Prevalence And Factors Predisposing To Under Nutrition Among Children Under Five Years Attending Kampala International University Teaching Hospital In Bushenyi District

ABSTRACT

Introduction

Malnutrition is one of the major causes of mortality and morbidity among under- five children in sub-Saharan Africa. Western Uganda has persistently registered highest levels of child malnutrition despite being referred to as” food basket’’ of the country.

Objective

The major objective of the study was to determine the prevalence of under nutrition among children under- five years attending KIU TH Bushenyi district western Uganda

Methods

The study was across sectional descriptive study that used quantitative and qualitative methods. The study was carried out at pediatric ward and pediatric outpatient department of KIU TH.

The study was carried out on children under -five years (3 to 59 months). Nutrition level was determined using anthropometric measurements using the US national center for health statistics (NCHS) reference standards, which was approved for use in developing countries by the WHO. Height for age, weight for age and weight for length were used.

Data was collected using questionnaires in which questions were asked to the care takers and also measurements of weight, length or height were interpreted using z-score. Those children who were below -2 SD were considered to be undernourished. Data was analyzed using Microsoft excel.

Discussion

In the study, stunting, wasting and underweight were 47%, 25% and 27% respectively. Almost half (47%) of children in the study were stunted which was comparable to the national prevalence of 47.8% for western Uganda which is unacceptably high. This was also higher than the national prevalence according to (Uganda demographic and health survey, 2016). This may be because the majority of the participants had underlying diseases and diseases are known to cause under nutrition in children due to lack of appetite and diarrhea.

Conclusion

In the study, the prevalence of under nutrition among children under- five years attending KIU TH were 47% stunted, 25% wasted and 27% underweight.

The major determinants to under nutrition among children under five years attending KIU TH Bushenyi district were; age (1-3 years), birth interval of 1 to 2 years, breast feeding for less than 6 months, maternal age of less than 20 years, maternal education level (mothers who did not go to school and those who ended in primary school) and maternal occupation (peasant and business).

Recommendations

Encouraging girl child education, health education about nutrition, exclusive breast feeding and family planning were recommended.

Table of Contents

DECLARATION ....................................................................................................................... i

SUPERVISORS’ APPROVAL ................................................................................................ ii

DEDICATION ........................................................................................................................ iii

ACKNOWLEDGMENT ......................................................................................................... iv

LIST OF TABLES ................................................................................................................ viii

LIST OF FIGURES ................................................................................................................ ix

LIST OF ACRONYMS/ ABBREVIATIONS ..........................................................................x

1.1 Background to the study .....................................................................................................1

I.2 Problem statement ...............................................................................................................3

1.3 objectives .............................................................................................................................4

1.3.1General objective ...........................................................................................................4

1.3.2 Specific objectives .........................................................................................................4

1.4 Research questions ..............................................................................................................4

1.5 Significance of the study ......................................................................................................4

1.6 Conceptual frame work .......................................................................................................5

2.1 Introduction .........................................................................................................................7

2.2 The prevalence of under nutrition among children under five. ........................................7

2.2.1 Global situation.............................................................................................................8

2.2.2 Malnutrition in Uganda ................................................................................................9

2.3 Factors that predispose to under nutrition .........................................................................9

2.3.1Child related factors of under-five malnutrition ..........................................................9

2.3.1.1 Sex of child ..............................................................................................................9

2.3.1.2 Age of child .............................................................................................................9

2.3.1.3 Birth Order ............................................................................................................ 10

2.3.1.4 Birth Interval ......................................................................................................... 10

2.3.2 Maternal factors of malnutrition among under-five children .................................. 10

2.3.2.1 Maternal Education ................................................................................................ 10

2.3.2.2 Marital Status......................................................................................................... 11

2.3.2.3 Maternal Occupation .............................................................................................. 11

2.3.2.4 Mothers age at birth ............................................................................................... 11

2.4 Effects of malnutrition ...................................................................................................... 11

2.4.1 Underweight ................................................................................................................ 12

2.4.2 Stunting ....................................................................................................................... 12 vi

2.4.3 Wasting ....................................................................................................................... 12

2.5 Assessment of nutritional status ....................................................................................... 13

2.5.1 Use of body measurements (anthropometry)............................................................. 13

2.6 Summary of the literature review ..................................................................................... 13

CHAPTER THREE ................................................................................................................ 14

3.1 Study design. ...................................................................................................................... 14

3.2 Study area .......................................................................................................................... 14

3.3 Study Population ............................................................................................................... 14

3.3.1 Inclusion criteria ......................................................................................................... 14

3.3.2 Exclusion criteria ........................................................................................................ 14

3.5 Sampling procedure. ......................................................................................................... 15

3.6 study variables. .................................................................................................................. 15

3.7 Data collection methods .................................................................................................... 16

3.8 Data analysis ...................................................................................................................... 16

3.9 Quality control ................................................................................................................... 16

3.11 Study limitations .............................................................................................................. 16

CHARPTER FOUR ................................................................................................................ 17

PRESENTATION AND INTERPRETATION OF RESULTS ............................................. 17

4.1 Introduction ....................................................................................................................... 17

4.2 prevalence of under nutrition among children under five years attending KIU TH ...... 17

4.2 social demographic characteristics of children and their care takers ............................. 17

4.2.1 Child factor. ................................................................................................................ 17

4.2.2 Maternal factor ........................................................................................................... 19

4.3 relationships between child and maternal factors with under nutrition among children below five years attending KIU TH ........................................................................................ 20

4.3.1 Relationship between child factor and under nutrition among children under five years old attending KIU TH................................................................................................ 20

4.3.2 Relationship between maternal factors and under nutrition among children under five years attending KIU TH ............................................................................................... 22

4.4 Factors that lead to under nutrition among children under five years attending KIU TH ................................................................................................................................................. 24

4.4.1 Independent variable against stunting ....................................................................... 24

4.4.2 Independent variable against Underweight among children under five years attending KIU TH Bushenyi District .................................................................................. 25

4.4.3 Independent variable against Wasting ...................................................................... 26

CHAPTER 5 ............................................................................. 27