INFLUENCE OF CULTURE AND IGNORANCE TOWARD

MALNUTRITION IN INFANTS (0 TO 59MONTHS OF AGE) “A

CASE STUDY OF INGAWA LOCAL GOVERNMENT AREA,

KATSINA STATE”

BY

BASHIR ABDULLAHI
19/HPKK/009

A PROJECT SUBMITTED TO THE DEPARTMENT OF

ENVIRONMENTAL HEALTH SCIENCES, COLLEGE OF HEALTH
TECHNOLOGY KANKIA IRO, KATSINA STATE

IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE

AWARD OF NATIONAL DIPLOMA IN HEALTH EDUCATION
AND PROMOTION BY WEST AFRICAN HEALTH EXAMINATION
BOARD (WAHEB)

DECEMBER, 2020
 DECLARATION

This project work is authentic and is a product of an effort made under the

supervision of Malam Abdulhadi Adamu from the Department of

Environmental Health and Health Education and Promotion Unit, Kankia Iro

School of Health Technology, Kankia in Partial Fulfillment for the Award of

Professional Diploma in Health Education and Promotion.

Sign: __________________________________________

Date:_________________________

ii
 APPROVAL PAGE

This is to certify that this research project written by Bashir Abdullahi a

student of Health Education and Promotion has met all the requirements for

the award of National Diploma in Health Education and Promotion.

Project supervisor

Name: _______________________________________________________

Sign & Date:______________________________________

Head of Department (HOD)

Name: _______________________________________________________

Sign & Date:______________________________________

External Supervisor

Name: _______________________________________________________

Sign & Date:______________________________________

iii
 DEDICATION

I respectively dedicated this research project to my beloved parents for their

maximum and underutilized support and encouragement given to me who

only God knows the limitation both in the period of financial sufficiency and

period of financial insufficiency that sustained me during my study.

iv
 ACKNOWLEDGEMENT

All praise be to almighty Allah (S.W.A) the most beneficent the most

merciful for his guidance and protection throughout my academic career in

school of health technology Kankia successful peace be upon his noble

messenger Muhammad (S.A.W) for leading us to a strength path.

I acknowledged my beloved parents DSP. Bashir Muhammad and Hajiya

Hadiza Hussain for their fully encouragement and support spiritually,

financial and psychologically. May Allah guide and reward them with

Aljannatul Firdausi amin.

I also acknowledged the absolute efforts of my active supervisor in person of

Malam Abdulhadi Adamu for the effort and guidance given to me

throughout this course of study may Allah reward him abundantly.

I would like to thank my brothers and sisters, Abubakar, Umar, Nura,

Usman, Aminu, Fatima, Asiya, Zainab and Zara for giving me all the

necessary moral and support direction toward s the success of the study.

Also my friends like Abubakar Sani (Abba Captain), Labigisi Garba, Hamza

Zuladaini, Amiru Abubakar (Kanso), Mubarak Salisu, Bolu Oluwole and

Abdullahi Sulaiman Abukur (DG).

v
I also thank the entire members of the Department of Environmental Health

and Health Education Unit, Kankia Iro School of Health Technology

Kankia, for their assistance, directions, advices, particularly H.O.D. Malam

Sanusi Umar Radda, M. Abubakar Surajo, Malam Usman Usman Tsauri,

Malam Mannir Lawal, M. Zakariya’u Yakubu, M. Umar Shitu, M. Aminu

Ali, M. Abubakar Iliya, M. Abdullahi Adamu and M. Shamsu Sale.

I also like to thank my entire class mates like Sadiku Kabir (Captain),

Mannir Shitu, Ammar Ibrahim, Saliki Ibrahim, Jamilu Sani, Habiba Magaji,

Salima Tukur, Halimatu M. Iro and G. Abdul.

vi
 TABLE OF CONTENT

Title Page i
Declaration ii
Approval Page iii
Dedication iv
Acknowledgement v
Table of Content vii
Abstract ix
CHAPTER ONE
BACKGROUND OF THE STUDY
1. 0 Introduction 1
1.2 Statement of the Problem 3
1.3 Objectives of the Study 4
1.4 Research Hypothesis 4
1.5 Significance of the Study 5
1.6 Delimitation of the Study 5
1.7 Definition of Terms 6
CHAPTER TWO
REVIEW OF RELATED LITERATURE
2.0 Introduction 7
2.1 Nutrients 8
2.2 Deficiency Diseases 19
2.3 Exclusive Breastfeeding 21
2.4 Complementary Feeding 22

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2.5 Anthropometry 23
CHAPTER THREE
RESEARCH METHODOLOGY
3.0 Introduction 22
3.1 Research Design 22
3.2 Population of the Study 25
3.3 Sample and Sampling Techniques 25
3.4 Instrument for Data Collection 25
3.5 Pilot Survey 26
3.6 Method of Data Analysis 26
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
4.1 Introduction 27
4.2 Data Presentation and Analysis 27
CHAPTER FIVE: SUMMARY, DISCUSSION, CONCLUSION AND
RECOMMENDATION
5.0 Introduction 40
5.1 Re-Statement of the Problem 40
5.2 Summary 41
5.3 Discussion of the Findings 42
5.4 Conclusion 43
5.6 Implication of the Study 43
5.7 Recommendation 44
5.8 Suggestions for Further Study 45
References 46
Questionnaire 47

viii
 ABSTRACT

The main concept of this research work is to investigate the influence of

culture and ignorance toward malnutrition in infants. This research work

(took) place in Ingawa Local Government Area therefore the bases of the

research depend on the data obtained in Ingawa. This study is significance

in Medical and Paramedical Practitioners such as Community Health

Practitioners, Environmental Health Officers, Health Educators, Nurses

and Midwives etc. to upgrade their knowledge in area of endeavor. The

instrument used for data collection was questionnaire relevant literatures

were also reviewed in carrying out this research.

ix
 CHAPTER ONE

BACKGROUND OF THE STUDY

1.1 INTRODUCTION

Malnutrition: According to Benjamin and Woother (2007), this is the

condition that occurs when a person’s body is not getting enough nutrients

sources. The condition may result from adequate or unbalance diet, digestive

difficulties and mal-absorption worldwide malnutrition continuous to be

significant problem especially among infant and pre-school children who

feed adequate for themselves culture and ignorance contribute to the

malnutrition.

Culture: According to Henry (1993) determine the language we speak the

food we eat the types of clothes we put on, where we seek health care and

our religious practice which is the system of community as regard to the

types food they eat and grow what should be eaten and forbidden and how

food is cooked affect the health status of the community. Malnutrition is not

just caused by culture and also by the ignorance are the contributing factors

responsible for high prevalence of malnutrition among infants in developing

countries especially Africa. There in a community that their culture

forbidden them from eating valuable nutrients (food) such as meat of certain

1
animals such as rabbits, snakes, snails and edible insects. The fact that

becomes very important when considering the nutritional status of the at risk

groups in the community such as pregnant women, children and lactating

matters.

According to Demen (1987) emphasizes culture has been described as a

learned and shared human pattern or method for living day today living

pattern these pattern and model provide all aspects of human social

interaction.

According to Lederech (1995) emphasizes it was explained that culture is

the shared knowledge and scheme created by a set of people for perceiving,

interesting, expressing and responding to social realities around them.

According to Glogmen (1969-1999) cited while ignorance was explained as

the condition or state of someone lack knowledge about something and was

previous as the most violent element in the societies.

According to Red et-al (2006) said from the control India compare from the

recommended dietary allowance (RDA) calcium and iron consumption were

very low among them, apart from central India intake of colorizes (2211

kcal) proteins (76g), fat (26g) and other macro and micronutrients for

consumption per day.

2
According to Black et-al (2003) said but still under nourishment continuous

to be major public health issue and cause substantial problem of child death

every year especially in the developing countries till India. According to

Gopalan (2002) emphasize the large section of population were suffering

from varying degree of protein energy deficiency which is the most

important nature in the body.

1.2 STATEMENT OF THE PROBLEM

Sincerely speaking culture and ignorance are the serious problem of

malnutrition in infants in the world in the term of morbidity and mortality

and the nation in general apart from these pregnant women are forbidden

from eating edible and available food which is valuable for her health and

body. Also leads to the serious problem of mal nutrition among infant and

per-school children. (Mahapatre et-al 2000)

According to Bharati (2005) cited children as well as necessity of special

and temporal community specific data across section surgery was done

among per-school children and 0.5 years to across the health and nutrition

status.

According to Jeliffe (1966) and who (1995) said qualitative and quantities

assessment was through actual weight of row food item.

3
Anthropometive measurement (weight and height) we measured domical

sign of malnutrition defiance were concluded.

The research will answer the following questions:

1. Is there any significant nutrition problem in infants that associated

with ignorance?

2. Does culture practice affect nutritional status of infants?

3. Does a nutritional problems affects infant of educational groups?

1.3 OBJECTIVES OF THE STUDY

The aims of the study are timed out influence of culture and ignorance

toward malnutrition among infants.

1. To identify the common culture practice toward nutrition in the

community.

2. to identify the various nutritional problems of infants that are

associated with ignorance;

3. to determine the knowledge of the people toward malnutrition; and

4. to health educate parents on the factors responsible for causing

malnutrition in the area of study.

4
1.4 RESEARCH HYPOTHESES

1. Nutritional problems of infants are associated with ignorance.

2. Culture practice significantly affects nutritional status of infants.

3. Nutritional problems do not affect infants of education group.

1.5 SIGNIFICANCE OF THE STUDY

Finding it complete will guide community, local government, state, federal

agencies and other non-governmental organizations in crutching problems of

malnutrition among children, the study highlight executives in carrying their

duties, it will also help health practitioners or personnel working in rural

areas. On the other hand help students in health training institutions a

services a source of literate one of the basic fact of the study that, there is on

community that will help greatly in identifying various improvements by

means of preventing malnutrition problems.

1.6 DELIMITATION OF THE STUDY

This research is only limited to area of study Ingawa, Ingawa Local

Government, Katsina State. Due to the lack of time, transport and finance as

such research cannot cover large areas.

This research for the area is influence of culture and ignorance toward

malnutrition in infants.

5
1.7 DEFINITION OF TERMS

1. Morbidity: Refers to the state of being diseased or unhealthy within

a population.

2. Mortality: Is the term used for the number of people who died

within a population.

3. Metabolism: Is the chemical processing there is no community

carryout by the body cell.

4. Warming: Is the gradual introduction of the semi-solid food while

breastfeeding continuous or stop.

5. Enzymes: Are organs catalyst that accelerate or rate clinical

reaction.

6. R.D.A: Means Recommended Dietary Allowance.

7. Calories: Is the amount of heat requires to raise the temperature of

1kg of water through 1C.

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 CHAPTER TWO

REVIEW OF RELATED LITERATURE

This chapter examines literature from published and unpublished works,

literature and internets. Areas covered conceptual and theoretical review

couple with the examination of various empirical studies.

2.0 CONCEPT OF MALNUTRATION

According to BT Basavanthappa (2013), malnutrition implies imperfect

assimilation or nutrition or both. It has been defined as “a pathological state

resulting from a relative or absolute deficiency or excess of one or more

essential nutrients”.

While the people of developing countries suffer from under nutrition, over

nutrition is the major concern of the developed countries (Satyanarayana and

Chakrapani 2015)

Malnutrition may be in the following forms (BT Basavanthappa 2013: 264).

1. Under nutrition: it is due to the insufficient food eaten over an extended

period of time due to poverty, ignorance and culture.

2. Over-nutrition: it is due to the excessive quantity of food over an

extended period of time due excessive food of ignorance.

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3. Imbalance: it is due to imbalance such as quantitative imbalance of

calcium, phosphorus and vitamin D.

4. Specific deficiency: it is due to specific deficiency such as goiter iodine

deficiency.

Malnutrition is the condition most prevalent in our country. It is more

common among children, pregnant ladies, and nursing mothers. It effects are

kwashiorkor, marasmus, xerophthalmia, beriberi, pellilagia, goiter, rickets

etc. this malnutrition condition predispose to diseases like tuberculosis,

diarrhea, parasitic infestation, leads to high sickness rate and increased

infant mortality rate. Fishben’s (2010)

 CAUSES OF MALNUTRION

1. Population Growth: The rapid growth of population leads to gap

between food production and food consumption which causes

malnutrition

2. Agriculture and Food Production: In Nigeria, India and some countries

food production depends upon nature. There is no adequate source of

timely irrigation. Farmers have to depend on natural rainfall, which is

unpredictable.

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3. Prevalence parasitic and infectious disease: This is responsible for

decreased intestinal absorption and poor hygiene which is important

factors that hider diet.

4. Religious and cultural fads: These prevent people from using the

locally available nutritious foods. Fishben’s (2000)

5. General illiteracy and ignorance: Ignorance contributes toward the

development of malnutrition in our societies.

6. Socio-economic barrier: Socio-economic condition and economic

constraints do participate in malnutrition. K. Park et-al (2002)

 PREVENTIVE MEASURES OF MALNUTRITION

1. Increased food production by scientific cultivation.

2. Vulnerable groups’ i.e. infants, preschool children, lactating mothers

should be protected by best utilization of locally available food

substitution.

3. Fortification of flour with protein and calcium. Milk should be fortified

with vitamin A and D.

4. Education of public on fundamentals of diet and nutrition and help from

voluntary and international organizations.

5. Projects and program in the field of food and nutrition induction nutrition

education should receive a high priority.

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Different nutrient are associated with different disease (or malnutrition) if

they are deficient or excess in biological system but we will concern only

with the common and prevalent ones especially those associated with

proteins, vitamins and minerals e.g.

 Protein (Kwanshiokor and marasmus)

 Xerophthalmia (Vitamins)

 Rickets (Minerals) etc.

2.1 NUTRIENTS

The foodstuff contains substances known as “nutrients” therefore nutrients

are chemical compounds that contain the elements necessary to perform

various functions in the body (Basavanthappa 2013).

 CLASSIFICATION OF NUTRIENT

There are six categories of nutrients they are:

1. Carbohydrates
2. Proteins
3. Fats
4. Vitamins
5. Minerals
6. Water

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 Further, the above mentioned nutrients can be grouped as

1. Macronutrients
i. Carbohydrates
ii. Proteins
iii. Fats
iv. Water
2. Micronutrients
i. Vitamins
ii. Minerals

Macronutrients are those nutrients which the body requires in relatively

large amounts.

While micronutrients are those nutrients which the body requires in small

quantities

Nutrients

Carbohydrates Protein Fats Water Vitamins Minerals

 CARBOHYDRATES

According to Satyanarayana (2015), carbohydrates may be defined as

polyhydroxyaldehy des or Ketones or compound which produces them on

11
hydrolysis. In a simple term it can be defined as a main source of energy

composed of carbon, hydrogen and oxygen.

NUTRITIONAL IMPORTANCE OF CARBOHYDRATE

Dietary carbohydrates are the diet sources of energy. They contribute to 60-

70% of total caloric requirement of the body. Incidentally, carbohydrates

rich food cost less (Fishben’s 2010). Carbohydrates are the most abundant

dietary constituents, despite the fact that they are not essential nutrients to

the body. From the nutritional point of view, carbohydrates are grouped into

2 categories:

1. Carbohydrate utilized by the body-starch glycogen, sucrose, glucose,

fructose etc.

2. Carbohydrates not utilized (not digested) by the body-cellulose,

hemicelluse, pectin, gum etc. ( Krummi 2010)

Among the carbohydrate utilized by the body, starch is the most

abundant. The consumption of starch has distinct advantages due to its

bland taste, satiety value and slow digestion and absorption. Sucrose the

table sugar), due to its sweetness, can be consumed to a limited extent.

Excessive intake of sucrose causes dental caries, and an increase in

plasma lipid level is associated with many health complications.

12
 FUNCTIONS OF CARBOHYDRATES

1. Carbohydrates are the major sources of energy.

2. It performs protein sparing actions

3. The brain and other parts of CNS are dependent on glucose for

energy.

4. Synthesis of fat

5. Synthesis of pentose’s.

6. Non-digestible carbohydrates prevent constipation and lower

cholesterol absorption.

SOURCES OF CARBOHYDRATES

Carbohydrates are abundant in several naturally occurring foods. These

include table sugar, cereals, pillses, roots and tubes (Drave and Kossen 2013)

PROTEINS

Proteins have been traditionally regarded as body building food; however

10-15% of total body energy is derived from proteins. As far as possible,

carbohydrates spare proteins and make the latter available for body- building

process. The functions carried out by proteins in a living cell are

innumerable. (Ariffin 2013)

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FUNCTIONS OF PROTEINS

1. Proteins are the fundamental basis of cell structure and its functions.

2. All the enzymes, several hormones, immunoglobulin’s etc. are protein.

3. Proteins are involved in the maintenance of osmotic pressure, clothing of

blood, muscle contraction. (Micicenna 2010).

4. During starvation proteins (amino acids) serve as the major suppliers of

energy. It may be noted that the structural proteins themselves serve as

‘storage protein’ to meet the emergency energy needs of the body. This is

in contrast to lipid and carbohydrates which have storage forms.

DIETARY SOURCES OF PROTEIN

The protein content of foods is variable, cereal, pulses, meats, eggs, leafy

vegetables etc. (Huber 2011).

RDA

Adult 0.8-1.0g/lg

Children, pregnant and lactating women should nearly be double. (Luthan 2009)

LIPID

14
Lipids may be regarded as organic substances relatively insoluble in water

soluble in organic solvent (alcohol either) actually or potentially related to

fatty acids and utilized by the living cells

NUTRITIONAL IMPORTANCE OF LIPIDS

Triacylglycerol (fats and oils) are the concentrated dietary source of fuel,

contributing 15-50% of the body energy requirements. Phospholipids and

cholesterol from animal sources) are also important in nutrition. The

nutritional and biochemical functions of fat, phospholipid and cholesterol

are required by the living organism

FUNCTIONS OF LIPIDS

Dietary lipids have two major nutritive functions.

1. Supply triacylglycerol that normally constitute about 90% of dietary

lipids which is a concentrated source of fuel to the body.

2. Provide essential fatty acids and fat soluble vitamins.

VITAMINS

15
Vitamins may be regarded as organic compounds required in the diet in small

amounts to perform specific biological functions for normal maintenance of

optimum growth and health of the organism. (Lucas and Gilles, 2011)

CLASSIFICATION OF VITAMINS

There are about 15 vitamins, essential for humans. They are classified as that

soluble (A, D, E and K) and water soluble (C abd B- group) the B- complex

vitamins may be subdivided into energy releasing (B1, B2, B6, biotin etc.)

and haemopietic (folic acid and B12) most of the water soluble vitamins

exert the functions through their respective coenzyme while one fat soluble

vitamin (K) has been identified to function as coenzyme.

Deficiency of vitamin B1, B6 and B12 is more closely associated with

neurological manifestations.

Vitamins

Fat Soluble Water Soluble

Vitamin A

Vitamin D Non B-complex B-complex

Vitamin E Vitamin C

Vitamin K

Energy Releasing Haemopoietics

16
 Thiamine (B1) Folic Acid

Riboflavin (B2) Cynocobalamin (B12)

Niacin (B3)

Pyridoxine (B6)

Biotin (B7)

Pantothenic Acid (B5)

MINERALS

The minerals (inorganic) elements constitute only a small proportion of the

body weight. There is a wide variation in their body content, for instance

calcium constitute about 2% of body weight while cobalt about 0.00005%.

GENERAL FUNCTIONS

Minerals perform several vital functions which are absolutely essential for

the very existence of the organism.

These include calcification of bone, blood coagulation, neuromuscular

irritability acid-base equilibrium fluid balance and osmotic regulation.

Certain minerals are integral components of biologically important

compound such as hemoglobin (fe), thyroutine (I), insulin (Zn) and vitamin

B12 (CO). Sulfur is present in thiamine, biotin, lipoid acid and coenzyme A.

17
several minerals participate as co-factors for enzyme in metabolism (e.g.

Mg, Mn, Cu, Zn, K) some elements are essential constituents of certain

enzymes (e.g. CO, MO, Se)

CLASSIFICATION

The minerals are classified as principal element trace elements. The seven

principals’ elements (macro minerals) constitute 5—80% of the body’s in

organic materials. These are calcium, phosphorus, magnesium, sodium,

potassium, chloride and sulfur.

The principal elements are required in amount greater than 100 mg/day.

The (micro minerals) are 100mg/day. They are subdivided into three

categories.

1. Essential trace elements: iron, copper, cobalt, fluorine, selenium and

chromium.

2. Possibly essential trace elements: Nickel, vanadium, and barium.

3. Non-essential trace elements: Aluminium, lead, mercury, boron, silver,

bismuth.

WATER

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Water is the solvent of lite. Undoubtedly, water is more important than any

other single compound to life. It is involved in several body functions.

FUNCTIONS OF WATER

1. Water provides the aqueous medium to the organism which is essential

for various biochemical reactions to occur.

2. Water directly participates as a reactant in several metabolic reactions.

3. It serves as vehicle for transports of solute.

4. Water is closely associated with the regulation of body temperature.

2.2 DEFICIENCY DISEASES

Deficiencies diseases are group of disease that concerned with the

insufficient nutrients or absence of nutrients which leads common

malnutrition’s of other nutrients occur. Let us consider proteins and vitamins

malnutrition’s only.

PROTEIN-ENERGY MALNUTRITION

Protein-energy malnutrition (PEM) sometimes called protein-calorie

malnutrition (PCM) is the most nutritional disorder of the developing

countries. PEM is widely prevalent in the infants and MARASMUS is the

two extreme forms of PEM.

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KWASHIOKOR

The term kwashiorkor was introduced by cicely Williams (1933) to a

nutritional disease affecting the people of gold coast (Modern Ghana) in

Africa. Kwashiorkor literally means sickness of the dispose child i.e. a

disease the child gets when the next baby is born.

 Occurrence and causes; Kwashiorkor is predominantly found in children

between 1-5 years of age. This is primarily due to insufficient intake of

proteins, as the diet of a weaning child mainly consists of carbohydrate.

 Clinical Symptoms; the major clinical manifestation include stunted

growth edema (Particularly on legs and hands) diarrhea, apathy and

moonfaced.

 Biochemical manifestations; kwashiorkor is associated with a decreased

plasma albumin concentration (‹2g/dl against normal 3-4.5g/dl), fatty

liver deficiency of K+ due diarrhea, edema.

Occur due to lack of adequate plasma proteins to maintain water distribution

between blood and tissue. Disturbance in the metabolism of carbohydrates,

protein and fat are also observed. Several vitamin deficiencies occur. Plasma

retinol binding protein (RBP) is reduced. The immunological response of the

child to infection is very low.

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 Treatment: ingestion of protein rich food or the dietary combination to

provide about 3-4g of protein/kg body weight/day will control

kwashiorkor. The treatment can be monitored by measuring plasma

albumin concentration, disappearance of oedema and gain in body

weight.

MARASMUS

Marasmus literally means “to waste”. It mainly occurs in children under one

year age. Marasmus is predominantly due to deficiency of calories. This is

usually observed in children given watery gruels (of cereals) to supplement

the mothers breast milk.

The symptoms of marasmus include growth retardation, muscle wasting

(emaciation), anaemia and weakness, a marasmus child does not show

oedema or decreased concentration of plasma album: this is the major

difference to distinguish marasmus from kwashiorkor.

RICKETS

Rickets is a disorder of defective calcification of bones. This may be due to

low levels of vitamin D in the body or due to a dietary deficiency of calcium

and phosphorus or both. The concentration of serum calcium and

21
phosphorus may be normal. An increase in the acetify of alkaline

phosphatase is a characteristic feature of rickets (Lazarus 2010).

2.3 EXCLUSIVE BREAST FEEDING

A child is considered exclusively breastfeed when he or she receives only

breast milk without any additional food or liquid, even water, with the

exception of oral rehydration solution, drops syrups of vitamins, minerals or

medicines.

ADVANTAGES OF EXCLUSIVE BREASTFEEDING

Breast feeding, lowers your baby`s risk of having asthma or allergies. Plus,

babies who are breastfed exclusively for the first 6 months, without any

formula have a fewer ear infection, respiratory illness, and bouts of

diarrheoa. They have fewer hospitalizations and trips to the doctor.

Exclusively breastfeeding as defined by WHO and UNICEF is the practice

whereby an infant receives only breast milk from the mother or a wet nurse

or expressed breast milk.

2.4 COMPLEMENTARY FEEDING

Complementary breastfeeding is the term used for giving other foods and

drinks in addition to breastfeeding after the completion of the 6 months

22
exclusively breastfeeding period. According to WHO, this process lovers the

period from 4-24 months of age and is a critical period of growth during

which infants are at high risk of nutrients deficiencies and illness.

 Early and late introduction of complementary feeding: according to

Basavanthappa (2010): Teeming of the first introduction of solid food
during infancy may have potential effects on lifelong health. It can be
seen that very often solid foods are either given too early or too late.
According to UNICEF, the frequency and amounts of food that is given
may be insufficient, hence, hindering the normal growth of the child or
the consistency or energy density may be incorrect in relation to the
child`s needs.

2.5 ANTHROPOMETRY

According to Suddarth (2013); anthropometry is a system of measurement of

the size and makeup of the body and specific body parts. Anthropometric

measurements that aid in identifying nutritional problems include weight,

height; wrist circumference, mid-upper arm circumference (MUAC) and

triceps skin fold (TSF)

1. Weight: the weight should be taken with minimum clothing and recorded

to the nearest quarter kilograms (Woodham 2009).

2. Height: the height should be taken in a standing position.

23
3. Wrist circumference: was used to estimate the patient’s body frame. A

tape measure is used to measure the wrist distal to the steroid process.

(Krumm 2010)

4. Mid-upper arm circumference (MUAC): the MUAC determines muscle

wasting.
5. Triceps skin fold (TSF): skin fold measurements are used to determine
fat content of subcutaneous tissue. (Sullivan and Deeker 2011).

CHAPTER THREE

RESEARCH METHODOLOGY

INTRODUCTION

This chapter is the third chapter and it is concerned with the method adopted

to conduct the project and consist of research design, population study,

sample and sampling techniques, and instrument for data collection, pilot

survey and method of data analysis.

3.1 RESEARCH DESIGN

The research design used was descriptive survey this method was chosen

because it permits to carefully describe and explains the variables that exist

in the study based on the data collected. Gay and Razaria (2011) see

descriptive survey as a modern method of research which allowed the

researcher to interrogate with the respondents and gives adequate reports as

24
it existence in the study area. Hence this research design is designed initially

to look in to the “influence of culture and ignorance toward malnutrition in

infants”.

3.2 POPUPLATION OF THE STUDY

Population can be defined as it best applied in research aspect or group of

people, object and institution within a particular place having the same or

similar characteristics.

The target population of the research study consist of nurses in paediatrics

and patients guardians in General Hospital Ingawa.

Sample size was determined by using Morgan population sampling table and

the sample size for the target population which is exactly 40 people.

3.3 SAMPLE AND SAMPLING TECHNIQUES

As mentioned above, the samples are nurses and patients guardians in the

General Hospital Ingawa.

A random sampling technique was used to select respondents.

25
3.4 INSTRUMENTS FOR DATA COLLECTION

The instrument which is used for data collection is designed into four

sections “A” is concerned with personal information such as type of

respondent (staff nurse or patients guardian), age and gender, while section

“B” contains items that are related influence of culture and ignorance toward

malnutrition in infants.

3.5 PILOT SURVEY

Pilot survey is a strategy used to ascertain and validate the efficacy and

quality of instrument used in data collection i.e. questionnaire.

A percentage of questionnaires are distributed to few people to respond

before the actual distribution to detect some points that need to be corrected.

3.6 METHOD FOR DATA ANALYSIS

The data collected in this research was obtained using frequency table and

percentage.

26
 CHAPTER FOUR

DATA PRESENTATION AND ANALYSIS

4.0 INTRODUCTION

This chapter deals with the analysis of data presented and answering

research questions the collected data were analyzed in accordance with

research questions using tables and charts.

4.1 Data Presentation

Section A: Respondent’s Bio-data

Table 1: Age Distribution of the Respondents

Age Frequency Percentage

21-25 years 15 37.5%
26-30 years 20 50%
31-35 years 3 7.5%
27
36 and above 2 5%
Total 40 100%

From the above table 37.5% of the respondents are within the age of 21-

25years and 50% are within the age of 26-30 years, 7.5% are within the age

of 31-35 years while 5% are within the age of 36 and above.

Table 2: Sex Distribution of the Respondents

Sex Frequency Percentage

Male 9 22.5%
Female 31 77.5%
Total 40 100%

From the above table 22.5% of the respondents are males while 77.5% are

female i.e. most of the respondents are females because the patients

guardians are mostly females.

Table 3: Marital Status of the Respondents

Marital Status Frequency Percentage

Single 5 12.5%
Married 35 87.5%
Total 40 100%

From the above table 12.5% of the respondents are single while the

remaining 87.5% of the respondents are married.

Table 4: Religion of the Respondents

28
 Religion Frequency Percentage
Islam 38 95%
Christianity 2 5%
Others 0 0%
Total 40 100%

From the above table 95.5% of the respondents are Muslims, 5% are

Christians and 0% are of other religions.

Table 5: Tribe of the Respondents

Tribe Frequency Percentage

Hausa 33 82.5%
Yoruba 5 12.5%
Igbo 2 5%
Others 0 0%
Total 40 100%

From the table above 82.5% of the respondents are Hausa, 12.5% are

Yoruba and 5% are Igbo.

SECTION “B”

Figure 1: Complications of malnutrition

Mathematical illustration

Yes: 37 No: 3
37
Yes: ×=360=3330
40

3
No: ×=360=27 0
40

29
 333 Yes
27 No

The figure above shows that 37 respondents ticked “Yes” meaning they

agreed that malnutrition has complication having 333 0 at the above pie chart

depicted and only 3 respondents ticked “No” there 270 is corresponded.

Table 6: How often do you come with case of malnutrition?

Frequency of hospitality Frequency Percentage

Often 20 50%
Very often 7 17.5%
Rare 10 25%
Very rare 3 7.5%
Total 40 100%

From the table above 50% of the respondents come to hospital with case of

malnutrition, 7 respondents (17.5%) come very often, 10 respondents (25%)

rarely come in case of malnutrition while only 3 respondents (7.5%)

respondents come very rarely.

30
Figure 2: Do you think the incidence of malnutrition has increased in
the world?

Mathematical illustration
15
Yes: ×=360=1350
40

20
No: ×=360=1800
40

5
Don’t Know: ×=360=450
40

180

Yes
No

45

135

The figure above shows that 15 respondents think that incidence of

malnutrition has increased in the world having 1350 in the above pie chart 20

respondents ticked “No” having 1800 in the above pie chart while 5

respondents ticked don’t know.

Table 7: Does the incidence of malnutrition affect only children?

Response Frequency Percentage

31
Yes 10 25%
No 30 75%
Total 40 100%

From the table above shows that, 10 respondents out of 40 agreed that

malnutrition affect only children while 30 respondents (75%) do not agree.

Figure 3: Lack of awareness among mothers on weaning plan can also

lead to infant malnutrition.

Mathematical illustration
35
Yes: ×=360=3150
40

5
No: ×=360=450
40

27

Yes
No

315

The figure above shows that 35 respondents equivalent to 315 0 in the pie

chart agreed that lack of awareness among mothers on weaning can also lead

to infant malnutrition while the remaining 5 respondents 450 did not agree.
32
Table 8: Is any of your children died of malnutrition?

Response Frequency Percentage

Yes 15 37.5%
No 25 62.5%
Total 40 100%

From the table above shows that, about 15 respondents’ children (37.5%)

died of malnutrition and the remaining 25 (62.5%) did not.

Table 9: Ignorance can cause malnutrition in children?

Response Frequency Percentage

Yes 37 92.5%
No 3 7.5%
Total 40 100%

From the table above shows that, 37 respondents fully agreed that ignorance

can cause malnutrition in children, (92.5%) while the remaining 3

respondents (7.) did not agree.

Figure 4: Can malnutrition be cured?

Mathematical illustration
36
Yes: ×=360=324 0
40

4
No: ×=360=36 0
40

33
 36

Yes
No

315

The figure above shows that 36 respondents equivalent to 324 0 in the pie

chart agreed that malnutrition can be cured while the remaining 4

respondents 360 did not agree by ticking “No”.

Table 10: Do you agree that poverty can cause malnutrition in children?

Response Frequency Percentage

Yes 39 97.5%
No 1 2.5%
Total 40 100%

From the table above shows that, about 39 respondents (97.5%) ticked “yes”

meaning that they agreed that poverty can cause malnutrition, but only one

respondent did not agree.

Figure 5: Is there any of your children suffers from malnutrition?

34
Mathematical illustration
31
Yes: ×=360=2790
40

9
No: ×=360=810
40

81

Yes
No

279

The figure above shows that 31 respondents equivalent to 270 0 in the pie

chart ticked “yes” meaning one or more of their children suffer from

malnutrition while the remaining 9 respondents ticked “No” about 81 0 in the

pie chart.

Figure 6: How can malnutrition be diagnosed?

35
 35

30

25
Number of respondents

20
Series 1
15

10

0
Physical E History Taking Lab. Invest Both
Diagnosis

The figure above shows that 30 respondents ticked “Both”, 5 respondents

ticked laboratory investigation, 4 respondents go with history taking and 1

respondent ticked physical examination as a method that malnutrition can be

diagnosed.

Table 11: Do you think lack of education can be major cause of

malnutrition?

Response Frequency Percentage

Yes 36 90%
No 4 10%
Total 40 100%

36
From the table above shows that, about 36 respondents (90%) agreed that

lack of education can be the major cause of malnutrition while 4 respondents

(10%) did not agree.

Figure 7: Do you agree that improper breastfeeding can lead to infant

malnutrition in the society?

Mathematical illustration
30
Yes: ×=360=2700
40

10
No: ×=360=90 0
40

90

Yes
No

270

The figure above shows that 30 respondents equivalent to 270 0 in the pie

chart agreed that improper breastfeeding can lead to infant malnutrition

while the other 10 respondents 900 did not agree.

37
Table 12: Does malnutrition has high morbidity and mortality rate?

Response Frequency Percentage

Yes 21 52.5%
No 19 47.5%
Total 40 100%

From the table above shows that, about 21 respondents (52.5%) ticked “yes”

meaning that they agreed that malnutrition has high morbidity and mortality

rate while remaining 19 respondents did not agree.

Figure 8: Which of the following is the major influence of malnutrition

among children?

16

14

12
Number of respondents

10
Series 1
8

0
Culture Ignorance Poverty Population growth
Influence

The figure above shows that 15 respondents ticked culture as the major

influence of malnutrition in our community, 13 respondents ticked

38
ignorance, 8 respondents ticked poverty but only 4 respondent ticked

population growth

Figure 9: Which of the following do you think is the preventive measure

of malnutrition among children?

25

20
Number of respondents

15
Series 1

10

0
Health Education Food Production Fortification Breastfeeding
Measures

The figure above shows that 20 respondents ticked health education as the

major preventive measure of malnutrition, 10 respondents ticked food

production, 5 respondents go with fortification while the remaining 5

responded ticked breastfeeding.

CHAPTER FIVE

39
 SUMMARY, DISCUSSION, CONCLUSION AND

RECOMMENDATIONS

5.0 INTRODUCTION

This chapter deals with re-statement of the problems, summary, major

finding, discussion of the findings, conclusion, implication of the study,

recommendation, limitation of the study (if any) and suggestions for further

study.

5.1 RE-STATEMENT OF THE PROBLEM

Sincerely speaking culture and ignorance are the serious problem of

malnutrition in infants in the world, in terms of morbidity and mortality.

Apart from pregnant women are forbidden from eating edible and available

food which is valuable for health and the body, also leads to the serious

problem of malnutrition among infants and pre-school children. (Mahapatre

et-al, 2000)

According to Bharati (2005) said children as well as necessary of special and

temporal community specific data; across section survey was done among

pre-school children and 0.5 years to across the health and health status.

40
According to Jellife (1966) and WHO (1995) said qualitative and gustative

assessment was done through actual weight to raw food item.

Anthropometric measurement (weight and height) we measured chemical

sign of nutrition deficiency were conclude.

5.2 SUMMARY

Malnutrition according to Benjamin and Woother (2007). This is the

condition that occurs when a person’s body is not getting enough nutrients

sources. The condition may result from an inadequate or unbalance diet

digestive difficulties and mal-absorption, worldwide malnutrition

continuous. To be significant problems especially among infant and

preschool children who cannot feed adequately for themselves, culture and

ignorance contribute to the malnutrition.

According to Goplan (2002) the large section of population were suffering

from various degrees of protein energy malnutrition which is the most

important nutrients in the body.

In some part of the country, some community’s cultures are in the practice

of neglecting breastfeeding at birth by mothers to their newborn babies due

to illiteracy problem and lack of awareness this is the best nutrients for

infants and certain antibodies to help fight against infection, while nutrition
41
and health were the most important contributory factors for human

development.

MAJOR FEEDING

From the information gathered by the questionnaire distributed ignorance

and culture habit among the communities members are contributors of

malnutrition among infants.

5.3 DISCUSSION OF THE FINDINGS

Table 4.1 nutritionals are associated with ignorance from the generated data

of questionnaire it shows it shows that out of forty (40) representing 83.5%

agrees, while the other respondents representing 16.5% do not agree with the

statement.

Table 4.2 culture practice significantly affects nutritional status of infants.

However, from the generated data of questionnaire it shows that out of forty

(40) respondents who fill the questionnaire (36) people are figure

representing 87% agree, while the other are figure representing about 13%

does not agree with the statement.

Table 4.3 nutritional problems do not affects educated communities from the

generated data of the questionnaire 33 people are figure representing 82.5%

42
agree, while 7 others representing about 17.5% does not agree with the

statement.

5.4 CONCLUSION

Based on the previous discussion and analysis, it can be conducted that

infants with malnutrition are more likely to suffer from various category of

diseases than well-nourished children as a result of low immunity resulting

from deficiency of food intake of nutrient particularly protein and

carbohydrate. It can also that culture and ignorance among community’s

members affects infant mentally and physical growth which load to different

complication and even death may occur.

Finally good health education, counseling, provision as well balanced diet,

improving economic level of the country, early diagnosis and proper in

treatment, exclusive breast feeding improving level of education so that

parents will understand the important of feeding their children.

5.5 IMPLICATION OF THE STUDY

1. There is need for sound health education and food demonstration to

the mothers as well as the households.

43
 2. There is need for proper community mobilization so that people will

become aware of the types so that food needs to be given to the

infants.

3. Family planning should be encouraged to parents whenever the need

arises.

5.6 RECOMMENDATION

The following are the recommendation made by the researcher at the end of

this project write up to a government and non-governmental organizes and

the community in general.

a. The government should participate in the provision of nutritional

supplement so as to reduce the implication of malnutrition among

infants in both rural and urban area.

b. All existing local government should cooperated and coordinate all

their activities to eradicate and prevent malnutrition where and agency

such as primary health care department could serve as coordinator to

ensure a planned comprehensive approach and complementary effect.

c. Government should also consider culture in the implementation of

nutritional dietary campaign so as to motivate the general public to

accept the program.

44
 d. Government should also provide available health care facilities to

ensure maternal and child health care delivery.

e. Mothers should also be educated and encouraged about breast feeding

and weaning plan.

f. Government should also have to enact low on food and nutrition.

5.7 SUGGESTIONS FOR OTHER STUDIES

This research work is not final investigation of the problems rather there is

need for further research to be done which may be under and broader.

Anybody wishing to write further should endeavor to write on this cheapest

option of the influence of culture and ignorance toward malnutrition in

infants and possible solutions to the problems.

45
REFERENCES

Angella and Market (1994) A Practical Guide to Working with Babies

Published by University Printing Press Nigeria.

Anneten (1984) A Comprehensive Guide to Risk and Infants of Vitamin

Supplement First Edition Published by Pockets Book New York.

Fishben’s (1981) Medical and Health Encyclopedia Vol. 19 International

Unified Edition Published.

Henry a. (1993) A. Z. Community Health and Social Medicine for Medical

and Nursing Practical Published by ZAM Communication Dugbe,
Ibadan, Nigeria.

Joseph F. (1910) The Catholic Encyclopedia vol. III published Remy

Lessport New York.

K. Park et-al (1986) Preventive and Social Medicine for Tropic Second
Edition Published by University Press Manchester, England.

Lukas and Gilles (1990) A New Start Textbook of Preventive Medicine for
the Tropic Published by ELBS with Edward Arnold.

Rahan et-al (2004) In fact Maternal Depression on Infant’s Nutrition status

and Illness Published by Science New India.

Twins M. (2006) Malnutrition is Cheating its Supervisor and African Future

Article in the New York.

46
 SAMPLE QUESTIONNAIRE

Kankia Iro School of Health

Technology Kankia, Kankia
Local Government, Katsina
State,

Dear respondent,
QUESTIONNAIRE: INFLUENCE OF CULTURE AND IGNORANCE
TOWARD MALNUTRITION IN INFANTS (0 TO 59MONTHS OF
AGE) “A CASE STUDY OF INGAWA LOCAL GOVERNMENT AREA,
KATSINA STATE”

I am a final year student of the above named institution conducting project

on the above mentioned topic. The research is purely for academic purpose
and all information obtained will be treated confidentially. Questionnaire is
divided into 4 sections, Section “A” deals with personal data of the
respondents and Section “B” deals with the questions that are related to
influence of culture and ignorance towards malnutrition.

Instructions: Please do not write your name; respond to the questions and
statement on this paper by writing or ticking on the space provided
appropriately.

SECTION A
1. Age: 21-25 ( ) 26-30 ( ) 31-35 ( ) 36 and above ( )
2. Sex: Male ( ) Female ( )
3. Marital Status: Married ( ) Single ( ) Divorced ( )
4. Religion: Islam ( ) Christianity ( ) Others ( )
5. Tribe: Hausa ( ) Yoruba ( ) Igbo ( ) Others ( )

47
 SECTION B

6. Does malnutrition has a complication?

a. Yes ( ) b. No ( )

7. How often do you come with case of malnutrition?

a. Often ( ) c. Rare ( )

b. Very often d. Very rare

8. Do you think the incidence of malnutrition has increased in the world?

a. Yes ( ) b. No ( ) c. Don’t Know
9. Does the incidence of malnutrition affect only children?
a. Yes ( ) b. No ( )
10.Do you believe that lack of awareness among mothers on weaning plan
can also lead infants to malnutrition?
a. Yes ( ) b. No ( )
11.Are any of your children your children died of malnutrition?
a. Yes ( ) b. No ( )

12.Ignorance can causes malnutrition in children?

a. Yes ( ) b. No ( )

13.Can malnutrition be cured?

a. Yes ( ) b. No ( )

14.Do you agree that poverty can cause malnutrition in children?

a. Yes ( ) b. No ( )

15.Is there any of your children suffers from malnutrition?

48
 a. Yes ( ) b. No ( )

16.How can malnutrition be diagnosed?

a. Physical Examination ( ) c. History Taking ( )

b. Laboratory Investigation ( ) d. Both ( )

17.Do you think lack of education can be the major cause of malnutrition?

a. Yes ( ) b. No ( )

18.Do you agree that improper breastfeeding can lead to infant malnutrition

in the society?

a. Yes ( ) b. No ( )

19.Does malnutrition has high morbidity and mortality rate?

a. Yes ( ) b. No ( )

20.Which of the following factors is the major influence of malnutrition

among children?

a. Culture ( ) c. Poverty ( )

b. Ignorance ( ) d. Population growth ( )

21.Which of the following do you think is the major preventive measure of

malnutrition among children?
a. Health education to mothers on malnutrition ( )
b. Increased food production ( )
c. Fortification of food ( )
d. Exclusive breastfeeding ( )

49