Academic journal article International Journal of Child Health and Human Development

A Cross-Sectional Study to Assess the Relationship between Environmental Risk Factors and Malnutrition in Children under the Age of Five Living in the Chipata Compound of the Lusaka District, Zambia

Academic journal article International Journal of Child Health and Human Development

A Cross-Sectional Study to Assess the Relationship between Environmental Risk Factors and Malnutrition in Children under the Age of Five Living in the Chipata Compound of the Lusaka District, Zambia

Article excerpt

Introduction

The World Health Organization estimates that 50% of malnutrition is related to the consumption of unsafe water, inadequate sanitation, and poor hygiene, which results in repeated bouts of diarrhoea and intestinal worm infection (1). More than three million children under the age of five years die annually from environment-related causes. Individuals who live in deprived areas with poor sanitation, inadequate hygiene, and unsafe drinking water are exposed to enteric pathogens which cause diarrheal illnesses (2). Intestinal worms infect over 85% of children in the developing world, leading to malnutrition, anaemia, and retarded growth (3). In addition to infection, risk factors for malnutrition include inadequate dietary intake and limited access to maternal and child healthcare. Breast feeding and good basic hygiene practices such as hand washing decrease the risk of infection and hence the risk for malnutrition (4).

Neonates are born with passive immunity acquired from their mothers. As this immunity wanes, infections increase between the ages of six to 24 months of life. Malnutrition and anaemia follows and often cannot be fully reversed (5, 6) Because the causes of malnutrition are multi-factorial, successful intervention must occur at both the community and household level (5).

In recent decades, adolescent pregnancy has become an important health issue in many countries, both developed and developing countries. Undernourished girls have a greater likelihood of becoming undernourished mothers, who in turn have a greater chance of giving birth to low-birth-weight babies (7). In a cohort study carried out in a densely populated section of Freetown, Sierra Leone (8), a strong positive correlation was discovered between older age of the mothers and improved nutritional status of the child. Children of younger mothers had higher mortality rates, due to increased malnutrition, measles and diarrheal diseases, the three major disease conditions associated with under-five mortality.

In a study conducted to assess the nutritional status and feeding practices of children under the age of 5 years among the pastoral communities of Simanjiro District, northern Tanzania, an educated mother was less likely to have an undernourished child, while a teenage mother was more likely to have an undernourished child (9).

The Zambia Bureau of Statistics (10) has shown that education attainment has a strong effect on nutrition. Similarly, the United States Agency for International Development (USAID) (11) noted that mothers' education was related to knowledge of good childcare practices, including appropriate meals to be given to infants, and diagnosis and treatment of common illnesses. In India, educated mothers were found to be more likely to acquire knowledge or to adopt new ideas related to nutrition and health issues than were less-educated mothers (12). Other factors that influence food intake include health status, food taboos, and personal choice (13).

Methods

We conducted a cross-sectional, household study in the Chipata compound of the Lusaka District over a 4week period in early 2015. Chipata covers some 1,000 hectares and has a population of approximately 45,000 (about 10,000 households). The Chipata compound is a squatter settlement and was declared "an improvement area" under the Zambia Housing (Statutory and Improvement Area) Act. The community considered water supply to be its highest priority need. The source population for study was all mothers with children aged 6 months to 59 months obtaining health services from the Chipata First Level Hospital. Systematic random sampling guided the recruitment.

The data collection techniques used were researcher-administered questionnaires and review of children's under-five cards. An under-five card is maintained for every child. Each time a mother makes a monthly visit to a hospital or clinic, the weight of the child is recorded to show the growth curve for the child. …

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