Nigerian Journal of Paediatrics

Nutritional status and its possible determinants among children attending early child care centres in Benin City Edo State Nigeria

Niger J Paediatr 2018; 45 (3):151 -158

ORIGINAL

Obarisiagbon OE

CC – BY Nutritional status and its possible

Omuemu VO

Okojie OH

determinants among children

attending early child care

centres in Benin City, Edo State,

Nigeria

DOI:http://dx.doi.org/10.4314/njp.v45i3.3

Accepted: 19th September 2018

Abstract :

Background: Nutri-

with IBM SPSS version 21.0 and

tional status of children has be-

statistical significance was deter-

Obarisiagbon OE (

)

come a worldwide public health

mined using Chi square with p

Omuemu VO, Okojie OH

issue and its assessment has been

value set at < 0.05.

Department of Community Health

adjudged the best global indicator

Results: Seventy nine (14.5%) of

College of Medical Sciences

of well-being in children. One in

the children were stunted, while 68

University of Benin, Benin City

three children under the age of

(12.5%), 67 (12.3%) and 13

Edo State, Nigeria

five (178 million children) in de-

(2.8%) were underweight, wasted,

Email: obasotas@gmail.com

veloping countries are stunted due

and obese respectively. Significant

otaniyenuwa.obarisiagbon

to chronic under-nutrition and

possible determinants of being

@uniben.edu

poor quality diets. Without ad-

underweight and wasted among

dressing malnutrition, the Sustain-

the children were age of child (p =

able Development Goal 2 of end-

0.041) and exclusive breastfeeding

ing hunger, achieving food secu-

(p = 0.011) while the predictor for

rity and improved nutrition may

wasting was exclusive breastfeed-

not be attained. This study as-

ing (p = 0.011).

sessed the nutritional status and

Conclusion: Over a tenth of the

its possible determinants among

respondents were either stunted,

children attending Early Child

underweight or wasted while a few

Care Centres in Benin City, Edo

of the children were obese. All

State, Nigeria.

stakeholders involved in ensuring

Methods: A descriptive cross-

and promoting proper nutrition

sectional study was carried out on

among under-five children should

544 under-five children attending

work as a team in order to develop

ECCCs in Benin City. Data was

intervention programmes and en-

obtained with pretested inter-

sure adequate nutrition in children.

viewer-administered

question-

naires. Nutritional status was as-

Key words: Nutritional Status;

sessed

using

anthropometric

Determinants; Early Child Care

measurement. Data was analyzed

Centers

Introduction

Early Childcare Centres (ECCCs) are pre-primary facili-

ties for children aged 0 – 5 years where optimal devel-

Adequate nutrition during infancy and early childhood is

opment of children is assured via a stimulating environ-

essential for health, growth and development of children

ment, adequate nutrition and social interaction with at-

tentive caregivers. They serve as the alternative option

so that they can attain their full potential. Nutritional

1,2

status of children has become a worldwide public health

regarding childcare when mothers take paid employment

issue and its assessment has been adjudged the best

outside the home in order to augment the family in-

global indicator of well-being in children.

3,4

Nutritional

come.

8-10

Various policies guide the operations of the

status has a direct relationship with dietary intake, how-

Early Childcare Centres and these include National Pol-

ever, factors other than food play important roles in the

icy on Education, Universal Basic Education Act, Na-

nutritional status of children amongst which include

tional Policy for Integrated Early Childhood Develop-

diseases and infestations.

5-7

The nature of the environ-

ment, and the National Minimum Standard for early

ment where a child is cared for is important to assure

child care centres.

11,12

Around the world, 10 million chil-

dren die before their fifth birthday every year.

13-14

adequate growth and development, hence, the interplay

Over

a half of these deaths are associated with malnutrition.

that exists between health, nutrition, sanitation and edu-

cation. A balance in these factors helps ensure that the

One in three children under the age of five (178 million

child maintains proper development.

children) in developing countries is stunted due to poor

152

quality diets and chronic under-nutrition.

15-17

Sub-

assessed the level of implementation of the policy on

Saharan Africa continues to have the highest prevalence

Early Child Care Centers (ECCCs) by ECCCs in Benin

of undernourished children. An estimated 126 million

City, Edo State. Thus, a total population of the children

African children are underweight, 200 million are

in the selected ECCCs, whose parents agreed to partici-

chronically malnourished and 5 million die of hunger

pate in the survey was studied for the assessment of nu-

annually. In Nigeria, the National Nutrition and Health

tritional status and its possible determinants.

survey conducted in 2014 revealed that, 32.0% of chil-

dren under-5 years are stunted indicating chronic malnu-

Data for this study was obtained with pretested struc-

trition, 8.7% and less than a quarter (21.0%) are wasted

tured interviewer-administered questionnaire (adapted

and underweight, respectively.

19-20

Without addressing

from the 2008 NDHS questionnaire).

It comprised of

malnutrition, the Sustainable Development Goal 2 of

open and closed ended questions which covered the ob-

ending hunger, achieving food security and improved

jectives of the study. The questions were broadly di-

nutrition and promoting sustainable agriculture will not

vided into sections: Socio-demographic characteristics

be realized. Research has revealed that malnutrition dur-

of the respondents (parents of the under-five children

ing early development (0-3years) can harm the body and

were the respondents), nutritional history of the under-

lead to learning and memory deficits, lower intelligence

five children, determinants of nutritional status and

quotient (IQ), poor school achievement and behavioral

clinical findings that reflected the clinical status of the

problems in childhood and adolescence.

21- 22

Research by

children. The nutritional status of the children was as-

several authors has also revealed that the primary deter-

sessed using anthropometric measurements of the chil-

minants of malnutrition, relate to poor nutrient intake

dren’s weight and height.

and repeated infections, or a combination of the two.

23-26

Weight measurement: The weights of the children were

Early Childcare Centres (ECCCs) are environments

measured in kilogram (kg) using an electronic scale

where children have been demonstrated to be more sus-

(Sonachi® model no ssc-2208) with a capacity of

ceptible to acquiring repeated infections as well as dis-

150kg. The scale was calibrated to zero reading before

eases.

27-31

This may be because many of these centres

each weighing session and standardized every day using

are overcrowded, lack proper infrastructure and facili-

a 6 kg dumbbell. The scale was placed on an even floor

ties. Over two-thirds of the staff have been found to lack

with the child standing in the centre, hands by the sides

good personal hygiene, hence facilitating the spread of

and in light clothing. For the very young children (less

parasitic and skin infections among the children.

32-34

than 2 years old), the weight of the adult alone was

This could further increase the prevalence of malnutri-

taken. Thereafter, adult’s weight was taken with the

tion. In order to achieve one of the targets of SDG 3

adult carrying the child. Subtraction of the adult’s

which is to end preventable deaths of newborns and

weight from the combined weight gave the weight of the

child.

children under-five years of age, there is need to identify

and overcome the barriers to a healthful nutritional

status in the children. This study therefore assessed the

Height measurement: The very young children (less than

nutritional status of children attending ECCCs as well as

2 years) and those that were yet to stand erect without

its determinants with a view to providing baseline data

support were laid on flat platforms and measured from

which will be useful in the development of appropriate

the vertex to the heel.

interventions and improve child health outcomes.

Height of the children aged 2 years and above was

measured in Centimetres (cm) using a stadiometer

(Axiom® RGZ-160) according to the National Health

and Nutrition Examination Survey (NHANES)

Methodology

protocol.

This descriptive cross sectional study was carried out

The questionnaires were screened for completeness by

from March 2014 – June 2015 among children less than

the researcher after which they were coded, entered into

five years of age who attend ECCCs in Benin City, Edo

the IBM SPSS version 21.0 software and analysed. The

State. Benin City is made up of three Local Government

WHO Anthro® version (1.0.6) software was used to

Areas; Ikpoba-Okha, Oredo and Egor. There are 435

calculate Body mass index (BMI) plot the graphs

public and private ECCCs in these 3 LGAs. A mini-

(weight-for-age, height-for-age, weight-for-height). For

mum sample size for the children attending ECCCs was

height for age; Z score values ≤ - 2SD was regarded as

calculated using the Cochrane formula for single propor-

stunted. For weight for height, Z score values ≤ - 2SD

tion (n= (Zα/2 + Z 1- β ) pq/d ) where n=minimum sam-

2 35

was regarded as wasted and for weight for age, Z score

ple size, Zα/2 = standard normal deviate (1.96), Z 1- β

values ≤ -2SD was regarded as underweight, Z score

=Power of study (1.282) d= degree of precision (4%),

values > + 2SD to <+3SD was regarded as overweight

q=1-p, p = prevalence of wasting in under-five children

while Z score values ≥ + 3SD was regarded as obese.

in a cross sectional study to assess nutritional status in

Test of associations were carried out using Chi-squared

Buthan (4.3%).

Thus the minimum sample size was

tests or the Fishers’ Exact test where appropriate to

481. Addition of 10% non-response rate (48) increased

determine associations between socio-demographic

sample size to 529. However, 544 children participated

characteristics and the nutritional status of the children.

in the survey. This study was part of a larger study that

Multivariate analysis using binary logistic regression

153

was carried out using the ‘enter approach’ to further

Table 1: Socio-demographic characteristics of the under-fives

determine

significant

predictors

stunting,

and their care givers

underweight, wasting as well as overweight and control

Variables

Frequency (n = 544)

Percent

Age group (months)

for

confounders.

The

International

Standard

12 - 23

122

22.4

Classification of Occupations (ISCO-08) was adapted

24 – 35

115

21.1

and modified to group the occupation of the parents/

36 – 47

142

26.1

caregivers of the children into skill level 1 to skill level

48 – 59

165

30.3

4 and unemployed. The statistical measure for the

Mean age ±SD (months)

41.5±11.9

analysis was the adjusted odds ratio at 95% confidence

Sex

Male

263

48.3

interval. The level of significance was set at p < 0.05 for

Female

281

51.7

all statistical associations. Frequency tables were used to

Birth order

present the results.

First

182

33.5

Second

132

24.3

Third

119

21.9

Ethical clearance was obtained from the University of

Fourth

10.1

Benin Teaching Hospital Ethics and Research Commit-

Fifth or more

10.3

tee. Permission to carry out this study was sought and

Number of siblings

obtained from the Chief Inspector for Education (in the

≤4

498

91.5

8.5

Ministry of Basic Education, Benin City), the Primary

Level of education of care giver

Health Care Coordinators of the various LGAs and

No formal education

4.8

owners of the Early Childcare Centres. The study was

Primary

13.1

described to the parents/caregivers of the children who

Secondary

334

61.4

Tertiary

113

20.8

were the respondents and written informed consent ob-

tained from them. In order to ensure confidentiality,

Table 2: Dietary diversity of the children in the 24 hours

serial numbers rather than names were used to identify

preceding the study

the respondents. Respondents were informed that they

had the right to decline participation or to withdraw

Variables

Frequency

Percent

(n = 544)

from the study at any time they wished. Respondents

Carbohydrates

were also informed that there were no penalties or loss

Food made from grains (rice, noodles)

510

93.8

of benefits for refusal to participate in the study or with-

Food from roots (potatoes, yam and

266

48.9

drawal from it.

cassava)

Fruits and vegetables

Vegetables

314

57.7

Fruits

210

38.6

Results

Proteins and fats

Meat/milk

290

53.3

Liver, kidney and heart

11.6

A total of 544 children who attended Early Child Care

Eggs

230

42.3

Centers participated in this study. The mean age of the

Fresh or dried fish

408

75.0

children was 41.5±11.9 months with a higher proportion

Beans/peas

229

42.1

165 (30.3%) seen to be in the 48 – 59 months age group.

Oils

287

52.8

Over half of them 281 (51.7%) were females and 182

*Snacks

461

84.7

(33.5%) were of the first birth order. Majority 498

*Snacks include Biscuits, Chin chin, etc.

(91.5%) had ≤ 4 siblings and 342 (62.9%) had a house-

Multiple response

hold size of 5 – 7. Three hundred and thirty four care-

givers (61.4%) had secondary level of education and

over two-thirds of their spouses 401 (73.7%) as well.

A higher proportion of children in the 36 – 47 months

Two hundred and fifty six (47.1%) of the caregivers

age group 23 (16.2%) were stunted compared to other

earned an average monthly income of ≤ ₦24,999

age groups, however, the association between age group

(69.442 USD). (Table 1)

and stunting status was not statistically significant (p =

0.421, OR = 1.447, 95% CI = 0.589 – 3.589). A higher

Majority of the children 510 (93.8%) had eaten food

proportion of the males were stunted 41 (15.6%) com-

made from grains (rice, noodles), 314 (57.7%) vegeta-

pared with the females 38 (13.5%). (Table 3)

bles and 210 (38.6%) fruits in the 24 hours preceding

Age group 36 – 47 months had the lowest proportion of

the survey. Three-quarters of the respondents 408

children who were underweight 12 (8.5%) compared to

(75.0%) and 461 (84.7%) had eaten fresh or dried fish

other age groups. The association between age group

and snacks, respectively as part of their meals in the 24

and underweight status of the respondents was statisti-

hours preceding the survey. (Table 2) Seventy nine

cally significant (p = 0.0041, OR = 0.472, CI = 0.229 –

(14.5%) of the respondents were stunted, 68 (12.5%)

0.970). Children who were exclusively breastfed were

and 67 (12.3%) were underweight and wasted, respec-

higher in proportion with regards to their underweight

tively. (Table 2)

status 46 (15.9%) compared to children who were not

exclusively breastfed 22 (8.7%) Children who were

exclusively breastfed were 1.990 times likely to be un-

derweight compared with those not who had been not

been exclusively breastfed. The association between the

154

underweight status and exclusive breast feeding was

other age groups, however, the association between age

statistically significant (p = 0.011, CI = 1.170 – 3.460).

group and overweight status was not statistically signifi-

cant (p = 0.070, OR = 2.177 , 95% CI = 0.939 – 5.048).

Table 3: Factors associated with stunting among children

A higher proportion of the females were overweight 26

attending ECCCs

(9.3%) compared with the males 25 (9.8%). (Table 6)

Variable

Stunting

Odds

95%CI

ratio

value

Yes

Table 5: Factors associated with wasting among children at-

(n = 79)

(n = 465)

tending ECCCS

Freq (%)

Variable

Wasted

Odds

95%CI

Age group (months)

ratio

value

12 – 23

17 (13.9)

105 (86.1)

1.402

0.687 – 2.863

0.354

Yes

24 – 35

17 (14.8)

98 (85.2)

0.643

0.323 – 1.279

0.208

(n = 67)

(n = 477)

36 – 47

23 (16.2)

119 (83.8)

1.447

0.589 – 3.589

0.421

Freq (%)

48 – 59

22 (13.3)

143 (86.7)

Age group (months)

Sex

12 – 23

4 (3.3)

118 (96.7)

1.410

0.669 – 2.974

0.366

Male

41 (15.6)

222 (84.4)

1.246

0.709 – 2.191

0.445

24 – 35

16 (13.9)

99 (86.1)

0.952

0.476 – 1.904

0.889

Female

38 (13.5)

243 (86.5)

36 – 47

19 (13.4)

123 (86.6)

1.131

0.575 – 2.226

0.721

Caregivers’ level of education

48 – 59

28 (16.9)

137 (83.1)

None

4 (15.4)

22 (84.6)

0.657

0.202 – 2.130

0.484

Sex

Primary

11 (15.5)

60 (84.5)

0.720

0.260 – 1.997

0.528

Male

37 (14.1)

226 (85.9)

0.681

0.407 – 1.141

0.145

Secon-

45 (13.5)

289 (86.5)

0.834

0.279 – 2.489

0.745

Female

30 (10.7)

251 (89.3)

dary

Caregivers’ level of education

Tertiary

19 (16.8)

94 (83.2)

None

1 (3.8)

25 (96.2)

0.508

0.104 – 2.493

0.404

History of worm infection in the last six months

Primary

6 (8.5)

65 (95.5)

0.522

0.119 – 2.282

0.388

Yes

24 (18.9)

103 (81.1)

1.530

0.89 – 2.580

0.110

Secon-

50 (15.0)

284 (85.0)

0.963

0.195 – 4.747

0.963

55 (13.2)

362 (86.8)

dary

Exclusively breastfed

Tertiary

11 (9.7)

102 (90.3)

Yes

36 (12.4)

254 (87.6)

0.733

0.430 – 1.120

0.136

Birth

43 (16.9)

211 (83.1)

order

First

18 (9.9)

164 (90.1)

0.830

0.320 – 2.152

0.701

Second

17 (12.9)

115 (87.1)

0.812

0.302 – 2.181

0.679

Table 4: Factors associated with underweight among children

Third

20 (16.8)

99 (83.2)

0.900

0.327 – 2.481

0.839

attending early child care centres

Fourth

7 (12.7)

48 (87.3)

0.823

0.258 – 2.625

0.742

Fifth or

5 (8.9)

51 (91.1)

Variable

Underweight

Odds

95%CI

ratio

value

History of worm infection in the last six months

Yes

14 (11.0)

113 (89.0)

0.850

0.44 – 1.570

0.613

(n = 68)

(n = 476)

53 (12.7)

364 (87.3)

Freq (%)

Exclusively breastfed

Age group (months)

Yes

26 (9.0)

264 (91.0)

0.510

0.300 – 0.860

0.011

12 – 23

14 (11.5)

108 (88.5)

0.663

0.331 – 1.325

0.244

41 (16.1)

213 (83.9)

24 – 35

15 (13.0)

100 (87.0)

0.767

0.388 – 1.516

0.445

36 – 47

12 (8.5)

130 (91.5)

0.472

0.229 – 0.970

0.041

48 – 59

27 (16.4)

138 (83.6)

Table 6: Prevalence of overweight and obesity among children

Sex

attending ECCCS and associated factors

Male

33 (12.5)

230 (87.5)

1.008

0.605 – 1.677

0.974

Variable

Overweight and Obe-

Odds

95%CI

Female

35 (12.5)

246 (87.5)

sity

ratio

value

Caregivers’ level of education

Yes

None

1 (3.8)

25 (96.2)

0.271

0.560 – 7.859

2.098

(n = 51)

(n = 493)

Primary

6 (8.5)

65 (95.5)

0.864

0.321 – 3.872

1.115

Freq (%)

Secon-

50 (15.0)

284 (85.0)

0.468

0.442 – 5.919

1.161

dary

Age group (months)

Tertiary

11 (9.7)

102 (90.3)

12 – 23

9 (7.4)

113 (92.6)

0.997

0.378 – 2.632

0.996

History of worm infection in the last six months

24 – 35

12 (10.4)

103 (89.6)

1.335

0.531 – 3.358

0.540

Yes

17 (13.4)

110 (86.6)

1.110

0.604 – 1.980

0.760

36 – 47

19 (13.4)

123 (86.6)

2.177

0.939 – 5.048

0.070

51 (12.2)

366 (87.8)

48 – 59

11 (6.7)

154 (93.3)

Exclusively breastfed

Sex

Yes

46 (15.9)

244 (84.1)

1.990

1.170 – 3.460

0.011

Male

25 (9.5)

238 (90.5)

1.080

0.581 – 2.007

0.808

22 (8.7)

232 (91.3)

Female

26 (9.3)

255 (90.7)

The proportion of children who were exclusively breast-

Caregivers’ level of education

fed 26 (9.0%) were less than those who were exclu-

None

4 (15.4)

22 (84.6)

0.418

0.089 – 1.962

0.269

Primary

5 (7.0)

66 (93.0)

0.512

0.152 – 1.728

0.281

sively breastfed 41 (16.1%) and they were 0.510l times

Secon-

29 (8.7)

305 (91.3)

0.686

0.186 – 2.539

0.573

less likely to be wasted compared with those not who

dary

had been not been exclusively breastfed. The association

Tertiary

13 (11.5)

100 (88.5)

between the underweight status and exclusive breast

History of worm infection in the last six months

feeding was statistically significant (p = 0.011, CI =

Yes

9 (7.1)

118 (92.9)

1.463

0.691 – 3.096

0.320

0.3000 – 0.860). (Table 5)

42 (10.1)

375 (89.9)

A higher proportion of children in the 36 – 47 months

Exclusively breastfed

Yes

21 (7.6)

257 (92.4)

1.510

0.838 – 2.721

0.170

age group 19 (13.4%) were overweight compared to

30 (11.3)

236 (88.7)

155

Discussion

food necessary to meet the body’s energy and nutrient

requirements, have diminished cognitive abilities, re-

Nutrition is of utmost importance to the growth of chil-

duced school performance, growth retardation, impaired

dren. Adequate nutrition and healthy eating habits are

resistance to infections and increased morbidity and

mortality rates. More parents and caregivers needs to be

fundamental skills for young children and it is important

to help children learn about and enjoy a variety of nutri-

enlightened about the importance of providing their chil-

tious foods each day as this lays the foundation of

dren with proper nutrition and this may translate into

growth, early child development and education.

40-42

improved nutritional status. This could be a step forward

this study, food made from grains such as rice and noo-

towards achieving the SDG 2 and 3 in Nigeria.

dles were the most frequently consumed and organ

meats, fruits, beans/peas and eggs were the least con-

An interesting finding in this study was that children

sumed food groups. This is in line with the findings

who were exclusively breastfed were more likely to be

from a study conducted in South Western Nigeria in

underweight and children who were not exclusively

2013. This finding may be as a result of the fact that

breastfed were more likely to be stunted. A study carried

generally, food made from grains are convenient foods

out in San Pablo, Ecuador in 2012, however reported

and can be prepared in a variety of ways. Additionally,

contrary findings which stated that exclusive breastfeed-

ing had no effect on the stunting status of the children.

children have been noted to have a certain preference for

these kind of meals.

Over-consumption of carbohy-

There is often the wrong notion among mothers that

drates without a proper balance with proteins, vitamins

breast milk alone may be sufficient even after 6 months

and vegetables which were observed to be the least con-

of age for growth and development of the children, but

sumed groups in this study, can lead to Protein – Energy

this notion could result in under-nutrition and subse-

Malnutrition among these children and the resulting

quently the children being underweight which is an

consequences such as growth and developmental prob-

acute disorder. On the other hand however, stunting has

lems, mental problems as well as frequent ill health.

been found to be as a result of early malnutrition and is a

chronic disorder, so children who were not exclusively

Less than a fifth of the children in this study were

breastfed from birth have higher chances of being

stunted, underweight, wasted. This is at variance with

stunted as breast milk has been widely shown to contain

findings from a study carried out in Anambra State, Ni-

all the nutrients that a child under 6 months could possi-

bly need for proper growth and development.

geria in 2009 where 7.7%, 2.4% and 7.7% were stunted,

underweight and wasted respectively.

Another study

carried out among day care attendees in Port Harcourt,

Overall prevalence of overweight and obesity in this

Rivers State in 2015 also reported similar findings of

study was 9.8%. This is in contrast to studies carried out

5.5% prevalence of stunting and 3.0% prevalence of

in Port Harcourt, Nigeria in 2015, and Jeddah, Saudi

underweight and 7.1% prevalence of wasting.

Arabia in 2017, where overall prevalence of overweight

males than females were stunted in this study. This is

and obesity reported were 23.6% and 25% respec-

tively.

52-53

similar to findings from a meta-analysis of 16 demo-

The prevalence of overweight in this study

graphic and health surveys carried out in countries in

was 6.98%. This is in contrast to studies done in Bahrain

Sub-Saharan Africa where the average prevalence of

in 2013 and Lagos State, Nigeria in 2014, where the

stunting was found to be consistently higher in the males

reported prevalence of overweight of 9.8% and 13.7%

respectively.

54-55

(40.0%) compared to females (37.0%). A similar study

The prevalence of obesity in this study

carried out in Democratic Republic of Congo also had a

was 2.8%. This finding is far lower than results from

46.1% prevalence of stunting in the males and 41.7% in

studies done in Eastern province of Saudi Arabia in

the females.

However, a study carried out in Osun

2010 and Port Harcourt, Nigeria in 2015 which reported

State, Nigeria in 2011, presented contrasting findings of

prevalence of obesity of 18.1% and 8.6% respective-

46,56

3.2% prevalence of stunting in the males which was

. The varied prevalence rates may be attributed to

lower compared to 5.2% observed in the females. The

the difference socioeconomic status of the studied popu-

prevalence of wasting in this study was also higher

lations. In addition, the methods of assessing overweight

among the males. This is in contrast to findings reported

and obesity differed among the various studies. Child-

from studies carried out in day care centres in Port Har-

hood obesity is one of the most serious public health

challenges of the 21st century. Overweight and obese

court, Rivers State and Osun State in 2015 and 2011

respectively.

46, 50

children are likely to stay obese into adulthood and more

likely to develop non communicable diseases like diabe-

tes and cardiovascular diseases at a younger age. Over-

This is worrisome because wasting reflects a recent and

in some cases, severe process of weight loss which is

weight and obesity, as well as their related diseases, are

often associated with acute starvation and /or severe

largely preventable. Intervention programmes targeted at

disease. The prevalence of wasting that exceeds 5% ac-

prevention of childhood obesity are needed to reverse

cording to WHO standing is alarming as this may be a

this condition.

pointer to an increase in mortality of the children. The

consequences of stunting in children is also dire as

The strength of the findings of this study is that a large

stunted children grow to become stunted adults and may

sample size was utilized and the nutritional status of the

also give birth to stunted children making it intergenera-

under-fives was assessed and compared with WHO stan-

tional. Children who consume inadequate amount of

dards. However, a limitation of this study is that the die-

156

tary history was based on self-report by the caregivers

wasted among the children were age of child and exclu-

and the children`s nutrition and perhaps their nutritional

sive breastfeeding while the predictor for wasting was

status may have been affected either positively or nega-

exclusive breastfeeding. There were no significant deter-

tively by virtue of their attendance at the Early Child

minants for overweight and obesity in this study. It is

Care Centres.

therefore pertinent that more awareness campaigns and

health seminars on proper nutrition in children be em-

barked upon by the government and stakeholders in-

volved so as to further educate the mothers.

Conclusion and recommendation

Majority of the children were well nourished, however,

Conflict of Interest: None

over a tenth were either stunted or underweight while

Funding: None

nearly a tenth of them were overweight and obese. Sig-

nificant possible determinants of being underweight and

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