INTRODUCTION

1.1 Background of the Study

Human nutrition describe the process whereby cellular organelles, cells, tissues,

organs, systems, and the body as a whole obtain and use necessary substance

obtained from food(nutrients) to maintain structural and functional integrity ;

Michael, Susan, Aedin, and Hester ed., (2009). The health or disease state of the

different organs and system will determine the nutrient requirements of the bodyZ as

a whole.

All human beings need a balance amount of nutrients for the proper function of the

body system. Nutrition is a fundamental pillar of human life health and development

throughout the entire life span (World Bank, 2006).

Nutrition is directly or indirectly linked to the seventeen Sustainable Development

Goals (SDGs) (National Population Commission, 2014), and it is critical in the

overall development of individuals and the nation at large. Given nutrition’s,

fundamental importance for the health and development, world health organization

(WHO) has consistently regarded nutrition as central to its mandate since the

organization was established in 1948. WHO focus on priority issues at all these

levels, namely in basic nutritional science, in nutritional care throughout the life span,

from infancy to old age, and most importantly, in nutrition policies and programs for

sustainable development. Proper food and good nutrition are essential for survival,

physical growth, mental development, performance and productivity, health and

wellbeing. It is an essential foundation of human and national development; (WHO,

2000).

Good nutrition is a fundamental pillar for the maintenance of positive health. A healthy

nation’s health depends on the healthy citizens. Good nutrition is crucial for maintaining

healthy growth and development in children (under-five). Preventing infection and managing

infectious disease –minimizing their incidence, duration and severity –are essential for

optimizing nutrition (WHO, 2000).

A healthy adult emerges from a healthy child who is given good nutritional care. Nutrition

of under-five children is of greatest importance because the foundation of our lifetime health,

strength, intelligence and vitality is laid during this period. Optimal infant feeding practice is

an important factor in determining growth and development of a child, Udoh and Amodu

springerplus (20165:2073).

Malnourishment is the major cause of ill health, morbidity and mortality of under-five

children worldwide. Undernourished children have lower resistance to infection and are more

likely to die from common childhood ailment such as diarrheal disease and respiratory tract

infection (B Ganga, 2021).

Malnutrition encompasses both under nutrition and over nutrition (obesity). However,

mostly, it is refers to under-nutrition resulting from improper feeding practices, impaired

utilization of nutrients due to infections and inadequate food and health security, poor

environmental conditions and lack of proper child care practices. This gives room for many

opportunistic infections which could lead to death. Those who survive may be locked into a

vicious cycle of recurring sickness and faltering growth often with irreversible damage to

their cognitive and social development. Malnutrition prevents individuals, community and
the whole country from achieving full potentials and is closely related with struggle of

survival; poverty and underdevelopment. Our country (Nigeria) faces the burden of diseases

in which nutritional deficiencies are most common in under-five children (Sonika and

Nowreen, 2019).

The Millennium Development Goals (MDGs) number four (4) targeted the

reduction of child mortality by the year 2015, However, from recent report

Nigeria’s progress toward reducing child mortality by two-third since 1990 is

off of track with only an average of 1.2% reduction in under five mortality

yearly (FMH and Save the Children 2011). Annually nearly one million

children die in Nigeria before the reach the age of five years and globally

about 11 million under-five children die. In 2006 there was an estimated 9.5

million deaths of children of under-five years of age globally and poor

nutrition which increases the risk of illness contributed directly or indirectly

to more than one-third of these deaths. In study in the northern Nigeria on

feeding practices and nutritional status of under five children, Sa’adatu,

Aisha and Hafiz (2020), Knowledge, Attitude and practice of infant and

young child feeding in Kumbotso Local Government Area, kano state,

Nigeria, Pakistan Journal of Nutrition, 19:444-450, adduced that only 23.7%

of mothers initiated breast feeding (BF) within one hour of birth. While only

15.4% practiced exclusive breast feeding (EBF) 19.26% started

complementary feeding at the right time and only 26.63% of children

between 6-59 months of age had adequate dietary diversity. Only 11.35% of

children reported intake of meat/ meat product and 15.7% of milk/milk

 product based on 24 hours recall. Less than half (48.7%) of the children (24-

59 months of age) consumed fruits and vegetables. Only 11.4% of care givers

wash their hands before feeding their child. The burden of malnutrition

among under-five children has not changed much even though various

intervention programs are in operation in Nigeria. Healthy eating and

physical; activities are essential for growth and development in childhood.

Hence to help children develop healthy eating patterns from an early age it is

very significant that the food and eating patterns to which they are expose

(both at home and outside) are those which promote positive attitudes of

good nutrition. The knowledge of mothers has important role in the

maintenance of nutritional needs to ensure sound foundation and secure

future of any healthy society. Therefore mothers have to be made more aware

about feeding practices and this will go a long way in reducing the severity of

malnutrition (Sonika and Nowreen, 2019).

Hence this study was undertaken with aim to assess knowledge attitude and practices (KAP)

of mothers regarding nutrition of under-five children and prevention of malnutrition.

1.2 STATEMENT OF THE PROBLEM

middle-income countries are now witnessing a rise in childhood overweight and obesity,

especially in countries in Africa and Asia The world faces challenges from malnutrition of all

forms, with one in three people being directly affected by, underweight, vitamin and mineral

deficiency or overweight, obesity and diet-related non communicable diseases (NCDs).

Moreover, these conditions increasingly coexist, whether in a nation, a community or a

household, or even in the same individual across the life course. In 2015, more than 1.9
billion adults were overweight or obese worldwide, while 462 million were underweight. In

2017, 151 million children aged under-five years were affected by stunting, while 38 million

were overweight and 51 million were affected by wasting. Furthermore, in 2016, over 340

million children aged 5–19 years were overweight or obese, while 192 million were

underweight. Under nutrition continues to cause nearly half of deaths in children aged under-

five years; it also impedes children’s achievement of their full physical growth, and their

economic, social, educational and occupational potential. However, low- and.

Under-nutrition is still persistent in the WHO African Region, with major implications for

health, particularly among poor and vulnerable population groups. Twenty five of the

Region’s 47 countries have high (>30%) or very high (>40%) rates of stunting. In fact,

analysis of trends shows that these rates are rising, instead of falling so as to meet the target

of reducing the number of stunted children by 40%. Only 17 countries have “acceptable”

levels of wasting (Along with persistent under-nutrition, the prevalence of overweight among

children under-five years of age (as well as the overall number of children affected) is rising,

whereas the target is to halt its increase ( WHO Regional Office for Africa, 2017).

Nutritional outcomes among under-five children in Nigeria are among the worse globally.

Malnutrition including micronutrient deficiencies is a significant public health problem in

Nigeria. More than one-third of children under-five years of age in Nigeria are stunted (i.e.

too short for their age or with height for age < -2) which represent about 9.7 million stunted

Nigeria children in 2013. Likewise, appropriately 18 % of under-five children are wasted (i.e.

too thin for their height or with weight for height < -2) in the same year. The tragic

consequence of malnutrition includes death, disability, stunted mental and physical growth

and as a result retarded national socio-economic development. Some 49% of the 10.7 million
deaths among under-five children each year in the developing world are associated with

malnutrition. Poor complementary feeding practices very wide spread-a major cause of

childhood malnutrition. The prevalence of under nutrition is higher for less educated mothers

with about half of children of less educated mothers reported stunted in 2013. In addition,

school attendance rate and educational attainment for women are very low in rural Nigeria.

More than half of women in rural Nigeria never attended school and higher percentage of

girls drop out of school before they attain the age of 15 years of age thereby denying them

the basic knowledge of health and nutritional and so due to the lack of basic knowledge of

health and nutrition many children are found with different nutritional deficiency such as

iodine deficiency which is the greatest single preventable cause off brain damage and mental

retardation worldwide and vitamin A deficiency remains the single greatest preventable

cause of needless childhood blindness and zinc deficiency in deprived populations

contributing to growth retardation, diarrhea, immune deficiency, skin lesion. This is shown as

a high prevalence especially among pregnant women and children under-five years. This

affects cognitive development lower school performance adult productivity reduces

immunity and eventually contributes to high burden of infants and child morbidity and

mortality.

1.3 OBJECTIVES OF THE STUDY

i. To assess the level nutritional practice of under-five children among mothers.

ii. To understand the nutritional requirement for infancy and early childhood

iii. To find out the factors associated with malnutrition among children under-five years.

iv. To ascertain ways of improving the nutritional status of children under-five years.

1.4 SIGNIFICANCE OF THE STUDY

This research would be useful for the improvement of nutritional knowledge attitude and

practices among mothers. Some mothers of Shabu, lafia Local Government Area in

Nasarawa State of Nigeria have low nutritional education while some are educated but have

low nutritional knowledge. For this reason this research work is to give nutritional education

to mothers would be very important and beneficial. With an improved nutritional knowledge

of mothers, it is expected that they can apply it for a better feeding pattern to the children

thus preventing the risk of moderate or severe malnutrition.

1.5 RESEARCH QUESTIONS

i. What are the levels of assessing the nutritional practices of children among mothers?

ii. What are the nutritional requirement for infancy and early childhood?

iii. What are the factors associated with malnutrition?

iv. What are the ways of improving the nutrition of children under-five years?

1.6 SCOPE OF THE STUDY

This study focuses on assessing the nutritional practices among women with children under-

five years and it was carried out in Shabu community of Shabu, Lafia North Development

Area of Nasarawa State due to time and financial constrain.

 CHAPTER TWO

2.0 INTRODUCTION:

Human nutrition describe the process whereby cellular organelles, cells, tissues, organs, systems,

and the body as a whole obtain and use necessary substance obtained from food(nutrients) to

maintain structural and functional integrity ; Michael, Susan, Aedin, and Hester ed., (2009).

Nutrition is a critical part of health and development. Better nutrition is related to improved

infant, child and maternal, health, stronger immune systems, safer pregnancy and child birth, low

risk of non-communicable diseases (such as diabetes and cardiovascular diseases), and longevity

(WHO, 2023).

Healthy children learn better. People with adequate nutrition are more productive and create

opportunities to gradually break the cycles of poverty and hunger (WHO, 2023).

Malnutrition, in every form, presents significant threats to human health. Today the world faces a

double burden of malnutrition that’s includes both under-nutrition and overweight, especially in

low – and middle-income countries. There are multiple forms of malnutrition, including under-

nutrition (wasting and stunting), inadequate vitamins or minerals, overweight, obesity, and

resulting diet-related non-communicable diseases (WHO, 2023).

The developmental, economic, social and medical impacts of the global burden of malnutrition

are serious and their families, for communities and for countries.
The children who are not growing well are the victims of the three strands of the triple burden of

malnutrition that is rapidly emerging in communities around the world, including in some of the

world’s poorest countries.

The first strand is under-nutrition. Despite some declines, under-nutrition continues to affect tens

of millions of children. Its presence is visible in the stunted bodies of children deprived of

adequate nutrition in the crucial first 1,000 days – from conception to the child’s second birthday

– and often beyond. These children may carry the burden of early stunting for the rest of their

lives and may never meet their full physical and intellectual potential. Under-nutrition is also

evident in the wasted bodies of children at any stage of life when circumstances such as food

shortages, poor feeding practices and infection, often compounded by poverty, humanitarian

crises and conflict, deprive them of adequate nutrition and, in far too many cases, result in death.

In 2018, 149 million children under 5 were stunted and almost 50 million were wasted

(UNICEF, 2019).

The second strand of malnutrition is hidden hunger. Deficiencies of essential vitamins and

minerals – often referred to as micronutrients – rob children of their vitality at every stage of life

and undermine the health and wellbeing of children, young people and women. This heavy toll is

made all the more insidious by the fact that hidden hunger is rarely noticed until it is too late to

do anything. The numbers of children affected by hidden hunger are striking. Based on the most

recent data available, UNICEF estimates that at least 340 million children under 5 suffer from

micronutrient deficiencies (UNICEF, 2019).

The third strand is overweight and, in its more severe form, obesity. The numbers of obese girls

and boys between the ages of 5 and 19 have soared since the mid-1970s, rising by between 10-

and 12- fold globally. Overweight, long thought of as a condition of the wealthy, is now
increasingly a condition of the poor, reflecting the greater availability of ‘cheap calories’ from

fatty and sugary foods in almost every country in the world. It brings with it a heightened risk of

non-communicable diseases, such as type 2 diabetes and coronary heart disease. Analysis carried

out as part of the Global Burden of Disease study suggests that diets lacking adequate nutrition

are now the leading cause of death worldwide (UNICEF, 2019).

The state of children’s malnutrition in the 21st century can be summed up like this: more

children and young people are surviving, but far too few are thriving. They are not thriving in the

crucial first 1,000 days, when the foundations for healthy, lifelong physical growth and mental

development are laid. And they are not thriving at other crucial development stages of life across

childhood and into adolescence. Malnutrition has many causes. A mother’s nutritional status, for

example, profoundly affects her child’s survival, growth and development, as does the child’s

feeding in the first hours and days of life. For far too many children, the causes of malnutrition

also include poor access to essential health services and to clean water and adequate sanitation,

which can lead to illnesses that prevent the child from absorbing nutrients (UNICEF, 2019).

But to understand malnutrition, there is an increasing need to focus on food and diet, and at

every stage of the child’s and young person’s life. The picture that emerges is a troubling one: far

too many children and young people are eating too little healthy food and too much unhealthy

food.

These problems start early on. In their first six months, only two out of five children are being

exclusively breastfed, depriving them of the best food a baby can get. When it comes to the ‘first

foods’ (or complementary foods) that infants should start consuming at around the age of 6

months, these too are, in far too many cases, not meeting children’s needs. Fewer than one in

three children between 6 and 23 months is eating the diverse diet that can support their rapidly
growing bodies and brains. For the poorest children, the proportion falls to only one in five.

Among older children, low consumption of fruits and vegetables is widespread. This is true, too,

of many adolescents, many of whom also regularly miss or skip breakfast and consume soft

drinks and fast food (UNICEF, 2019).

The diets of children today increasingly reflect the global ‘nutrition transition’, which is seeing

communities leave behind often more healthy, traditional diets in favor of modern diets. For

many families, especially poorer families, this means an increasing reliance on highly processed

foods, which can be high in saturated fat, sugar and sodium and low in essential nutrients and

fibre, as well as on ‘ultra-processed’ foods, which have been characterized as formulations

containing little or no whole food and which are extremely palatable, highly energy dense, and

low in essential nutrients. Often missing from these diets are whole grains, fruit, nuts and seeds,

vegetables, and omega-3 fatty acids.

2.1The World Health Organization recommends that babies be exclusively breastfed for their

first 6 months of life, and then introduced to first (or complementary) foods, which gradually

replace breast milk between the ages of 6 and 23 months. Results from the workshop suggest that

feeding practices in many instances are not optimal. Almost all of the women breastfed either

from birth or within the first 10 days after birth.116 However, around two out of five mothers

introduced breast milk substitutes (BMS) by the time their baby was 8 weeks old, and most were

combining breast milk and BMS (and, often, other liquids) before their baby reached 6 months of

age. Most mothers introduced first foods at 6 months of age, but a fifth started before their baby

was 5 months old. Some waited until the baby was between 7 and 9 months.

What barriers do mothers face in feeding their babies well?

 Financial: Overwhelmingly, the main barrier to feeding babies healthily was financial
  Expensiveness of healthy food

 Access and availability are also obstacles:

2.2 NUTRITION REQIUREMENT OF CHILDREN

 Early initiation of breast feeding:

Early initiation of breast is extremely important in establishing successful lactation as well as for

providing ‘Colostrums’ (mother’s first milk) to the baby. Ideally the baby should receive the first

breastfeed as soon as possible and preferably within half an hour of birth. The new born baby is

very active during the first half an hour and if the baby is kept with the mother and effort is made

to breastfeed, the infants learns sucking very fast. This early sucking by the infant starts the

process of milk formation in the mother and helps in early secretion of breast milk. In case of

caesarian deliveries, new born infants can be started with breastfeeding within 4-6 hours with

support to the mother. Newborn babies should be kept close to their mothers to provide warmth

and ensure frequent feeding. This also helps in early secretion of breast milk and better milk

flow.

It is very important that babies get the first breast-milk called colostrum which is thicker and

yellowish than the later milk and comes only in small amount for the first few days. Colostrum is

all the food and fluid needed at this time – no supplements are necessary, not even water.

During this period and later, the newborn should not be given any other fluid or food like honey,

ghutti, animal or powdered milk, tea, water or glucose water, since this are potentially harmful.

The mother, especially with first birth, may need help in proper positioning the for breastfeeding.

Breastfeeds should be given as often as the baby desires and each feed should be for as long as

the baby wants to suckle.

 Value of colostrums
The milk secreted after the child birth for the first few days is called ‘Colostrum’. It is yellowish

in colour and sticky. It is highly nutritious and contain anti-infective substances. It is very rich in

vitamin A. colostrums has more protein, sometimes upto 10%. It has less fat and the

carbohydrate lactose than the mature milk. Feeding colostrum to the baby helps in building

stores of nutrients anti-infective substance (antibodies) in the baby’s body. The anti-infective

substance protects the baby from infectious disease such as diarrhoea, to which the child might

be exposed during the few weeks after birth. Colostrums is basically the first immunization a

child receives from the mother. Difference in the colour and consistency could be possible

reasons for such beliefs.

Delayed initiation of breastfeeding is a common practice in the country and this deprives the

newborns from concentrated source of anti-infective properties, vitamin A and protein available

in colostrums. In some communities breastfeeding started as the fifth day for various

superstitions and ignorance. Sa’adatu, et’al, (2020) adduced that in Nigeria, only 23.7% of

mothers initiated breast feeding (BF) within one hour of birth.

Late initiation of breastfeeding not only deprives the child of the valuable colostrums, but

becomes a reason for the introduction of pre-lacteal feeds like glucose water , honey, ghutti,

animal or powder milk which are harmfully potential and invariably contributes to diarrhoea in

the new born. Late initiation of breastfeeding also causes engorgement of breasts which further

hampers establishment of successful lactation.

Educating and the communities about the value of colostrums would help tin ensuring that the

colostrum is not 1wastedbut fed to the child.

 Exclusive breastfeeding
Exclusive breastfeeding means that babies are given only breast milk and nothing else- no other

milk, food, drinks, and not ever water. During the first six months exclusive breastfeeding should

be practiced. Breast milk provides best nourishment to the baby during the first six months. The

babies who are exclusively beastfed do not require anything else namely additional food or fluid,

milk alone is adequate to meet the hydration requirement even under the extremely hot and dry

summer conditions prevailing in the country.

 Complementary feeding

Around the age of 6 months, an infant’s need for energy and nutrients starts to exceed what is

provided by breast milk, and complementary foods are necessary to meet those needs. An infant

of this age is also developmentally ready for other foods. If complementary foods are not

introduced around the age of 6 months, or if they are given inappropriately, an infant’s growth

may falter. Guiding principles for appropriate complementary feeding are:

 Continue frequent, on-demand breastfeeding until 2 years of age or beyond;

 Practice responsive feeding (for example, feed infants directly and assists older children.

Feed slowly and patiently, encourage them to eat but do not force them, talk to the child

and maintain eye contact);

 Practice good hygiene and proper food handling;

 Start at 6 months with small amounts of food and increase gradually as the child gets

older;

 Gradually increase food consistency and variety;

 Increase the number of times that the child is fed: 2–3 meals per day for infants 6–8

months of age and 3–4 meals per day for infants 9–23 months of age, with 1–2 additional

snacks as required;

 Use fortified complementary foods or vitamin-mineral supplements as needed; and

 During illness, increase fluid intake including more breastfeeding, and offer soft, favourite

foods.

At all ages, children are not eating diets with enough nutrients or diversity, and they are

eating too much sugar, salt and fat. The risks at each age can lead to one or more forms of

malnutrition: stunting, wasting, hidden hunger or overweight and obesity. These conditions

can affect school performance and lifelong economic opportunities, and present health risks

into adulthood; UNICEF (2019).

What should children eat? It’s a simple question, but for many parents and caregivers, and

even children themselves, the answer is not straightforward. The exact make-up of a healthy

diet depends on each individual and local contexts, but the basic principle of a healthy diet is

one that contains fruits and vegetables, whole grains, fibres, nuts and seeds, and during the

complementary feeding phase, animal source foods. Healthy diets limit free sugars, sugary

snacks and beverages, processed meats, saturated and industrially produced trans-fats and

salt; UNICEF (2019).

Ninety countries have developed food-based dietary guidelines, often based on

recommendations from international organizations, into clear, understandable dietary advice

that can also be visualized to aid communication. However, these guidelines are often not

specific to the different phases of children’s development and rely on recommendations that
 are not harmonized globally. Countries also struggle to provide clear guidance in the context

of rapidly changing modern food environments, with ultra-processed, packaged foods taking

up more of children’s daily diet. Dietary recommendations can also become politicized, with

food producers pushing back if government recommendations urge the public to eat less of

their products. There is remarkably little data on dietary intakes and food consumption

patterns over time, which also affects the design and updates of such guidelines. Most

national dietary guidelines advise eating a varied diet of four to five food groups:

 Fruits and vegetables (up to half of daily diets in many cases) †

 Whole grains and starchy foods †

 Healthy, lean proteins and dairy foods †

 Limited intake of sugar, fat and salt.

Across all child age groups, energy intake should be in balance with energy expenditure

to prevent overweight and obesity. While a common guideline of an adequate diet applies

throughout childhood, there are specific recommendations for birth to age 2; UNICEF

(2019).†

 Exclusive breastfeeding from the first hour of life until 6 months of age, and

continued breastfeeding until age 2.

 Nutritious and safe complementary (soft, semi-solid and solid) foods should be

progressively introduced starting at 6 months, with a particular emphasis on a diverse

range of iron rich, nutrient-dense foods without added salt, sugar or fat, such as lean

animal-source foods (including eggs, meat, fish and dairy), fruits and vegetables, and

legumes, nuts and seeds UNICEF (2019).

2.3 FACTORS ASSOCITED WITH MALNUTRITION

The following are the factors associated with malnutrition includes the following:

 POVERTY:

It is general knowledge that malnutrition is a condition that is associated with poverty

since it comes with hunger and lack of food at the right quantity and quality. Malnutrition

could also come as a result of loss of appetite, and this may be common among

terminally ill people such as HIV/AIDS, cancer and failed organ patients, kwashiorkor

people and elderly people (Etim, 2016).

Etim (2016) has reported that, in Sub-saharan Africa, the proportion of people affected by

extreme poverty has nearly doubled from 164 million in 1982 to 313 million as of 2002

in the last two decades. It is estimated that over 70% of Nigerians live below poverty line

of $1 per day with Northern Nigeria being the worst hit area (Olanrewaja, 2011).

Olanrewaja (2011) has attributed poverty in Nigeria to be precipitated by such factors as

corruption, unfavorable government policies, poor investment in education, etc.

 FAMILY SIZE:

According to Chaudhury (2009), children nutritional status can be affected by increase in

family size due to decrease in per capita income. That means that increase in the number

of children in a household decreases the food allocated to each child which consequently

affects children nutritional status. Increase in household size also facilitates fertility

decision between couples. In such situations, large family size may adversely affect the

nutritional status of children and household members thereby promoting poor dietary

practices especially in poorer households (Chaudhury, 2009).

 HOUSEHOLD INCOME AND EXPENDITURES:

 A household income level is clearly determined by the rate of expenditure on food.

Expenditure on food is likely to increase where there is improvement of household

income thereby increasing the rate of caloric and protein intake among children and

members of the household (Reutlinger and Selowsky, 1976).

On the other hand, poor household income can lead to less expenditure on food and low

nutrient/dietary intake. Chaudhury (2009) pointed out that a synergistic relationship

exists between dietary adequacy, dietary intake and per capita expenditure.

 HOUSEHOLD FOOD SECURITY AND INSECURITY:

Certain factors such as location of the house, family income level and household size can

significantly influence household food security. Food security is the sufficient

availability, nutritionally adequate and safety of food consumed in a way that is socially

acceptable (Oquntin, 2010).

On the other hand, food insecurity occurs when the ability to acquire safe, nutritionally

adequate food is limited or uncertain (Oquntin, 2010).

It has been observed that, in most developing countries, the dietary practice in

populations experiencing food insecurity tends to meet their energy requirements but do

not provide sufficient nutrients to optimize health and prevent infection. Hence, it can be

inferred that overnutrition and under-nutrition are strongly associated with food

insecurity (Babatunde et al., 2007; Awoyemi et al., 2012).

Factors such as poor academic performance, physical and mental ill-health, psycho-social

problem and anaemia related to iron deficiency are consequences of food insecurity in

children (Food and Agricultural Organization, 2008; Akinyele, 2009).

 EDUCATIONAL STATUS:
 Parent education is a strong determinant of children nutritional status. That means that

higher educational status of parents is associated with better child rearing and care

practices. According to Chaudhury (1983), children whose parents are educated up to the

tertiary level are more likely to have a nutritious diet irrespective of income level due to

their increased level of knowledge on basic child nutrition. On the other hand, parents

with higher educational attainment may promote values to the detriment of children’s

health (Chaudhury, 1983).

For instance, women who work outside their homes are less likely to breastfeed their

babies consistently and exclusively; and these women are more likely to practice early

weaning (Chaudhury, 1983).

 LACK OF ACCESS TO FOOD:

Food insecurity usually results from the inability of individuals to purchase enough food

and not because of lack of food itself. Etim (2016) reported that poor road networks,

scarcity of food in markets and poor family income levels are factors that promote food

insecurity among the disadvantaged populations. Countries sometimes depend on the

importation of food especially when there is food scarcity in their own countries (Etim,

2016). Etim (2016) reports that many people especially the poorer populations are

affected by fluctuations in food prices. In situations when the price of food is low,

farmers may produce less food products which may not be proportionate to the demand

by consumers, and as such may result in food scarcity in markets (Etim, 2016).

 SOCIO-DEMOGRAPHIC FACTORS:

In Sub-saharan Africa, several demographic trends inhibit the amelioration of

malnutrition in children (Etim, 2016).

 For instance, rapid population growth has been identified as a major demographic factor

exacerbating malnutrition in under-five children (Etim, 2016).

It is often observed that higher fertility is highly exhibited by the poor who are more

likely to be malnourished than people who belong to the wealthy quintiles (Etim, 2016).

However, the poor urban and rural populations suffer most from poor nutrition (Etim,

2016).

 ENVIRONMENTAL FACTORS:

In sub-tropical and tropical regions, 95% of all malnourished individuals live in relatively

stable climate. Thus, climate change is a significant factor to be considered when

ensuring substantial availability of food (food security) (Climate Change, 2007). Latest

report has shown that temperature increase in the sub-tropics and tropics are very likely

(climate change) Climate Change, 2007).

A United Nations study carried out in over 40 developing countries showed that climate

change directly or indirectly influence the decline in agricultural production and may as a

result increase the number of people suffering from hunger each year (Action Against

Hunger, 2012).

Even a slight change in temperature can affect the weather conditions (Climate Change,

2007).

Agricultural production and good nutrition are highly affected by the impact of these

events. For instance, during the Central Asian drought, there was about 50% reduction in

wheat production and 80% loss of livestock products (Battisti, 2008).

 In Subsaharan Africa, extreme weather conditions such as drought can diminish

productivity of many crop species thereby exacerbating the impact of malnutrition

(Battisti, 2008).

Poor children often reside in urban slums or very rural areas where there is absolute lack

of basic amenities such as water supply and other sanitation facilities which lead to

contamination of water bodies which in turn, can cause diarrhoea (Black et al., 2011).

Diarrhoea promotes wasting and prevents children from getting enough nutritious food.

 OTHER FACTORS

In the face of conflicts and crisis within countries, food security and access to food are

significantly compromised. Conflicts often lead to annihilation of farmlands and farm

businesses, low food productivity and limited level of food distribution internally. As a

result, people are often susceptible to starvation, illness and diseases than may arise from

food insecurity. A recent survey carried out in Afghanistan revealed that water-related

hardship was a major determinant of health and nutritional status of children under-five

years of age (Mashal et al., 2008).

2.4 WAYS OF IMPRFOVING THE NUTTRITION OF CHILDREN

Meeting the malnutrition challenge requires action across five key systems: those for food,

health, water and sanitation, education and social protection. There are already many examples

from around the world of how each of these systems is helping to support improvement in

maternal and child nutrition (UNICEF, 2019).

 Food system
Commercial fortification of staple foods with micronutrients is one of the most successful and

cost-effective interventions to combat hidden hunger. In the 1920s, Switzerland and the United

States started adding iodine to salt, virtually eliminating goitre and cretinism – the most severe

forms of iodine deficiency disorders – and paving the way for subsequent fortification initiatives.

Today, many countries routinely fortify refined cereal grains with micronutrients (UNICEF,

2019).

While technically simple, commercial fortification requires cooperation between government

agencies and a mature food industry with centralized and specialized processing and an adequate

distribution infrastructure. It also requires monitoring and quality control and is more effective

when paired with consumer education campaigns to promote consumption. Commercial

fortification has been widely successful in urban areas, where people typically purchase food in

central markets and stores. It is more challenging in rural areas, where the distribution

infrastructure may be more patchy (UNICEF, 2019).

 Universal salt iodization and large-scale food fortification

Universal salt iodization is one of the great global nutrition success stories. Today, iodized salt

is available to 86 per cent of world’s households. The result is that, between the early 1990s and

2016, the number of countries in which iodine deficiency is a public health problem fell from

113 to just 19. This progress has led to a major decline in iodine deficiency disorders and has

contributed to improving the intellectual development of millions of children. Salt iodization is

also highly cost-effective, costing only about US$0.05 per person per year (UNICEF, 2019).
Following the success of salt iodization in developed countries, momentum gathered to scale it

up globally. In 1994, WHO and UNICEF endorsed universal salt iodization as a safe, effective

and sustainable way to address iodine deficiency. However, salt iodization has made slow

progress in Southeast Asia and sub-Saharan Africa, especially in rural areas with poor

infrastructure and in countries that rely on small-scale salt processors. As with any form of food

fortification, successful scale-up requires political commitment, engagement from the food

industry, and links with national nutrition programmes and other development priorities.

Programmes also need to align with changing dietary patterns. For example, the increased

consumption of salt through processed foods, rather than as table salt, means that food industries

should ensure they use iodized salt. Salt iodization is also compatible with WHO’s

recommendation to reduce salt intake to less than 5g a day. By ensuring that all food-grade salt is

iodized, this limit can be safely met (UNICEF, 2019).

 Large-scale food fortification

The success of salt iodization paved the way for subsequent fortification initiatives around the

world. In the United States, for example, salt iodization was followed in 1933 by the fortification

of milk with vitamin D to prevent rickets and, in 1942, with the requirement to add thiamine,

riboflavin and iron to flour. In 1996, the government mandated the addition of folic acid to flour

to reduce the prevalence of neural tube defects, the most common of which are spina bifida and

anencephaly, a fatal condition. Subsequent assessments demonstrated that the prevalence of

neural tube defects had decreased by 19–32 %. Numerous other countries have seen similar

improvements. New national flour fortification programmes are being considered, including in

high-income settings such as the United Kingdom, where folic acid fortification is under review.
Currently 81 countries – from South Africa, Morocco and Jordan, to Indonesia, to Mexico and

Uruguay – mandate fortification of wheat flour alone or in combination with maize flour and

rice. Even so, significant untapped potential remains: if all countries worldwide fortified flour

with folic acid, this could prevent an estimated 230,000 cases of neural tube defects a year. Other

obstacles include the reality that national flour fortification standards do not always meet

minimal requirements for key nutrients such as iron, zinc and vitamin B12 (UNICEF, 2019).

As set out in the 2015 Arusha Statement on Food Fortification, critical actions are still needed.

These include improved oversight and enforcement of food fortification standards and

regulations, better evidence to guide policy and programme design, stronger accountability and

global reporting, continued advocacy, and additional (albeit modest) investment (UNICEF,

2019).

 Health system

Health facilities can play a major role in improving nutrition outcomes, but all too often, these

opportunities are missed. For national health systems to meet their full potential, they need to

deliver preventive services and curative care, but also to foster positive family practices, such as

breastfeeding, that can significantly scale up nutrition results. Cambodia, Rwanda and India are

three examples of countries where the health system is taking on this role (UNICEF, 2019).

Cambodia has invested substantially in awareness raising in communities, as well as in improved

quality of care around the time of delivery. As a result the percentage of deliveries by a skilled

birth attendant doubled between 2005 and 2014 to 89 percent in 2014, while institutional
deliveries increased from 22 per cent to 83 per cent. Importantly, rates of early initiation of

breastfeeding rose more than tenfold between 1998 and 2014 to 63 per cent. The programme has

also helped stop the rise of breastmilk substitute use among newborns (UNICEF, 2019).

Rwanda has also made significant progress. It implemented an intensive and sustained

communication campaign around feeding practices, including early initiation of breastfeeding,

and the Baby-Friendly Hospital Initiative. By 2014, skilled birth attendants assisted at 91 per

cent of deliveries, up from 39 per cent in 2005, including at nearly all births in health facilities.

The rates of early initiation of breastfeeding also increased; from 64 per cent in 2005 to 81 per

cent in 2014.29 Rwanda now has 45,000 community health workers who counsel mothers about

adequate feeding practices and safe deliveries (UNICEF, 2019).

In India, national and state governments implemented a multi-pronged strategy to support

breastfeeding, including large-scale programmes, effective capacity-building initiatives, strong

partnerships, community-based action, and communications campaigns. As a result, early

initiation of breastfeeding rose from 24.5 % in 2006 to 44.6 % in 2014. The increase was even

greater – from 12.5 % in 2006 to 34.4 % in 2014 – in the seven states with the highest rates of

newborn deaths (UNICEF, 2019).

These examples demonstrate how countries can integrate and improve the quality of

breastfeeding counseling within the health system to achieve results at scale. All three countries

were able to strengthen the capacity of health workers and health facilities to deliver nutrition

interventions. These positive results demonstrate the benefits of institutionalization, protection,

promotion and support of breastfeeding in maternity facilities, particularly in the first day

(UNICEF, 2019).
  Water and sanitation system

By causing conditions such as diarrhoea and dysentery, which prevent children from

absorbing nutrients, poor water and sanitation are major factors in malnutrition.

Improvements in the water, sanitation and hygiene (WASH) system, combined with

nutrition interventions, can therefore play a critical role in preventing stunting and other

forms of malnutrition. Such approaches have been adopted in Pakistan and Ethiopia,

which both suffer high rates of stunting – more than one third of children aged under-five

are affected – and where access to basic sanitation services is still a major national

concern (UNICEF, 2019).

In Pakistan’s Sindh province, UNICEF Pakistan and its partners implemented an integrated

package of WASH and nutrition interventions focused on the crucial first 1,000 days. The

WASH activities focused on reducing the incidence and severity of infection and controlling

environmental enteropathy, a chronic inflammation of the gut. Interventions included

maintaining safe water supplies, encouraging community-based approaches to eliminate open

defecation, improving hygiene behaviour, and developing service provider capacity. Challenges

remain, but there has been significant progress. Community healths workers have been mobilized

and WASH clubs have been formed in schools to empower children to promote positive

practices. In total, an estimated 922,000 children aged under-five and women have been reached

with packages of nutrition services, including micronutrient supplementation (UNICEF, 2019).

In Ethiopia, UNICEF implemented a Baby WASH programme in 2017, with the aim of

protecting babies and young children from microbial infections during play and feeding. The

programme includes interactive communication for development tools and materials, including a

radio drama series, public service announcements (PSAs), and discussion groups with mothers

(UNICEF, 2019).

The intervention has helped change behaviours. According to an internal evaluation report,

almost three quarters of those who listened to the radio programmes and PSAs said they had

made changes. Around half said they were washing their hands more often and using soap, while

around a quarter had stopped open defecation. Work has already begun with the Ministry of

Health to scale up the approach across the country, including the development of national

guidelines and a training manual, and the launch of a national training initiative for trainers who

will implement the Baby WASH approach in the regions (UNICEF, 2019).

 Education system

School-based food and nutrition interventions can play a key role in creating an environment

that provides and promotes healthy diets and nutrition among children and adolecents. By

educating and influencing children (and their parents) to make healthy food choices, education

systems can deliver not only nutrition-specific interventions but also ensure nutrition-friendly

environments (UNICEF, 2019).

Some countries in Africa (including Senegal, Ethiopia and Rwanda) have recorded significant

reduction in stunting during recent years. All of these countries are very different albeit similar

within a wider African political, geographical, cultural and social context. They all have been

implementing ‘typical’ national nutrition programs with a ‘package’ of (primarily) nutrition

specific interventions (including vitamin A supplementation, de-worming, iron-folate

supplementation in pregnancy, CMAM in selected circumstances, breast-feeding promotion, and

general public education on the importance of a ‘balanced diet’). These interventions were

implemented alongside other programs on integrated management of childhood illnesses,

AFRICA REGIONAL NUTRITION STRATEGY (2015–202).

 Social protection system

Social protection programmes are a powerful instrument to not only lift families and children

out of poverty, but also to promote maternal and child nutrition. A range of interventions, such as

conditional and unconditional cash transfers, food rations and school feeding, can all help limit

the long-term effects of deprivation and provide communities with the means to access and

afford nutritious food. Cash-transfer programmes, in particular, have proven benefits for the

nutritional status and health outcomes of children (UNICEF, 2019).

Social protection programmes have been widely implemented in Latin America, and have

helped countries reduce poverty, promote food security and improve nutritional outcomes for

children, young people and families. In Brazil, for example, the Bolsa Familia (‘family

allowance’) programme launched in 2003 reached more than 13 million families in its first

decade of implementation, and contributed significantly to social and public health

improvements. Specifically focused on nutrition, the programme played a vital role in helping

low income families to purchase food, thus enhancing their dietary quality and diversity. Among

children aged under-five the programme was crucial to reducing child mortality, which is closely

linked to malnutrition. A study published by The Lancet showed that Bolsa Familia was crucial

to reducing child mortality among children aged five, by incentivizing pre- and post-natal care
and supporting immunization campaigns and health and nutrition activities for mothers and

children (UNICEF, 2019).

Similarly, Mexico’s conditional cash-transfer programme, Prospera, has benefited around 7

million families. Child nutrition has been a major component of the programme from its

inception. Families included in the programme benefit from regular maternal and child services

where children’s nutritional status is monitored. Nutrition services aim to improve families’

capacity to eat healthily and feed their children a nutritious, safe and affordable diet. As studies

have shown, the programme has helped to promote nutrition and optimum growth, and has also

enhanced dietary diversity among families and children (UNICEF, 2019).

These large-scale interventions prove the importance of nutrition-sensitive social protection

systems, helping countries not only to mitigate the effects of poverty, but also to strengthen

families in their childcare role, which is a fundamental aspect of ensuring healthy eating habits

and better child nutrition (UNICEF, 2019).

COMPUTATION OF ANALYSIS

SECTION B

RESEARCH QUESTION 1: What are levels of nutritional practice among mothers?

S/N SA A UD D SD X RM
 1. 5x5=25 2x4=8 25x3=75 9x2=18 9x1=9 2.7 UD

2. 7x5=30 4x4=16 4x3=12 30x2=60 5x1=5 2.56 UD

3. 31x5=155 13x4=52 2x3=6 1x2=2 3x1=3 4.36 A

4. 7x5=35 10x4=40 3x3=9 27x2=54 3x1=3 2.82 UD

5. 10x5=50 18x4=72 10x3=30 19x2=38 3x1=3 3.86 A

6. 10x5=50 13x4=52 8x3=24 11x2=22 8x1=8 3.12 UD

7. 11x5=55 24x4=96 6x3=18 9x2=80 0x1=2 3.74 A

Grand Mean = 4.41

Table 1: Reveals that the mean responses for item 1, 2, 4 and 6 on nutrition practice

among mothers were rated undecided with the weighted means ranging 2.7-2.82 while

the mean weighed response on items 3, 5, and 7 were rated as agreed. This shows that

mothers have poor nutritional practice.

SECTION C

RESEARCH QUESTION 2: What are the food requirements for infancy and early childhood?

8 5x5=25 2x4=8 25x3=75 10x2=20 7x1=7 2.5 UD

9 10x5=50 24x4=96 5x3=15 8x2=16 3x1=3 3.6 A

10 2x5=10 7x4=28 28x3=84 10x2=20 3x1=3 2.9 UD

11 10x5=0 3x4=12 20x3=60 17x2=34 0x1=0 2.8 UD

12 10x5=50 15x4=60 15x3=45 2x2=4 8x1=8 3.34 UD

13 5x5=25 5x4=20 10x3=30 20x2=40 10x1=10 2.5 UD

14 5x5=25 10x4=40 20x3=60 10x2=20 5x1=5 2.6 UD

Grand Mean = 4.04

Table 2: Reveals that the mean responses for item 8, 10, 11, 12, 13, and 14 on food

requirements for infancy and early childhood were rated undecided with the weighted
means ranging 2.5-3.34 while the mean weighed response on item 9 is rated as

agreed. This shows that mothers did not really know the right food to give to their

children during complementary feeding.

SECTION D

RESEARCH QUESTION 3: What are the factors associated with malnutrition?

S/N SA A UD D SD X RM

15 20x5=150 10x4=40 4x3=12 11x2=22 5x1=5 3.58 A

16 30x5=150 10x4=40 2x3=6 8x2=16 0x1=0 4.24 A

17 6x5=30 2x4=8 10x3=30 20x2=40 12x1=12 2.4 D

18 20x5=100 15x4=60 1x3=3 9x2=18 5x1=5 3.66 A

19 10x5=50 20x4=80 5x3=15 15x2=30 5x1=5 3.1 UD

20 26x5=130 21x4=84 3x3=9 0x2=0 0x1=0 4.46 A

21 5x5=25 20x4=80 5x3=15 10x2=20 10x1=10 3.0 UD

Grand Mean = 4.88

Table 3: Reveals that the mean responses for item 17 on factors associated with

malnutrition in children under-five is rated disagreed with the weighted mean 2.4 while

the mean weighed response on items 19 and 21 were rated as undecided and items 15,

16, 18 and 20 were rated agreed with weighted mean ranging from 3.58-4.46. This

shows that mothers agreed that the mentioned factors are factors associated with

malnutrition in children under-five years.

SECTION E

RESEARCH QUESTION 4: What are the ways of improving the nutrition if children?

S/N SA A UD D SD X RM
 22 20x5=100 15x4=60 11x3=33 1x2=2 3x1=3 3.96 A

23 10x5=50 26x4=104 3x3=9 7x2=14 4x1=4 3.62 A

24 18x5=90 10x4=40 12x3=36 10x2=20 2x1=2 3.76 A

25 17x5=85 4x4=16 4x3=3 10x2=20 15x1=15 2.96 UD

26 12x5=60 4x4=16 20x3=60 10x2=20 4x1=5 2.6 UD

27 10x5=50 10x4=40 2x3=6 10x2=20 4x1=4 2.88 UD

Grand Mean = 3.95

Table 4: Reveals that the mean responses for items 25, 26 and 27 on ways of

improving the nutrition of children under-five years were rated undecided with

weighted mean ranging from 2.6-2.96.while the mean weighed responses on items 22,

23 and 24 were rated as agreed. This shows that mothers agreed that the mentioned

ways of improving children nutrition are the possible ways.

CHAPTER FOUR

PRESENTATION AND DATA ANALYSIS

4.1 INTRODUCTION
This chapter is concerned with the presentation and analysis of data collected from the

respondents in order to assess the nutritional practices among mothers of Shabu, Lafia

Local Government Area of Nasarawa State.

Research question 1: what are the levels of nutritional practice among mothers ?

S/ The following are the causes of abortion X RM

6 Blood group incompatibility 2.7 UD

7 Drug ingestion 2.56 UD

8 Phospholipids anti body disorder 4.36 A

9 Abnormal placenta implantation 2.82 UD

10 Faulty implantation of the fertilize ovum 3.86 A

11 Failure of endometrial to accept the fertilized ovum 3.12 UD

3.74 A

Grand Mean = 4.04

Table 1: Reveals that the mean responses for item 1, 2, 4 and 6 on nutrition practice

among mothers were rated undecided with the weighted means ranging 2.48-2.82

while the mean weighed response on items 3, 5, and 7 were rated as agreed. This

shows that mothers have poor nutritional practice.

SECTION “C”

Research question 2: What are the food requirements for infancy and early childhood ?

S/N : The following are the complication of abortion X RM

12 Ectopic pregnancy 2.5 UD

13 Greater risk of premature birth 3.6 A

 14 Increase risk of breast cancer 2.9 UD

15 Sterility 2.8 UD

3.34 UD

2.5 UD

2.6 UD

Grand Mean = 4.04

Table 2: Reveals that the mean responses for item 8, 10, 11, 12, 13, and 14 on

food requirements for infancy and early childhood were rated undecided with

the weighted means ranging 2.5-3.34 while the mean weighed response on item

9 were rated as agreed. This shows that mothers did not really know the right

food to give to their children during complementary feeding.

SECTION “D”

Research question 3: what are the factors associated with malnutrition?

S/ The following are ways of prevention of abortion X RM

16 Improve access to contraception 3.58 A

17 Require federal paid family leave 4.24 A

18 Offer universal health care 2.4 D

19 Offer affordable or free child care option 3.66 A

20 Provide quantity prenatal and postnatal care 3.1 UD

21 Provide mental health support in postpartum 4.46 A

3.0 UD

Grand Mean = 4.88

Table 3: Reveals that the mean responses for item 17 on factors associated with

malnutrition in children under-five is rated disagreed with the weighted mean 2.4

while the mean weighed response on items 19 and 21 were rated as undecided and

items 15, 16, 18 and 20 were rated agreed with weighted mean ranging from 3.58-

4.46. This shows that mothers agreed that the mentioned factors are factors associated

with malnutrition in children under-five years.

SECTION “E”

Research question 4: What are the ways of improving nutrition of children?

S/N : The following are the effects of abortion X RM

22 Infertility 3.96 A

23 Ectopic pregnancy 3.62 A

24 Depression 3.76 A

25 A sense of isolation 2.96 UD

2.6 UD

2.88 UD

Grand Mean = 3.95

Table 4: Reveals that the mean responses for items 25, 26 and 27 on ways of

improving the nutrition of children under-five years were rated undecided with

weighted mean ranging from 2.6-2.96.while the mean weighed responses on items 22,

23 and 24 were rated as agreed. This shows that mothers agreed that the mentioned

ways of improving children nutrition are the possible ways.

CHAPTER FIVE

DISCUSSION, SUMMARY, RECOMMENDATION AND CONCLUSION

This chapter is concerned with re-statement of the problem, discussion of findings

based on research questions. Summary of the study conclusion and recommendation

5.1 RE-STATEMENT OF THE PROBLEM

Middle-income countries are now witnessing a rise in childhood overweight and obesity,

especially in countries in Africa and Asia The world faces challenges from malnutrition of all

forms, with one in three people being directly affected by, underweight, vitamin and mineral
deficiency or overweight, obesity and diet-related non communicable diseases (NCDs).

Moreover, these conditions increasingly coexist, whether in a nation, a community or a

household, or even in the same individual across the life course. In 2015, more than 1.9 billion

adults were overweight or obese worldwide, while 462 million were underweight. In 2017, 151

million children aged under-five years were affected by stunting, while 38 million were

overweight and 51 million were affected by wasting. Furthermore, in 2016, over 340 million

children aged 5–19 years were overweight or obese, while 192 million were underweight. Under

nutrition continues to cause nearly half of deaths in children aged under-five years; it also

impedes children’s achievement of their full physical growth, and their economic, social,

educational and occupational potential have high (>30%) or very high (>40%) rates of stunting.

5.2 SUMMARY OF THE STUDY

The research work consists of five chapters presented as following:

Chapter I: Deals with the introduction of the study, background of the study, research

questions and scope of the study.

Chapter II: Deals with the review of related literatures discussed under subheadings

as follow introduction, level of nutritional practice among mothers with children

under-five, food requirements for infancy and early childhood, factors associated with

malnutrition, ways of improving nutrition of children.

Chapter III: Deals with methodology, design of the study, area of the study,

population of the study, sample and sampling technique, instrument for method of data

collection and method of data analysis and interpretation.

Chapter V: Deals with the re-statement of the problem, summary of the study, major

findings, recommendations, suggestion, conclusion and references.

5.3 MAJOR FINDINGS

i. Respondents, i.e mothers have poor nutritional practice.

ii. Respondents, i.e mothers do not really know the right food to give their children

during complementary feeding.

iii. Respondents, i.e mothers have knowledge on the factors associated with

malnutrition.

iv. Respondents, i.e mothers have knowledge on the possible ways of improving

nutrition of children.

5.4 DISCUSSING OF FINDINGS BASED ON RESEARCH QUESTIONS.

Research question I: what are the levels of assessing the nutritional practices of

children among mothers? Research question I show that mothers have poor nutritional

practice.

Research question II: What are the nutritional requirement for infancy and early childhood?

Research question II shows that most of the respondents did not know the right to give their

children during complementary feeding..

Research question III: What are the factors associated with malnutrition?

Research question III shows that almost all the respondents are aware of the factors associated

with malnutrition in children under-five years. They have the knowledge on the factors

associated with malnutrition but are not able to tackle it. So it is important that vigorous

campaign or health education to create better awareness on the ways of tackling those factors.
Research question IV: What are the ways of improving the nutrition of children under-five

years?

Research question IV shows that the respondents agreed to possible ways of improving the

nutrition of children. Though the respondents are aware of the ways to improve the nutrition of

children but they are not put to action. So the government should put more effort in ensuring the

improvement of children nutrition.

5.5 CONCLUSION

Majority mothers had fair to good practice regarding under-five nutrition and prevention of

malnutrition. Adequate knowledge of mothers regarding dietary patterns of under-five children is

of paramount important as it will enhance their attitude and help them change the harmful

practices which would go a long way in solving the nutritional health problems in our settings.

5.6 IMPLICATIONS OF THE STUDY

The researcher implies that all necessary actions required to be taken in order to improve the

nutrition of children under five years should be seriously considered.

5.7 RECOMMENDATIONS

In line with the findings of this study, the following recommendations were made:

 The importance of exclusive breast feeding and the use of locally available,

highly nutritious food resources as weaning diet should be taught during ante-

natal period and community outreach programmes.

 Women empowerment should be encouraged as it promises to improve family

finances, better food security and better childhood nutrition. Because most of

the women in the study area are mostly farmers and traders.
 Health care personnel should educate mothers on factors that lead to poor

nutritional status. Improvement on nutritional status of children can be

achieved through increasing client’s knowledge especially in the rural areas to

discourage those detrimental practices that lead to malnutrition.

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Social Science (IOSR-JHSS), 26(08), 2021, pp. 52-61

B Ganga Bhavani. “A Study to Assess the Knowledge, Attitude and Practices of Mothers

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