Introduction: Understanding the socioeconomic characteristics of families with undernourished children is very critical to providing solution to the menace especially in rural communities where there is complexity in the relationship between economic activities, education and parental care and the undernutrition. Objectives: The study is aimed at understanding the nutritional status of children under the age of 5 years i n relation to the socio economic status of the family so as to determine causes of vulnerability. Methods: Hospital based cross sectional study was carried among 505 children under the age of 5 years, taking measurement of their Mid Upper Arm Circumference (MUAC) using standard techniques and also taking records of their families’ socioeconomic data using structured questionnaire. Results: Record of nutritional status of the children sampled shows that undernourished children were 345 (68.3%) and the nourished were 160 (31.7%). The number of times each child felt sick within the last one year shows that out of the total 505 children, 140 (27.72%) fell sick once, 155 (30.69%) fall sick twice in the previous year, 65 (12.87%) felt sick three times, 55 (10.89%) felt sick four times due to either malaria, undernutrition or other factors. Children born to farmers, constituting 51.5% of the sampled children have as high as 69.2% prevalence of undernutrition, compared to those born to beggars (0%). The highest prevalence is recorded in children born to petty traders (80%), followed by government workers and commercial motorcyclist with 75% each. Prevalence of 100% was recorded in the sampled children whose father attains tertiary level of education, followed by those who attain only secondary level of education (68%). Conclusion: There is high prevalence of undernutrition among children in rural communities which is often underestimated for the fact that rural dwellers of Kano are mostly farmers and that they are adequate to provide for their children. Frequency of illnesses among the children of rural dwellers is associated with the nutritional status of the children. Malnutrition is not always dependent on the occupation and educational status of the parents or whether child parents are alive or not. Children of farmers and learned persons are also very susceptible to malnutrition in the rural communities of Kano. Nutritional education and programs should as well target all families with varied socioeconomic status, including farmers, petty traders and those with high educational status without making assumptions that they are less susceptible to malnutrition.
The term malnutrition generally refers to both under nutrition and over nutrition [
The impact of malnutrition usually falls mainly on children under five years of age [
The 2015 National Nutrition and Health Survey (NNHS) results seem consistent with the GNR 2015 positive findings, as the overall NNHS 2015 global acute malnutrition (GAM) and severe acute malnutrition (SAM) prevalence for under-five children is reported at 7.2 and 1.8 percent respectively, whereas the same indicators were reported at 8.7 and 2.2 [
Nationally, the likelihood of a child being under weight is 3.5 times higher for children in the poorest households (bottom 20% of households) than children in the richest households (top 20% of households) [
Poverty is unmistakably the driving factor in the lack of resources to purchase or otherwise procure food, but the root causes of poverty are multifaceted. Poverty, combined with other socioeconomic and political problems, create the bulk of food insecurity around the globe [
Kano State is located in the North Central part of the country between longitude 8.500˚E and latitude 11.500˚N; it occupies a total surface area of 20,131 km2 (77,773 m2) and has a total population of approximately 11 million. Kano State is a commercial and agricultural region known for the production of groundnuts and cotton. It is also the second largest industrial center in Nigeria, with textile, tanning, footwear, cosmetics, plastic, and other industries. The state consists primarily of Sudan savannah type vegetation, with an annual mean rainfall of 800 - 900 mm, a temperature that ranges between 25˚C - 40˚C (mean approximately 26˚C), and a relative humidity of 47.43%. The climate of the study area is a tropical dry-and-wet season type typical of West African savannah. The wet season lasts from May to October, while the dry season extends from November to April [
This is a hospital based cross sectional study to determine relationship between nutritional status and the sociodemographic characteristics such as child school status, parents’ educational status, occupation, etc in Bichi and Tsanyawa Kano State between February and December, 2016. Children under the age of 5 years that have given their consent and met the inclusion criteria were selected randomly. MUAC measurement and socio-demographic variables such as age, gender, mother alive, father alive, educational status of parent/guardian, social class, child’s educational status and occupation of parent/guardian were noted and recorded into an investigator administered questionnaire.
1) All consenting children of age of 0 to 59 months who present to their records for the sake of the research.
2) All consenting healthy and unhealthy children matched for age, and other socio-demographical records also included.
1) Parents who declined consent.
2) Parents who are not willing to take part in the research.
3) Children under no parental or guardian care.
Systematic random sampling method was used to recruit participants until the desired sample size was obtained. A total of 505 children were selected for the research
For the calculation of sample size, the following formulae would be used:
Samplesize ( n ) = Z 1 − α / 2 2 P ( 1 − P ) d 2
where Z1−α/2 = standard normal variate (At 5% i.e. P < 0.05 = 1.96),
P = Expected proportion based on previous studies,
d = Absolute error or precision allowable by the researcher (5%) [
Ethical approval for the study protocol was obtained from the Research and Ethics Committee of Kano State’s Ministry of Health. When seeking consent from the volunteers in each facility, the objectives and procedures of the study were explained clearly to them in the local language, Hausa. Participants were also informed that they could withdraw from the study at any time without consequences. Thus, written and signed or thumb-printed informed consents were obtained from all adult participants and guardians/parents on behalf of their children before starting the survey; the ethics committees approved these procedures as well. All malaria-positive individuals were treated with the standard medication according to national malaria drug policy
Mid Upper Arm Circumference (MUAC) was measured using plastic tape using standard technique [
Data recorded on the questionnaire was transferred to a proforma (in excel format) developed on and then analyzed using the statistical package for social science SPSS V 20.0 (2010) Inc., IBM, New York, USA). Frequency and percentage analysis were done for the categorical variables. Data was presented in frequency charts, descriptive and analytical tables. Bar and pie charts was used to illustrate the results obtained from the participants. Association between studied variables was compared using Chi-Square (χ2) and Fisher’s exact tests while P-value < 0.05 was considered significant at 95.0 % confidence level. Logistic regression analysis was used to generate odds ratio to assess contribution of the various independent variables such as low educational level, parent alive (both mother and father), employment status of parent, educational status of child was taken.
This is hospital based study and children of the enlightened family are more likely to attend clinics when sick. There can be a lot more susceptible children in the communities who have not been attending clinics and therefore that category may not be represented in this study.
Socio-demographic characteristics of the study participants were collected from five hundred and five (505) participants who took part in the study. The age range is widely distributed amongst the children. Their age ranges from eight months to 59 months, the mean age 30.39 months. There were 260 (51.5%) males and 245 (48.5%) females sampled (
(none) makes 40 (7.9%), literacy classes 85 (16.8%), primary 235 (46.5%) constituting the highest counts in the respondent, secondary 125 (24.8%), while tertiary education completes 20 (4%) making the lowest counts in the data recorded (
The educational status of the children was taken as schooling and non-schooling where children schooling makes 135 (26.7%) where the non-schooling makes 370 (73.3%) (
The number of times each child felt sick within the last one year shows that out of the total 505 children, 140 (27.72%) fall sick once, 155 (30.69%) fall sick twice in the previous year, 65 (12.87%) fall sick three times, 55 (10.89%) fall sick four times due to either malaria, malnutrition or others factors (
The below table shows some of the socio-demographic results in count and percentage of the data.
Nutritional Status | Total | |||
---|---|---|---|---|
Undernourished | Nourished | |||
None | Count | 75a | 35a | 110 |
% within Occupation | 68.2% | 31.8% | 100.0% | |
Farmer | Count | 180a | 80a | 260 |
% within Occupation | 69.2% | 30.8% | 100.0% | |
Petty Trader | Count | 40a | 10a | 50 |
% within Occupation | 80.0% | 20.0% | 100.0% | |
Beggar | Count | 0a | 15b | 15 |
% within Occupation | 0.0% | 100.0% | 100.0% | |
Commercial Motorist | Count | 10a | 5a | 15 |
% within Occupation | 66.7% | 33.3% | 100.0% | |
Commercial Motorcyclist | Count | 15a | 5a | 20 |
% within Occupation | 75.0% | 25.0% | 100.0% | |
Government/Company Worker | Count | 15a | 5a | 20 |
% within Occupation | 75.0% | 25.0% | 100.0% | |
Labourer | Count | 10a | 5a | 15 |
% within Occupation | 66.7% | 33.3% | 100.0% | |
Total | Count | 345 | 160 | 505 |
% within Occupation | 68.3% | 31.7% | 100.0% |
Each subscript letter denotes a subset of Nutritional Status categories whose column proportions do not differ significantly from each other at the 0.05 level.
Value | df | Asymp. Sig. (2-Sided) | |
---|---|---|---|
Pearson Chi-Square | 36.461a | 7 | 0.000 |
N of Valid Cases | 505 |
a. 3 cells (18.8%) have expected count less than 5. The minimum expected count is 4.75.
Chi-square ( χ 2 = 36.461 , P < 0.005) shows to be significant among the occupation.
Nutritional Status | Total | |||
---|---|---|---|---|
Undernourished | Nourished | |||
None | Count | 20a | 20b | 40 |
% within Highest Educational Level of the Father | 50.0% | 50.0% | 100.0% | |
Literacy Classes | Count | 60a | 25a | 85 |
% within Highest Educational Level of the Father | 70.6% | 29.4% | 100.0% | |
Primary | Count | 150a | 85b | 235 |
% within Highest Educational Level of the Father | 63.8% | 36.2% | 100.0% | |
Secondary | Count | 95a | 30b | 125 |
% within Highest Educational Level of the Father | 76.0% | 24.0% | 100.0% | |
Tertiary | Count | 20a | 0b | 20 |
% within Highest Educational Level of the Father | 100.0% | 0.0% | 100.0% | |
Total | Count | 345 | 160 | 505 |
% within Highest Educational Level of the Father | 68.3% | 31.7% | 100.0% |
Each subscript letter denotes a subset of Nutritional Status categories whose column proportions do not differ significantly from each other at the 0.05 level.
Value | Df | Asymp. Sig. (2-Sided) | |
---|---|---|---|
Pearson Chi-Square | 21.273a | 4 | 0.000 |
N of Valid Cases | 505 |
a. 0 cells (.0%) have expected count less than 5. The minimum expected count is 6.34.
respect to higher educational level, most education 345 (68.3%) out of 505 are undernourished and only 160 (31.7%) are nourished.
From the result of this study, the proportion of male children attending clinics for treatment of aliments and accessing nutritional services only slightly differs from females (51.5% vs 48.5%) (
The study also shows that majority of fathers have primary education as the highest educational level, accounting for 46.53% followed by those with secondary school, 24.75%. This shows that majority of the fathers could not get the opportunity to further their education after completion of primary education, but venture into economic activities such as farming. Only 3.9% are opportune to proceed to tertiary institution. The school attendance of the sampled children is very low as only 26.7% are attending schools. This may not be unconnected with the fact that in rural communities, children are often not enrolled into school before attaining the age of 5 years.
The prevalence of malnutrition in the studied area is as high as 68%, despite the fact that majority of the children have fathers alive (81%) and mothers alive (89%) and that 51.5% of their fathers are farmers. This prevalence obtained in this study is far from what was reported by National Nutrition and Health Survey, 2015 [
However, the frequency of children assessed falling sick is that 30.69% fell sick at least twice a year. This may not be unconnected with the high prevalence of malnutrition found among the children. Even though it has long been recognized that malnutrition is associated with mortality among children [
A multitude of factors lead to malnutrition. These include not having enough money to buy sufficient nutritious food and not having a reliable supply of food throughout the year; gender inequality; poor infant and young child feeding practices; and limited access to healthcare, safe drinking water and adequate sanitation [
In view of the above, the fathers’ occupation, which is a function of and purchasing power, was studied in relation to the nutritional status of their children. Children born to petty traders are worse affected as the prevalence among them is as high as 80%, followed by commercial motorcyclists and government workers. This may be attributed by the fact that majority rarely stay with their families as they often on business tours outside the state, mostly in the southern part of the country. Findings also suggest that children born to farmers are significantly affected by undernutrition as 69.2% of the children with fathers’ occupation as farming are undernourished. Ironically, children whose fathers are beggars have 0% prevalence of undernutrition. This finding suggests that farmers are less likely to feed their children than the beggars. It is common practice in northern rural communities that farm produce are not adequately made availability to families, but rather taken to markets for sale. Additionally, the farmers predominantly produce less nutritionally valuable food for children such as maize, millet and corns. Protein rich food are inadequately produced and livestock rarely slaughtered and eaten. Socioeconomic inequalities in childhood malnutrition are more pronounced in urban centers than in rural areas [
In 47% of surveyed households in Daura LGA, agriculture production was found to account for less than 25% of the total household food consumption. The remainder of poor household’s diet comes largely from buying food in local markets and food received for work. The poor own few livestock and survive through a combination of smallholder agriculture, casual labour and petty trade [
Parents’ education status is one of the most important determinants of malnutrition [
There is high prevalence of malnutrition among children in rural communities which is often underestimated for the fact that rural dwellers of Kano are mostly farmers and that they are adequate to provide for their children. Frequency of illnesses among the children of rural dwellers is associated with the nutritional status of the children. Malnutrition is not always dependent on the occupation and educational status of the parents or whether child parents are alive or not. Children of farmers and learned persons are also very susceptible to malnutrition in the rural communities of Kano.
Based on this study, it is recommended that nutritional education in both rural and urban communities should be directed at not only the poor parents, but of particular importance to the educated, wealthy and farmers whose children appeared to be worse affected by undernutrition. Programs in rural communities should rather than focusing on the provision of Ready to Use Therapeutic Foods, concentrate on enlightening caregivers on the use of the locally available farm produce to enhance the nutritional status of their children.
It is also recommended that another study be conducted with sample children drawn from within the communities to cover those malnourished children whose parents have no faith in modern health care.
Muhammad, A.I., Yunusa, I., Bolori, M.T., Ezeanyika, L.U.S., Walla, H.A. and Gidado, Z.M. (2017) Malnutrition among Children under 5 Does Not Correlate with Higher Socio Economic Status of Parents in Rural Communities. Open Access Library Journal, 4: e3906. https://doi.org/10.4236/oalib.1103906