CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Nutrition is the sum total of the processes involved in the intake and

utilization of food substances by which growth, repair and maintenance of

the body are accomplished. According to Opoola et al (2016), it is a

fundamental pillar of human life, health and development across the entire

life span. The socioeconomic development of a country is largely

dependent on nutrition as adequate food and good nutrition are vital for

survival, physical growth, and mental development. Malnutrition is a silent

emergency which has devastating effects on children, the society and the

future of humankind. Nutritional status is the extent to which the

customary diet of any population group has been able to meet their

nutritional requirements. It is an important determinant of growth and is

the best indicator of the global wellbeing of children. De Onis et al (2000)

revealed that the efficiency with which the body utilizes the food consumed

is a key determinant of nutritional status. When the nutritional status of

children deteriorates, it leads to a vicious cycle of recurring sickness and

1
growth failure. Therefore, an in-depth knowledge of the nutritional status

of children has far reaching implications for promoting the health of future

generations.

Nutritional assessment is a detailed evaluation of objective and subjective

data relating to an individual’s food intake, lifestyle and medical history.

The results of this assessment then leads to either a plan of care or

intervention designed to help the individual maintain the assessed status or

attain a healthier status. In any community, nutritional assessment is

essential for accurate planning and implementation of intervention

programs which are designed to reduce the morbidity and mortality

associated with malnutrition. The most frequently used quantitative

method for assessment of the nutritional status of individuals or population

groups is anthropometry. Primary school age is a period of dynamic

physical growth and mental development. Research has shown that poor

nutritional status results in low school enrolment, high absenteeism, early

dropout and unsatisfactory classroom performance. Well-nourished children

are poised to perform better in school and are able to achieve their full

physical and mental potential. Several studies have been conducted

worldwide on nutritional status of children of all ages. In Nigeria, a good

2
number of studies have shown a high prevalence of undernutrition among

children. However, over nutrition is also an emerging health challenge in

the country. This study sought to evaluate the causes and effects of poor

nutrition on children under the age of fifteen in Aba South L.G.A of Abia

State.

1.2 Statement of Problem

The EFA Global Monitoring Report UNESCO (2011) states that more than a

quarter of children below fifteen years of age in sub-Saharan Africa are

underweight due to poor diet and malnutrition, making them more

vulnerable to disease and less able to concentrate at school. Malnutrition is

generally defined as a chronic condition which is a consequence of over- or

under-consumption of any or several essential macro- or micronutrients

relative to the individual’s physiological and pathological requirements

(Ecker and Nene 2012). Malnutrition is also a dangerous condition that

develops when your body does not get enough nutrients to function

properly. Poor nutrition can be caused by a lack of food or an unbalanced

diet that's missing or insufficient in one or more nutrients (Chinyoka and

3
Naidu, 2013). Children who do not consume adequate amounts of key

nutrients, including calcium, potassium and vitamin C may be unable to

work to their full potential at school. A study by Connell (2010:127)

revealed that 34 percent of low birth weight children were either repeating

grades or placed in special education classrooms while only 14 percent of

normal birth-weight children experienced the same outcomes. Another

research also reports elevated levels of grade repetition as a result of low

birth weight due to poor nutrition (Bray et al., 2010). Knowing more about

what nutritional deficiencies can lead to, in terms of learning, will help

families to feed their children adequately to succeed in class. This shows

that nutrition is of paramount importance in the academic performance of

children under the age of fifteen.

1.3 Purpose of the Study

The purpose of this study is to investigate the causes and effects of poor

nutrition on children under the age of fifteen years. The study is important

because it seeks to asses, examine and evaluate the causes and effects of

poor nutrition in children especially those under the age of fifteen with the

4
aim of suggesting sound measures and solutions thus, minimizing

consequences caused by poor nutrition on children.

1.4 Objectives of the Study

The following are the objectives of the study:

i) To analyze the effect of nutrition on the children’s health and

academic performance.

ii) To investigate the causes and effects of poor nutrition on children

under the age of fifteen.

iii) To determine the importance of child’s nutrition and growth.

iv) To examine the different measures on how to eradicate poor

nutrition in our society.

1.5 Research Hypotheses

These hypotheses were tested on the Correlation level of significance

based on the following relationships:

5
 i. There is a level of correlation between the causes of poor nutrition

in children.

ii. There is a level of correlation between the effects of poor nutrition

in children.

iii. There is a level of significance between parents’ knowledge on

nutrition and their children’s growth and performance.

iv. There is a level of correlation between the measures to eradication

poor nutrition in the society.

1.6 Research Questions

Based on the hypotheses the following research questions were

formulated:

i) What are the causes of poor nutrition in children under the age of

fifteen?

ii) How do parental knowledge on nutrition affect the growth and

performance of children under the age of fifteen?

iii) What are the effects of poor nutrition on children under the age of

fifteen?

6
iv) How can poor nutrition be eradicated in the society?

1.7 Significance of the Study

Malnutrition is a problem that defies pat solutions. It has many roots such

as inadequate food supply, limited purchasing power, poor health

conditions, and incomplete knowledge about nutrition. These causes often

combine in different ways over time and place. In any combination, they

are often aggravated by uncertain political commitment. Malnutrition is

every body’s business, but nobody’s main responsibility. The problem of

malnutrition was recognized to be substantial, and the effectiveness of

nutrition measures in reducing the number of deaths, decreasing the

severity of childhood infection, and preventing forms of blindness, anemia-

induced lethargy and other handicaps was reasonably well established and

was in itself regarded as sufficient justification for investment in better

nutrition.

Malnutrition is thus a health outcome as well as a risk factor for disease

and exacerbated malnutrition, and it can increase the risk both of morbidity

and mortality. Although it is rarely the direct cause of death (except in

7
extreme situations. Overpopulation, too, is a breakdown of the ecological

balance in which the population may exceed the carrying capacity of the

environment. This then undermines food production, which leads to

inadequate food intake and/or the consumption of non-nutritious food, and

thus to malnutrition. Therefore, the rationale of this study is to provide

answers to the problem of poor nutrition, its causes and effects on children

under the age of fifteen. Also, the study has come up with the

methodological strategic planning for improvement in investing on better

nutrition for the society.

1.8 Scope and Limitations of the Study

The study limited itself to only children under the age of fifteen in Aba

South L.G.A, so therefore population were selected for the study. It was

not possible to cover other regions because of financial and other logistical

constraints. The study also limited itself to students under the age of

fifteen as a measure of poor nutrition, leaving out others in higher levels.

1.9 Definition of Terms

8
Nutrition: are components of food required by the body in adequate

amount in other to grow, reproduce and live a normal life.

Malnutrition: Lack of enough of proper type of nutrients from food.

Home: This is a place of residence or refuge and comfort. It is usually a

place in which an individual or a family can rest and be able to store

personal property.

Poverty: For the purposes of this study, poverty is defined as a situation in

which someone does not have enough money to pay for basic need (food,

shelter and clothing).

Parents: These refer to father and mother.

Occupation: In this study, this refers to an activity or task with which one

occupies oneself.

9
 CHAPTER TWO

REVIEW OF RELATED LITERATURE

This chapter highlights some of the previous studies in the field citing

existing gaps in the causes and effects of poor nutrition on children under

the age of fifteen.

2.1 Theoretical Framework

10
This study is hinged on Abraham Maslow’s theory of needs. Maslow

proposed a theory of needs based on a hierarchical model of the basic

needs at the bottom and higher needs at the top (physiological, safety,

love, esteem, cognitive, aesthetic, self-actualization and transcendence

needs). The most fundamental and basic four layers of the pyramid contain

what Maslow called deficiency needs or d-needs, the individual does not

feel anything if they are met, but feels anxious if they are not met

(Snowman & Biehler 2011). Needs beyond the D-needs are called growth

needs, being needs or B-needs. When fulfilled, they do not go away, rather

they motivate further.

For children to grow, their basic needs must be fulfilled. Children cannot be

motivated to learn when they are hungry, fearful and insecure.

2.2 Concept of Malnutrition

According to Bello (1985) nutrition is the science that deals with the study

of intake of nutrients and their functions in the body. It also involves the

study of the chemical and physical properties of nutrients their food

sources, deficiency, symptoms and their appropriate proportion in a

balanced diet. The study of nutrition is very essential because of the

11
importance of food to the survival and development of human beings.

Good nutrition is also essential for good intellectual development of human

beings. People who are well fed have more resistance to disease than

those who are poorly fed.

Ricketts (1982) pointed out that infancy and first few years of life are the

most important years in life. This is because growth is rapid and the

demands for all food nutrients are high. As a result, these nutrients need to

be supplied in adequate amounts. When the supplies of the required

nutrients are inadequate, extra strain is put on the body by infection; the

child becomes ill as there is no enough defense mechanism. This illness

can develop rapidly and may result to death. In most cases the right food

given can bring a quick recovery.

Whaley and Wong (1979) described malnutrition to be a general term used

to refer to poor or inadequate nutrition. Olusanya (2000) on the other hand

defined malnutrition as a diseased condition that results when the nutrients

are not consumed in correct proportion as required; main forms of

malnutrition, namely under-nutrition and over-nutrition.

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According to Olusanya (2000) under-nutrition occurs when insufficient

quantities of nutrients are consumed e.g. kwashiorkor and anemia are due

to an insufficient consumption of protein and iron respectively. On the

other hand, over-nutrition is when an excess amount of some nutrients are

consumed such as eating too much of calorie food which leads to obesity

and too much of vitamins, particularly vitamin A and D that results in

hyper-vitaminosis which has some ill-effects on the body. The cost of

malnutrition has to be measured not only in terms of increased rates of

morbidity and mortality, but also as reduced productive capacity,

diminished mental potential, higher expenditure on health and unnecessary

human suffering.

2.3 Causes of Malnutrition

Lack of knowledge of nutrition on the part of a home maker, results in

nutritional problems in children. Uddoh (1980) attributed the causes of

malnutrition to many extrinsic factors which are as follows:

13
(1) Insufficient food production as a result of the mass exodus of people

from the villages to the cities in search of better paid jobs.

(2) Many people are illiterates or semi-illiterates and have no knowledge of

nutrition.

(3) Poor methods of food storage and transportation to big cities and

towns.

(4) Many persons are poor and do not have enough money to buy the right

kinds of food.

(5) Many people do not budget their house keeping money wisely.

Consequently, they spend a large part of the money on the latest

fashionable clothes, but buy the cheapest and poorest quality of foods to

feed their families.

2.4 Nutritional Deficiencies

Examples of protein energy malnutrition are kwashiorkor, marasmus and

marasmic kwashiorkor. Other examples of malnutrition include obesity,

14
nutritional anemia, rickets, infantile beriberi, and infantile scurvy. According

to Ricketts (1982) protein energy malnutrition is a range of pathological

conditions arising from coincidental lack of proteins and calories (quality

and quantity). It occurs most frequently in infants and young children and

commonly associated with infection. Examples of protein energy

malnutrition are kwashiorkor, marasmus and marasmic kwashiorkor.

2.4.1 Kwarshiokor

This is a form of severe protein energy deficiency disease occurring in early

childhood usually between the ages of one and two years. Kwashiorkor

occurs when the child is suddenly deprived of mother or the mother has

become pregnant. Uddoh (1980) highlighted the fact that kwashiorkor is a

serious nutritional problem known in the world over by different names,

including fatty liver disease, infant rouges, sugar baby in Jamaica (because

young patient looks obese). it is known as obivosi in Uganda. The

followings are signs which are always present in a child who is suffering

from kwashiorkor:

1. Failure of growth, weight and height are low for the age.

15
2. The child looks fat indicating oedema on the legs, feet and hands.

3. The skin looks discouraged and flaky.

4. The hair loses lustier and easily be pulled out.

5. The child lacks interest and looks unhappy. He/she does not seem to

have the energy even to cry, hence he/she merely whimpers.

6. Digestion is affected; usually there is diarrhea and loss of appetite.

2.4.2 Marasmus

Another instance of protein energy malnutrition is marasmus. This occurs

most frequently in children under one-year-old that are underfed, either

because too little food is offered or because of poor absorption. According

to Uddoh (1980) marasmus has some symptoms that are quite similar to

that of kwashiorkor that is why many people mistake them for each other.

But the difference is that instead of oedema in kwashiorkor, the infant is

dehydrated and it appears as skin and bones with dry body. He is said to

have dry malnutrition. The child is seen with characteristic facial

appearance, so striking in his appearance that he/she often resembles a

16
little old man. In some instances, the child presents with vitamin

deficiencies such as angular stomatitis, glossitis and chelosis.

Marasmus is however brought about as a result of one or more of the

followings:

1. Insufficiency of diet.

2. Improper feeding habits:

a. Short period of breastfeeding followed by artificial feeding with

wrongly reconstituted, over diluted milk.

b. Disturbed parent-child relationship.

c. Congenital malformations e.g. cleft lip and palate

d. Metabolic abnormalities.

Clinical features of marasmus were highlighted; as growth retardation, loss

of muscle and subcutaneous fat. The child loses weight, usually alert and

hungry looking. Some may present with starvation stool. There may be

vitamin deficiency as evidence by angular-stomatitis and keratomalacia, if

complicated by tuberculosis there will be signs of chest abnormality.

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2.4.3 Marasmic Kwashiorkor

Children classified as having marasmic kwashiorkor have clinical features of

both marasmus and kwashiorkor. They are regarded as representing

intermediate forms of severe protein energy malnutrition. Oedema is

present and body weight is less than 60 percent of expected standard for

age. Clinical features are psychological changes, skin and hair changes, a

palpable fatty liver as well as other clinical features are commonly found in

children with marasmic kwashiorkor. The syndrome is not as clear-cut as

kwashiorkor and marasmus.

2.4.4 Over-Nutrition

Obesity is an example of over-nutrition. Alleyne (1977) pointed out that

excessive accumulation of fats in subcutaneous and other tissues of the

body result in obesity. Its diagnosis is not made arbitrarily on weight but

on clinical appearance because it is difficult to pin point an example

between good nutrition and over-nutrition. The causes of obesity include:

i. Excessive intake of food.

ii. Genetic predisposition, that is, runs in the family.

18
 iii. Lack of activity and exercise and

iv. Chronic illness with prolonged hospitalization.

2.4.5 Rickets

Rickets is a disease of children in which the bones are softened and

deformed. It arises as a result of deficiency of vitamin D and failure to

absorb calcium from the small intestine. It has been found that this disease

seems to be a disease of poverty. This is because milk which provides

calcium and cream butter and egg that provide vitamin D are too expensive

for poor families to afford. Noticeable among the signs of rickets are bow

legs or knock-knees, spinal curvature, pigeon-chest, enlarged wrist, knee

and ankle joint, delayed eruption of the teeth, and pot-belly due to lack of

muscle tone.

2.4.6 Infantile Scurvy

Scurvy is a disease precipitated from prolonged lack of ascorbic acid. This

acid is obtained from fruits and vegetables. This causes a disturbance in

19
the structure of the connective tissue. The symptoms of this vitamin C

deficiency include poor appetite, swelling and bleeding of gum, bleeding

under the skin (haemorrhage) bruise anywhere in the body and delay in

eruption of teeth. Cases of scurvy are very complicated; sometimes it can

be mistaken for rheumatic fever or oesteomyelitis because of the pain

cause by haemorrhage. The refusal of the child to use one leg may cause

the disease to be mistaken for paralysis of the muscle. The signs of scurvy

are general weakness of the body, disorder and anaemia follows when the

diseases prevalent among the artificially fed babies because less ascorbic

acid vitamin C is present in cow’s milk than human milk. In another

instance it may be due to lack of insufficient intake of fruits and vegetables

which are sources of vitamin C.

2.5 Effects of Malnutrition

Even though it has long been recognized that malnutrition is associated

with mortality among children (Trowell, 1948; Gomez et al., 1956), a

20
formal assessment of the impact of malnutrition as a risk factor was only

recently carried out. In the early 1990s, results of the first epidemiological

study on malnutrition showed that malnutrition potentiated the effects of

infectious diseases on child mortality at population level (Pelletier, Frongillo

& Habicht, 1993), a result that up until then had only been observed

clinically. In fact, most malnutrition-related deaths were associated with

mild-to-moderate, rather than severe, malnutrition, because the mild-to-

moderately malnourished population was much bigger than the severely

malnourished population. The study also confirmed that malnutrition has a

multiplicative effect on mortality. Taking into account all underlying causes

of death, the results suggested that malnutrition was an associated cause

in about one half of all child deaths in developing countries. From a

national policy perspective, however, the epidemiological study had a

limitation: the global estimate of malnutrition-associated mortality could

not be applied to countries with distinct disease profiles.

Malnutrition in children can be assessed using anthropometry, biochemical

indicators (e.g. a decrease in serum albumin level) and clinical signs of

malnutrition (e.g. oedema, hair and skin changes). The advantage of

anthropometry is that body measurements are sensitive over the full

21
spectrum of malnutrition, whereas biochemical and clinical indicators are

useful only when a child is at least moderately malnourished. A

disadvantage of anthropometry is its lack of specificity, because changes in

body Measurements are also sensitive to several other factors such as

altitude, stress and genetic heritage. In children up to five years of age,

however, the effects of these factors on growth have not reached their full

potential, and their effects on anthropometric measurements are negligible

compared to the effect of malnutrition. Common anthropometric indicators

of child malnutrition are combinations of body measurements and age,

because the short-term response of a child’s body to inadequate food

intake is to slow or stop growth, usually as a consequence of famine or

severe disease; and underweight, or low weight-for-age, reflects both

wasting and stunting, and is thus a synthesis of the current status of body

proportion and linear growth (de Onis et al., 1993). In women of

reproductive age (15−44 years), it has been recommended that BMI values

be used to measure the prevalence of maternal underweight, which are

determined by dividing the weight of the mother (in kilograms) by her

height in metres squared. This indicator is in line with the index currently

recommended for monitoring anthropometry in adults. To assess the

22
prevalence of Low-Birth-Weight and Intrauterine-Growth-Restriction

(IUGR), it is recommended that infants be weighed as soon as possible

after birth, and an attempt made to get information from the mother on

the gestational age of her newborn in completed weeks (based on, for

example, her last menstrual period).

2.5.1 Malnutrition and Child Growth

Malnutrition commonly affects all groups in a community, but infants and

young children are the most vulnerable because of their high nutritional

requirements for growth and development. Another group of concern is

pregnant women, given that a malnourished mother is at high risk of giving

birth to a Low-Birth-Weight baby who will be prone to growth failure during

infancy and early childhood, and be at increased risk of morbidity and early

death. Malnourished girls, in particular, risk becoming yet another

malnourished mother, thus contributing to the intergenerational cycle of

malnutrition. In developing countries, poor prenatal conditions are

responsible for approximately 23% of all deaths among children younger

than five years old. These deaths are concentrated in the neonatal period

(i.e. the first 28 days after birth), and most are attributable to Low-Birth-

23
Weight (LBW) (Kramer, 1987). LBW can be a consequence of IUGR,

preterm birth, or both, but in developing countries most LBW births are

due to IUGR. Although the etiology of IUGR is complex, a major

determinant of IUGR in developing countries is maternal undernutrition.

Evidence has shown that there is a greater incidence of IUGR births among

women who are underweight or stunted prior to conception or who fail to

gain sufficient weight during pregnancy (Kramer, 1987;), compared to

women with normal weight and weight gain. Growth assessment is the

single measurement that best defines the health and nutritional status of a

child, because disturbances in health and nutrition, regardless of their

etiology, invariably affect child growth. There is ample evidence that the

growth (height and weight) of well-fed, healthy children from different

ethnic backgrounds and different continents is remarkably similar, at least

up to six years of age (Habicht et al., 1974). Moreover, growth assessment

is universally applicable: it does not pose any cultural problems; measuring

equipment is easy to transport; the tools are simple and robust, can be set

up in any environment; users require little training; and the procedure is

inexpensive and non-invasive. Studies have demonstrated that the more

malnourished children are, the sicker they are and the higher their risk of

24
early death. Severe malnutrition leads not only to increased morbidity

(incidence and severity) and mortality, but can also lead to impaired

psychological and intellectual development. Growth retardation in early

childhood, for example, has been linked to the delayed acquisition of motor

skills and to delayed mental development. These outcomes can have

severe consequences in adult life, such as significant functional impairment

that can affect a person’s economic productivity. Not surprisingly,

malnutrition is closely associated with socioeconomic status variables such

as income and education.

2.6 Nutrition of Children and its Importance

According to Bello (1985) “man is what he eats” from digestion,

assimilation and utilization of food, the body grows and functions. Proper

nutrition implies receiving adequate food and supplements to convey the

nutrients required for adequate nutrition allows for health, growth and

development of the body. Without proper nutrition and exercise, optimal

health and well-being cannot be attained. It is however unfortunate that in

Nigeria, a high percentage of parents cannot feed their children on

25
balanced diet. Most children are often fed on carbohydrates which can get

cheaply and can quickly satisfy hunger without giving any thought to other

nutrients necessary for the proper development and growth of children.

This condition, if prolonged, leads to nutritional deficiency diseases. Uddoh

(1980) pointed out that children are more prone to nutritional deficiencies

during the early years of rapid growth, which may be described as

extending from movement of the conception through gestation, infancy

and up to the age of five years, early severe malnutrition retards cell

division in the human brain. Bello (1985) added that the nutritional

deficiencies of childhood cannot be compensated for by improved nutrition

in adulthood. For this reason, infants should be made to feed on nutritious

food right from the time they are in their mother’s womb.

2.7 Empirical Study

In research, the level of education of mothers has been reported to have a

significant effect on the brain development and social adaptability of

children. Moreover, children with less educated or illiterate parents tend to

26
perpetuate the cycle of illiteracy in their own lives and generation. Just like

their parents such children also tend to make poor nutritional choices in

their own lives. Therefore, educating parents is a useful strategy for setting

the foundation for a healthier future generation and society.

The need for self-actualization is the extent a person is able to achieve or

realize his full potential. Mwamwenda (2010) posited a hierarchy of needs

based on two groupings, physiological needs and psychological needs. The

central point in Maslow’s theory is that people tend to satisfy their needs

systematically starting with the basic physiological needs and moving up

the hierarchy. He believed that the higher level needs can only be achieved

if the lower order needs have been satisfied first. For example, a hungry

child is not likely to be motivated to self-actualize until his/her hunger is

satisfied. The Hierarchy of Needs theory remains valid today for

understanding human motivation; personal growth and performance of

children under the age of fifteen in poverty stricken households.

CHAPTER THREE

RESEARCH METHODOLOGY

27
In this chapter, a rational for the research design and methodology that

guided the study is highlighted. The procedures used to investigate the

problem and their rational are outlined. Other sections on the research

design include the area of the study, the population of the study, sample

and sampling technique, description of research instruments, the validity

and reliability of research instruments, description of data collection

procedures and data analysis used for the study.

3.1 Research Design

The study is a descriptive survey. According to Nwogu (1991) the design

supports the studies that aim at collecting data and describing a systematic

manner characteristic features or facts about a given population. Studies

and findings from this are generated from the population.

3.2 Area of the Study

This study was carried out in Aba South Local Government Area of Abia

State. It is one of the seventeen local governments area of Abia state.

28
3.3 Population of the Study

The targeted population for the study, consists of all the parents in the

area, but due to limitations a sample of parents were chosen for the study.

3.4 Sample and Sampling Technique

The sample of the study comprised of all the parents in the area which two

hundred and fifty parents (traders, teachers, and parents with other

occupations) were chosen. They were randomly selected proportionate

sampling was altogether from the selected population making up the

sample size.

3.5 Instrument for Data Collection

29
The major instrument used in carrying out this study is the questionnaire;

the content was structured in the form of questions to be answered by

respondents. They are structured to meet the aims of the study.

3.6 Validation of the Instrument

The questionnaire was self-developed by the researcher and approved by

the project supervisor and the department of Education/ Biology.

3.7 Reliability of the Instrument

Pre-test, post-test reliability tests were used in establishing the reliability of

the instrument.

3.8 Administration of the Instrument

The questionnaire will be administered on face to face basis to the

respondents and will be collected immediately after giving their responses.

3.9 Methods and Techniques for Data Analysis.

30
The responses of the inhabitants were analyzed using the Spearman’s Rank

Correlation to discover the strength of their responses based on the

hypotheses; which is tested on the level of significance of the relationship.

The Spearman’s Rank Formula

6∑ d
2
R s=1−( 3
)
n −n

Where d = difference in ranks

n = number of pairs (variables)

Using, the scale of correlation to determine the relationship

+1 0 -1

Perfect positive correlation No correlation perfect negative correlation

CHAPTER FOUR

DATA PRESENTATION AND ANALYSIS

31
This chapter dealt with the analysis of result. The analysis result was alone

in respect of each question. To answer the research question, the

researcher used a two range decision value to categorize the responses of

the respondent for easy evaluation.

4.1 Research Question One

What are the causes of poor nutrition in children under the age of fifteen?

Table 1

Number of respondents = 250

S/N ITEMS YES RANK NO RANK d d^2

1. Insufficient food production 215 2 35 6 -4 16

2. Illiteracy 250 1 0 7 -6 36

3. Poor method of food stroage 150 5 100 3 2 4

4. Poverty 200 3.5 50 4.5 -1 1

5. Lack of knowledge of proper 100 7 150 1 6 36

diet (balanced diet)
6. Lack of budge 110 6 140 2 4 16

7. Improper feeding habit 200 3.5 50 4.5 -1 1

32
 ∑ d 2 = 110

The above table reveals that on the YES column, item one has a population

of 215 and rank of 2, item 2, 3, 4, 5, 6, and 7 has a population and rank

(in parenthesis) of 250 (1), 150 (5), 200 (3.5), 100 (7), 110 (6), 200 (3.5)

respectively; on the NO column, item one has a population of 35 and rank

of 6, item 2, 3, 4, 5, 6, and 7 has a population a rank of 0 (7), 100 (3), 50

(4.5), 150 (1), 140 (2) 50 (4.5) respectively. This shows that lack of

education (Illiteracy) is a major cause of poor nutrition followed by

insufficient food production, poverty and improper feeding habit.

4.2 Research Question Two

How does parental knowledge on nutrition affect the growth and

performance of children under the age of fifteen?

Table 2

S/N ITEMS YES RANK NO RAN d d^2

33
 K

8. Lack of pre-natal and post-natal 250 1 0 4 -3 9

care knowledge by mothers affect

the children

9. Lack of knowledge on adequate 115 3 135 2 1 1

feeding frequency

10. Lack of knowledge on budgeting 100 4 150 1 3 9

(planning).

11. Lack of knowledge on the 200 2 50 3 -1 1

educational outcomes of

malnutrition on children

∑ d 2 = 20

From the table 2 above, it has been observed that on the YES column item

8 has population (rank) of 250 (1) and followed by 11 with population

(rank) of 200 (2); then item 9 and 10 respectively with the population of

115 (3) and 100 (4) respectively. On the NO column, the items ranking

started from item 10 with the highest population 150 then to item 9, 11,

and 8 with population 135, 50, 0 respectively. this shows that in the

opinion of the inhabitant of Aba South that parents lack the knowledge of

34
pre-natal and post-natal care by mothers and the educational

outcomes/impact of malnutrition on the children under the age of fifteen.

4.3 Research Question Three

What are the effects of poor nutrition on children under the age of fifteen?

Table 3

S/N ITEMS YES RANK NO RAN d d^2

12. Cognitive deficiencies 235 2 15 5 -3 9

13. Poor performance 200 4 50 3 1 1

14. Ill health and infectious diseases 180 5 70 2 3 9

15. Death (mortality) 150 6 100 1 4 16

16. Loss of weight, muscles and 240 1 10 6 -5 25

subcutaneous fats

17. Obesity 230 3 20 4 -1 1

∑ d 2 = 61

Findings from table 3 above shows that item 12, 13, 14, 15, 16 and 17 has

the population (rank) of 235 (2), 200 (4), 180 (5), 150 (6), 240 (1), and
35
230 (3) respectively on the YES column of the table, while on the NO

column the population is 15 (5), 50 (3), 70 (2), 100 (1), 10 (6), and 20 (4)

respectively. This proves that poor nutrition has many effects (negative) on

the performance of children under the age of fifteen.

4.4 Research Question Four

How can poor nutrition be eradicated in the society?

Table 4

S/N ITEMS YES RANK NO RANK d d^2

18. Establishment of policies on nutrition 180 4 70 2 2 4

of pre-school children

19. Organization of nutrition programs 245 2 5 4 -2 4

20. Increase effect of feeding frequency 250 1 0 5 -4 16

(good quality food)

21. Enlightening the public on 190 3 60 3 0 0

educational outcomes/impact of

nutrition

22. NGO intervention/programs on 90 5 160 1 4 16

36
 nutrition

∑ d 2 = 40

Findings from table 4 reveals that item 18, 19, 20, 21 and 22 has

population (rank) of 180 (4), 245 (2), 250 (1), 190 (3), and 90 (5)

respectively on the YES column; on the NO column the population (rank) is

70 (2), 5 (4), 0 (5), 60 (3) and 160 (1) respectively for improved nutrition

to be attained in the society the level/ frequency at which the intake of

quality food must be increased as well as organizing nutrition programs

across the states to enlighten the public.

4.5 Testing of Hypotheses

The hypothesis was tested using the Spearman’s Correlation at a level of

correlation between -1 and +1.

Hypothesis One

There is a level of correlation between the causes of poor nutrition in

children.

37
From the value obtained in table 1 using the Spearman’s rank formula; Rs

= -0.96 (narrowly perfect negative correlation) and the degree of freedom

= 5; it proves that the hypothesis likelihood of occurrence is by chance.

See appendix B for details.

Hypothesis Two

There is a level of correlation between the effects of poor nutrition in

children.

From the data in table 3, the Rs = - 0.74 (narrowly perfect negative

correlation) and the degree of freedom = 4, therefore the hypothesis is

acceptable and reliable based on the significance level of the correlation.

See Appendix B for details.

Hypothesis Three

There is a level of significance between parents’ knowledge on nutrition

and their children’s growth and performance.

38
According to the data obtained from table 2 using the Spearman’s rank

formula Rs = -1(perfect negative correlation) and the degree of freedom =

2; this proves that the significance level of the hypothesis is acceptable.

See Appendix B for details.

Hypothesis Four

There is a level of correlation between the measures to eradication poor

nutrition in the society.

From the data in table 4, the level lof significance was determined using

the Spearman’s rank formula Rs = -1 (perfect negative correlation) and the

degree of freedom = 3 showing that the significance level of the

hypothesis is reliable. See Appendix B for details.

39
 CHAPTER FIVE

SUMMARY OF FINDINGS, RECOMMENDATION AND CONCLUSION

This chapter presents the summary of the study, conclusions drawn from

the findings, recommendations made there to and suggestions for further

research which was conducted in Aba South L.G.A.

5.1 Summary of Findings

Nutrition is required for growth and development of human beings. Food

consumed in the body should contain nutrients in their appropriate

proportion for normal body functions including cognitive development and

performance. Table 1 reveals that lack of education (Illiteracy) is a major

cause of poor nutrition followed by insufficient food production, poverty

and improper feeding habit.

From the table 2 above, it shows that in the opinion of the inhabitant of

Aba South, parents lack the knowledge of pre-natal and post-natal care by

mothers and the educational outcomes/impact of malnutrition on the

children under the age of fifteen.

40
Findings from table 3 above proves that poor nutrition has many effects

(negative) on the performance of children under the age of fifteen.

Findings from table 4 reveals that for improved nutrition to be attained in

the society the level/ frequency at which the intake of quality food must be

increased as well as organizing nutrition programs across the states to

enlighten the public.

5.2 Conclusions

In conclusion, parents did not give their children balanced diet, and they

did not have good knowledge of quality food. Some mothers lacked the

knowledge of pre-natal and post-natal care of their children. Moreover, if

the mothers play very well their roles of breastfeeding at the appropriate

time as well as preparing balanced diet from local food stuffs, malnutrition

will greatly be reduced. The government has not played the role of

sensitizing the public on the need for balanced diet, therefore if efforts

would be made in assuring sufficient food production and proper food

storage techniques by the agricultural sector, malnutrition will be

exterminated.

41
5.3 Recommendations

Sequels to the conclusion above, the following recommendations are given:

1. The importance of good nutrition for pregnant and lactating mothers

should be emphasized by the government and health workers.

2. Proper introduction of weaning diet and discouraging cultural beliefs and

taboos which interfere with child’s nutritional status should be embarked

upon by the government and the health workers.

3. Nutrition education should be given to the mothers to aid adequate

feeding of their children.

4. Government should subsidize balanced diet for the school age children.

5. Government should sponsor jingle on electronic media to sensitize

parents on importance of balanced diet.

6. Government should emphasize the teaching of nutrition in schools.

7. Government should enlighten the public on the need for balanced diet.

42
8. NGO’s intervention is also a sky-rocketing approach in improving the

standard of quality food in the society through organizing nutrition

programs for the public.

5.4 Suggestions for Further Studies

A similar study could be carried out in the whole of Abia State to find out

whether the same results will be obtained to allow for generalization of

results. The study focused on causes and effects of poor nutrition on

children under the age of fifteen years, another study can be conducted for

the adults as well. The researcher recommends that a similar study should

be carried out exploring the budget allocation for school feeding programs

and why the funds are not used properly.

43
 REFERENCES

Alleyne, G.A.O (1977): Protein Energy Malnutrition. Arnold. EIBS and

Edward.

Anazonwu-Bello, J.N (1985): Food and Nutrition in Practice. London.

Macmillan Education limited.

Bray R., Gooskens, I., Khan, L., Moses, S. & Seekings, J. (2010): Growing
up in the New South Africa: Childhood and Adolescence in Post-
Apartheid. Cape Town: HSRC Press.

Chinyoka, K. & Naidu, N. (2013): Uncaging the Caged: Exploring the

Impact of Poverty on the Academic Performance of Form Three
Learners in Zimbabwe. International Journal of Educational
Sciences, 6:203- 213.

Connell, RW. (2010): Poverty and education. Harvard and Educational

Review, 64: 125-150.

de Onis M, Frongillo EA, Blossner M. (2000): Is Malnutrition Declining?

An Analysis of Change in Levels of Child Malnutrition Since 1980.
Bull World Health Organ; 10:1222-1223.

44
Ecker, O. & Nene, M. (2012): Nutrition Policies in Developing
countries: Challenges and Highlights. Policy Note 1. Washington
DC, International Food Policy Research Institute.

Gomez J, and et al (1956): Mortality in Second and Third Degree

Malnutrition. The Journal of Tropical Pediatrics, 2:77−83.

Habicht JP and et al (1974): Height and Weight Standards for Preschool

Children. How Relevant are Ethnic Differences in Growth
Potential. Lancet, i: 611−614.

Kramer MS (1987): Determinants of Low Birth Weight: Methodological

Assessment and Meta-analysis. Bulletin of the World Health
Organization, 65(5):663–737.

Mwamwenda, TS. (2010): Educational Psychology: An African

perspective. Durban: Heinemann.

Olusanya, J.O et al (2000): Foods and Nutrition for WASSCE and

SSCE, Lagos.

Opoola F, Adebisi SS, Ibegbu AO. (2016): The Study of Nutritional Status
and Academic Performance of Primary School Children in Zaria,
Kaduna State, Nigeria. Ann Bioanthropol; 4:96-100.

Ozor MO, Iyamu OA, Osifo UC. (2014): Prevalence of Under Nutrition
among Fewer than Five Year Children in Ekpoma, Edo Nigeria. Inter
J Comm Res; 3(1): 34-38.

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Pelletier DL, Frongillo EA Jr, Habicht JP (1993): Epidemiologic Evidence for
a Potentiating Effect of Malnutrition on Child Mortality. American
Journal of Public Health, 83:1130−1133.

Ricketts, E. (1982): Food Health and You. London. Macmillan Education

Limited.

Snowman, J. & Biehler, R. (2011): Psychology Applied to Teaching.

Boston: Houghton Mifflin.

Trowell HC (1948): Malignant Malnutrition (Kwashiorkor).

Transactions of the Royal Society of Tropical Medicine and Hygiene,
42:417.

Uddoh, C.K.O (1980): Nutrition. Tropical Nursing and Health science

series. London. Macmillan.

UNESCO. (2011): EFA Global Monitoring Report 2011: The hidden crisis:
Armed conflict. Paris: UNESCO.

Whaley, G. and Wong, B. (1979): Nursing Care of Infants and

Children. U.S.A C.V Mosby Company. (1995a). Physical status: the
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Series No. 854).

46
 APPENDIX A

Department of Education/ Biology,

Imo State University,

Owerri,

Imo State.

10th August, 2019.

Dear Respondents,

The purpose of this questionnaire is to investigate on the Causes and

Effects of Poor Nutrition on Children Under the Age of Fifteen Years.

You are expected to tick either “Yes” or “No” option in the available boxes

provided. You are please requested to complete this checklist and return to

47
me as soon as possible. This information given to you should be treated

confidentially.

Thanks in anticipation of your cooperation.

Achinefu Florence N.
(Researcher)

Please fill in the spaces and tick on the appropriate box that corresponds
with your response.

Section A: Personal Data

Name: _____________________________________________

Occupation: ________________________________________________

Sex: _______________________________________________________

Section B: Questionnaires

1. What are the causes of poor nutrition in children under the age of

fifteen?

48
S/N ITEMS YES NO
1. Insufficient food production
2. Illiteracy

3. Poor method of food stroage

4. Poverty

5. Lack of knowledge of proper diet (balanced diet)

6. Lack of budge

7. Improper feeding habit

2. How does parental knowledge on nutrition affect the growth and

performance of children under the age of fifteen?

S/N ITEMS YES NO

8. Lack of pre-natal and post-natal care knowledge by

mothers affect the children

9. Lack of knowledge on adequate feeding frequency

10. Lack of knowledge on budgeting (planning).

11. Lack of knowledge on the educational outcomes of

malnutrition on children

3. What are the effects of poor nutrition on children under the age of

fifteen?

49
S/N ITEMS YES NO

12. Cognitive deficiencies

13. Poor performance

14. Ill health and infectious diseases

15. Death (mortality)

16. Loss of weight, muscles and subcutaneous fats

17. Obesity

4. How can poor nutrition be eradicated in the society?

S/N ITEMS YES NO

18. Establishment of policies on nutrition of pre-school children

19. Organization of nutrition programs

20. Increase effect of feeding frequency (good quality food)

21. Enlightening the public on educational outcomes/impact of

nutrition

22. NGO intervention/programs on nutrition

50
 Appendix B

4.1 What are the causes of poor nutrition in children under the age of

fifteen?

Table 1

Number of respondents = 250

S/N ITEMS YES RANK NO RANK d d^2

1. Insufficient food production 215 2 35 6 -4 16

2. Illiteracy 250 1 0 7 -6 36

3. Poor method of food stroage 150 5 100 3 2 4

4. Poverty 200 3.5 50 4.5 -1 1

51
5. Lack of knowledge of proper 100 7 150 1 6 36
diet (balanced diet)
6. Lack of budge 110 6 140 2 4 16

7. Improper feeding habit 200 3.5 50 4.5 -1 1

∑ d 2 = 110

From the table data, using the Spearman’s Rank Formula

6 ∑ d2 6∗110
R s=1−( 3
) ¿ 1−( 3
)
n −n 7 −7

660
R s=1− R s=1−1.96=−0.96
336

Considering the scale of correlation to determine the relationship

+1 0 -1

Perfect positive correlation No correlation perfect negative correlation

The Rs is a narrowly perfect negative correlation, then checking for the

significance of the relationship; using the degree of freedom calculated as

(n – 2) where n = no of variables/ items

52
∴ degree of freedom = 7 – 2 = 5.
Using the spearman’s correlation graph, it proves that the hypothesis

likelihood of occurrence is by chance.

4.2 How does parental knowledge on nutrition affect the growth and

performance of children under the age of fifteen?

Table 2

S/N ITEMS YES RANK NO RAN d d^2

53
 K

8. Lack of pre-natal and post-natal 250 1 0 4 -3 9

care knowledge by mothers affect

the children

9. Lack of knowledge on adequate 115 3 135 2 1 1

feeding frequency

10. Lack of knowledge on budgeting 100 4 150 1 3 9

(planning).

11. Lack of knowledge on the 200 2 50 3 -1 1

educational outcomes of

malnutrition on children

∑ d 2 = 20

From the table data, using the Spearman’s Rank Formula

6 ∑ d2 6∗2 0
R s=1−( ) ¿ 1−( )
3
n −n 4 3−4

12 0
R s=1− R s=1−2=−1
60

Considering the scale of correlation to determine the relationship

+1 0 -1

54
 Perfect positive correlation No correlation perfect negative correlation

The Rs is a perfect negative correlation, then checking for the significance

of the relationship; using the degree of freedom calculated as (n – 2)

where n = no of variables/ items

∴ degree of freedom = 4 – 2 = 2.
Using the spearman’s correlation graph, it proves that the hypothesis is

acceptable and reliable based on the significance level of the correlation.

55
4.3 What are the effects of poor nutrition on children under the age of

fifteen?

Table 3

S/N ITEMS YES RANK NO RAN d d^2

12. Cognitive deficiencies 235 2 15 5 -3 9

13. Poor performance 200 4 50 3 1 1

14. Ill health and infectious diseases 180 5 70 2 3 9

15. Death (mortality) 150 6 100 1 4 16

56
16. Loss of weight, muscles and 240 1 10 6 -5 25

subcutaneous fats

17. Obesity 230 3 20 4 -1 1

∑ d 2 = 61

From the table data, using the Spearman’s Rank Formula

6∑ d
2
6∗61
R s=1−( 3
) ¿ 1−( 3
)
n −n 6 −6

366
R s=1− R s=1−1.74=−0.74
210

Considering the scale of correlation to determine the relationship

+1 0 -1

Perfect positive correlation No correlation perfect negative correlation

The Rs is a narrowly perfect negative correlation, then checking for the

significance of the relationship; using the degree of freedom calculated as

(n – 2) where n = no of variables/ items

57
∴ degree of freedom = 6 – 2 = 4.
Using the spearman’s correlation graph, it proves that the hypothesis is

acceptable and reliable based on the significance level of the correlation.

4.4 How can poor nutrition be eradicated in the society?

Table 4

S/N ITEMS YES RANK NO RANK d d^2

18. Establishment of policies on nutrition 180 4 70 2 2 4

of pre-school children

19. Organization of nutrition programs 245 2 5 4 -2 4

20. Increase effect of feeding frequency 250 1 0 5 -4 16

(good quality food)

58
21. Enlightening the public on 190 3 60 3 0 0

educational outcomes/impact of

nutrition

22. NGO intervention/programs on 90 5 160 1 4 16

nutrition

∑ d 2 = 40

From the table data, using the Spearman’s Rank Formula

6∑ d
2
6∗40
R s=1−( ) ¿ 1−( )
3
n −n 53−5

240
R s=1− R s=1−2=−1
12 0

Considering the scale of correlation to determine the relationship

+1 0 -1

Perfect positive correlation No correlation perfect negative correlation

59
The Rs is a perfect negative correlation, then checking for the significance

of the relationship; using the degree of freedom calculated as (n – 2)

where n = no of variables/ items

∴ degree of freedom = 5 – 2 = 3.
Using the spearman’s correlation graph, it proves that the hypothesis is

acceptable based on the significance level of the correlation.

60