ASSESSING MATERNAL LITERACY AND NUTRITIONAL STATUS OF CHILDREN, 0-5 YEARS

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ASSESSING MATERNAL LITERACY AND NUTRITIONAL STATUS OF CHILDREN, 0-5 YEARS

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

The prevalence of chronic malnutrition among under-five infants remains persistently high in Nigeria. For example, in the Northern Region of Nigeria, 32.5% of infants below five years are stunted, 12.9% wasted, and 21.8% underweight (1). Inadequate childcare practices are fundamental to addressing malnutrition among infants. Poor maternal education (formal and informal) has been identified as a major constraint to good childcare practices in Nigeria (2). A well-resourced, targeted and coordinated nutrition education can improve maternal nutritional knowledge, healthcare-seeking behaviours, and practices significantly. Consequently, a number of health-related non-governmental organizations, including Catholic Relief Services (CRS), Adventist Development and Relief Agency (ADRA), World Vision International (WVI), and the Nigeria Health Service (GHS) have been promoting proper childcare practices, including appropriate infant-feeding practices and management of childhood illnesses, such as diarrhoea. Health and nutrition messages are usually targeted to mothers, most of whom have not received formal education. These women usually patronize health services at antenatal clinics and child welfare centres (CWC). Additionally, patronage of preventive health services provides an opportunity to improve care practices through both preventive healthcare (immunization, antenatal care for the mother, etc.) as well as management of childhood morbidity. Effective utilization of knowledge and skills gained from health and nutrition education is, therefore, expected to improve the health and nutritional status of infants through improved knowledge and care practices. However, there are limited data on the impact of nutrition education, especially in women who have not received formal education. Care behaviour choices are mediated by knowledge as well as by resource availability. Practices and behaviours of individuals are influenced by knowledge, awareness and skill levels. Even in households with similar levels of access to disposable income and resource, there is a wide variation in nutritional outcomes of infants (3), which tends to suggest that factors other than resources are responsible for nutritional status of infants. Adequate childcare is an underlying factor for optimal growth. Caregiving behaviours that provide conducive environment within which infants are raised are central to nutritional outcomes of infants, and policy attention to them has been recommended by the International Conference on Nutrition (4).

The fundamental role of care to child nutrition has been well-established since 1990 through UNICEF Model of Care. To provide care adequately, caregivers require education (both formal and informal), time, and support (e.g. control of resources). In the Nigeriaian context, it remains unclear what the relationship is between the nutritional knowledge of non-literate mothers and nutritional status of their infants. One would expect that mothers’ knowledge of child nutrition and childcare practices would have a significant effect on their infants’s nutritional status. However, there are conflicting study results on this.

Whereas some studies have reported that maternal nutritional knowledge is positively associated with the nutritional status of infants (5–7), others have also shown that adequate knowledge per se is not always translated into appropriate actions (8–10). Understanding the factors that determine the translation of adequate child health and nutritional knowledge into appropriate action in impoverished environment might help design more effective interventions against malnutrition. It remains unclear whether giving mothers adequate knowledge on proper childcare practices has an independent impact on child growth. This study, therefore, investigated the relationship between mother’s knowledge level in childcare practices and nutritional status of preschool infants living in impoverished rural communities of Northern Nigeria.

1.2 Statement of the problem

In Nigeria, health and nutrition education is a common intervention targeted to mothers, most of whom have not received formal education. However, inadequate empirical evidence exists on the relationship between nutritional knowledge of non-literate mothers and nutritional status of their infants. Although maternal education is an important determinant of nutritional status of infants, it remains unclear whether mother’s practical knowledge about nutrition has an independent effect on child growth. Furthermore, the factors that influence translation of acquired knowledge into practice are not well-understood. It is this knowledge gap that this study attempts to address.

1.3 Research questions

What is the level of maternal knowledge in recommended childcare practices in the study population?
Does household socioeconomic status influence mother’s ability to translate acquired knowledge into practice in order to improve the nutritional status of infants in impoverished rural communities of Nigeria?
Is there a direct link between child growth and a composite childcare knowledge index?

1.4 Objectives of the study

The main aim of the study was to assess the relationship between maternal nutritional knowledge in childcare practices and child growth among infants aged 0-36 month(s) in Northern Nigeria.

The specific objectives of the study were to: (i) assess mothers’ knowledge level in recommended childcare practices relating to nutrition; (ii) investigate whether translation of acquired health and nutritional knowledge into practice is dependent on the socioeconomic status of the household in impoverished rural communities; (iii) assess the nutritional status of infants and young infants aged 0-36 month(s); and (iv) build a composite childcare knowledge index and investigate its relationship with nutritional indicators in infants.

1.5 Significance of the study

In order for policy-makers to better promote change and improve infants’s wellbeing in impoverished communities, it is necessary to provide more insight into the relationship between maternal knowledge and child health outcomes. The circumstances under which acquired knowledge is put into practice are all important in deciding on possible interventions. This study attempts to fill this knowledge gap.

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