Health, Feeding Pattern and Anthropometric Status of Preschool Children (2-5 Years) in Ikwuano Local Government Area of Abia State, Nigeria

¹Department of Public Health Sciences, Faculty of Basic Medical Sciences, College of Medical Sciences, Rivers State University Nkpolu- Oroworukwo, Nigeria

²Department of Human Nutrition and Dietetics, Michael Okpara University of Agriculture, Nigeria

*Corresponding author: Dr. Ada Daisy Oguizu, Department of Public Health Sciences, Faculty of Basic Medical Sciences, College of Medical Sciences, Rivers State University Nkpolu- Oroworukwo, P.M.B. 5080, Port Harcourt, Rivers State, Nigeria, Phone: +2348038132055, E-mail: [email protected]

Received Date: April 01, 2024

Publication Date: April 13, 2024

Citation: Oguizu AD, et al. (2024). Health, Feeding Pattern and Anthropometric Status of Preschool Children (2-5 Years) in Ikwuano Local Government Area of Abia State, Nigeria. Nutraceutical Res. 3(1):6.

Copyright: Oguizu AD, et al. © (2024).

ABSTRACT

The study design was a cross sectional survey aimed at determining the health profile, feeding pattern and anthropometric status of preschool children (2-5 years) in Ikwuano Local Government Area of Abia State. A multistage sampling technique was used to select 228 preschool children for the survey of which males were 117 and females 111. A semi-structured questionnaire was used to obtain information on the socio-demographic and economic characteristics of parents, the physical health profile and household feeding pattern of the studied children. Data was analyzed using SPSS version 22. Pearson’s correlation was used to establish the association between health status and anthropometric status. Significance was accepted at P-value < 0.05. Anthropometric measurements (weights and heights) were used to obtain the height-for-age, weight-for-age and weight-for-height which were calculated using WHO Anthro. The results reveals that 2.2% of the children were wasted, 16.7% stunted and 3.5% were underweight. The study showed that the children met their minimum meal frequency (MMF) of three or four meal times per day with one or two snacks as desired, and their minimum dietary diversity (MDD) of consumption of at least four food groups among seven food groups per day. Factors which were significantly associated (P<0.05) with health and anthropometric status of the preschool children studied showed that weight-for-height (WHZ) z-scores correlates positively with incidence of malaria (r=.198, p=0.003) and child’s deworming frequency (r=.180, p=0.007), while diarrhoea correlates negatively with height-for-age (HAZ) z-scores (r=-.229, p=0.000). It is recommended that a community based Nutrition education is needed for all mothers so as to keep them informed on the importance of timely deworming of children and to teach them appropriate feeding practices for children to ensure adequate nutrition for the children and other members of the family.

Keywords: Health, Feeding Pattern, Abia State, Anthropometric Status, Preschool Children.

Table 6 shows the nutritional status of under-five children studied based on weight-for-height (wasting), height for-age (stunting) and weight-for-age (underweight). About 2.2% of the children were wasted. Females (1.8%) were more wasted than males (0.9%). Children aged 2years (1.3%) were more wasted than the other age groups. About 16.7% of the children were stunted. Males (11.4%) were more stunted than females (5.3%). Children aged 2years (6.1%) were more stunted than the other age groups.  About 3.5% of the children were underweight. Females (3.6%) were more underweight than males (3.4%). Children aged 3years (2.2%) were more underweight than the other age groups.

Table 6. Prevalence of malnutrition in children by age and sex (N=228)

Table 7 shows the Pearson’s correlation between anthropometric status and health status of the children studied. The study shows that weight-for-height correlates negatively with height-for-age (r = -.193; P < 0.01), this indicates that the higher the prevalence of weight-for-age (wasting), the lower the prevalence of height-for-age (stunting). The study revealed that Weight-for-height correlates positively with weight-for-age (r = .204; P < 0.01), this indicates that the higher the prevalence of weight-for-age (wasting), the higher the prevalence of weight-for-age (underweight). The result shows that children who had malaria in the last 3 months before the survey had a significantly higher weight-for-height z scores than those that did not have malaria (r = .198; P < 0.01). The result shows that the deworming frequency of children had a significantly higher weight-for-height z scores than those that did not have their children dewormed (r =.180; P < 0.01).  The study also shows that height-for-age z score correlates positively with weight-for-age (r =.362; P < 0.01), this indicates, that the higher the prevalence of height-for-age (stunting), the higher the prevalence of weight-for-age (underweight). The result reveals that Height-for-age z scores of the children who had diarrhoea in the last 3 months before the survey had a significantly higher height for age z scores than those who did not have diarrhoea  survey (r = .229; P <0.01).

Table 7. The Pearson’s correlation between anthropometric status and health status of the children (N =228)

**. Correlation is significant at 0.01 level (2-tailed). 

* Correlation is significant at 0.05 level (2-tailed).

 WHZ= weight-for-height z- scores; HAZ= height-for-age z- scores; WAZ= weight-for age z scores

DISCUSSION

More than half of the respondents in this study were males. This is close to the findings of Jude et al. [17] conducted in South Eastern Nigeria, where 50.6% of the respondents were males. This finding is consistent with a similar study conducted in Zambia by Emmanuel et al. [18] where more than half (51.8%) of the children were males. The result shows that children aged 2years dominated during the study. Majority of the respondent were from monogamous families. This is so because most families in South Eastern Nigeria practice monogamy. More than half of the children lived with both parents. This study report is close to the report of NHDS [14], where 70.7% of children in Abia State lived with both parents. With respect to family size, more than half of the children came from 5-7 person’s family size. Comparing the results with NDHS [14], majority of the children had an average size family structure, since the minimum size for rural households are five. Also, based on the classification of family according to Zerida [19], low household size was a household with one to three members, a household of moderate size consist of five to seven members and a large household size comprises seven or more members. The child’s well-being is affected by his/her environment (including the home) which is largely influenced by the family structure, composition and relationship to members in the household [20]. Parents of the preschool children studied were young and in their productive years since most of them fell between 21-40years age bracket. Majority of the parents were married. The high percentage of married parents is expected as the study was carried out in the Eastern part of Nigeria which is dominated mainly by Christians who advocate for stability in marriages [21]. More than half of the mothers had secondary education. Women’s education offers leverage for improving nutritional status of children through the provision of more effective parental care in the home. Educated mothers are better, well informed to use health care facilities to ensure nutrition security, have better hygienic practices, practice child spacing, give birth to fewer children and have better opportunities to pursue work outside the home to generate additional household income and also have higher status in the family. Increases in female social status and education account for half of the reduction in child malnutrition rates during the past 25 years [22]. The occupation of the parents gives a clue to the family income. In the study group, most of the parents were employed, skilled labourers and traders which give a high level of both socio economic and better life implication to the children. Parents occupation are important especially fathers, as it improves the socioeconomic status of family. With regards to weekly food purchase, more than half of the families spent between ₦6,000-₦10,000 weekly on food.  Naturally the level of income has a huge impact on standard of living and food consumption pattern of families. The housing condition of the families was good, since majority lived in cemented. This is so as the area under study was dominated by civil servants, artisans and traders. Majority of the families’ used bore-hole as their source of drinking water. This report is similar to study by Nigeria Demographic and Health Survey which reported that 61% of households in Nigeria have access to an improved drinking water source and the percentage of households with improved sources of drinking water is highest in the South East (81%) (NDHS, 2018) [8]. From the study, most of the families used water closet toilet. According to NDHS [14], 56% of Nigerian households use improved toilet facilities. More than half of the families used firewood as their cooking fuel. This is similar to NDHS report that firewood is the main cooking fuel used in Nigerian households [14]. All the children studied had their immunization card intact and started their immunization at birth, mostly due to their mother’s educational levels. Majority of the children were fully immunized. This conforms to NDHS [14], which reported that vaccination coverage in Nigeria has improved over the past 10 years. All the studied children were dewormed, but the problem remains on how often the children were being dewormed. This report conforms to NNHS [23] report, that the national coverage for deworming was 40% among children age 12-59 months. Majority of the children ate more than 4 times in a day, which is satisfactory for their ages. This is expected because in rural communities, there are lots of farms and forests that provide different fruits and vegetables to the rural dwellers. The frequency of feeding of the children conforms to the Indicators for assessing infant and young child feeding practices on minimum meal frequency where Non-breastfed children should be fed meals four or five times per day, with one to two snacks as desired. Decisions on what is eaten in the more than half of the families was determined by the fathers; this is typical in most African setting, where fathers are the traditional heads and breadwinners of households whose role is to provide for both immediate and extended family members [24]. What was eaten in most households was determined by the availability of food in the households, cost of food and by seasonality. This is so because households in rural areas consume what is seasonally available from their farmland. Most of the households obtained their food from their farms and market. The high dependence on partly produced and purchased foods in the study could be due to change in livelihoods as people are more gainfully employed and are in diverse businesses to increase and stabilize their incomes away from the agricultural farming. Rural livelihoods are not solely based on agriculture but on a diverse array of activities and enterprises [25]. The study also reveals that most of the preschool children were fed by their Mothers and Grandma. This result agrees with the expectation that mothers are responsible for feeding preschool children as child feeding requires patience and time. The children’s favourite foods were noodles, rice and stew, tea and bread. The favourite meals consumed by the children were within expectation and similar to the reports of Akerele et al. [26] that children are known to favour tasty meals that will give them less stress to eat. In this study, many of the children did not skip any meal; this may be attributed to high literacy level of the mothers who know the importance and benefits of each meal to their children. This result is similar to the study of Olusanya [27]. In a rural community in Ogun State. The reason for skipping meal was majorly due to food dislike and not being hungry.  This is similar to study of Scagiloni et al. [28] who reported that Food likes and dislikes play an important role in food choices, especially in children. The prevalence of wasting in this study was very low compared to previous studies of rural school children carried out within Nigeria. Other studies have reported 12. 9% in Enugu Urban [29], and 11.3% in South-Eastern Nigeria by Jude et al [17]. The prevalence of wasting was more among females than males. This result contradicts reports from studies by Okwori [30] and Maitanmi [31], where male children were more wasting than girls. The prevalence of stunting in this study was lower than that reported by Amadi et al. [29] and Jude et al. [17]. The prevalence of stunting was more among males than females. This conforms to the study of Maitanmi [31]. The prevalence of underweight in this study was higher than that reported by Onifade et al. [32], but lower than the report of Amadi et al. [29]. The prevalence of underweight in this study is consistent with the study of Etim et al. [33] but in contrast with study of Amosu et al. [34] where underweight was higher among females than among males. The prevalence of wasting, stunting and underweight observed from this study is lower than the report of the NDHS [14]. The reason for this seemingly low prevalence of malnutrition in this study area could be attributed to the high level of economic activities in this area due to the presence of a higher institution of learning. Increased income for mothers and caregivers may have indirectly had a positive effect on the nutritional well-being of the children and their families [35,36].

CONCLUSION

The socioeconomic characteristics of preschool children’s family were average as majority of the children had a conducive living condition with good family income and spending ability on food, cement/zinc house, and good source of drinking water and toilet facilities. All the mothers of the preschool children studied were aware of immunization through different source and had the immunization cards of their children, while the children all started their immunization at birth. There were few incidence of diarrhoea, fever and cough, 3 months before the survey and  all the children studied had all been dewormed although the frequencies of their deworming status varies respectively. Majority of the children ate more than 4 times in a day and father’s determined what their families ate depending mostly on the availability of food at home, in season and cost of food as majority of the household partially purchased and produced their own food. Findings from the study revealed that the prevalence of wasting, stunting and underweight were low. We found that the Under-5 children studied had low prevalence of malnutrition and more adequate nutrition with only a few of them being undernourished. However, despite the low prevalence of wasting and underweight in the studied children, there is need for nutrition education programs for the mothers, as stunting is more prevalent.

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