Current Issue

2024: Volume 3, Issue 1

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

Oguizu AD1,*,  Nwoke IC2

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.

INTRODUCTION

The health and nutritional status of children is an index of national investment in the development of its future man power [1]. Nutrition is a basic human right for all human beings, including children, as set out in the “Convention  on  the  rights  of  the  child”  and  other  human  rights  agreements. In order  to  develop  fully  and  maintain  physical and  mental  health and  wellbeing,  children need  to  be  free  from  hunger  and  malnutrition  [2].

Children are considered to be the most important natural resource and biggest human investment for development in every community. However, the quality of life of school children continues to be poor in developing countries and the conditions is worst in the rural areas of the developing countries [3]. Children who are malnourished often  fail  to  thrive,  are  more  likely  to  suffer  from impaired  physical  and  intellectual  growth  which make  them  less  productive  during  adulthood  [4].

Preschool children (defined as age 2-5 years) constitute the most vulnerable segment of the population and their nutritional status is considered to be a sensitive indicator of community health and nutrition [5]. A school play an important role in the physical, mental and emotional development of children and is the most active phase of childhood growth. Common outcome of malnutrition among children under five years also include poor school performance, school absenteeism, delayed intellectual achievement, reduced cognitive development morbidity and mortality [6].

Child health plays a vital role in the development of a country. The first six years of life constitutes the most crucial span in life. Far from simple health cannot be defined in measurable terms, its presence or absence is subjective. Many indicators are employed to understand health.

The main child health indicators are poverty, malnutrition, health care provision, maternal health, empowerment of women, birth weight, breast feeding, immunization, access to health care and anaemia and the child mortality indicators are perinatal mortality rate neonatal mortality rate, infant  mortality rate and under 5 mortality rates [7]. The  consumption  pattern  of  a  household is  the  combination  of  qualities, quantities,  acts  and  tendencies  characterizing  a  community  or  a  human group’s use of resources for survival, comfort and enjoyment and the type  of  food  and  non-food  items  consumed,  vary  from  region  to  region [8].

Although economic factors are important determinants of nutritional status, feeding practices are often stronger determinants of childhood nutritional status, independent of socioeconomic determinants. In recognition of the role of infant and young child feeding practices on the nutritional status of children under 2 years, a global strategy for optimal infant and young child feeding (IYCF) was set up by World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) in order to reduce malnutrition among the children, which recommends early initiation of breastfeeding within one hour of birth, exclusive breastfeeding for the first six months and continued breastfeeding with the timely introduction of appropriate, adequate, and safe complementary foods along with continuing breastfeeding up to two years and beyond [9]. Complementary feeding practice includes introduc­ing solid, semi-solid, and soft foods, which when com­bined with breastfeeding is an important step in reducing the risk of Undernutrition and its consequences [10].

Objectives of the study

  • Determine the socio-economic characteristics of parents of preschool children studied in Ikwuano L.G.A.
  • Assess the health status of the children
  • Assess the feeding pattern of the children
  • Assess the anthropometric status of the children
  • Determine the relationship between health status and anthropometric status of the children.

MATERIALS AND METHODS

Study design

The study design was a cross sectional survey of the health, feeding pattern and nutritional status of preschool children (2-5 years) in Ikwuano Local Government Area of Abia State.

Study area

Ikwuano Local Government Area is one of the local government area in Abia State, Nigeria with it’s headquarter at Isiala Oboro. Ikwuano has an area of 281km2 and a population of 137, 993. Ikwuano is located at approximately 50 251 6011 degrees north of the equator and about 70 341 011 degrees east of the Greenwich meridian [11]. The Northern border of Ikwuano is 3 miles (4.8km) South of Umuahia urban centre, the capital of Abia State of Nigeria’s South East. The Southern border is 15miles (24km) from Ikot-Ekpene, Akwa-Ibom State. Ikwuano is bordered by Olokoro and Ibeku communities in the North and North-West, and by Bende in the East. It is also bordered by Nkalu in the South-East; Oboro-Akara in the South and Ohielu-Nsulu in the South and South-West. Ikwuano local government is made up of four large clans which include; Oboro, Ibere, Oloko and Ariam [11]. The climate is typical of the humid tropics and fairly even and uniform temperature throughout the year. The crops commonly grown in the area include Cassava, Plantain, Maize, Yam, Rice, Sweet Potatoes, African Yam Bean, Ukazi and Achara. The majority of the people are predominantly skilled labourers, followed by traders who engage in different business activities alongside civil service and farming [12].

Population of study

The study population was comprised of preschool children aged 2-5 years from the four clans/zones that make up Ikwuano LGA namely; Oboro, Oloko, Ibere and Ariam.

Sample size determination

Determination of sample size was based on Araoye, 2003 formular [13]

N= Z2Pq/e2

N= sample size

Z= selected critical value of desired confidence level 95%

P= estimated proportion of an attribute that was present in the population 17%

q = 1-p

e = the desired level of precision 5%.

Prevalence of malnutrition (stunting) in Abia State is 17% (0.17) and 95% confidence level (1.96) with [endif]--> 5% (0.05) precision.

The prevalence of malnutrition (stunting) in Abia State is 17% [14].

The calculation for this project will be calculated as:

 Z =1.96, P =0.17, hence q = 1- 0.17 = 0.83, e = 0.05.

Thus N = (1.96)2 (0.17) (0.83)/(0.05)2 = 217

An estimated total sample size of 217 was gotten from the calculation, then, to account for drop outs 10% of 217 was added to total sample size giving 238 which was approximated to 240.

Sampling procedures

Multistage sampling technique was used in selecting the sample size for the study. Simple random sampling was used to select four (4) Wards out of the ten (10) Wards in Ikwuano Local Government. The four (4) Wards selected were, Oboro ward 2, Oloko ward 1, Ibere ward 2 and Ariam ward.  Eight (8) villages (Amaoba, Umudike, Umugo, Awomukwu, Ngwugwo, Obuohia, Ekpiri Ala-ala, Ariam Elu-elu) were randomly selected from the Twenty two (22) villages in the four Wards under study; two (2) villages from each Ward.

A systematic random sampling technique was used to select Two hundred and forty (240) households from Nine hundred and sixty-eight (968) households in the four (4) Wards under study (Household were systematically selected by counting every fourth household). Children 2-5 years in the selected households were used for the study. Information where gotten for all the 2-5 years old children in a particular household  and where a household does not have children of the age bracket, the household is left for the next household.

Informed consent and ethical approval

Oral consent was sought from the village heads, parents and caregiver of the preschool children from the randomly selected households in the local government. The nature, objectives, procedure and safety of the research were explained to the parents/guidance of the participants to gain their trust and have their full consent. Ethical approval for the study was obtained from Ikwuano local government health authority, Isiala Oboro.

Data collection

Data was collected by 4 trained research assistants via face-to-face interviews using a well-structured and validated questionnaire. The well-structured questionnaire instrument included sections on:

Socio-demographic characteristics

This section was focused on collecting information on the background characteristics of the study participant’s (age, sex) and the socio-demographic characteristics of their households- the occupation and educational level of their parents, number of children and adults in each  household and tenancy status and household ownership of assets using a well-structured questionnaire.

Anthropometric assessment

Anthropometric measurements were taking using the procedure described by Lee and Nieman [15,16].

  • Weight Measurements

Body weight was obtained using a newly purchased bathroom scale (Camry Mechanical Personal Scale Model: BR9012 (1 - 120 Kg capacity.), placed on a hard floor with the sliding weight placed at zero and the balance bar aligned to balance. Subjects were asked to remove heavy outer clothing, take off shoes and empty their pockets, such as trousers. They were asked to stand still in the centre of the scale as to distribute their weight equally on both feet, without touching anything during the process of measurements. The weight was recorded on the questionnaire in nearest 0.1 kilograms, as an average of two measurements taken. These scales were calibrated each morning and checked at regular intervals during the day [15,16].

  • Height Measurements

Height for children were measured by means of a stadiometer (locally constructed), with vertical scale of metres and a sliding headpiece, to the nearest 0.1 cm. The children were asked to remove their shoes, heavy clothes and were positioned to face straight towards the trained assistant and relax with their back to the height ruler. They were helped to put their legs and knees straight together with arms aside, and to stand still with feet and heels touching together. The measuring rod was lowered to press the hair flat and the height was taken in centimetres on the questionnaire. The average of two measurements was taken [15,16].

Health examination 

 Health examination and Information about immunization records and common illness of the child was recorded from the child’s vaccination card and the mother’s verbal report. The information also accessed the mothers awareness of immunization, how fully immunized their children where and the occurrence of diarrhoea, malaria and cough in the last 3 months before the survey.

Feeding pattern

This section on dietary practices provides information on usual behaviours related to meal consumption pattern and frequency, meal skipping and snacking.

Data analysis

A total number of 240 children and their households were interviewed. Data for 12 children were removed because the children were more than five years (60 months), thus final analysis were based on 228 children. The health status of the children with no and yes option were scored with binary number 0 and 1 respectively. The prevalence of malnutrition was merged because the number of preschool children studied that were severely wasted, stunted and underweight was small. For the prevalence of malnutrition in the studied children <-3 SD Severely underweight and those underweight from ≥-3 to <-2 SD were merged as underweight, children <-3 SD severely stunted and those stunted from ≥-3 to <-2 SD were merged as stunted, while children from ≥-2 to <+3 SD were Normal for underweight and stunted respectively. <-3 SD were severely wasted and from ≥-3 to <-2 SD wasted were merge as wasted, from ≥-2 to ≤+1SD were Normal.

Statistical analysis

Data was entered and analysed using IBM SPSS Statistics Version 22. Descriptive statistics was used to describe the Socio-demographic and household characteristics of the preschool children and their parents/caregivers. Frequencies and percentages were computed for categorical variables. Frequencies and proportions were used to describe the dietary practices of the preschool children with respect to usual meal frequency, meal skipping and snacking habits. Also, weight for height, height for age, and weight for age Z-scores was computed using the WHO Anthro software and frequencies as well as proportions was calculated to describe the anthropometric status of the preschool children. Pearson’s correlation was used to establish the relationship between anthropometric status and health status. Significance was accepted at P-value < 0.05.

RESULTS

Table 1 show the Personal characteristics of the preschool children studied. More than half (51.3%) of the respondents were males, while 48.7% were females. Most of the children (46.5%) were aged 2 years, 32.0% were 3 years, 16.7% were 4 years, while 4.8% were 5 years old. Majority (90.8%) of the respondents were from monogamous families, while 9.2% were from polygamous families. More than half (68.9%) of the children lived with both parents, 25.4% lived with their mother’s alone and 5.7% lived with their father’s alone. With respect to family size, 39.5% of the respondents came from 2-4 person family size, more than half (52.6%) were from 5-7 person family size, while 7.9% were from above 7 person’s family size.

Table 1. Personal characteristics of preschool children studied

Variables

Classification

Frequency

No

%

Gender

Male

117

51.3

Female

111

48.7

Total

228

100

Age

2 years

106

46.5

3 years

73

32

4 years

38

16.7

5 years

11

4.8

Total

228

100

Family type

Monogamous

207

90.8

Polygamous

21

9.2

Total

228

100

Child’s care giver

Both parents

157

68.9

Mother alone

58

25.4

Father alone

13

5.7

Total

228

100

Family size

2-4 persons

90

39.5

5-7 persons

120

52.6

Above 7 persons

18

7.9

Total

228

100

Table 2 shows the Socio-demographic characteristics of the parents of preschool children studied. About 49.1% of the mothers were between the ages of 21-30 years, 30.7% were between the ages of 31-40 years. For the father’s age, 14.9% were between the ages of 21-30 years, 46.9% were between the ages of 31-40 years and 33.8% were above 41 years. Majority (89.0%) of the mothers were married, 4.4% were divorced, while 4.8% were widowed.  About 96.5% of the fathers were married, 2.2% were divorced and 1.3% widower. About 21.8% of the mothers had primary education, more than half (58.7%) had secondary education and 19.6% had tertiary education. For the fathers 23.2% had primary education, 53.2% had secondary education. One third (36.0%) of the mothers were skilled labourers, 31.6% traders and 24.9% were civil servants. Majority (45.5%) of the fathers were skilled labourers, Up to 28.6% civil servants, 18.2% traders and 5.0% unskilled labourers.

Table 2. Parents Socio-demographic characteristics

Variable

Classification

Mothers

No            %

Fathers

No   %

Age

< 20 years

38          16.7

2        0.9

21-30 years

112          49.1

34      14.9

31-40 years

70          30.7

10      46.9

41 years above

5           2.2

77      33.8

Not alive

3            1.3

8        3.5

Total

228           100

228       100

Marital status

Married

206          89.0

220     96.5

Single

4            1.8

-            -

Divorced

10            4.4

5       2.2

Widowed

8            4.8

-            -

Widower

-              -

3       1.3

Total

228           100

228       100

Educational qualification

Primary

49           21.8

51       23.2

Secondary

132           58.7

117      53.2

Tertiary

44           19.6

52      23.6

Total

225            100

220       100

Occupation

Civil servant

56           24.9

63      28.6

Skilled labourer

81           36.0

100      45.5

Trading

71           31.6

40      18.2

Farming

17             7.6

6        2.7

Unskilled labourer

-                -

11        5.0

Total

225            100

220       100

 

Table 3 shows only 21.1% of the parents earned ₦6,000-₦10,000 weekly, 44.7% earned ₦11,000-₦15,000, up to 29.4% earned ₦16,000-₦20,000, while 2.6% earned above ₦20,000 in a week. As much as 28.9% of the parents spent ₦1000-₦5,000 on weekly food purchase, more than half (53.9%) spent ₦6,000-₦10,000 on weekly food purchase, while 1.8% spent above ₦15,000. The study revealed that the housing condition of the families were good, since majority (99.1%) lived in cement house, and of the cement type house; 39.5% lived in bungalow, 37.3% in two rooms, 16.2% in flat, and 7.0% in one room, while 0.9% of parents lived in mud/thatch houses. Majority (71.1%) of the families’ used bore-hole water, 22.8% used sachet water, while a few 6.1% used stream/river water as their source of drinking water respectively. From the study, most of the families (71.1%) used water closet toilet, 26.3% used pit latrine and 2.6% used bush system. More than half (58.3%) of the families used firewood as their cooking fuel, 11.8% used cooking gas, while 8.3% used both firewood and kerosene, and 2.2% of families used both kerosene and cooking gas.

Table 3. Parents Socio-demographic characteristics (N=228)

Variable

Classification

Frequency

No              %

Family income weekly

₦6,000-₦10,000

48            21.1

Family income weekly

Family food purchase weekly

₦11,000-₦15,000

102       44.7

₦16,000-₦20,000

 

67      29.4

₦1,000-₦5,000

66           28.9

Family food purchase weekly

Family house type

₦6,000-₦10,000

123            53.9

₦11,000-₦15,000

35          15.4

Above ₦15,000

 

4            1.8

Mud/thatch

2             0.9

Family house type

If cement (type)

Cement/zinc

 

226         99.1

Bungalow

90           39.5

If cement (type)

Source of drinking water

Flat

37           16.2

One room

16            7.0

Two rooms

 

85            37.3

Borehole

162           71.1

Source of drinking water

Family toilet type

Stream/river

14            6.1

Sachet water

 

52            22.8

Water closet

162           71.1

Family toilet type

Source of cooking fuel

Pit latrine

60            26.3

Bush system

 

6              2.6

Firewood

133           58.3

Source of cooking fuel

Kerosene

32             14.0

Cooking gas

27            11.8

Firewood and Kerosene

19             8.3

Firewood and Cooking gas

12             5.3

Kerosene and cooking gas

5               2.2

 

 

Table 4 showed that all (100%) the mothers were aware of immunization. The source of their awareness were found to be mostly through the work of the community leaders (53.1%), while 20.6% of mothers were aware through the mass media and 15.4% were through health workers. All the children studied (100%) had their immunization card intact and started their immunization at birth. Majority (98.7%) of the children were fully immunized, while only 1.3% was partially immunized. Mothers of the two hundred and twenty eight preschool children studied, reported different health cases that they have experienced within the last three months before the study. About 4.8% of the mothers reported history of diarrhoea in their children, 67.5% reported history of malaria and 34.6% reported cough.

Table 4. Health status of the preschool children studied (N=228)

Variables

Classification

Frequency

No         

 %

Mother’s awareness of immunization

No

-

-

Yes

228

100

Means of immunization awareness

Mass media

47

20.6

Friends

25

11

Health workers

35

15.4

Community leaders

121

53.1

Immunization card available

No

-

-

Yes

228

100

Child starts immunization

At birth

228

100

Don’t know

-

-

Immunization status of child

Fully immunized

225

98.7

Partially immunized

3

1.3

Incidence of diarrhoea in last 3 months before survey

No

217

95.2

Yes

11

4.8

Incidence of malaria fever in last 3 months before survey

No

74

32.5

Yes

154

67.5

Incidence of coughing in last 3 months before survey

No

149

65.4

Yes

79

34.6

Deworming of child

No

-

-

Yes

228

100

Deworming frequency of child

3 months

3

1.3

6 months

43

18.9

9 months

40

17.5

Yearly

77

33.8

Others

65

28.5

Table 5 revealed that majority (82.5%) of the children ate more than 4 times a day, while 17.5% of the children ate 3 times a day. More than half (51.3%) of the decision of what was eaten in the family was determined by the fathers, 46.5% by mothers, while only 2.2% of the children decided on the food eaten in their families. Factors that determined foods eaten in households were; availability of food in the house (57.9%), seasonality (23.7%), cost of food (15.8%) and child’s choice (2.6%). About 22.8% of foods eaten in the study area were purchased from the market, while majority (77.2%) were partly purchased from the market and produced from the farm. The study also reveals that 35.5% and 20.6% of the preschool children studied were fed by their Mother and Grandma respectively. About 19.3% of the children’s favourite food was noodles and rice and stew respectively and 18.4% tea and bread. In this study, 64.5% of the children did not skip any meal. Only 9.6% of the children skipped breakfast, while lunch and supper were skipped by 15.8% and 10.1% respectively. The reason for skipping meal was majorly due to food dislike (12.3%), not being hungry (7.9%) hungry and not having anyone to cook the food (6.6%).  About one third of the children (31.6%) ate small quantity of food when sick. More than half of the children (71.1%) consumed snacks three times every day.

Table 5. Feeding pattern of preschool children (N=228)

Variables

Classification

Frequency

No              %

Number of times child eats in a day

2 times

-                   -

3 times

40                17.5

More than 4 times

 

188             82.5

Decision of food eaten

Mother

117              46.5

Father

106              51.3

Child

 

5                  2.2

Factors that determine food eaten

Cost of food

36                 15.8

Availability of food

132              57.9

Child’s choice

6                    2.6

Nutritional value

-                    -

Season

 

54                 23.7

Food source

Purchased from market

52                22.8

Produced from farm

-                      -

Partly produced and purchased

 

176              77.2

Person that  feeds child

Mother

81               35.5

Father

34               14.9

Self

52               22.8

House help

14                 6.1

Grand ma

 

47                20.6

Child’s favourite food

Noodles

44                19.3

Rice and stew

44                 19.3

Beans and plantain

36                15.8

Soup and garri

34                14.9

Tea and bread

42                18.4

Others, specify

 

28                12.3

Meals usually skipped in a day

Breakfast

22                  9.6

Lunch

36                 15.8

Dinner

23                 10.1

None

 

147               64.5

Meal skipping reason

No one to cook food

15                   6.6

No food

5                   2.2

Dislike food

28                 12.3

Limited time to feed

15                   6.6

Not hungry

18                   7.9

Does not skip meals

 

147               64.5

Child’s eating pattern when sick

Small quantity

72                 31.6

Skip meals

57                  25.0

Eat more of snacks

29                  12.7

Refuses to eat anything

 

70                 30.7

Child’s daily snack consumption frequency

Less than 3 times

3times

41                 18.0

25                 11.0

More than 3 times

162               71.1

 

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)

Variables

2years

F (%)

3years

F (%)

4years

F (%)

5years

F (%)

Total

F (%)

Prevalence

Male         Female

F (%)         F (%)

Wasted

3 (1.3)

1 (0.4)

1 (0.4)

0 (0.00)

5 (2.2)

1 (0.9)

4 (1.8)

 

Normal

 

103 (45.2)

 

72 (31.6)

 

37 (16.2)

 

11 (4.8)

 

223 (97.8)

 

116 (99.1)

 

107 (96.4)

 

Total

 

106 (46.5)

 

73 (32.0)

 

38 (16.7)

 

11 (4.8)

 

228 (100)

 

117 (100)

 

111 (100)

 

Stunted

 

14 (6.1)

 

13 (5.7)

 

9 (3.9)

 

2 (0.9)

 

38 (16.7)

 

26 (11.4)

 

12 (5.3)

 

Normal

 

92 (40.4)

 

60 (26.3)

 

29 (12.7)

 

9 (3.9)

 

190 (83.3)

 

91 (77.8)

 

99 (89.2)

 

Total

 

106 (46.5)

 

73 (32.0)

 

38 (16.7)

 

11 (4.8)

 

228 (100)

 

117(100)

 

111 (100)

 

Under

Weight

 

2 (0.9)

 

5 (2.2)

 

1 (0.4)

 

0 (0.0)

 

8 (3.5)

 

4 (3.4)

 

4 (3.6)

 

Normal

 

104 (45.6)

 

68 (29.8)

 

37 (16.2)

 

11 (4.8)

 

220 (96.5)

 

113 (96.6)

 

107 (96.4)

 

Total

 

106 (46.5)

 

73 (32.0)

 

38 (16.7)

 

11(4.8)

 

228 (100)

 

117(100)

 

111 (100)

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)

 

WHZ

HAZ

WAZ

Incidence of diarrhea in the last 3 months

Incidence of malaria in the last 3 months

Incidence of coughing in the last 3 months

Deworm of child frequency

WHZ

Pearson Correlation

1

           

Sig. (2-tailed)

             

 

HAZ

 

Pearson Correlation

 

-.193**

1

         

Sig. (2-tailed)

.004

           

 

WAZ

 

Pearson Correlation

 

.204**

 

.362**

1

       

Sig. (2-tailed)

.002

.000

         

 

Incidence of diarrhea in the last 3 months

 

Pearson Correlation

 

.039

 

-.229**

 

-.068

1

     

Sig. (2-tailed)

.557

.000

.304

       

 

Incidence of malaria in the last 3 months

 

Pearson Correlation

 

.198**

 

-.059

 

.071

 

-.063

1

   

Sig. (2-tailed)

.003

.378

.283

.347

     

 

Incidence of coughing in the last 3 months

 

Pearson Correlation

.

005

 

-.120

 

-.062

 

.094

 

-.027

1

 

Sig. (2-tailed)

.936

.072

.355

.157

.688

   

 

Deworm of child frequency

 

Pearson Correlation

 

.180**

 

.004

 

.097

 

.007

 

.011

 

-.006

1

Sig. (2-tailed)

.007

.958

.143

.917

.871

.926

 

**. 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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