ABSTRACT
Appropriate feeding practices are essential for the
nutrition, growth, development and survival of infants and young children.
Assessment of infant and young child feeding (IYCF) practices and nutritional
status of children (0-23 months) in Funtua Local Government Area, Katsina State
was carried out which incorporated qualitative and quantitative data collection
techniques. Data was obtained using pretested semi-structured questionnaire
with weight and length taken, in addition to their serum mineral status (Iron,
Zinc, Copper and Calcium) using standard methods. Results indicated that early
initiation of breastfeeding was practiced by 82.4% whereas exclusive
breastfeeding was very low (5.1%) and continued breastfeeding up to two years
was practiced by 60.6% of the respondents in the study area. Proportion of
children that had minimum dietary diversity were low (5.3%) with minimum meal
frequency of 38.8 and 5.3% for breastfed and non-breastfed children
respectively, while Iron rich or iron fortified foods were consumed by 21.2% of
the respondents and minimum acceptable diet for breastfed and non-breastfed was
4 and 8.3% respectively. Nutritional status of the children indicates stunting
(55.7%), wasting (25.3%) and underweight (49.1%) showed significant correlation
with breastfeeding practices. Serum minerals level of iron and zinc were low in
76% and 54% of the children respectively, as well as serum copper (69%) and
calcium (60%). Haemoglobin and Packed Cell Volume were less than the
recommended levels ( ≥ 11mgldL and ≥ 33% respectively). The high prevalence of
malnutrition obtained in the study area may be due to the poor feeding
practices. Further studies are needed to identify the barriers to optimize IYCF
practices of caregivers in the study area.
CHAPTER ONE
1.0 INTRODUCTION
1.1 Background of the Study
Nutritional status is the state of the body with respect to
each nutrient, body size and overall condition (WHO, 2013). It is a powerful
factor in promoting health, preventing and treating diseases (WHO, 2013).
Nutritional status affects immune response and response to medical therapies
(Fieldman et al., 2010). Globally, almost seven million children under the age
of five die every year, and undernutrition directly or indirectly accounts for
about 35% of all the deaths among these children (WHO, 2012). The risk factors
of malnutrition are multifaceted and complex, these include poverty, seasonal
supply of food, gender inequality, poor infant and young child feeding (IYCF)
practices, limited access to healthcare, unsafe drinking water and poor
sanitation (WHO, 2012). In Nigeria, an estimated 60% of all child deaths in the
country are attributable to underlying malnutrition that results from poor
infant and young child feeding and hygiene practices (FMOH, 2012).
Infant and young child feeding (IYCF) practice is a set of
well-known and common recommendations for appropriate feeding of newborn and
children less than 2 years of age (FMOH, 2012); it comprises of breastfeeding
as well as complementary feeding which play a major role in determining the
nutritional status of children (Das et al., 2013). Optimal IYCF practices play
an important role in reducing early childhood morbidity and mortality, as well
as improving early child growth and development (FMOH, 2012). Global estimation
showed that 41% of infants are exclusively breastfed for the first six months of life,
while the majority of infants (60%) receive some other foods or fluids in the
early months (WHO and UNICEF, 2018). Adequate nutrition is essential in early
childhood to ensure healthy growth, proper organ formation and function, strong
immune system, and neurological and cognitive development (UNICEF, 2012). Thus,
Ogbo and Agho, (2015) reported that caregivers level of education,
socioeconomic status, type of delivery and lack of access to healthcare
services are among the factors affecting optimal lYCF practices.
Breastfeeding is the healthiest and least expensive feeding
method that fulfils the infant‟s needs (Oche, 2011: Okafor et al., 2014). It is
considered as the most complete nutritional source for infants because breast
milk contains the essential fats, carbohydrates, proteins, and immunological
factors needed for infants to thrive and resist infection in the first year of
life (Okafor et al., 2014). Exclusive breastfeeding (EBF) for six months and
continued breastfeeding to one year have been identified as the most effective
preventive intervention method in reducing child morbidity (Sreedhara and
Banapurma, 2013). It has been estimated that exclusive breastfeeding reduces
infa nt mortality rate by up to 13% in low income countries (Jones et al.,
2003). Similarly, the work of Kayode et al. (2012) confirmed that breastfeeding
of children for more than 18 months contributes immensely in reducing the risk
of under-five mortality.
A revised set of population‑ based Indicators of IYCF was
developed in 2007 which came up with a set of simple, valid and reliable
indicators that measure food-related aspects of complementary feeding
(including dietary variety and frequency of eating episodes), as well as current
guidance on the feeding of non-breastfed infants and young children up to 24
months of age which was aimed at enhancing IYCF practices in order to reduce
the risk of under- five mortality (WHO, 2008). This is also a major strategy
for prevention of infant and child malnutrition (Bhutta et al., 2010).
1.2 Statement of Research Problem
Malnutrition continues to be a problem of public health
importance based on the reported number of infant and maternal deaths in
Nigeria which was reported second highest in the world after India (UNICEF,
2012a; WHO, 2013). Suboptimal IYCF practices directly affect the nutritional
status of children under two years of age and ultimately, impact child survival
(Anjanaand Dattatreya, 2015). The NDHS (2013), reported a stunting prevalence
of 37% among children under 5 years of age, while 29% and 18% were underweight
and wasted, respectively. Also, Black et al. (2013) suggested that suboptimal
breastfeeding increases the risk of child mortality in the first two years of
life. Infant and Young Child Feeding practices in Nigeria, are characterized by
low rates of early initiation of breastfeeding after birth, very low rates of
exclusive breastfeeding (17%) and poor quality of complementary foods that
result in deficiencies of vitamins and minerals (FMOH, 2012; NDHS, 2013). Thus,
there is paucity of information and data on IYCF practices at community level
especially in Northern Nigeria.
1.3 Justification
The critical one thousand days comprise of the period of pregnancy
and the first two years of life which are the most crucial for positive impact
on a child‟s cognitive and physical development (WHO, 2013). Poor infant and
young child feeding practices are one of the immediate factors causing
malnutrition in children. As a result of high malnutrition cases in Katsina State,
where all the local governments contributed to the overall status, many donor
funded projects (Working to Improve Nutrition in Northern Nigeria, Save the
Children etc.) are presently working to support and improve nutrition in the
state, but Funtua Local Government is not part of the programme beca use, it is
not among the top three Local Governments having a critical level of
malnutrition although it is not malnutrition free, and there was no documented
data on IYCF and nutritional status for the local government. This necessitated
the need for this study, as it will aid in documenting an overall picture of
the patterns of feeding practices of children in the first two years of life
and their nutritional status in Funtua Local Government Area of Katsina State
1.4 Aim and Objectives
1.4.1 Aim
The aim of this study is to Assess Infant and Young Child
Feeding (IYCF) Indicators and Nutritional Status of Children Under Two Years of
Age in Funtua Local Government Area of Katsina State.
1.4.2 Specific Objectives of the work
The specific objectives of the work are to;
i. Determine the Infant and Young Child Feeding practice
indicators of children (0-23 months) in Funtua local Government Area.
ii. Determine the nutritional Status of children (0-23 months)
based on anthropometric measurement.
iii. Correlate association between feeding practices and
nutritional status of children (0-23 months) in the study area.
iv. Assess the micronutrient status (Fe,
Zn, Cu and Ca) and Haematological parameters (Hb and PCV) of children (0-23
months) in Funtua Local Government Area.
1.5 Null Hypothesis
IYCF practices have no effect on the nutritional status of
children (0-23 months) in Funtua LGA.
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