ASSESSMENT OF FEEDING PRACTICE AND ANTHROPOMETRIC STATUS OF UNDER FIVE ATTENDING OUTPATIENT CLINIC IN TWO TERTIARY HOSPITAL IN ENUGU.
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Background of the Study
The nutritional status of children under five years is a critical indicator of public health, particularly in low- and middle-income countries (LMICs). Adequate nutrition during the first five years of life is essential for growth, cognitive development, and overall health. The feeding practices adopted by caregivers play a pivotal role in determining the nutritional status and, consequently, the anthropometric measurements of children. Anthropometric indicators such as weight-for-age, height-for-age, and weight-for-height are commonly used to assess the nutritional status of children, providing insights into undernutrition, stunting, and wasting (de Onis et al., 2019).
In Nigeria, malnutrition among children under five remains a significant public health challenge, with high rates of stunting, wasting, and underweight observed across different regions (National Bureau of Statistics, 2021). The causes of malnutrition are multifaceted, involving inadequate dietary intake, poor feeding practices, and infectious diseases. The World Health Organization (WHO) emphasizes the importance of optimal feeding practices, including exclusive breastfeeding for the first six months of life, followed by the introduction of appropriate complementary foods (WHO, 2020).
Enugu State, located in the southeastern region of Nigeria, is home to several tertiary healthcare institutions that provide outpatient services to children under five. These hospitals serve as crucial points of contact for assessing the feeding practices and nutritional status of children. However, despite the availability of healthcare services, malnutrition persists as a challenge, necessitating a closer examination of feeding practices and their impact on anthropometric outcomes.
Recent studies have highlighted the relationship between maternal knowledge, cultural practices, and the nutritional status of children in Nigeria. For instance, Olatona et al. (2017) found that maternal education and knowledge of infant feeding practices were significantly associated with better nutritional outcomes among children in Lagos, Nigeria. Similarly, a study by Ekpenyong et al. (2021) in Cross River State emphasized the role of cultural beliefs and practices in shaping feeding behaviors, which in turn influenced the nutritional status of children.
In the context of Enugu, understanding the feeding practices adopted by caregivers and their impact on the anthropometric status of children is crucial for developing targeted interventions. Previous research has shown that poor feeding practices, including delayed initiation of breastfeeding, inadequate complementary feeding, and reliance on low-nutrient foods, contribute to the high prevalence of malnutrition in the region (Eze & Eze, 2018). Moreover, the accessibility of healthcare services, socio-economic status, and caregiver knowledge are important factors that influence feeding practices and nutritional outcomes.
The assessment of feeding practices and anthropometric status in outpatient clinics of tertiary hospitals in Enugu provides an opportunity to identify gaps in knowledge, practices, and healthcare delivery. This study seeks to build on existing literature by exploring the feeding practices adopted by caregivers, the socio-economic and cultural factors influencing these practices, and their impact on the anthropometric status of children under five attending outpatient clinics in two tertiary hospitals in Enugu.
1.2 Statement of the Problem
Malnutrition among children under five years remains a significant public health issue in Nigeria, contributing to high rates of morbidity and mortality. Despite various interventions aimed at improving child nutrition, the prevalence of malnutrition in Enugu State, particularly among children attending outpatient clinics, continues to be a concern. Poor feeding practices, such as inadequate breastfeeding and inappropriate complementary feeding, have been identified as key contributors to malnutrition. However, there is limited empirical evidence on the specific feeding practices adopted by caregivers in Enugu and their direct impact on the anthropometric status of children under five.
Furthermore, the socio-economic and cultural factors that influence feeding practices in this region are not well understood. The existing literature suggests that factors such as maternal education, cultural beliefs, and access to healthcare services play a significant role in shaping feeding behaviors, yet these factors have not been thoroughly explored in the context of Enugu. This gap in knowledge hinders the development of effective, context-specific interventions aimed at improving child nutrition and reducing malnutrition rates.
Given the critical importance of the first five years of life for child development, it is essential to assess the current feeding practices and their impact on the nutritional status of children attending outpatient clinics in tertiary hospitals in Enugu. Addressing this problem will provide valuable insights for healthcare providers, policymakers, and caregivers, ultimately contributing to improved child health outcomes in the region.
1.3 Objectives of the Study
1.3.1 General Objective
The general objective of this study is to assess the feeding practices and anthropometric status of children under five attending outpatient clinics in two tertiary hospitals in Enugu.
1.3.2 Specific Objectives
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To identify the common feeding practices adopted by caregivers of children under five attending outpatient clinics in two tertiary hospitals in Enugu.
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To assess the anthropometric status of children under five attending outpatient clinics in two tertiary hospitals in Enugu.
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To examine the relationship between feeding practices and the anthropometric status of children under five in the study area.
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To explore the socio-economic and cultural factors influencing feeding practices among caregivers in Enugu.
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To provide recommendations for improving feeding practices and nutritional outcomes among children under five in Enugu.
1.4 Research Questions
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What are the common feeding practices adopted by caregivers of children under five attending outpatient clinics in two tertiary hospitals in Enugu?
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What is the anthropometric status of children under five attending outpatient clinics in two tertiary hospitals in Enugu?
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What is the relationship between feeding practices and the anthropometric status of children under five in the study area?
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What socio-economic and cultural factors influence feeding practices among caregivers in Enugu?
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What strategies can be recommended to improve feeding practices and nutritional outcomes among children under five in Enugu?
1.5 Significance of the Study
This study holds both practical and theoretical significance in the field of public health and nutrition. From a practical standpoint, the findings of this study will provide valuable insights for healthcare providers, policymakers, and caregivers in Enugu. By identifying the prevalent feeding practices and their impact on the anthropometric status of children under five, this study will inform the development of targeted interventions aimed at improving child nutrition in the region.
Healthcare providers in tertiary hospitals can use the findings to enhance their counseling and support services for caregivers, particularly in the areas of breastfeeding, complementary feeding, and dietary diversity. The study's recommendations will also be valuable for policymakers in designing and implementing nutrition programs that address the specific needs of children under five in Enugu. Moreover, the study will provide caregivers with evidence-based guidance on optimal feeding practices, contributing to better nutritional outcomes for their children.
Theoretically, this study will contribute to the existing body of literature on child nutrition and feeding practices in Nigeria, particularly in the context of tertiary healthcare settings. By exploring the socio-economic and cultural factors that influence feeding practices, the study will enhance our understanding of the complex determinants of child nutrition in Enugu. This knowledge will be useful for researchers and academics interested in public health, nutrition, and maternal and child health.
Furthermore, the study's findings will have broader implications for other regions in Nigeria and similar LMICs facing challenges related to child malnutrition. The insights gained from this study can inform comparative research and cross-regional studies, contributing to the global effort to improve child nutrition and reduce malnutrition rates.
1.6 Scope and Delimitation
This study is focused on assessing the feeding practices and anthropometric status of children under five attending outpatient clinics in two tertiary hospitals in Enugu. The study will specifically examine the feeding practices adopted by caregivers, including breastfeeding, complementary feeding, and dietary diversity. The anthropometric status of the children will be assessed using standard indicators such as weight-for-age, height-for-age, and weight-for-height.
The study is delimited to two tertiary hospitals in Enugu, which serve as major healthcare providers for children in the region. The choice of these hospitals is based on their capacity to provide comprehensive outpatient services, including nutritional assessment and counseling. However, the study does not include children attending other healthcare facilities or those not attending any healthcare services, which may limit the generalizability of the findings to the broader population of children under five in Enugu.
The study will also explore the socio-economic and cultural factors influencing feeding practices, with a focus on maternal education, household income, and cultural beliefs. However, other potential factors, such as environmental conditions and access to food resources, are beyond the scope of this study.
1.7 Definition of Terms
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Feeding Practices: The behaviors and practices adopted by caregivers in feeding children, including breastfeeding, complementary feeding, and the types of food provided.
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Anthropometric Status: The physical measurements of a child, such as weight, height, and body mass index (BMI), used to assess their nutritional status.
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Under-Five: Refers to children aged between 0 and 59 months.
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Outpatient Clinic: A healthcare facility where patients receive medical treatment without being admitted to the hospital.
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Tertiary Hospital: A specialized healthcare facility that provides advanced medical care and treatment, often serving as a referral center for other hospitals.
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