JENNY FAITH MARIE B.
ABELLA
RELATED LITERATURE
According to the World Health Organization (WHO), 462
million adults are underweight, while 1.9 billion adults are
overweight and/or obese. In children under 5 years of age,
155 million are stunted, 52 million are wasted, 17 million are
severely wasted and 41 million are overweight and/or obese
[1]. The manifestation of malnutrition is multifold, but the
paths to addressing prevention are key and include
exclusive breastfeeding for the first 2 years of life, diverse
and nutritious foods during childhood, healthy environments,
access to basic services such as water, hygiene, health and
sanitation, as well as pregnant and lactating women having
proper maternal nutrition before, during and after the
respective phases (levels and trends) [3].
It is vital that malnutrition is addressed in children as
malnutrition manifestations and symptoms begin to appear
in the first 2 years of life [4]. Coinciding with the mental
development and growth periods in children, protein energy
malnutrition (PEM) is said to be a problem at ages 6 months
to 2 years. Thus, this age period is considered a window
period during which it is essential to prevent and/or manage
acute and chronic malnutrition manifestations [ 4, 5, 6]. Child
and maternal malnutrition together have contributed to 3.5
million annual deaths. Furthermore, children less than 5
years of age have a disease burden of 35% [7]. In 2008, 8.8
million global deaths in children less than 5 years old were
due to underweight, of which 93% occurred in Africa and
Asia. Approximately one in every seven children faces
mortality before their fifth birthday in sub Saharan Africa
(SSA) due to malnutrition [8].
Young malnourished children are affected by compromised
immune systems by succumbing to infectious diseases and
are prone to cognitive development delays, damaging long
term psychological and intellectual development effects, as
well as mental and physical development that is
compromised due to stunting [7, 9, 10, 11]. A malnutrition
cycle exists in populations experiencing chronic
undernutrition and in this cycle, the nutritional requirements
are not met in pregnant women. Thus, infants born to these
mothers are of low birth weight, are unable to reach their full
growth potential and may therefore be stunted, susceptible
to infections, illness, and mortality early in life. The cycle is
aggravated when low birth weight females grow into
malnourished children and adults, and are therefore more
likely to give birth to infants of low birth weight as well [ 9].
Malnutrition is not just a health issue but also affects the
global burden of malnutrition socially, economically,
developmentally and medically, affecting individuals, their
families and communities with serious and long lasting
consequences [1].
Studies in Sudan, Ethiopia, Bangladesh, and Haiti have
indicated that the causes of malnutrition are multi-faceted,
with both environmental and dietary factors contributing to
malnutrition risk in young children [12]. Diet and disease
have been identified as primary immediate determinants;
with household food security, access to health facilities,
healthy environment, and childcare practices influenced by
socio-economic conditions [13]. Mother’s antenatal visit and
body mass index were also identified as risk factors for
malnutrition [14]. In children under 3 years of age some of
the main factors included poor nutrition, feeding practices,
education and occupation of parent/caregiver, residence,
household income, nutrition knowledge of mother [ 15]. These
studies have suggested that nutrition education for the
mother is important, as it is a resource that mothers can
utilize for better care of their children. It can also provide the
necessary skills required for childcare, improvement of her
feeding practices, enable her to make choices and have
preference of health facilities available, increase her
nutritional needs awareness, and give her the chance of
changing her beliefs regarding medicine and disease [ 16].
Some of the nutritional interventions that have had some
success in addressing malnutrition include exclusive
breastfeeding for the first 6 months of life, vitamin A
supplementation, deworming, zinc treatment and
rehydration salts for diarrhea, food fortification, and folic
acid/iron for lactating and pregnant women, improvement of
access to piped water and hygiene [17]. These interventions
have positively influenced the development, growth and
survival of children [18]. Malnutrition is not a uniform
condition and therefore groups and areas that experience
high risk of malnutrition must be identified and targeted
interventions available to assist [17].
