NUTRITIONAL STATUS OF PRIMARY SCHOOL CHILDREN IN ENUGU SOUTH LOCAL GOVERNMENT AREA, ENUGU STATE

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Abstract

The study was conducted to ascertain the nutritional status of primary school children in Enugu South Local Government Area, Enugu State. Fifteen specific objectives were posited with fifteen corresponding research questions and twelve null- hypotheses were also postulated to guide the study. The descriptive survey research design was used for the study. The population for the study was eight thousand, eight hundred and seventy primary school children while the sample for the study consisted of 405 PSC. A three-sectioned researcher designed questionnaire was the instrument used for data collection. The instrument was validated by five experts: three from the Department of Health and Physical Education and two from Department of Home and Food Science, all in the University of Nigeria Nsukka. The reliability correlation-coefficient index obtained was .87. Percentages, frequencies and Chi-square were used to analyze the data obtained and testing of hypotheses. The results of the study showed that: majority of PSC were normal regarding height-for-age (stunting) (80.0%), regarding weight-for-height (wasting) (93.6%), and as regards weight-for-age (underweight) (93.1%). Majority of male PSC were normal (83.2%) as regards height-for-age (stunting), female were normal (94.5%) as regards weight-for-height (wasting) and as regard weight-for-age (underweight) (93.6%). Majority of  PSC in rural area were normal (89.6%) as regards height-for-age (stunting),as regard weight-for-height (wasting) (95.7%) and weight-for-age (underweight) (95.1%).Also  majority of PSC of age group 6.0-6.9 to 9.0-9.9 years were normal (84.4%) as regards height-for-age (stunting), with regard to weight-for-height(wasting) (94.6%),As regards weight-for-age (underweight) majority of the both age were normal(93.2%), higher proportions of food were given to PSC occasionally, 2-3times per week. There were significance difference in location, age group, the proportion of food given to PSC according to level of education of parents/caregivers/guardians, based on income and number of children in the family.  Following from the results, discussions and conclusions of the study. The researcher recommended that appropriate counseling on nutritional intake should be given to primary school children to avoid revert, also to their parents or caregivers or guardians. Also government and non government agency should intensify effort on importance of family planning and advocate small family size.

                                                        CHAPTER ONE

Introduction

Background to the Study

The quality of nutrition throughout life determines the growth, development and disease susceptibility. Nutrition is a critical part of health and development.  World Health OrganizationWHO (2000) stated that nutrition improves children’s health, enhances stronger immune system, longevity and lower risk of non-communicable diseases. Healthy children learn better and children with adequate nutrition are more productive. Mandndhar, Krishna and Patowary (2008) opined that the nutritional status is an indicator of the level of the quality of life of school children. WHO (2009) maintained that children’s nutritional status is a reflection of their overall health, when children have access to  adequate food supply, they can reach their growth potential and are considered well nourished. Nutritional status is essential for identifying undernourished and over nourished states of children and in estimating the optimum intake of adequate nutrition to promote normal growth and well-being. Height and weight are the most commonly used indicators of the nutritional status of primary school children. (Himes, 2009).Hence the need for the anthropometric method.

The anthropometric method which involved the measurement of weight and height to determine the nutritional status of an individual is an easy-to-use method *because it requires weighing scale and a tape measure. The anticipated nutritional status of school children are as follows: < (-2)SD to<(-3)SD indicates weight-for-age(underweight) children, < (-2)SD to< (-3)SD indicates height-for-age (stunting) children,< (-2)SD to < (-3)SD indicates weight-for- height(wasting) and -1SD< X< +2SD of NCHS/CDC median indicates normal children while>+2SD indicates over-nourished children between the ages 6years to 12years (Odenigbo, Odenigbo & Oguejiofor, 2010).According to WHO (2000) appropriate height-for-age of children reflect linear growth and can measure long term growth or stunting (indicator of past or long term under- nutrition) while appropriate weight-for-height reflects proper body proportion or the harmony of growth. Weight-for-height is particularly sensitive to acute growth disturbances and is useful to detect the presence of wasting (indicator of present under nutrition). Weight-for-age represents a convenient synthesis of both linear growth and body proportion and thus can be used for the diagnosis of underweight (convenient synthesis of both present and past under nutrition) children. The presence of under nutrition in children was assessed using these anthropometric parameters thus; weight-for-age, height-for-age and weight-for-height and compared it with internationally accepted reference standards. The outcome showed that children that have a low height-for-age, a z-score below two standard deviations of the reference population mean (-2 Z-score) are categorized as “stunted”. Similarly, a low weight-for-age is diagnosed as “underweight” children, while a low weight-for-height is indicative of “wasting” children (WHO, 2009).

According to Suvama (2007) growth is the major characteristics of school children and this is dependent on adequate supply of nutrients.  Growth and development of the children is largely dependent on its nutritional status. Ijarotimi and Ijadunola (2007) asserted that nutritional status is very necessary to be determined because it helped in estimating the optimum intake of nutrition to promote good quality of life among primary school children. Hence, the present study used the anthropometrics parameters to determine the nutritional status of primary school children. The parameters are height- for-age which is the index used to compare children’s height with the expected value of children of the same age from a reference population. It is a measure of stunting. Secondly, weight -for-height, is the index used to compare children’s weight with the expected value of children of the same height. It is a measure of wasting. Thirdly, weight-for-age is the index used to compare children’s weight with the expected value of children of the same age. It is a measure of   underweight (Pullum, 2008). Davis (2001) maintained that it is vital to recall that the fundamental pillar of children’s life, health and development across their entire life span is nutrition.

Nutrition is the process by which living things receive the food necessary for them to grow and be healthy. Nutrition is the study of food in relation to the physiological processes that depends on its absorption by the body growth, energy production, repair of body tissues (Martin, 2003). Nutrition is basically the use of food by the body for the processes of growth, repair and work. (Akinsola, 2006). Basavanthappa (2008) defined nutrition as combination of dynamic process by which the consumed food is utilized for nourishment, structural and functional efficiency of every cell of the body.  Panebianco (2009) maintained that nutrition is also known as nourishment   from food in order to support life. Nutrition is the intake of nutrients and their subsequent absorption and assimilation by the tissue. Hence, in this study nutrition was referred to as a combination of dynamic processes by which the consumed food is utilized for nourishment, structural and functional efficiency of every cell of the body, adopted from Basavanthappa (2008) because the definition is easy and clearly articulated. Foods that contain the elements necessary to perform various functions in the body are nutrients.                                     

 Harper (1999) defined nutrients as a substance present in food and used by the body to promote normal growth, maintenance, and repair. Nutrients are defined as organic and inorganic complexes contained in food (Park, 2009). The present study referred to nutrients as a substance present in food and used by the body to promote normal growth, maintenance, and repair. Nutrients include carbohydrates, fats, proteins, minerals, vitamins and water (Martin, 2003).

Basavanthappa (2008) maintained that carbohydrates are the main sources of energy required by children to carry out daily activities and exercise. Any extra energy is stored in the body until it is needed. Fats are required in children’s diet to help them attain normal growth and development. Proteins are essential for children’s growth, repair and maintenance of body tissue. Minerals help the children to develop, grow and stay healthy. It is necessary to many mental and physical bodily functions, including emotional and cognitive functions. Vitamins are important in children’s diet for making red blood cells, formation of strong bones and teeth, and contribute to maintenance of their eyes, skin, liver and lungs. Water is the most important nutrient required by children because the function of cells depends on a fluid environment. Tanko (2006) observed that good nutrition is reflected not only in the growth and functions of the cell but in body appearance.  This implies that the eyes, skin, hair and teeth indicate whether body nourishment is good or poor. Poorly nourished children will fail to grow properly and deficiency diseases may occur.

      Poor nutrition may result from excesses in the diet as well as deficiencies of certain vitamins or minerals which are capable of producing potentially lethal diseases.  Excess of carbohydrates or fats can result in obesity among primary school children. A diet deficient in protein causes a disease called kwashiorkor in children; a diet deficient in both protein and calories results in marasmus with lethargy and abdominal enlargement. Generally, deficiency diseases can be treated successfully and cured by ensuring that the nutritional needs of the primary school children are met on a daily basis (Harvey, 2011). Poor growth and development will result, unless the whole children’s health is good as well as their status.

          Status is the situation at a particular time (Hornby, 2006). Merrian (2007) defined status as a particular state or condition. Specifically, Bourdieu (2011) identified that status are internalized at an early age and school children eat food which indicates their status as it relates to nutrition. For instance, children from the lower end of the social hierarchy are predicted to eat “heavy fatty foods which are cheap” than adequate diet and these bring about obesity, underweight, wasting and stunted growth among these children. In this study status was referred to as a particular state or condition.  The ability of children to be productive and grow can be hampered as a result of their nutritional status.   Nutritional status is the conditions of health of a person that is influenced by the intake and utilization of nutrients (Typpo, 2011). Winstead (2009) defined nutritional status as the state of a person’s health in terms of the nutrients in his or her diet. He further added that how well the body functions is a direct reflection of what the body takes as food and the balance between the two. When one or several of the body systems are malfunctioning, it most likely relates in some degree to nutritional status. David (1999) defined nutritional status as a state of the body in relation to the consumption and utilization of nutrients. The present study referred to nutritional status as the state of a person’s health in terms of the nutrients in his or her diet.  Odenigbo, Odenigbo and Oguejiofor (2010) affirmed that nutritional status can be determined using different methods such as Body Mass Index (BMI), clinical examination, biochemical examination, anthropometry, dietary assessment, questionnaires and checklist. The anthropometric method which involves the measurement of height and weight to determine the nutritional status of an individual is an easy-to-use method because it requires only tape and scale measure. Anthropometric method was used in this study to determine the nutritional status of primary school children because of changes in their body composition.  Frisancho (2011) maintained that nutritional status of children are determined with reference to height and weight using the standard from the National Center for  Health Statistics (NCHS) as a reference to determine the extent to which children are growing either normally, advanced, or delayed for their age.

NUTRITIONAL STATUS OF PRIMARY SCHOOL CHILDREN IN ENUGU SOUTH LOCAL GOVERNMENT AREA, ENUGU STATE