REQUIREMENTS FOR RESEARCH.

OGADA DORCAS OWITI.

RESEARCH TITLE:

KAKOLA AHERO SUB LOCATION.

MISTER KEVIN.

PAPER CODE:

INDEX NUMBER:

BUSINESS ADDRESS:

EMAIL: ogadadorcas1212@[Link]

PHONE NUMBER:0758738791

CENTER CODE: 616104

EXAM SERIES:
CHAPTER ONE.

Declaration.

I do hereby declare that this project is my original work and no part of it has been produced,
transcribed in any form by any means electronics or mechanical, photocopying, recording or
otherwise without my prior knowledge.

NAME: Dorcas Ogada.

SIGNATURE:

DATE: 28/01/2025
DEDICATION.

I dedicate this research to my parents for financial and moral support. I also dedicate it to the
Sigalagala Social workers trainers whom supported me to the accomplishment of the research.
AKNOWLEDGEMENT.

I thank the Almighty God for giving me courage and determination as well as guidance in
conducting this research study despite the challenges. I would like to express my heartfelt
gratitude to my supervisor mister Ngusale Kevin. Finally, I thank all who assisted me during this
research development. Be blessed for the contribution you all made.
ABSTRACT.

The objective of the study was to establish the effects of malnutrition to the physical
development of chicken in Kakola Ahero sub-location. To investigate the methods of controlling
malnutrition. To determine causes of malnutrition. The main source of data was the Kenya
Demographic and Health Survey. Use of questionnaire, observations and descriptive analysis
were the methods used for data analysis. The bivariate results revealed that the independent
variables had a significant influence on the odds of malnutrition among children under-five.
Based on those findings the study found that lower age at child birth, longer duration of
breastfeeding, low birth order and low birth interval increase the likelihood of malnutrition
among children under five. The analysis revealed that stunting and wasting still remain a public
health issue in the sublocation and contributes to the physical development of children. Key
recommendation of the study are both academics and policy a recommendation of further
research that is qualitative in nature and recommendation in government policy to boost nutrition
levels and nutrition programs of under-five children in Kakola Ahero Sub-location.
CHAPTER ONE.

1.0 INTRODUCTION.

This section presents the background of the study, that is the effects of malnutrition to the
physical development of children, statement of the problem, purpose and objectives of the study,
research questions, theoretical, conceptual framework, justification of the study and definition of
terms.

1.1 BACKGROUND OF THE STUDY.

Malnutrition is a multi-dimensional. In the simplest term is lack of proper nutrition,

caused by not having enough to eat, not eating enough of the right things or too many
calories, carbohydrates, vitamins or minerals. Good nutrition is the basic need for
children to thrive, grow, learn, play and participate. Section 28(i) (c) of the Bill of Right
in the South African Constitution guarantees every child the right to basic nutrition,
shelter, basic Health- Care services and social services that are related to the best interest
of the child. Access of every child to sufficient food may be the responsibility of the
parent and child to determine the fulfilment of this right. Malnutrition often steals dreams
from their young lives and hangs their future in the balance. It remains a public health
concern for the children under the age of 5 years in many low- and middle-income
countries because it is still the leading underlying cause of children morality in these
countries children are more vulnerable to macro and micro-nutrient deficiencies caused
by high demand for food during their years of growth.

The effects of Malnutrition in children under the age of 5 years include underweight,
stunting, wasting with or without oedema (previously known as marasmus) and
kwashiorkor respectively and even death. Malnutrition is the most severe consequence of
food insecurity amongst children under the age of 5 years. Acute malnutrition can lead to
morbidity, mortality and disability as well as impaired cognitive and physical
development with an increased risk of concurrent infections. Physical and mental health
development is a fundamental right of a child, and their optimum level of health can be
accessed with good nutritional support. On 1 April,2016, the United Nations General
Assembly declared a decade of action on nutrition to address all forms of malnutrition by
2025. The sustainable Development Goal (SDG)-2 (end hunger achieve food security)
and improve nutrition (SDG-3) (ensure healthy lives and promote well-being for all ages)
and global strategy for women’s, children’s and Adolescent’s health also set the relevant
nutritional outcome targets by 2030. Despite the ample support from the United Nations
International Children’s Emergency Fund (UNICEF), World Health Organization (WHO)
and World Bank towards achieving nutritional freedom, we are still far from the world
without malnutrition. The WHO report published in 2020 revealed insufficient progress
towards the World Health Assembly target set for 2025 and the SDG set for 2030.
According to the WHO 2020 report, about 144 million children under 5 years have
stunted growth, 47 million children are wasted and 14.3 million children are severely
wasted. Whilst 38.3 million are overweight or obese. According to the 2016 South
African Demographic and Health Survey (SADHS) the prevalence rate of wasting was
found to be 2.5% and underweight was 6% whilst the stunting rate remained high at
27.0% amongst children under 5 years. Around 45% of deaths reported amongst children
under 5 years.

Around 45% of deaths reported amongst children under the age of 5 years are linked to
undernutrition. In Kenya more than a quarter of children under the age of five, or two
million children, have stunted growth. Stunting is the most frequent form of under-
nutrition among young children. If not addressed, it has devastating long term effects
including diminished mental and physical development. Under-nutrition among the poor
children imposes greater burden in the rural areas. Particularly rural children are more
vulnerable to malnutrition because they receive food having low nutritional values along
with discriminatory distribution of food within the household. Also, in early childhood
due to lack of appropriate care they suffer from recurrent infections and multiple disease
either causing delayed development of the vulnerable children or fatal effect. The
demographic and socio-economic factors influence the nutritional status and neuro-
development of the vulnerable children. Methods: The aim of present study is to assess
the nutritional status of developmentally challenged children of less than five years
through Z-scores of height-for-ages, weight-for-height and weight-for-age, by
demographic characteristics in backward district of the state. West Bangal, India. Indices
of nutritional status and calculated based on the WHO child growth standards. Result
says that it has been observed that there are gender differences and group variations in the
nutritional status of children who are developmentally challenged. Under-nutrition is a
major problem with vulnerable children in rural area who suffer from developmental
delay.

There are important variations in the distribution of child under-nutrition across counties
in Kenya. Stunting is as high as 46% in Kitui and West Pokot counties. Wasting ranges
from 1% in some areas of Kenya, to over 20% in many arid and semi-arid lands (ASAC)
counties. Key drivers of childhood under-nutrition include diseases and poor diets
especially between six and 23 months. This is due to food insecurity, insufficient care
practices and harmful social norms. The consequences of malnutrition should be a
significant concern for policy makers in Kenya where out of a total under – 5 population
of 7 million, 1.82 million children (26%) are suffering from chronic malnutrition Kenya
National Bureau of Statistics (KNBS). Malnutrition remains a major risk to Kenyan’s
children survival, growth and development as outlined in the National Nutrition Action
Plan 2012-2017. Poor nutrition infancy and early childhood increases the risk of
morbidity and morality in infants, decreasing cognitive and physical development due to
poor school performance. Malnutrition later in life also impacts productivity. One of the
metrics used to measure progress against SDGs. Child malnutrition can be due to a
variety of factors, including poor nutrition policies for children and young children, poor
maternal health low access to adequate and varied diets, children’s diseases and
insufficient access to health and nutrition programs (ministry of health,2012).

The National Nutrition Action Plan focuses on practices that will lead to leveraging the
crucial opportunity window from conception to two years of age as supported by the
2010 UN Nutrition Summit Resolution. According to the Lancet Nutrition Series
published in 2008, if the essential Nutrition Interventions package is effectively accessed
by mothers from conception and children up to two-years of age and implemented on a
broader scale, infant morality would be reduced by 25% in the short term, maternal
mortality by 20% and chronic malnutrition/ reduction by 30 % in children.
In July, 2017 the Integrated classification of the phase of food security (IPC) for acute
malnutrition reported a very critical nutrition nutritional situation in Turkana Central,
North and South and in Marsabit County. North Horr, Turkana’s acute malnutritional
levels are very troubling and similar to those reported in 2011 Horn of Africa crisis with
the maximum 37% global. Acute malnutrition (GAM) registered in South Turkana. A
serious nutrition condition was recorded in East Pokot (Baringo) County, Samburu
Central Pokot, Turkana West, Garissa, Wajir and Mandera. While Laikipia registered an
extreme nutritional situation in GAM WHZ 10-0-14.9 Moyale and Saku was graded as
Alert GAM WHZS to 9.9 million, while GAM WHZ <5 percent were appropriate for
Narok, Kajiado, Makueni, Mbeere, Kwale and Kilifi.

The overall food situation remains of great concern relative to February 2017, despite
worsening in some counties in addition, the situation in most counties in the coming
months is at risk of further deterioration due to the expected worsening of food security
situation.

Currently 420674 children aged 6 to 59 months and 39,068 pregnant and lactating women
across ASAC and urban counties require treatment for acute malnutrition integrated
phase classification for Acute malnutrition (IPC AMN) analysis conducted during the
2023 short rains assessment report writing workshop had on February 2024, showed
improved nutrition situation in most arid counties compared to the July 2023, analysis.
The improvement is attributed to improved food security situation including increased
milk availability and food stocks resulting from the good performance of the rains
copupled with a robust drought and flood emergency response. However, malnutrition
remains prevalent in arid areas due to factors such as cumulative net offset of the failed
previous seasons which still linger as communities continue to recover from drought
related impacts, poor child feeding practices, poor water, high disease burden and
multiple recurrent shocks which slow down the positive effects of the 2023 rains seasons.
1.2 STATEMENT OF THE PROBLEM.

Malnutrition remains a significant health issue affecting the physical development of

children in Kenya. Despite various government and non-governmental effects to combat
the problem, many children continue to suffer from under-nutrition and micro-nutrient
deficiencies which impair their physical growth and overall well-being. Malnourished
children are more likely to experience stunted growth, weakened immune systems,
delayed motor development, and reduced cognitive abilities ultimately limiting their
potential and future potential. This problem is exacerbated by factors by factors such as
food insecurity, poverty, inadequate healthcare services and poor dietary practices.
Additionally regional disparities in access to food and healthcare further aggravate the
issue particularly the marginalized and arid areas of Kenya.

Understanding the specific effects of malnutrition on the physical development of

children in Kakola is essential for designing effective interventions and informing
policies aimed at improving child health outcome. This study seeks to explore these
effects and highlight potential strategies to combat malnutrition among Kenyan and
Kakola Ahero children.

1.3 OBJECTIVES OF THE STUDY.

1.3.1 General objective.

To determine the effects of malnutrition to the physical development of children

of children in Kakola Ahero sub-location.

1.3.2 Specific Objectives.

i) To identify methods of controlling malnutrition in Kakola Ahero sub-
location.
ii) To identify causes of malnutrition in Kakola Ahero sub-location.
iii) To determine the possible solutions of solving malnutrition in the physical
development of children.
1.4 Research Questions.
i) What are the methods used in controlling malnutrition in Kakola Ahero sub-
location?
ii) What are the causes of malnutrition in Kakola Ahero sub-location?
iii) What are the possible solutions of soling malnutrition in the physical
development of children?
1.5 Justification of the study/ Significance of study.

In early childhood, frequent and chronic malnutrition attacks have a potential negative
impact on children’s physical and mental growth in Kakola Ahero.

The study of the effects of the malnutrition on the physical development of children is
essential for understanding how inadequate nutrition impact their growth and overall
well-being in the location Kakola Ahero. Malnutrition during critical development stages
can lead to stunted growth, weakened immune system, delayed motor skills and long-
term health issues, by exploring this issue, researchers, healthcare providers, and policy
makers can identify the rot causes and consequences of poor nutrition, allowing them to
develop effective interventions and preventive strategies. Furthermore, such a study
raises awareness about the importance of proper nutrition in early childhood, which plays
a vital role in shaping a child’s future physical and cognitive capabilities. Understanding
these effects also provides valuable insight for educational programs, community
outreach and government initiatives aimed at reducing child malnutrition and promoting
healthier generations.

1.6 The scope of study.

The study was based on the effects of malnutrition to the physical development of
children at Kakola Ahero sub-location, Nyando sub-county, Kisumu County. The study
success relies on the cooperation and willingness of community members and leaders to
participate in data collection activities.
 1.7 LIMITATION OF THE STUDY.
i) Data collection and measurements- Obtaining accurate and reliable data on
malnutrition and the effects on child development can be challenging researchers may
face difficulty in measuring nutritional status, accessing development can be
challenging researchers may face difficulty in measuring nutritional status, accessing
development outcome and collecting data in relevant socio-economic and
environmental factors that influence malnutrition and child development.
ii) Sample selection and representativeness ensuring representative sample for children
and families for research studies on malnutrition can be challenging especially in low
resources setting whose access to healthcare and nutrition services maybe remitted.
Researchers must consider issues of selection of sample size and generalizability of
findings to broader population.
iii) Ethical consideration researchers involving children and vulnerable population such
as malnourished children raise ethical consideration related to informed consent
confidentiality privacy and potential harm researchers much adhere to ethical
guidelines and protocols to protect the rights and well-being of study participation.
CHAPTER TWO: LITERATURE REVIEW.

2.0 INTRODUCTION.

This chapter consists of literature according to the objectives. The literature presented in this
chapter consist of the knowledge and findings of other researchers on the topic of study.

2.1. EMPIRICAL REVIEW.

2.1.1 IDENTIFY CAUSES OF MALNUTRTION.

An inadequate diet is a primary cause of malnutrition in children, leading to both undernutrition

to over nutrition. This occurs when children do receive sufficient nutrient, resulting in conditions
such as stunting (low height for age, wasting.) (low weight for height), and deficiencies in
essential vitamins and minerals. Over nutrition on the other hand involves excessive intake of
certain nutrients leading to overweight and obesity. Lack of diet diversity-children consuming
monotonous diet that lack variety and may miss out on essential nutrients necessary for growth
and development for instance, diets heavily reliant on staple foods without adequate fruits,
vegetables and proteins sources can lead to micronutrient deficiencies. Poor feeding practices are
suboptimal infant and young child feeding practices such as delayed introduction of
complementary foods or adequate breastfeeding. Limited access to sufficient and nutritious food
due to economic constraints or supply issues force families to rely on low-cost nutrient-poor
foods, exacerbating malnutrition in Kakola. Certain cultural norms may restrict the consumption
of specific nutrient rich foods for children leading to imbalance diets, illness and infections with
nutrient -rich food for children leading to imbalance diets.

Chronic undernutrition impairs growth, leading reduced height for age and potential cognitive
delays. Acute malnutrition causes rapid weight loss and weakened immunity increasing
susceptibility to infections. Micronutrient deficiencies

Poverty is one of the most significant causes of malnutrition in Kakola Ahero sub-location. It
creates multiple barriers to accessing adequate nutrition and health care contributing to both
undernutrition and overnutrition. Surveys tells that families living in poverty often cannot afford
a balanced diet with fresh fruits, vegetables, proteins and other essential nutrients. Reliance on
cheap calories-dense becomes common. Malnourished mothers give birth to underweight infants,
perpetuating the cycle of malnutrition and also lack of financial resources prevent access to
prenatal and post-natal care.

Uncertainty of where the next meal will come from leads to inconsistent food intake. Hunger and
prolonged fasting affect the infants since they cannot access the nutrients. Poverty in Kakola
Ahero has made the most vulnerable children lack access to immunization deworming and
treatment for infections worsening malnutrition since they cannot afford the transit amount to the
facility, rather diarrhea and respiratory infections, worsen the malnutrition. Lack of clean
drinking water as they fully depend on untreated [Link] and there is no proper sanitation
hence increases the risk of diseases affecting nutrient absorption. Poverty has brought about
limited education about healthy feeding practices making it difficult for parents to make
informed food choices.

Limited access to sufficient and nutritious food due to economic constraints or supply issues,
forces families to rely on low-cost, nutrient poor foods, exacerbating malnutrition. The data in
Kakola Ahero shows that persistent lack of adequate leads to stunting where children have a
lower height for their age. Yet the condition is often irreversible and can impair physical
development into adulthood. Severe shortages of food over short periods result to low weight for
height weakening the muscles and reduces energy levels making children more prone to illness.
Inadequate nutrition compromises the immune system, making children more susceptible to
infections such as pneumonia and diarrhea, hence further depletes the body’s nutrients reserves.
Insufficient intake of key nutrients like protein, calcium, and vitamins impairs proper bone
growth and muscle development to the physical development of children. Vitamins and minerals
such as Iron(I) iodine and vitamin A, lead to conditions like anemia, poor vision and weakened
body function of children. Prolonged malnutrition during childhood may delay the onset of
puberty and physical maturation during adolescence.

Parents or caregivers with limited education may lack knowledge about the importance of
balanced diet, diet requirements and appropriate feeding practices for children, lack of awareness
about exclusive breastfeeding, timely introduction of complementary foods and age-appropriate
meals results in nutritional deficiencies. Poor understanding of hygiene sanitation practices
increases the risk of foodborne illnesses. Uneducated parents in the area do not recognize the
signs of early malnutrition and may not seek timely medical intervention. Due to lack of
education parents do not know how to select, prepare and store nutritious foods. Misconceptions
or food taboos further restrict essential food intake for children. Low-income levels lead to food
insecurity and poor nutritional choices.

Climate change and natural disasters such as drought, floods and weather patterns reduce
agricultural productivity in Kakola Ahero, leading to food shortages thus affects the availability
of essential nutrients making the children suffer a lot. Exposure to polluted water and soil affect
the quality of food consumed lowering nutrient density in crops hence weakening the immune
system and increase respiratory diseases, indirectly impacting nutrition. In some areas there are
poorly managed waste system, creating breeding grounds for diseases carrying vectors like
mosquitoes and flies, contributing to malnutrition related diseases to the physical development of
children.

Data shows that some parents are unaware of proper feeding routines affecting the child’s diets
hence hindering growth. Domestic violence, divorce and financial stress disrupt family stability
and reduce access to nutritious food in the area hence the children experience poor eating
patterns. Families without social support faces challenges in accessing information, resources
and assistance programs to meet nutritional needs in Kakola Ahero.

2.1.2 METHODS OF CONTROLLING MALNUTRITION.

Nutrition- sensitive agricultural programs this plays a vital role in controlling malnutrition by
addressing the root cause of food insecurity. Encouraging the cultivation of nutrient rich crops
such as fruits, vegetables, legumes and biofortified cereals. Promoting, improving food
production, access and consumption of diverse and nutrient reach foods, nutrition-sensitive
agricultural programs contribute significally to reducing malnutrition and fostering healthier
community.

Providing concentrated doses of essential vitamins and minerals in the form of capsules, tablets
or syrups, since they provide immediate relieve from severe deficiencies. They are also for high-
risk group like pregnant women, and the children. It reduces mortality and morbidity for
conditions exacerbated by micro-nutrient deficiencies.

Food fortification and supplementation are powerful tools in fighting against malnutrition hence
its foster a healthier society. Maternal and child health programs plays a crucial role in improving
nutrition by ensuring proper care during pregnancy, infancy and early childhood. These programs
focus on promoting good health practices and providing essential health and nutritional services.

Provision of social protection programs are essential tools in the fight against malnutrition
particulars for the vulnerable such as low-income families like distribution of food during
emergency, droughts and flood. Free distribution of nutritional supplements such as iron, folic
acid and vitamin A to support exclusive breastfeeding and complementary practices.
Empowerment of women by giving out cash transfer programs, giving them better control over
household food choices. Effective research and monitoring are critical components in the fight
against malnutrition. They provide evidence needed to design, implement, evaluate and refine
nutrition interventions.

2.1.3 POSSIBLE SOLUTIONS OF SOLVING MALNUTRITION.

Addressing malnutrition in Kakola require targeted, community- driven approaches that improve
food access, healthcare and education. Encouraging the cultivation of diverse, nutrient -rich
crops such as vegetables, legumes, training farmers on climate-smart agricultural practices to
enhance food security. Training communities on food preservation (e.g. solar, drying and
fermentation) to reduce post-harvest loses. Providing maternal nutrition and micro-nutrient
supplementation during pregnancy. Encouraging conduct of regular child growth monitoring to
detect early malnutrition early. Implement school feeding programs to improve children nutrition
and school attendance. Including locally produced foods to support the village economy.

Consuming awareness campaign on the importance of balanced diets, hygiene and safe food
handling. Training community health volunteers to offer nutrition counselling and promote
healthy feeding practices.

Establish boreholes, water tanks and water purification systems to ensure access to clean
drinking water and also promoting the construction and use of pit latrines and handwashing
facilities to reduce disease transmission diseases like measles, which exacerbate malnutrition.
Also providing deworming programs to reduce nutrient loss by parasitic infections.
Collaboration with NGOs, the private sector and governmental bodies to implement and scale-up
nutrition programs. Advocate for policy support to improve rural food system and health care
services.

2.1.4 EFFECTS OF MALNUTRITION.

Stunted growth and development- malnutrition during childhood can severely affect a child’s
growth chronic malnutrition make children have shorter height for age compared to well-
nourished peers. It is also associated with poor development of children organs and long-term
health issues. Acute malnutrition make children lack nutrient hence causing rapid weight loss,
making children thin and frail for their hteight. Wasting weaken the body immune system of
children, increasing the risk of infections and diseases. Inadequate intake of calcium, protein and
other essential nutrients leads to poor bone density and muscle strength in children making them
delay in crawling, walking and running. Malnourished children are more susceptible to diseases
such as pneumonia, diarrhea and malaria severe malnutrition during childhood cause delayed
onset of puberty and reproductive development of children. Deficiencies in vitamins and
minerals like vitamins C, A and calcium cause tooth decay, gum disease and skin condition to the
children often experience fatigue, low energy levels and reduced stamina making them to
struggle to participate in physical activities. Severe acute malnutrition, if untreated lead to death
of toddlers leading to child mortality. Malnourished children are at a higher risk of chronic
conditions in adulthood like cardi-vascular diseases.

2.1.5 CHALLENGES

The challenges of malnutrition are both long and short impacts. In the society people talk about
how malnutrition has weakened the immune system of children making it more susceptible to
diseases and infections resulting to stunted growth. Survey says that malnutrition affects the
productivity and increase in healthcare cost that they cannot afford, and reduced economic input.
Due to poverty, low income and more rural communities lack access to nutritious food due to
economic constraints hence poverty and malnutrition reinforce each other. Children who suffer
from malnutrition often experience cognitive impairments making them find it difficult to
succeed academically hence affecting their future opportunities. Lack of immediate awareness of
malnutrition symptoms has made it more rapid to find out solutions, immediately, hence this may
lead to loss of young souls. Poor brain development in children, lowering concentration and
learning capacity leading to long term intellectual limitations.

Malnutrition-World Health Organization (WHO).

Manika Blossner, Mercides Denis (2005)

2.2 THEORITICAL FRAMEWORK.

Malnutrition remains a significant contributor to morbidity and mortality among children in the
area inspite the global effort at achieving adequate nutrition. The World Health Organization
estimated that malnutrition was associated with over 50% all childhood deaths in developing
countries (WHO 2009). District hospitals has a significant role in reducing mortality (Snow
2000) but resources are often limited and care may be of limited quality (Nolan 2001). Proper
nutrition in children can reinforce lifelong eating habit that contribute to child overall well-being
and help them to grow up to their full potential and healthy life. Under nutrition in children
mostly occurs between the ages 1 and 3 years when the diet is grossly deficient in protein. The
condition often develops in association with the weaning period, when the child is taken from the
breast and is placed mainly on starchy diet (Mugyambusa 1996) hence children appetite begins
to diminish around one year consistent with slowing growth. Thereafter, children spontaneously
vary their food intakes to coincide with their growth pattern. Individual children’s energy needs
food during periods of rapid growth than during slow growth. Individuals children’s energy
needs vary widely depending on their growth and physical activity (Whitney and Roltes) (2002).
A study done in Siaya sub-county hospital 2006, found that 1,2002 children under five years old
admitted to the hospital were diagnosed with the presence of severe wasting and oedema a
common condition among children admitted to hospitals in East Africa (Sunguya, Koola and
Atkinson) 2006.

2.2.1 TRIPLE BURDEN OF MALNUTRITION THEORY.

Popularized by FAO, WHO and Sir Barry Popkin. A single community experience difference
forms of malnutrition; hence a child might suffer from stunting due to chronic under-nutrition.
Economic growth leads to shifts in dietary habits, increasing the consumption of processed
foods. It underscores the complexity of modern malnutrition challenges. Addressing it requires
integrated policies that tackle undernutrition, micronutrients deficiencies and over nutrition by
focusing on sustainable food systems education and healthcare.

2.2.2 FOOD SYSTEM THEORY.

It examines the complex interaction between food production, distribution, consumption and
their impact on nutrition, health and environment. It highlights how various factors such as
Agriculture economics, policies and culture affect food security and nutrition outcomes. This
theory highlights the needs a holistic approach to solving malnutrition by addressing food
production, distribution and consumption. By strengthening food system countries like Kenya in
Kakola Ahero can achieve better nutrition, improved health and sustainable food development.

2.2.3 ECOLOGICAL THEORY OF MALNUTRITION.

It explains how various environmental, social economic and biological factors interact to
influence nutritional status. The theory is rooted in Urie Bronfenbrenner’s Ecological system
which describe how individuals are shaped by their surroundings. In the context of malnutrition,
its highlights how food security, climate conditions, cultural practices and government policies,
collectively impact nutrition outcomes. Cultural beliefs and food tradition influence what people
eat. It provides a holistic understanding of malnutrition by considering the complex interactions
between individuals and their environment.

2.3 STUDY GAPS.

Limited Research on the triple Burden of Malnutrition. There is need for more comprehensive
research that examines how these forms coexist within households and communities.
Understanding these interactions can develop integrated interventions rather than isolated
programs targeting only one aspect of malnutrition. Insufficient Data on Rural and Marginalized
populations since studies are done in urban settings, leaving gaps in understanding the unique
challenges faced by rural and marginalized communities. Factors such as food insecurity, cultural
dietary practices and limited healthcare services access. Weak monitoring and evaluation of
nutrition programs since there is limited data on the effectiveness of existing programs making it
difficult to assess their long-term impact. More studies are needed to identify which nutrition
interventions work best, under what conditions, and how they can be scaled up effectively.
2.4 CONCLUSION.

In conclusion child malnutrition is a multifaceted issue that is influenced by wide range of

factors operating at a different level of the ecological system framework. Understanding and
addressing the factor within the context of children immediate environments interactions
between setting external influences in broader cultural and societal factors and changes a holistic
approach informed by ecological system theory researchers policies make practitioners can
design comprehensive interventions that can target the root cause of malnutrition and promote
nutritional over time is essential in developing effective strategies to prevent and address child
malnutrition. By taking well-being. Collaboration across sectors including healthcare,
educational social services and community is crucial in implementing sustainable solutions that
address systematic barriers to healthy eating and ensure equitable access to nutritious food to all
children.
CHAPTER THREE.

RESEARCH METHOLODY.

3.0 INTRODUCTION.

This chapter presents the sources of data and methods used for analysis of the study.

3.1 RESEARCH DESIGN.

This was a descriptive cross-sectional study aimed at establishing the prevalence of malnutrition
and related factors among children in Nyando sub-county Kakola Ahero su-location.

3.2 POPULATION OF STUDY.

The study population compromised of 115 suffering from malnutrition, 32 medical

superintendent, 20 nutritionist and 15 nurse in-charge of pediatric medical ward in Kakola Ahero
sub-location.

3.3 SAMPLING DESIGN AND PROCEDURE.

Simple random sampling using the admission register was employed in this study in Kakola
Ahero sub-location in the wards visited. Purposive non probability and systematic probability
sampling was then utilized. The eligible children were those age 6 to 60 months. The selection
was done as follows.

Stage 1: Selection of hospitals and wards in Kakola Ahero.

Bunde District Hospital was purposively selected since within the community its located in a
area situated with problems, include low farm productivity, high rate of unemployment and most
strikingly, resource-constrained health facilities due to poverty. It also has high rates of morbidity
and mortality in the country due infectious diseases. Pediatric ward was purposively selected
since this is where children aged 6-60 months are admitted.

Stage 2: Selection of children from the wards in Kakola Ahero sub-location.

In the ward systematic sampling was utilized to eligible children who met the inclusion criteria.
Admission books in the pediatric ward were utilized. The interval was every 2nd child in the
admission books in the ward were selected as random by balloting to determine the starting
point. Data was collected until the required number of eligible (115) children in the ward was
reached. It took 12 days to get the sample of the 115 children admitted in the pediatric ward.

3.3.1 SAMPLE SIRE.

The following fisher’s formula was used to determine the sample size.

( I −P )
n=z 2 p
d2

Where n= minimum sample size

z- is the table value for standard normal deviate corresponding as % significance level
(=1.96).

P- prevalence of characteristic being estimated (in this case prevalence of acute malnutrition
=7%) (WHO Guidelines for Integrated Management of Acute Malnutrition in Kakola Ahero)

d- Margin error, set at ± 0.05

2 0.93
n=1.96 ×0.07 × 2
=100
0.05

3.3.2 SAMPLING TECHNIQUE.

This is the technique of selecting children with acute malnutrition to make statistical inferences
from an estimate characteristic of use of non-random sampling associated with the findings in the
area and collection of data from in-charge and parents. The target population is the pediatric
wards in Kakola Ahero to the number of children admitted.

3.4 TOOLS OF DATA COLLECTION.

3.4.1 Anthropometry Assessment.

This instruments for assessment of anthropometrics measurement of height and weight/length

were salter scales for weighing the children and length mats for taking length/height of the
children. It helped in assess nutritional status growth patterns and obesity levels in malnutritious
children. Despite the benefit the measurements may also be affected by posture, clothing or
inconsistence in measurement techniques.

3.4.2 CLINICAL AND BIOCHEMICAL ASSESSMENT.

It is used for diagnosing micronutrient deficiencies and malnutrition. It detects the infections and
deficiencies that impact nutrition. Their accuracy is detecting nutrient test or protein-energy
malnutrition via albumin levels. They are particularly useful in identifying “hidden hunger”
where individuals suffer from micronutrient deficiencies without obvious symptoms. One major
drawback is their cost, as laboratory tests require expensive equipment reagents and trained
personal making it assessable in the area.

3.4.3 QUESTIONNAIRE.

CLOSE-ENDED QUESTIONNAIRE.

Instruction: Please answer the following questions honestly. Your response will be used for
research purposes only.

SECTION A: Demographic Information.

1. Age of child: ___years.

2. Gender: Male Female.
3. Location: __________
4. Education level of parents.
No formal education.
Primary education.
Secondary education.
Higher education.
5. House hold income level (Monthly)
Low (Below 5000)
Middle (1000-3000)
High (Above 3000)
SECTION B: NUTRITIONAL INTAKE.

1. How many meals does the child eat per day.

One meal
Two meals.
Three or more meals.
2. What type of food that the child consumes regularly.
Fruits and Vegetables.
Dairy products (Milk, Cheese, Yoghurt).
Protein (Meat, Fish, Eggs, Beans)
Grains (Rice, Bread, Pasta)
Fast foods (junk foods).
3. Does the child experience a lack of food due to financial constraints?
Yes
No.

SECTION C: Physical Development and Health Status.

1. Has the child experienced delayed growth (height and weight) compared to peers.
Yes No
2. Does the child often suffer from illness such as colds, infections or weakness?
Yes No
3. Has a healthcare professional ever diagnosed the child with malnutrition?
Yes No
4. How often does the child engage in physical activities such as playing or exercising?
Daily Occasionally Rarely.

Open-Ended Questionnaire.

Instructions- (Respondents provide their own detailed response)

 1. In your own opinion, what are the causes of malnutrition among children in Kakola
Ahero sub-location?
2. How does malnutrition affect the child’s physical development based on your observation
in Kakola Ahero Sub-location?
3. What challenges do parents face in providing adequate nutrition for their children?
4. Have noticed any long-term effects of malnutrition on children’s health and growth? If
yes please describe.
5. What steps do you think can be taken to reduce malnutrition among children?
6. Can you share any personal experience or example of how malnutrition has impacted a
child’s development?

A LETTER TO SEEK A CONCENT FROM THE KAKOLA AHERO SUB-LOCATION

ASSISTANT CHIEF.

DORCAS OWITI

P.O BOX 41-40101

AHERO

ogadadorcas1212@[Link].

17-02-2024

ASSISTANT CHIEF, KAKOLA LOCATION

P.O BOX 86-40101

AHERO

RE: REQUEST FOR CONSENT TO CONDUCT A STUDY ON THE EFFECTS OF

MALNUTRITION ON CHILDREN’S PHYSICAL DEVELOPMENT.

DEAR: SIR/MADAM.
I am writing this letter to seek your consent to conduct a study on the effects of malnutrition on
the physical development of children within Kakola Ahero Sub-location. This study aims to
assess the impact of malnutrition on children growth and overall health with the goal of
providing insights that can contribute to improved nutrition practices and child welfare program.
The study will involve gathering information from parents, guardians and healthcare providers
through questionnaires and interviews. I assure you that all data collected will be kept
confidential and used solely for research purposes. I kindly request your permission to proceed
with this study in your jurisdiction. Your support in facilitating access to relevant stakeholders
will be highly appreciated. Please let me know if a meeting is required to discuss further details.

I appreciate your time and consideration and look forward to your positive response.

Yours Faithfully,

Dorcas Ogada

STUDENT SIGALAGALA POLYTECHNIC.

0114806888.

3.5 DATA VALIDITY AND RELIABILITY.

In studying the effects of malnutrition on the physical development of children, ensuring data
validity and reliability is crucial for obtaining accurate and meaningful result. By achieving
the validity, the research used a well open and close-ended questionnaire, reliable medical
assessments and standardized growth indicators. The reliability ensured that the result of the
study is consistent and reproduceable. Reliability was achieved by repeating measurement
over time to check for consistency. By maintaining high validity and reliability, the study
provides trustworthy insight into the long-term physical effects of malnutrition on the
children, support effective interventions and policies to address this critical health issue.

3.6 DATA ANALYSIS.

The data was analyzed using the statistical package for social sciences (SPSS). Descriptive
statistical was used to summarize the data. Frequencies of all the variables was generated and
used for checking the outliers. The anthropometric statistical program (WHO Anthro) was
employed to convert raw anthropometric measurements or data (weight, height or length of
the children) into anthropometric indices of WAZ, WHZ and HAZ and compared with the
Who reference data. The frequencies and the variables generated from SPSS were then cross
tabulated with the nutritional status of the children to generate p values and Ch. squares
CHAPTER FOUR.

DATA ANALYSIS AND PRESENTANTION.

4.0 INTRODUCTION.
This chapter outline the presentation, analysis and discussion of data and the result that
are obtained by the researcher to identify causes and effects of malnutrition to the
physical development of children in Kakola Ahero sub-location.

4.1 QUANTITAVE ANALYSIS.

The method gave numerical information and hence easy to understand and analyze the
causes, perceptions and social dominant influencing nutritional status. The use of tables and
pie charts were also used as a method of presentation which were also easy to interpret and
understand.

4.1.1 CAUSES OF MALNUTRITON TO THE PHYSICAL DEVELOPMENT OF

CHILDREN.
Here is a table showing causes of malnutrition and their impact on the physical
development of children in population of 200 children. The data includes frequency
(number of affected children) and percentage (% of total population)

Causes of malnutrition Frequency(n) Percentage (%)

Inadequate Dietary Intake 50 25%
Poor feeding practices 40 20%
Infectious diseases 35 17.5%
Lack of parental awareness 30 15%
Food insecurity/poverty 25 12.5%
Poor sanitation and 20 10%
hygiene.
TOTAL 200 100%

The information was presented in the pie chart shown below.

4.1.2 EFFECTS OF MALNUTRITION TO THE PHYSICAL DEVELOPMENT OF
CHILDREN.

According to the researcher’s findings on the effects of malnutrition to the physical

development of children malnutrition significantly impairs children’s physical development,
leading to conditions such as stunting, wasting and underweight. In Kakola Ahero 22.3% of
the children were stunted, 6.8 were wasted and 5.6% were overweight. These statics
underscore the widespread impact of malnutrition on children’s growth and development
highlighting the urgent need for effective nutritional interventions.

4.1.3 DETERMINE POSSIBLE SOLUTION OF SOLVING EFFECTS OF

MALNUTRITION TO THE PHYSICAL DEVELOPMENT OF CHIOLDREN.

Below is a table summarizing potential solutions their descriptions and the estimated
percentage of children.

Intervention Description Estimated impact

Nutritional Education Educating caregivers on 25%
balanced diets, proper
feeding & the importance of
micronutrient.
Supplementary feeding Providing nutrients rich food 20%
programs supplementations to under
nourished children to
improve their nutritional
status.
Healthcare source access Ensuring regular health 15%
check-ups, immunizations
and prompt treatment of
illnesses to prevent
nutrition-related
complications.
Food security Supporting community 15%
agricultural food
diversification and economic
empowerment to ensure
consistent access to
nutritious food
 Water sanitation and hygiene Improving access to clean 15%
water sanitation facilities
and promoting hygiene
practices to reduce
infections that exacerbate
Micronutrient Providing vitamin sand 10%
supplementation minerals such as vitamin A
and iron to address specific
deficiencies

4.2 QUALITATIVE ANALYSIS.

This method is used to gather non-numerous data and gain a deeper understanding of a
particular topic. It involves interviews and observations.

4.2.1 METHODS OF CONTROLLING MALNUTRITION.

The researcher conducted interviews with parents, caregivers and healthcare providers
through observations parents and caregivers often knowledge about balanced diet and proper
infant feeding practices. Interviews showed that many caregivers believe certain traditional
foods are healthier leading to dietary imbalances hence they are to be given education and
counselling. Due to poor sanitation children exacerbating malnutrition interviews shows that
caregivers acknowledge that clean water access improves children’s health but infrastructure
challenges.

4.2.2 EFECTS OF MALNUTRITION.

Chronic malnutrition, particularly during the critical growth periods of infancy and early
childhood, leads to reduced height-for-weight. Acute malnutrition often manifests as wasting
where children in Kakola Ahero loss muscle mass and fat making them visibly thin. Thin
condition increase and can impair physical strength. Inadequate nutrition delay development
of milestones such as walking, crawling or running muscles weakness and reduced energy.
4.3 CONCLUSION.

In summary, malnutrition is a multifaceted challenge that significally impairs the physical

development of children. It root lie in combination of inadequate dietary intake, poor feeding
practices, frequent infections and broader socio-economical environmental and political
factors. Ultimately addressing malnutrition is not solely about providing food. Demands a
comprehensive multi sectoral approach.