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Study on risk factors for Poor Nutritional Status among <5 children in Yaqshid
district Mogadishu-Somalia

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 MOGADISHU UNIVERSITY

FACULTY OF HEALTH SCIENCES

DEPARTMENT OF PUBLIC HEALTH

Graduation Thesis

Study on risk factors for Poor Nutritional Status

among <5 children in Yaqshid district

Student’s Name Supervisor’s Name

Ibrahim Ali Mohamud Mr. Walid Abdulkadir Osman

Student’s ID No. 11008

THIS THESIS IS SUBMITTED IN PARTIAL FULFILLMENT FOR THE

AWARD OF THE DEGREE OF BACHELOR SCIENCE IN PUBLIC
HEALTH OF MOGADISHU UNIVERSITY

ACADEMIC YEAR
2016/2017
Mogadishu – Somalia
May, 2017

I
 DECLARATION

I, hereby declare that all the work presented in this thesis is my own original work
unless otherwise acknowledged. It has never been presented either in part or in full for
publication or award of a degree in any university. I, therefore, present it for the award
of Bachelor degree in Public Health of Mogadishu University, Somalia.

Student

Ibrahim Ali Mohamud

Signature: ......................... Date: ...../...../2017

I
 APPROVAL

We confirm that the candidate under our supervision carried out the work reported in
this thesis.

Supervisor

Mr. Walid Abdulkadir Osman Al Sha'bani

Signature: ......................... Date: ...../...../2017

Dean Faculty of Health Sciences

Mr. Abdulqadir Abdinur Barre

Signature: ......................... Date: ...../...../2017

II
 DEDICATION

This thesis is dedicated to my dear Mother, Zeinab Ali Mohamed and my dear Father Ali
Mohamud Absuge, my Aunt Hawa Ali mohamud Dabble and my Sister Anab Ali
Mohamud and all my brothers and sister who endured hardships for me until this day,
and all my dear brothers and sisters in Islam.

III
 ACKNOWLEDGEMENT

First and foremost all praise to almighty ALLAAH, the most merciful and the most
compassionate who enabled me to complete this project and also gave me the ability to
perform this remarkable task.

I would like to express my sincere graduate to my supervisor, Mr. Walid Abdulkadir

Osman Al Sha'bani for his support and advice during the course and completion of this
project. Also, my appreciation goes to all my competent lecturers who touch me one
time or the other.

My special appreciation goes to my beloved parents, Zeinab Ali Mohamed and my

father Ali Mohamud Absuge. All for the special care they have granted me. My Allah,
forgive me and forgive my parents and Muslim in here after. My ALLAAH mercy on
them as they nourished me when I was young.

I am deeply thankful to my family for their loving, support, constant encouragement and
willingness to help at home when needed and their understanding when I was unable to
spend time with them because of the study commitment. Without their love and
understanding, I would have been unable to complete this study.

My special gratitude goes to my friend‟s colleagues at the university Mogadishu

specially my classmates of Health Science for their friendship support and concern me
this research is be beneficial to all such as: Safia Ahmed Sh. Farah, Abdinasir Abdullahi
Mohamud, Mohamed Hussein Khaasim, Mohamed Abubakar Moalim Abshir and all my
friends in Mogadishu university who support and Advice until completing this thesis.

I wish to acknowledge and the time and willingness of those women who participated in
this study and did so without expectation or personnel benefit. Last but not least my
great respect for all people who participate and help me in the success of this study

IV
 ABSTRACT

Nutritional status is defined as the condition of the body resulting from the intake,
absorption and utilization of food. It is determined by a complex interaction between
internal/constitutional factors and external environmental factors. World Health
Organization (WHO) in 2001reported that 54%of all childhood mortality was attributable,
directly or indirectly, to malnutrition. It is not only an important cause of mortality and
morbidity but also leads to physical and mental impairment in children.

The geographical location was Yaqshid district in Mogadishu city, Somalia. The aim of
this study was to determine risk factors for Poor Nutritional Status among <5 children. It
was undertaken on time frame (from December 2016 – May 2017).

A cross-sectional study is the method used in this project because respondents are
almost view number and for purpose of time. Sample size of 50 respondents was used.
A convenient sampling, type of non-probability sampling method, was applied for the
selection of the study sample. Questionnaire method has been used for data collection.
Quantitative method was used to collect data from the respondents.

The highest number of the respondents‟ family income is 100-299 USD; their family
members is ≥5 persons; they have >3 children who ages less than five years; that they
exclusively breastfeeding their child; their children weren‟t being immunized; their
children had suffered from Diarrhea within the last six months; they don‟t wash their
hands before and after handling with their children; they dispose the garbage disposal
by burning it; and they use water without treatment, 13 (26%) said by Filtration.

Therefore, the researcher recommends: To encourage exclusive breastfeeding for first

six months of life and continued breastfeeding for two years or more. Children should be
immunized in order to prevent malnutrition. There is a great need to focus the attention
of policy-makers on the nutritional status of children as one of the main indicators of
development and as a precondition for the socioeconomic advancement of societies in
the long term.

V
 TABLE OF CONTENTS

DECLARATION ............................................................................................................................. I
APPROVAL ................................................................................................................................... II
DEDICATION ............................................................................................................................... III
ACKNOWLEDGEMENT ............................................................................................................. IV
ABSTRACT .................................................................................................................................. V
ABBREVIATIONS ..................................................................................................................... VIII
1.CHAPTER ONE ......................................................................................................................... 1
1.1 Background of the study............................................................................................................ 1
1.2 Statement of the problem .......................................................................................................... 2
1.3 Objectives of the study .............................................................................................................. 3
1.3.1 General objective ............................................................................................................... 3
1.3.2 Specific objectives .............................................................................................................. 3
1.4 Research questions ................................................................................................................... 3
1.5 Significance of the study ........................................................................................................... 3
1.6 Scope of the study ..................................................................................................................... 4
1.7 Research limitations................................................................................................................... 4
1.8 Definition of terms ...................................................................................................................... 4
2.CHAPTER TWO ........................................................................................................................ 5
2.1 Introduction .................................................................................................................................. 5
2.2 Factors affecting nutritional status of Young children ........................................................... 6
3.CHAPTER THREE .................................................................................................................... 8
3.1 Study design ............................................................................................................................... 8
3.2 Study area- Yaqshid .................................................................................................................. 8
3.3 Sampling Frame ......................................................................................................................... 9
3.3.1 Inclusion criteria .................................................................................................................. 9
3.3.3 Exclusion criteria ................................................................................................................ 9
3.3 Sample size and sampling method.......................................................................................... 9
3.5 Method of data collection .......................................................................................................... 9
3.6 Type of data collection ............................................................................................................... 9
3.7 Ethical considerations ................................................................................................................ 9

VI
4.CHAPTER FOUR .................................................................................................................... 10
4.1 Age group of the respondents ................................................................................................ 10
4.2 Marital status of the respondents ........................................................................................... 10
4.2.1 Educational level of the respondents ............................................................................ 11
4.3 Employment status of the respondents ................................................................................ 12
4.4 Family Income of the respondents ........................................................................................ 13
4.5 Number of family members of the respondents................................................................... 14
4.6 Number of children who ages less than 5 years ................................................................. 14
4.7 Whether they exclusively breastfeeding their child ............................................................. 14
4.8 Whether their children being immunized .............................................................................. 15
4.9 Whether the respondents‟ children suffered from Diarrhea within the last six months . 16
4.10 Whether the respondents wash their hands before and after handling with their children
16
4.11 Respondents‟ used method to dispose the garbage disposal ........................................... 17
4.12 Respondents‟ on how they use water ................................................................................... 19
5.CHAPTER FIVE ....................................................................................................................... 20
5.1 Conclusion ................................................................................................................................. 20
5.2 Recommendations ................................................................................................................... 20
REFERENCES ........................................................................................................................... 21
APPENDICES ............................................................................................................................. 23
APPENDIX I: QUESTIONNAIRE ................................................................................................ 23
APPENDIX II: MAP OF YAQSHID DISTRICT ............................................................................ 26
APPENDIX III: MAP OF MOGADISHU CITY .............................................................................. 27
APPENDIX IV: MAP OF SOMALIA ............................................................................................. 28
APPENDEX VI: LETTER TO THE ETHICAL COMMITTEE ....................................................... 29

VII
 ABBREVIATIONS

WHO: WORLD HEALTH ORGANIZATION

FSNAU: FOOD SECURITY AND NUTRITION ANALYSIS UNIT

UNFPA: THE UNITED NATIONS POPULATION FUND

NGOS: NON-GOVERNMENTAL ORGANIZATIONS

AIDS: ACQUIRED IMMUNE DEFICIENCY SYNDROME

IQ: INTELLECTUAL QUOTIENT

VIII
 LIST OF FIGURES

Figure 4.1 Marital status of the respondents ................................................................. 11

Figure 4.2 Educational level of the respondents ........................................................... 12
Figure 4.3 Employment status of the respondents ........................................................ 13
Figure 4.4 Family Income of the respondents ............................................................... 14
Figure 4.5 Number of family members of the respondents............................................ 14
Figure 4.6 Number of children who ages less than 5 years........................................... 14
Figure 4.7 Whether they exclusively breastfeeding their child ....................................... 15
Figure 4.8 Whether their children being immunized ...................................................... 16
Figure 4.9 Whether the respondents‟ children suffered from Diarrhea within the last six
months .......................................................................................................................... 16
Figure 4.10 Whether the respondents wash their hands before and after handling with
their children .................................................................................................................. 17
Figure 4.11 Respondents‟ used method to dispose the garbage disposal .................... 18
Figure 4.12 Respondents‟ on how they use water ........................................................ 19

IX
 List of table

Table 4.1 Respondents by age ................................................................................... 10

X
 1 CHAPTER ONE

INTRODUCTION

1.1 Background of the study

Nutritional status is defined as the condition of the body resulting from the intake,
absorption and utilization of food. It is determined by a complex interaction between
internal/constitutional factors and external environmental factors: Internal or
constitutional factors like: age, sex, nutrition, behavior, physical activity and diseases.
External environmental factors like: food safety, cultural, social and economic
circumstances (Joshi, Gupta Joshi and Vipul, 2011).Undernutrition is associated with
poverty and is an indicator of non-income poverty. One of the major pathways through
which WASH can affect poverty is child nutrition. Children who get sick less often and
who eat a better diet grow taller and stronger over time (Evans and Marcy 2004).
Children who suffer from undernutrition during childhood fail to reach their human
capital potential, which keeps not only them in poverty, but future generations of
children as well (Victora, Adair, Fall, Hallal, Martorell, Richter and Sachdev, 2008).

World Health Organization (WHO) in 2001reported that 54%of all childhoodmortality

was attributable,directly or indirectly, to malnutrition. It is not only an important cause of
mortality andmorbidity but also leads to physical and mental impairmentin children.
Health and physical consequences of prolongedstates of malnourishment among
children were delay in theirphysical growth, lower intellectual quotient, poor
cognitiveability, decreased economic productivity, decreased reproductiveperformance,
poor school achievement and poorschool performance, greater behavioral problems
and deficientsocial skills, and susceptibility to contracting diseases (Pechlaner and
Otero, 2010).

Globally, an estimated 101 million children below five years of age were underweight.
These accounted for 16% of children below five years of age. The prevalence was the
highest, which was 33%, followed by Sub-Saharan Africa, which was 21%. These were
59 million in South Asia, while 30 million were in sub-Saharan Africa (De Onis, Brown,

1
Blossnerand Borghi, 2012).About one-third of deaths among children below five years
of age were attributed to under nutrition and it can lead children to be at greater risk of
death and severe illness due to common childhood infections, such as pneumonia,
diarrhea, malaria, human immunodeficiency virus, or AIDS and measles (UNICEF,
2013).

Somalia is a sub-Saharan developing country undergoing shortage of Food due to

recurrent droughts; it also faces rapid urbanization resulting in changing lifestyles and
dietary habits. Poor nutritional status is thought to be the underlying cause in over a
third of under-five child deaths. The nutritional status of Somali children is among the
worst in the world and remains a huge public health concern(UNICEF, 2016). According
to FSNAU report in 2016 the level of malnutrition, especially among children, is serious
with nearly 305,000 children under the age of five years are acutely malnourished.
58,300 children face death if are not treated. Most diseases in childhood are associated
with Malnutrition as well as chronic diseases in adulthood related to dietary habits and
practices which are mainly formed during childhood. Therefore, the main aim of this
study was to determine associated factors of poor nutritional status among children
below five years of age in Yaqshid district, Mogadishu, Somalia.

1.2 Statement of the problem

Adequate Nutrition is the fundamental right of every human being. Malnutrition is not
just a stark manifestation of poverty, it is also the non-income face of poverty and
it helps perpetuate poverty (World Bank Report, 2012).Malnutrition continues to be a
primary cause of ill health and mortality among children in developing countries. It is a
major public health problem and accounts for about half of all child deaths worldwide
(UNICEF, 2004).

Poor nutritional status imposes significant costs on the economy as well as society. The
high mortality due to malnutrition leads to the loss of the economic potential of the child.
It affects children in many ways, predisposing them to different infectious diseases,
psychosocial maldevelopment, and cognitive deficiencies. Health and physical
consequences of prolonged states of malnourishment among children are: delay in their
physical growth and motor development; lower intellectual quotient (IQ), greater

2
behavioral problems and deficient social skills; susceptibility to contracting disease
(Black, Morris and Jennifer, 2003).The high levels of under nutrition in children pose a
major challenge for child survival and development. Besides poverty, there are other
factors that directly or indirectly affect the nutritional status of children. Several studies
showed that maternal education emerges as a key element of an overall strategy to
address malnutrition (Christiansen and Alderman (2001).

1.3 Objectives of the study

1.3.1 General objective

The main objective of the study is to determine the risk factors for Poor Nutritional
Status among <5 children in Yaqshid district, Mogadishu, Somalia.

1.3.2 Specific objectives

a) To identify the socio-demographic and socioeconomic factors for Poor Nutritional
Status among <5 children in Yaqshid district, Mogadishu, Somalia.
b) To describe the medical and environmental factors Poor Nutritional Status
among <5 children in Yaqshid district, Mogadishu, Somalia.

1.4 Research questions

a) What are the sociodemographic and socioeconomic factors for Poor Nutritional
Status among <5 children in Yaqshid district, Mogadishu, Somalia?
b) What are the medical and environmental factors Poor Nutritional Status among
<5 children in Yaqshid district, Mogadishu, Somalia?

1.5 Significance of the study

The findings of the study will be helpful to encourage local people to improve current
nutritional status by improving feeding pattern and habit of children, pregnant and
lactating women. It will also serve as helpful guide to plan suitable nutritional and health
programs for this community based on the facts and figures discovered from this study.

The findings and recommendations of this study should be important for parents who
have children aged below five years, the entire health staffs, medical students, clinical
instructors, policy makers, voluntary institutions like NGOs and future researchers as
well as it enables the reader to generate ideas for better determination and effective

3
way of making efficient case studies for future utilization and act as a tool to develop
programs and policies related to nutrition.

1.6 Scope of the study

The geographical location of the study was Yaqshid district in Mogadishu, Somalia. The
study was tried to determine the associated factors related to poor nutritional status
among <5 children. The study will be under take on time frame (from December 2016 –
May 2017.)

1.7 Research limitations

 Financial constraints.
 Lack of internet library facilities.
 Data analyzing obstacle.
 Time limit.

1.8 Definition of terms

Health: A state of complete physical, mental and social well-being and not merely the
absence of disease or infirmity.

Malnutrition: The condition that results from an imbalance between dietary intake and
requirements. It includes under nutrition, which results from less food intake and hard
physical work and over nutrition results from excess food intake and less physical
activities.

Nutritional status: The condition of health of a person that is influenced by the intake
and utilization of nutrients is called nutritional status.

4
 2 CHAPTER TWO

LITERATURE REVIEW

2.1 Introduction
Nutrition has been defined as the food at work in the body. Nutrition includes everything
that happens to food from the time it is eaten until it is used for various functions in the
body (Srilakshmi 2002).Nutrition is a core pillar of human development and concrete
large scale programming not only can reduce the burden of under nutrition and
deprivation but also advances the progress of nations (Medical Gazzette, 2012)
Nutritional status is the state of our body as a result of the foods consumed and their
use by the body. Nutritional status can be good, fair or poor (Mudambi et al, 2012).
According to the WHO, in 2011 over 101 million children under the age of 5 were
underweight (low weight for age), 165 million were stunted (low height for age), and
approximately 52 million were wasted (low weight for height). Ten and half million
children under 5 years of age die every year worldwide, with 98% of these deaths
occurring in developing countries. Diarrhoea and respiratory diseases are major causes
of child mortality, and the high prevalence rates of emaciation and linear growth
retardation reflect the poor health status of children in developing countries (UN, 2007).

Malnutrition is one of the major public health problems all over the world. Currently, it
faces and associated with more than 41% of the deaths that occur annually in children
from 6 to 24 months of age in developing countries, which were approximately 2.3
million.When the person is not getting enough food or not getting the right sort of food,
malnutrition is just around the corner. Even if people get enough to eat, they will
become malnourished if the food they eat does not provide the proper amount of
micronutrient- vitamins and minerals. According to United Nation report (2007), 46% of
children under the age of five years suffer from under nutrition. Malnutrition is the direct
or indirect cause for 50% of the total deaths among children (Srilakshmi 2014).
Malnutrition has been defined as ―a pathological state resulting from a relative or
absolute deficiencies or excess of one or more essentials nutrients (Park 2011).It is
generally recognized that frequent occurrence of infectious diseases such as diarrhea,
5
dysentery or malaria affects adversely the health of individuals. In developing countries,
infection and infestation are important factors involved in the causation of severe
malnutrition among preschool children consuming inadequate and ill balanced diets
(Swaminathan, 2008).

2.2 Factors affecting nutritional status of Young children

The factors affecting nutritional status are mother„s food security, breast feeding
practices, types of food given to young children, feeding frequency, status of women
and child nutrition and last but not the least who feeds the child and how the child eats
(NMICS, 2010).There are many other factors that influence the nutritional status some
of which are food availability and its distribution system, consumption of food, income
source and purchasing power, family size, illiteracy, sociocultural and religious belief,
environmental sanitation and health facility.Socio-economic and environmental factors
at the household level, as well as the characteristics of mothers, have been shown to be
associated with both the health and nutritional status of children less than 5 years old in
most developing countries. The present study was performed to assess, beyond these
socio-economic factors, independent associations between the health and nutritional
status among children under 5 years of age and family behavioural factors related to
women with regard to child care and war-related experience by the household of
hardships.

Food is not just something to eat; it is an integral part of culture of a community, region,
or nation. Food is a relative concept. Good health depends on an adequate food supply
and this in turn on sound agricultural policy and a good system of food distribution (Adel
and Hartoget all, 2006). For the achievement of nutrition adequacy, increased
production of food groups making the national diet balanced is one of the most
important measures. Adverse consequences are manifested themselves if the national
diet are deficient in nutrients. Vitamin A deficiency followed by iron deficiency, blindness
among children, PEM and so on which could be overcome by supplying or consuming
diets rich in these nutrients (Gyawali, Rajiv 2007). In multiple logistic regression
analysis, paternal educational status, diarrheal disease occurrence, and respiratory tract
infection in the last one month were statistically significant variables for stunting.

6
Diarrheal disease and acute respiratory tract infection in the last one month were
factors independently associated with stunting.Maternal educational status, paternal
educational status, monthly income,

Breastfeeding in the first years of life protects children from infection, provides an ideal
source of nutrients, and is economical and safe. However, many mothers stop
breastfeeding too soon and there are often pressures to switch to infant formula, which
can contribute to growth faltering and micronutrient malnutrition and is unsafe if clean
water is not readily available.WHO/UNICEF provide the following feeding
recommendations (NMISC 2010): exclusive breastfeeding for first six months of life b.
Continued breastfeeding for two years or more; safe, appropriate and adequate
complementary foods beginning atsix months of age; frequency of complementary
feeding: two times per day for 6–8- month-olds; three times per day for 9–11-month-
olds; it is also recommended that breastfeeding be initiated within onehour of birth.In
certain communities, children receive only breast milk until they begin to eat adult„s
food. Mother will generally feed their infants on demand but workloads interfere with the
frequency of feeding.

Nutrition and health education has been defined as educational measures for including
desirable behavioural changes for the ultimate improvement in the nutritional and health
status of individual. This is one of the most commonly implemented measures, not only
of the health sector, but of other sector concerned with development of human
resources. Growth is influenced by nutrition. Frequent attacks of infectious diseases
affect their growth and increase the requirements of various nutrients (Srilakhsmi,
2011). As we know nutritional status of individual has direct impact upon ones
development and as a whole on the productivity too. It is hampered because of under
nutrition and good nutrition is not possible with low productivity as it results in low living
standard. Thus the developing and under developed countries generally have a vicious
cycle of poverty resulting in malnutrition (Dahal, 2002).

7
 3 CHAPTER THREE

METHODS & MATERIALS

3.1 Study design

The design of study was cross sectional study. This means that sample was selected
from target and information was obtained responders at the same time on a particular
point in time.

3.2 Study area- Yaqshid

Yaqshid district is one of the 17 districts of Banadir region and situated in the north part
of the Banadir region,it‟s bordered by Sahibs in the south, Wardhiglay in the west,
Karan and Helwaa in the east,and Bal‟ad (middle Shebelle district) in the north.The
district covers approximately 45km2 (15km in length and 3 km width), and it is one of
the largest district of Banadir region.The district is divided in to seven Villages (sections)
and each village is also subdivided into sub quadrants: Hegan village; Horsed village;
Towfiq village; Jungle village; 1st July village; Tawakal village; Insurance(caymis)
village.Recent years there have been several super and mini markets established
themselves in all district quadrants in which people come to sell or buy all needed daily
stuff. All marketable goods, merchandise sold in these markets are mostly imported
from Asia, markets in district as the only means of economic income and assisted both
customers and sells persons in many ways, however, here are some of the most
common markets in district: Bal‟ad market; Towfiq market; Jungle market; and Daryel
market.

The population of Yaqshid district is estimated approximately 172,677 persons (MOP

and UNFPA, 2014). Although of lack formal central government this estimation was not
accurate.Yaqshid district also one of the largest districts in Banadir region.

8
3.3 Sampling Frame

3.3.1 Inclusion criteria

Those children in Yaqshid district who have not turned 5 years of age as on 28 April
2017 are included.

3.3.2 Exclusion criteria

 Those mothers who were not given consent.
 Those who were sick at the time of data collection.
 Those under five children in other districts.
 Those above five children in Yaqshid district.

3.4 Sample size and sampling method

50 respondents were conveniently selected from the target population.

3.5 Method of data collection

Questionnaire method has been used for data collection.

3.6 Type of data collection

Quantitative method was used to collect data from the respondents.

3.7 Ethical considerations

Every respondent was asked for permission to complete the questionnaire. Good
explanation of the respondents was done before filling the questionnaire. Privacy and
confidentiality was kept.

9
 4 CHAPTER FOUR

DATA ANALYSIS

4.1 Age group of the respondents

The majority of the respondents 15(30%) were aged between 26 and 33 years, followed
by 15(30%) who were aged 34 – 41 years, while 10(20%) were aged 18– 25years, and
10(20%) were aged above 41years.

Table 4.1 Respondents by age

Respondents by age # of the respondents Percentage (%)

18– 25 years 10 20%

26 – 33 years 15 30%
34– 41 years 15 30%
Above 41years 10 20%

Total 50 100%

4.2 Marital status of the respondents

Half of the respondents 25(50%) were Married, 16(32%) were Divorced, while 9(18%)
were widowed.

10
 50%
50
45
40
35 32%
30
25
20
18%
15
10
5
0
married
Divorce
widow

Figure 4.1 Marital status of the respondents

4.2.1 Educational level of the respondents

The highest number of the respondents 18(36%) had Informal education, 15(30%) were
primary school level, 10(20%) were Secondary school level, while 5(10%)were
University level, and 2(4%) were illiterates.

11
 40 36

30 30

20 20

10 4
10
0
Illitrate
Informal
Primary
Secondary
University

Figure 4.2 Educational level of the respondents

4.3 Employment status of the respondents

The highest number of the respondents 20 (40%) were Unemployed, 15(30%) were
House wife, 5(10%) were working in public services, 5 (10%) were self-employed, while
5(10%) were private sector workers.

12
 40
40

35
30
30

25

20

15
10 10 10
10

0
House wife public service Self-employed Private sector Unemployed

Figure 4.3 Employment status of the respondents

4.4 Family Income of the respondents

Half of the respondents 25(50%) reported that their family income is 100-299 USD,
while 15(30%) were said <100 USD, and 10(20%) were said >300 USD.

>300 USD 20

100-299 USD 50

<100 USD 30

0 10 20 30 40 50 60

13
Figure 4.4 Family Income of the respondents

4.5 Number of family members of the respondents

Most of the respondents 34(68%) reported that their family members is ≥5 persons,
while 16(32%) said< 5 persons.

68%

70

60

50

40 32%

30

20

10

0
<5 persons ≥5 persons

Figure 4.5 Number of family members of the respondents

4.6 Number of children who ages less than 5 years

The majority of the respondents 34(68%) reportedthat they have >3 children who ages
less than five years, while 16 (32%) said <3 children.

Figure 4.6 Number of children who ages less than 5 years

4.7 Whether they exclusively breastfeeding their child

The majority of the respondents 28 (56%) reported that they exclusively breastfeeding
their child, while 22(44%) were said No.

14
 44

56 Yes
NO

Figure 4.7 Whether they exclusively breastfeeding their child

4.8 Whether their children being immunized

The majority of the respondents 31(62%) reported that their children weren‟t being
immunized, while 19(38%) were said Yes.

62%
no

38%
yes

0 10 20 30 40 50 60 70

15
Figure 4.8 Whether their children being immunized

4.9 Whether the respondents’ children suffered from Diarrhea within the last six
months
The majority of the respondents 32(64%) reported that their children had suffered from
Diarrhea within the last six months, while 18(36%) were said No.

No 36

Yes 64

0 10 20 30 40 50 60 70

Figure 4.9 Whether the respondents’ children suffered from Diarrhea within the
last six months

4.10 Whether the respondents wash their hands before and after handling with
their children
The highest of respondent 34(68%) reported that they don‟t wash their hands before
and after handling with their children, while 16(32%) were said Yes.

16
 32

Yes
No

68

Figure 4.10 Whether the respondents wash their hands before and after handling
with their children

4.11 Respondents’ used method to dispose the garbage disposal

More than half of the respondents 30(60%) reported that they dispose the garbage
disposal by burning it, 20(40%) said use landfill, while no one use recycle.

17
 40
c) Landfill

60
b) Burn

0
a) Recycle

0 10 20 30 40 50 60

Figure 4.11 Respondents’ used method to dispose the garbage disposal

18
4.12 Respondents’ on how they use water
Most of the respondents 30(60%) reported that they use water without treatment,
13(26%) said by Filtration, while 7(14%) said by Boiling.

60
Without any Treatment

14
By Boiling

26
By Filtration

0 20 40 60

Figure 4.12 Respondents’ on how they use water

19
 5 CHAPTER FIVE

CONCLUSION AND RECOMMENDATIONS

5.1 Conclusion
The majority of the respondents 15(30%) were aged between 26 and 33 years. Half of
the respondents 25(50%) were Married. The highest number of the respondents
18(36%) had Informal education. The highest number of the respondents 20 (40%)
were Unemployed. Half of the respondents 25(50%) reported that their family income is
100-299 USD. Most of the respondents 34 (68%) reported that their family members is
≥5 persons. The majority of the respondents 34(68%) reportedthat they have >3
children who ages less than five years. The majority of the respondents 28 (56%)
reported that they exclusively breastfeeding their child. The majority of the respondents
31(62%) reported that their children weren‟t being immunized. The majority of the
respondents 32(64%) reported that their children had suffered from Diarrhea within the
last six months. The highest of respondent 34(68%) reported that they don‟t wash their
hands before and after handling with their children. More than half of the respondents
30(60%) reported that they dispose the garbage disposal by burning it. Most of the
respondents 30(60%) reported that they use water without treatment, 13(26%) said by
Filtration.

5.2 Recommendations
The researcher recommends:

 To give health education to the mothers about the effects of poor childhood
nutrition in order to increase their awarenessregarding the nutritional intake of the
child.
 To encourage exclusive breastfeeding for first six months of life and continued
breastfeeding for two years or more. Child should be immunized to prevent
malnutrition, because there is a relationship between Malnutrition and Infectious
Diseases.
 There is a great need to focus the attention of policy-makers on the nutritional
status of children as one of the main indicators of development and as a
precondition for the socioeconomic advancement of societies in the long term

20
 REFERENCES

United Nations Children's Fund: The State o

f the World's Children 2007: Women and Children. New York. 2007.

Dahal P, 2002. Diagnosis of Malnutrition Problem and its treatment through dietary
supplements in under six age chamar children of madhesa VDC, Sunsari B Tech.Food
Dissertation, Central Campus of Technology Tribhuvan University Nepal.

World Bank Report, 2012. Nutrition in Nepal- Documents and Reports 8th May 2012.

Joshi S, Gupta R, Joshi M and Mahajan Vipul (2011).Determinants of Nutritional Status

of School Children - A Cross Sectional Study in the Western Region of Nepal.

M. De Onis, D. Brown, M. Blossner, and E. Borghi (2012).Levels and Trends in Child

Malnutrition.UNICEF-WHO-The World Bank Joint Child Malnutrition Estimates,
UNICEF, New York, NY, USA.

UNICEF (2013).Improving Child Nutrition: The Achievable Imperative for Global

Progress, United Nations Children's Fund.

G. Pechlaner and G. Otero (2010). “The neoliberal food regime: neoregulation and the
new division of labor in North America,” Rural Sociology, vol. 75, no. 2, pp. 179–208.

UNICEF (2004), State of World‟s Children, 2004

Christiaensen L, Alderman H (2001). Child Malnutrition in Ethiopia: Can Maternal

Knowledge Augment The Role of Income? Africa Region Working Paper Series.

Black R, Morris S, Jennifer B (2003). Where and Why Are 10 Million Children Dying
Every Year?. The Lancet, 361: 2226-2234. 10.1016/S0140-6736(03)13779-8.

Srilakshmi, B. (2002). Nutrition Science. Delhi, India.: 1st edition New Age International
(P) Limited, Publisher.

Evans and Marcy ( 2004). poor nutritional status under five children.
21
Department of Committee, M. N. ( September 2012). Nutritional status in Under five
childrenl. Medical Gazzette, , 11.

Joshi, Gupta Joshi and Vipul, .( 2011). nutritional status. docment-report .

MOP and UNFPA.(2014). estimate population. 10.

Mudambi et al. (2012).Fundamental of Food nutrition and diet therapy 6th editio. Delhi
India , 6

Pechlaner and Otero, 2010.(2010). food nutrion.

Rajiv, G. (2002). Nutritional survey of satar community at Lakhanpu.JhapaB ,

Swaminathan.(2008). Food & Nutrition. Advanced Textboo .

Victora, Adair, Fall, Hallal, Martorell, Richter and Sachdev, 2008). (2008). nutritional
status in nepal. nutritional science .

22
 APPENDICES

APPENDIX I: QUESTIONNAIRE

Study on risk factors for Poor Nutritional Status among <5 children in
Yaqshid district

Instructions to respondents
o Do not write your name on this questionnaire.
o The research is for academic purpose monetary not for money.
o All information will be private.
o Please fill in the space provided to the best of your knowledge.
o You are free to choose not to fill it.

PART ONE: Sociodemographic and socioeconomic factors

1. Age?
a) 18 – 25 years
b) 26 – 33 years
c) 34 – 41 years
d) >41 years

2. Marital status?
a) Married
b) Divorced
c) Widow
3. Level of education?
a) Illiterate
b) Informal
c) Primary school
d) Secondary school
e) University
d) Others (please specify)______________________________

23
4. Employment status?
a) House wife
b) Public service
c) Self-employed
d) Private sector
e) Unemployed
f) Others (please specify)______________________________

5. Family Income?
a) <100 USD
b) 100 – 299 USD
c) ≥300 USD

6. Number of family members?

a) <5 persons
b) ≥5 persons

7. Number of children who ages less than 5 years?

a) <3children
b) ≥3children

PART TWO: Medical and environmental factors

8. Do you exclusively breastfeeding your child?

a) Yes
b) No
9. Is your child being immunized?
a) Yes
b) No

24
10. Have you child suffered from Diarrhea within the last six months?
a) Yes
b) No

11. Do you wash your hands before and after handling with you child?
a) Yes
b) No

12. How do you dispose the garbage disposal?

a) Recycle
b) Burn
c) Landfill

13. How do you use water?

a) By Filtration
b) By Boiling
c) Without any Treatment

Thanks for your time!

25
APPENDIX II: MAP OF YAQSHID DISTRICT

26
APPENDIX III: MAP OF MOGADISHU CITY

27
APPENDIX IV: MAP OF SOMALIA

28
 APPENDEX VI: LETTER TO THE ETHICAL COMMITTEE

Mogadishu University

Faculty of Health science/ Public Health

Name: Ibrahim Ali Mohamud Absuge

To: The ethical committee (Benadir Region)

Dear Sir/ Madam

Re-application to be allowed to undertake research in Benadir Region

I am a student in Mogadishu University, Faculty of Health science/ Public

Health

I am going to undertake a research Study on risk factors for Poor Nutritional

Status among <5 children in Yaqshid district

Therefore, I am kindly requesting you for permission to conduct research in

Benadir region special in Yaqshid district.

I promise that all the ethical regulations will be considered and put in place.

I am looking forward to a positive response

Thank You

29
 Curriculum Vitae (CV)
PERSONAL DATA

Name Ibrahim Ali Mohamud

Mother’s Name : Zainab Ali Mohamed

Date of Birth : 1993

Nationality : Somali

Marital Status : single

Sex : male

Address : Yaqshid-Mogadishu

Mobile : +252-61-5402059

Email Address :
muxtafid143@gmail.com/muxtafid114@gmail.com

EDUCATION BACKGROUND

Date Degree Title Institution

Bachelor Degree of
Public Health
2016-2017 Mogadishu University

30
 diploma of Nutrition Mogadishu University

2016-2017

2016-2017 WASH Project Toosiye institute of

health science and
languages

2013-2014 English diploma Al-imra education

batch institute of languages

2012-2013 Secondary certificate Jabir bin hayan

primary and
secondary school

2009-2010 Primary certificate Maka almukaram

primary and
secondary school

20 Diploma health Al-abadir health

training Training instititute

09-2010

2008-2009 Computer certificate Banadir zone

Training Courses

Date Course name Duration

2008-2009 Computer 1 year

31
2012-2013 Human 3 months
resource
management

2013-2014 Hospital 4 months

management

2013-2014 Project 2 months

proposal
2 months
writing skills

2013-2014 Project
monitoring and
evaluation

2013-2014 Journalism 4 month

Certificate

2013-2014 Communication 2 months

skills training
course

2014-2015 6 month

Journalism
Certificate

2016-2017 Health worshop 4 month

certificate

2016-2017 First Aid 1 Month

32
WORK EXPERIENCE

Date Job Title Institution Name

2013-2014 Teacher City zone information

technology

2014-2015 Supervisor Assessment of IDP’s in

Benadir Distructs

2015-2016 Teacher Janaral daud primary

and secondary school

2016-2017 MCH Health center of

bondhere

Professional Skills

 Skill for MCH

 Skill for Writing and Reading
 Skill of preparing health report.
 .Skills for conflict resolution and reconciliation.
Work Shops and Seminars Attended

 Participated teachers training at Abssador hotel by EDC.

 Participated teachers traing at FPENS
 Research Methodology, Data Entry and Statistical package
for Social Science(SPSS)
 Education (how to prevent eye disease ) Mogadishu
university
 Participated project management training at Darul-hikma
universty
 Participated peace and conflict resolution workshop by
Mogadishu university
 Participated health workshop at Youth peer education
network

33
  Participated Reproductive health program held at
Mogadishu-somalia may 2017 by SOMSA
HOBBIES

 Reading Holy Qur,an

 Leadership and team management
 Reading History books
 Conflict Resolution
 Sports and swiming
 Budgeting and controlling
 Monitoring and evaluation

Languages

Languages Writing Reading Speaking

English Excellent Excellent Excellent

Arabic normaly Very Good Good

Somali My Mother language

References:

Names Title & Tell Email

institution

Alas Hassan Lecture of +252-61- dralaskamaal@gma

Mohamed Mogadishu 5514971 il.com
University

Imran Ahmed Lecture of +252-61- imranahmdmu@g

Abdulkadir Mogadishu 7452696 mail.com
University

34
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