CBOs, TBAS, nongovernmental organization etc to institute proper nutrition intervention. It would also be useful tool to Sokoto State Government, Ministry of Health to plan nutrition intervention and implement for under- five children in the State.

This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

1.8 Scope of Study

The scope of this research focuses on the Food Consumption Pattern, Anthropometric Indices and Micronutrient Status of Children Aged 6 - 59 Months in Sokoto State, Nigeria.

1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Research material: availability of research material is a major setback to the scope of the study.
3. Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
4. 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).

1.10 Definition of Terms

The following terms are operationally defined as used in this study;

Analysis: Analysis is the process of breaking down a something into its parts to learn what they do and how they relate to one another.

Value: Values are basic and fundamental beliefs that guide or motivate attitudes or actions. They help us to determine what is important to us.