ABSTRACT

The study was conducted in Lyamkena ward in Njombe region to determine the nutritional status,
prevalence of malnutrition and its associated risk factors of under-five children in the community in June
2022.

BACKGROUND:

Malnutrition is a public health problem worldwide. Tanzania has made significant achievements in the
reduction of childhood malnutrition over the past two years whereas different indicators were used
such as stunting, wasting, overweight and underweight. A cross sectional study was conducted at
Lyamkena ward with the aim of assessing the nutrition status among under -five children in the
community.

METHODS:

Community based descriptive Cross-sectional study was conducted in June from 18 th to 21st . A total
population of 720 children were included in the study. Data was collected via Semi-structured
questionnaire which was online data kit and asked verbally through home visits and anthropometric
measurements (Weight, Height, and Mid upper arm circumference (MUAC)) of under five children .

RESULTS

CONCLUSION:

Based on the study findings, it shows there are few cases of malnutrition at Lyamkena wards in Njombe
city and is the leading form.

TERMINOLOGIES

Acute malnutrition – Form of malnutrition caused by a decrease in food consumption and/or illness that
result in sudden weight loss or edema (fluid retention)

Anthropometric measurement – Measurements used to access the size shape and composition of
human body.

Chronic malnutrition – This is the condition that develop when children do not eat the correct balance of
nutrients in the first 1000 days of life
Food Security: Refers to the availability of food which is safe, at a right quantity and quality within a
household or community.

Immunization – Process where by a person is made resistant to an infectious disease typically by the
administration of vaccine

Macronutrient – These are energy producing chemicals substances consumed by an organism in large
quantities

Malnutrition refers to imbalance, inadequate intake and underutilization of all the necessary body
requirements (macronutrients and micronutrients). The macronutrients are such as carbohydrates, fats
and proteins while micronutrients are such as vitamins and Tanzania) under nutrition is much more
common.

Micronutrients – These are essential elements required by an organism in small quantity throughout life
to orchestrate a range of physiological function to maintain health

Nomadism – way of life of peoples who do not live in the same place but more cyclically or periodically

Nutrition – a process of providing or obtaining the food necessary for health and growth

Nutrition status – requirement of health of a person convinced by the diet, the levels of nutrients
containing in the body and normal metabolic integrity

Obesity – Disorders involving excess body fat that increase the risk of health problem

Overweight – Weight above what is considered healthy often measured using body mass index

Stunting refers to a state where a child is short for his/her age but not necessarily thin. It reflects chronic
malnutrition because this carries long-developmental risk.

Taboos – Social or religious customs prohibiting or forbidding association with a particular person, place
or thing

Underweight refers to state where a child has the weight below the standard value with respect to
age. It measures both acute and chronic malnutrition but it does not discriminate between the two.

Vaccination – Administration of a vaccine to help the immune system develop protection from a disease

Wasting refers to when the child is thin for his/her height. It reflects acute malnutrition and it carries
immediate risk of morbidity and mortality. Overweight is having more body fat than is optimum healthy.
Being overweight is more common in most western countries especially where food supplies are
plentiful and lifestyle is sedentary.
1. INTRODUCTION

1.1Background information

Nutrition is a vital component in development of physical and mental health in all stages of human
growth; from fetal, infancy, childhood, adolescence, adulthood, and old age. Nutrition status is the
physiological state of an individual, which results from the relationship between nutrient intake and
requirements, and from the body’s ability to digest, absorb and use these nutrients (FAO, 2007).

Nutrition plays a vital role in growth and development of children. Inadequate nutrition may lead to
malnutrition, growth retardation, reduced work capacity and poor mental and social development. The
World Health Organization considers that poor nutrition is the single most important threat to the
world’s health. Overall under-nutrition represents the single largest killer of under-five children, being
responsible for 3.1 million child deaths each year (45% of the total under 5 years’ deaths) In 2013, 52
million children under age 5 (10% of the global population) were wasted, meaning that, due to acute
malnourishment, they had low weight for their height. Other 165 million children in the world, a quarter
of the world’s under-5 population, were too short for their age, or stunted, which can impact the child’s
physical and 7mental development (Kaur, 2018).

Malnutrition is a big problem the world over particularly in the developing countries.In Africa, according
to WHO report of 16 November, 2017 the report pointed out that the absolute number of stunted
children was in fact increasing from 50.4 million in 2000 to 58.5 million in 2016.

In Tanzania, malnutrition is very much evident in many regions. Malnutrition adds to the causes of
approximately 130 child deaths daily (Exclusively, 2016). Over the last ten years more than 600000
under-five children died due to malnutrition while in 2010 only, 43000 died prematurely. This makes an
average of one child death per every 12 minutes (Note & Note, 2010). Increasing population adds to the
threat of malnutrition. Increasing population causes the absolute numbers of stunted and wasted
under-fives are still on the peak, increasing in some contexts (S. Africa, 2017). According to Tanzania
Demographic and Health Survey (TDHS) of 2015-2016, 34% of children are stunted, 14% are
underweight and 5% of children under-five years of age are wasted (Exclusively, 2016).

The causes for malnutrition under-five children are complex and multifaceted. Poor socio-economic
conditions, food insecurity, poverty, and adverse conditions such as illness or inadequate feeding
practices can drastically alter the growth pattern of children. According to the UNICEF conceptual
framework, malnutrition can be caused by insufficient diet intake, infections, poor breastfeeding or
inadequate complementary foods.

The term malnutrition addresses three broad group of condition which are under-nutrition which
includes wasting, stunting and underweight, micronutrients related malnutrition which include
micronutrient deficiency (lack of vitamins and minerals or micro nutrient excess; and overweight,
obesity and diet related non communicable diseases such as heart diseases, stroke, diabetes and some
cancers. Nearly half of all deaths in children under 5 are attributable to under-nutrition; under-nutrition
puts children at greater risk of dying from common infections, increases the frequency and severity of
such infections, and delays recovery.

The interaction between under-nutrition and infection can create a potentially lethal cycle of worsening
illness and deteriorating nutritional status. Poor nutrition in the first 1,000 days of a child’s life can also
lead to stunted growth, which is associated with impaired cognitive ability and reduced school and work
performance.

We are still far from a world without malnutrition. While the 2020 edition of the joint malnutrition
estimates shows that stunting prevalence has been declining since the year 2000, more than one in five
– 144 million children under 5 –were stunted in 2019, and 47 million suffered from wasting. Meanwhile,
the number of overweight children worldwide has remained stagnant for more than a decade.

Measures of child under-nutrition are used to track development progress. In the Post-2015
Development Era, estimates of child malnutrition will help determine whether the world is on track to
achieve the Sustainable Development Goals – particularly, goal 2 to “end hunger, achieve food security
and improved nutrition, and promote sustainable agriculture”.

Therefore the study was carried out to assess nutritional status and its determinants among under five
aged children in Lyamkena ward.

1.2 PROBLEM STATEMENT

Despite of the intervention done by the government and non-governmental organization; malnutrition is
still a problem in our country. Previous information on under-nutrition in Tanzania is well documented in
regional level but not specific at district level. According to TDHS 2022 Njombe Region is among the
region with high prevalence of malnutrition whereby the prevalence of wasting was 14.4%, stunting was
50.4% and underweight was 12.2%. Njombe Region is among the Regions with high food production. It
is also well known for timber and Tea cash crop production.

Therefore, this study thought to determine the prevalence and assessing the factors contributing to
under nutrition among children between six months and fifty-nine months at Makambako district in
Njombe region, July- August 2023.