Nutritional status and its determinants in children under five years of age in Rweibaare Parish, Bushenyi District.
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Under-nutrition and infection are the major causes of morbidity and mortality in the developing world. These two problems are interrelated. Under-nutrition compromises barrier function, allowing easier access by pathogens, and compromises immune function. Thus malnutrition predisposes to infection. Studies done worldwide by UNICEF indicate that Africa has the worst nutritional status with high levels of underweight, stunting and wasting countrywide (UDHS 2000 - 2001 and 1995). UNICEF also estimated that 40% of all deaths among children under five years of age were related to malnutrition, with high levels of underweight up to 12%. The general objective of this study was to assess the nutritional status of children under five years of age in Rweibaare Parish, Bushenyi District. A descriptive cross-sectional study using quantitative data collection methods was used to collect data from mothers or caretakers of 215 children under five years. A structured/standardized questionnaire was used to collect the data and anthropometric measurements (weight and height) were taken and recorded in a table. The measurements were transformed into the standard anthropometrical measurements and standard indices of physical growth were considered. Stunting, underweight and wasting. The data collected was analysed manually using frequency tables. The results revealed that the rate of malnutrition was high, of the 21 5 children assessed 32% of the children were stunted, 13% underweight and 2.8% wasted. The factors contributing to this state of affairs were likely to be related with socio-economic status of the mothers which included age of the mother, education level and main occupation. Lack of information about nutrition was also a contributing factor as evidenced by inadequate breastfeeding with children that stopped breast feeding at four months and below having a high likelihood of malnutrition. Chronic malnutrition was a predominant form of malnutrition in this study as seen by malnourished children being mostly stunted (32%) and underweight (13%). rapid, nutrients requirements are high and the diets given are often inadequate because of lack of suitable food, parental poverty, ignorance and the social customs to which they are subjected. Background to the study The world over, health problems still remain many and demanding. One of the most striking problems facing the World Health Organisation is the high morbidity and mortality rates in infants and under fives, (WHO 2002). Under nutrition is described as the most pervasive human problem especially in less developed countries. It has an adverse effect on the quality of life and social and economic development (Gabir 1995). The problem of under nutrition is most prevalent among vulnerable groups especially in developing countries notably among children, adolescents, pregnant and lactating women and people living in difficult situations, such as the landless, the displaced and the poor (MOH 2002). In Uganda, as in other developing countries children below five years of age have been the target group for nutrition programmes due to the high rates of mortality and morbidity in this age group. UNICEF (1998), reposted that the infant mortality rate was 97/1,000 live births and the under five mortality rate was 141/1,000 live births in Uganda. Thirty to forty percent of the children under five years of age are malnourished, 38% in the same age group are stunted 5% wasted, and 61% of the population living below the poverty line, (UDHS 1995). Despite the apparent abundance of food in Uganda, subsistence agriculture. The favourable climate, and enormous natural resources, malnutrition still exists. This is due to regional food imbalances due to ecological differences between the various regions of the country, the under-developed inter-regional food marketing system, poor road network and inadequate food processing and storage facilities. The nutritional status of children is influenced by both diet and frequency of infections. Under-five children have high mortality rates; they suffer from frequent infections such as malaria, measles, intestinal worms and skin diseases, (Jelliffe, 1996). It was therefore, concluded that malnutrition is a significant problem in Rweibaale Parish. Bushenyi District. It can also be concluded that malnutrition is caused by many factors hence a need for a multi-sectoral approach if the problem is to be solved. The results could also be an indicator of a need for reproductive health services especially in planning for their families, caring for their children and have a source of income. It is therefore, recommended that another study be done to cover whole District to give a broader picture of nutritional status of children since this study covered only one Parish. Other studies that would use other indicators in addition to what was used (height and weight) such as upper arm circumference and head circumference is necessary. Health workers should be trained and re-oriented to do growth monitoring and promotion of good nutrition as part of integrated management of childhood illnesses.