THE EFFECT OF NUTRITION ON THE HEALTH STATUS OF PHYSICALLY CHALLENGED CHILDREN IN SCHOOL OF SPECIAL NEEDS IN NIGERIA

1.1 Introduction

Nutrition is a fundamental requirement for good physical health, cognitive development and social development. Adults with lower physical and intellectual abilities, lower levels of productivity and higher levels of chronic illness and disability is as a result of malnourishment during childhood. Malnourished children can become adults with lower physical and intellectual abilities, lower levels of productivity and higher levels of chronic illness and disability (UNICEF, 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, Limitations of the Study and Definition of technical terms.

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1.2 Background of Study

There is, however, increasing national interest in the links between malnutrition and disability. There are a variety of possible reasons for poor nutrition in disabled children. Adequate nutrition is a fundamental prerequisite for good physical health, motor and cognitive development and social development (Meeks Gardner J et al, 2000; Water low JC, 2014). Malnourished children can become adults with lower physical and intellectual abilities, lower levels of productivity and higher levels of chronic illness and disability (UNICEF, 2018). Disabled people are often assumed to have poorer nutrition than their non-disabled counterparts and, indeed, surveys in developed countries have shown that disabled children and adolescents are vulnerable to poor nutritional care (Bax, 2003; Thomas et al, 2009). In contrast, far less information is available on the nutritional status of disabled children in developing countries where the situation is further complicated by widespread malnutrition among the general population.

Previous studies in Nigeria (Alakija, 2008; Ojofeitimi, 2003) identified mild malnutrition in school-age children with sensory or mental impairments. Many studies of children with cerebral palsy have reported evidence of growth impairment (Hals et al, 2016; Shapiro et al, 1986; Stallings et al, 2016) or micronutrient deficiencies (Hals et al, 1996; Rampage et al, 1996). Growth retardation and feeding problems have also been noted in groups with other disabilities, including mental retardation, congenital heart disease and deaf ± blindness (Thommessen et al, 2011; Suzuki et al, 2011). Adolescents with mental retardation may also be overweight as a result of a sedentary lifestyle and over eating (Suzuki et al, 2011). There is a close relationship between poverty and disability (Coleridge, 2013). Children with disabilities living in poverty may be put at further risk of inadequate nutrition due to financial constraints or social beliefs. Economic conditions may influence the parent’s responses to their child’s condition (Mallory et al, 2013).

However, disabled children in such situations are not always neglected; for example, in Tanzania disabled people were as far as possible integrated into the normal routine of the community (O’Toole & McKonkey, 2015). Estimates of the prevalence and severity of nutritional deficits among disabled children are complicated by the fact that physical disabilities will interfere with standard anthropometric measurements. For example, conditions such as kyphosis or bent legs can compromise the accuracy of standard height or length measurements and the extra arm exercise involved in using walking aids in some polio survivors can affect mid-upper arm circumference (MUAC) results. Although international guidelines suggest disregarding anthropometric results from disabled children (United Nations, 2006), these children have the same right to good nutrition as non-disabled children so it is important to solve these measurement problems. We compared the nutritional status of disabled children with their non-disabled counterparts in Nigeria to determine if the disabled children were nutritionally disadvantaged and see if a disabled child disadvantaged the nutritional status of the siblings. We also evaluated the use of demi-span and half-span as proxy indicators of height in disabled children.

Therefore, in Nasarawa Special School, Lafia where the research was carried out, the activities that was conducted is to know the Influence of Nutrition on the Health Status of Physically Challenged Children.

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1.3 Statement of the Problem

There is an increasing global interest in the links between the malnutrition and the physically challenged children in Nigeria. Because they both share many common features, there is hope that closer links and stronger working relationships between the two fields could lead to important synergies and mutual benefits: both fields address global problems affecting large numbers of often vulnerable individuals, including children and adults: some one billion people worldwide are malnourished, and around one billion live with a disability; both are related to key human rights: the right to food, a key determinant of nutritional status, is articulated in the 1948 Universal Declaration of Human Rights (Article 25); the General Comment on the Right to Food specifically mentions the rights of people with disabilities to have physical access to adequate food; the right of all children to adequate nutrition is laid out in the Convention on the Rights of the Child which has been ratified by all but two countries. Since health care for individuals with physical challenges requires specialized knowledge acquired by additional training, as well as increased awareness and attention, adaptation, and accommodative measures beyond what are considered routine. This researcher intends to evaluate the health status of physically challenged children in school of special needs in Nigeria.

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1.4 Aim and Objectives of the Study

The main aim of this study is to investigate the Effect of Nutrition on the Health Status of Physically Challenged Children in School of Special Needs in Nigeria using Nasarawa Special School in Lafia as a case study. In achieving this aim, the following specific objectives were laid out as follows:

1. To evaluate the health status of physically challenged children in school of special needs in the area under study;
2. To ascertain if there is a close link between malnutrition and the health status of physically challenged children in school of special needs in the area under study;
3. To enumerate factors associated with deterioration in physically challenged children’s nutritional status; and
4. To proffer possible solutions to the problems and challenges associated with malnutrition among physically challenged children in school of special needs.

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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 is any close link between malnutrition and the health status of physically challenged children in school of special needs in the area under study?
• What are the factors associated with deterioration in physically challenged children’s nutritional status?
• What is the health profile of physically challenged children in school of special needs in the area under study?
• Is there is any significant relationship between malnutrition and the health status of physically challenged children in school of special needs in the area under study?

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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 malnutrition and the health status of physically challenged children in school of special needs in the area under study
• H1: There is significant relationship between malnutrition and the health status of physically challenged children in school of special needs in the area under study

Hypothesis Two

• H0: Poverty is not associated with malnutrition among physically challenged children in school of special needs in the area under study
• H1: Poverty is associated with malnutrition among physically challenged children in school of special needs in the area under study

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1.7 Significance of Study

It is unbelievable to discover that many parents in this era still lack the fundamental idea or basic knowledge of malnutrition effect on the health of their children. It is believed that at the end of this study the findings will be of utmost benefits to every parent on the need to checkmate the nutritional level in their daily diets.

To health care practitioners for a need to intensify their awareness campaign against malnutrition, to all expectant mothers, nursing mothers and the general public. To teachers in taking up the challenge to further educate these impaired children and stress the importance of balance diet to both parents and children who are ignorance those variable that have effects on physically impaired children health.

To the government in making provisions on the concept of good health on the physically impaired children in school of special needs. Finally, the findings of this study will serve as a reverence material to scholars who intend to embark on a research of this nature.

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1.8 Scope of Study

The scope of this research focuses on the Influence of Nutrition on the Health Status of Physically Challenged Children using Nasarawa Special School in Lafia as a case study.

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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).

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1.10 Definition of Terms

Nutrition: Nutrition is the science that interprets the interaction of nutrients and other substances in food in relation to maintenance, growth, reproduction, health and disease of an organism. It includes food intake, absorption, assimilation, biosynthesis, catabolism and excretion.

Malnutrition: Malnutrition is a condition that results from eating a diet in which nutrients are either not enough or are too much such that the diet causes health problems. It may involve calories, protein, carbohydrates, vitamins or minerals.

Health: Health is the level of functional and metabolic efficiency of a living organism. In humans it is the ability of individuals or communities to adapt and self-manage when facing physical, mental, psychological and social changes with environment.

Status: Status is a state, condition, or situation.

Physically challenged: physical disability is a limitation on a person’s physical functioning, mobility, dexterity or stamina, other physical disabilities include impairments which limit other facets of daily living, such as respiratory disorders, blindness, epilepsy and sleep disorders.