ACKNOWLEDGEMENTS

I am thankful to God, whom my source of inspiration came from in writing this

work and for his infinite mercies, grace,strength support and directions.

My gratitude goes to my supervisor who is also the Head of Department, Dr. Mrs
Sally Ibe for dedicating her time and tolerance in making corrections and
contributions to ensure the work is completed and also for ensuring a conducive
learning environment to the students.

My sincere appreciation goes to the Dean, School of Health Technology, Rev. Sr.
(Prof) E.T. Oparaocha for her support toward the success of the Department.

I will not fail to acknowledge the entire lecturers in Public Health department,
who have impacted knowledge positively in me and helped me prepare for the
future that lies ahead.

They are as follow:, my class Adviser, Dr.(Mrs) B. Nworu, and all my lecturers, Prof.
I.N.S Dozie, Prof. O.C. Abanobi, Dr.( Mrs) E.A Nwoke, Dr.O.K Omokorie, Dr. C.O.
Emerole, Dr. J.N. Njoku, Dr. T.I. Ezejiofor, Dr.G U. ILoh, Dr.U Chukwuocha, Dr. S.I.
Okoronndu, Dr.I.E. Adieze, Dr.C. Iwuala, Dr.J. Nwaokoro, Dr.O.G. Uduji, Dr.C. Ebirim,
Dr.(Mrs) C.O.A Amadi, Dr.C Okereke, Dr.(Mrs) C.R. Nwofu, Dr.C. Onoh, Dr. G.N.U.
Iwuoha, Mrs W. Dozie, Mrs J. Ezelote and Mrs C. Orji for impacting knowledge and
discipline which has positively influenced my life.

My profound felicitation goes to my parents, Mr and Mrs John Enyia who started
me on this journey and have remained the source of my encouragement.

I would also like to thank my siblings who have in one way or another contributed
to my academic career.

I also want to thank my loving husband, Mr Bishop Adimelechi whose care and
support has encouraged me to this point of my academic career.

Thank you all!

 CHAPTER ONE

INTRODUCTION

1.1 Background information

Nutrition is a fundamental pillar of life, health and development across the entire
life Span, from the earliest stages of fetal development, at birth, through infancy,
childhood and adolescence and on into adulthood and old age. In addition,
nutrition is an essential foundation for human and national development. Thus,
monitoring the nutritional status of children and factors influencing it, is a
fundamental instrument for measuring the population's health.

According to World Health Organization ( WHO, 2017), nutrition is the intake of

food, considered in relation to the bodys dietary needs and nutritional status is
the state of the body in relation to the consumption and utilization of nutrients.

Nutritional status of children is an indictor of the level of development and future

potential of the community. The nutritional status of infants and children is of
concern since the the early years of life are crucial for optimal growth and
development (preschulck, Aldana and Hassan, 2009). Nutrition is believed to be
very essential for socio economic growth of the country and is an essential
component of Millennium Development Goals.

Malnutrition is one of the most important public health problems of developing

countries where resources are very limited. An estimated 54% of all childhood
death occurs globally because of malnutrition (WHO, 2016). The common cause of
malnutrition is lack of access to nutritious food. Poor feeding habit, such as
inadequate breast feeding, offering the wrong foods, and not ensuring that the
child gets enough nutritious food, contribute to malnutrition. Respiratory
infections, frequent diarrhea, malaria also undermines a child's nutritional status.

A study by Tufin Malambugi (2010) showed that mothers with informal or primary
education had more severely stunted children compared to secondary school
leavers. And that birth weight, diseases, type of food and weaning age were
factors influencing nutritional status of children. Another study by Endris, Asefa
and Dune (2017), indicated that, age of child was found to be significantly
associated with nutritional status, as the age of the child increases, the risk of
being malnourished increases. Endris et al stated that, their findings was in line
with other studies done in Tigray region, Nigeria and Bangladesh, and gave late
introduction of supplementary food with low nutritional quality and neglecting to
fulfill optimal food requirements of children as their age increases as possible
reasons why malnutrition increases with age. Another important factor that
influences nutritional status of under five children is family income (Endris et al,
2017).

The causes of malnutrition and other health problems related to nutrition are
complex and involves multiple factors. Emphasis should be given on maternal
education, proper child nutrition and improvement of socio economic status to
reduce the burden of childhood malnutrition and other health issues related to
nutrition.

1.2 STATEMENT OF THE PROBLEM

Undernutrition among children remains common in many parts of the world.

According to (WHO,2011), about 178 million children under five years worldwide
are too short for their age group, while 115 children are under weight. The same
report showed that stunting rate is among children is higher in Africa and Asia
than elsewhere.

In a fact sheet released by United Nations Children's Fund (UNICEF) in 2015, 37%
or 6 million children in Nigeria are stunted, 18% suffer from wasting and 29% are
under weight. Also in the same report sheet,50% of Nigeria children from rural
areas are stunted, 80% whose mothers have no education are under weight and
80% from the poorest 20% households are suffering from wasting.

Information on nutritional status of children under five years is an indictor of the

nutritional situation in a society. A good understanding of the nutritional situation
and factors influencing nutritional status of an area is necessary for improved
planning in order to change the situation. This study is geared towards
investigating factors that influence nutritional status of under five children in Obile
community and suggest ways of improving their nutritional status.

1.3 OBJECTIVE OF THE STUDY

1.3.1 General Objective

The general objective of this study is to determine the factors influencing the
nutritional status of under five children in Obile, Ohaji/Egbema LGA Imo state.

1.3.2. Specific Objectives

i. To assess the nutritional status of under five children in Obile,

Ohaji/Egbema LGA, Imo state.

ii. To ascertain influence of mother's educational level on nutritional status of

under five children in Obile, Ohaji/Egbema LGA Imo state.

iii. To ascertain the influence of family income on nutritional status of under

five children in Obile, Ohaji/Egbema LGA Imo state.

iv. To determine if age of child influences nutritional status of under five

children in Obile, Ohaji/Egbema LGA Imo state.

1.4 RESEARCH QUESTIONS

I. What is the nutritional status of under five children in Obile, Ohaji/Egbema

LGA Imo state?

II. Does mother's educational level influence the nutritional status of under
five children in Obile, Ohaji/Egbema LGA Imo state?

III. Is there an association between family income and nutritional status of

under five children in Obile, Ohaji/Egbema LGA Imo state?

IV. Does age of child influence nutritional status of under five children?
1.5 SIGNIFICANCE OF THE STUDY

This study will help identity the factors influencing nutritional status of under five
children and how they can be controlled. This study is also significant in educating
Obile people and the general public on how to identify factors influencing
nutritional status of under five children.

In addition, identifying nutritional status of under five children in Obile helps to

reduce malnutrition and other sicknesses associated with poor nutritional status
in under five children, helps the children grow healthy, happily and normally with
good brain and body development. It also helps reduce antisocial behaviors in the
society, thereby, creating a free and safe zone for all and sundry. Finally,
identifying nutritional status of under five children reduces the expenses made by
parents due to frequent visit to the hospital, helps generate more income to
parents and society when children grow up healthy, helps the government
increase work force and income in the country and also helps in public health by
reducing maternal and child mortality.

1.6. SCOPE OF THE STUDY

The variables of interest includes: Influence of mother's educational level, age of

child and family income on nutritional status of under five years. This study is
limited to under five children who were born and live in Obile community.

1.7. OPERATIONAL DEFINITION OF TERMS

Nutritional status: Nutritional status is a measure of the health condition of an
individual as affected primarily by the intake of food and utilization of nutrients.

Under-five children: children below the age of five.

Malnutrition: This refers to the lack of adequate nourishment in a child.

Wasting: pronounced loss of body mass.

Stunting: A check in growth

Influence: This is the power to control, affect or manipulate nutritional status.

Factors: An agent or representative that determines nutritional

 CHAPTER THREE

3.1. STUDY DESIGN

This is a community based, cross- sectional, descriptive survey study.

3.2 AREA OF STUDY

Ohaji/Egbema is an oil-rich Local Government Area of Imo State, Nigeria. Its

headquarters is Mmahu-Egbema. It has an area of 890 km and a population of
182,538 at the 2006 census. The postal code of the area is 464. The local council
lies in the south-western part of Imo State. It shares common boundaries with
Owerri in the East, Oguta LGA in the North and Ogba/Egbema/Ndoni in Rivers
State in the South-west. Agriculture is the mainstay of the people. Faming,
Fishing, Palm Oil processing, Hunting, and animal husbandry are vigorously
practiced. A good number of big companies, government agencies and voluntary
organizations have established farms in the various areas of the local government.
There is Adapalm (Nig) Ltd at Ohaji, Rubber Estate at Obitti, forest Reserve at
Ekugba etc. These serve as tourism attraction centers for visitors to the area.
Ohaji/Egbema has the following 16 autonomous communities: Egbema,
Umuagwo, Oloshi, Umunkwaku, Obile, Obitti, Mgbirichi/Alakuru, Opuoma, Assa,
Awarra, Ikwerede, Umuokanne, Obiakpu, Ohoba, Obosima, Mmahu. For the
purpose of this study, the community to be focused on will be Obile community.

Obile is an autonomous community in Ohaji/Egbema LGA of Imo state.

Obile is an Igbo speaking village with three villages namely; Umuoboke,
Umuikpo and Umuosu. These three communities are further divided
into clans and then kindreds.
The village is inhabited by men, women and children. And their major
occupation is farming. Obile use to be a very peaceful place until the
recent crisis due to cultism. Obile has a population of about 3000
people with the ratio of male equal to that of the female.

Obile is bounded In the East by Assa, in the west by Aggah, in the north
by Amafor and in the south by Etekwuru all in Ohaji/Egbema LGA except
for Aggah which is in rivers state.

The community monarchy is ruled by Ezeand their major religion is

Christianity. The major churches include, the saint Mary's Catholic
church, Baptist church of God and Overcomers ministry.

3.3 STUDY POPULATION

The study population for this study includes children within the age of 0
- 59 months.

3.4. SAMPLING G SIZE AND SAMPLING METHOD

3.4.1. Sample size

Eventual sample size ----> 364

Using, Taro yamene formula 2 calculate sample size.

n= N/1+N(e)^2

Where,

e =0.05^2, N = total population and n =?

n= 4000/1+4000(0.05)^2

n= 4000/11

n= 363.63~ 364

3.5. Sampling method

Purposive sampling method will be used to select a Community in Ohaji/ Egbema.

And Obile will be selected for this study. Then clans in each village in Obile will be
list out and a simple random sampling method will be used, in which one clan
from each village will be selected to represent the three villages.

3.5. INSTRUMENT FOR DATA COLLECTION

The instrument used is the questionnaire. Questionnaire for Determining the

factors influencing nutritional status in under-five.
The questionnaire consists of four sections namely; section one containing
personal data of each respondent, section two containing questions pertaining to
children nutritional status and socioeconomic variables, section three containing
questions that relate to the level of knowledge of nutritional status and how it
influences the nutritional status of a child and section four contains questions
related to the medical history of the respondent child/children.

3.6 VALIDITY OF INSTRUMENT

The questionnaire constructed by the researcher was properly examined by her

supervisor.
3.7. RELIABILITY OF INSTRUMENTS

In order to test the reliability of the items of the questionnaire, it was

administered to group of women with under-five children in the selected kindreds
in the three villages selected in Obile community and their opinion was recorded.
After one week, same questions were redistributed to same group of women and
same response was gotten. This showed the items on the questionnaire were
reliable.

The reliabilty was determined through the Test-Retest method.

3.8. METHOD OF DATA COLLECTION

The questionnaire was administered to the respondents after an informed

consent was obtained. The literate respondents were allowed to fill the
questionnaire themselves but for the non-literate respondents, the questions
were asked in local language and their responses were filled by the researcher.