CHAPTER ONE

GENERAL INTRODUCTION

1.1 Background of the Study

It is estimated that 19 million pre-school age Children, mostly from the WHO African Region and South East Asia Region are suffering from severe wasting (Black R et al., 2011 ). Childhood undernutrition is a major global health problem contributing to childhood mortality, morbidity impaired intellectual development suboptimal adult work capacity and increase risk of diseases in Children ( Black R et al., 2011 ) of the 7.6 measure deaths annually among children who are under 5 years of age ( New York United Nations Children Fund, 2012 ) , approximately 35% are due to nutrition related factors and 4.4 % of deaths have been shown to be specifically attributed to severe wasting ( Black R et al., 2011 )

Severe acute malnutrition remain a major cause of child mortality Worldwide, while Pneumonia and diarrhea are often the final steps in the pathway, severe wasting is estimated to account for around 400.000 child deaths each year for this reason the improve management of severe acute malnutrition is an integral part of the WHO to improve child survival and to reduce new growth standards for children age 0-5 years (WHO, 2013) . This represent the standard on which all WHO definition and estimate of malnutrition including moderate severe acute malnutrition and obesity are new based. In children who are 6-59 months of age, severe acute malnutrition is defined as weight- or – height less than -32 score 1 of the median or WHO growth standard clinical signs of bilateral standard or clinical signs of bilateral Oedema of nutritional origin despite other measures being above specific cut off value. Management of severe malnutrition a manual for physicians and other senior health workers. A Joint statement by the WHO , World Food Program United Nation Standard Committee on Nutrition and United Children Nation Children Fund ( UNICEF, 2007)  (United Children Fund, 2007) acknowledge the feasibility of community health workers or volunteers identifying children affected by severe acute malnutrition using simple color plastic strips that are designed to major mid upper arm circumference. The nutritional status of children can also be affected by chronic infections such as HIV. It is estimated that over 2 million children Worldwide are living with HIV 90% of the in sub-Sahara Africa. In a report describing children admitted to hospital in Southern Africa prevalence of HIV in children with severe acute malnutrition was 29 % and these children were likely to die than malnourished children who were not affected with HIV (Ferguson P et al., 2017) Higher HI. Prevalence that is up to 50% has been reported among children with severe acute malnutrition (Amadi B et al.,2014)

In 2004 the percentage of children with moderate and severe underweight, short status and slimness in Iran was 5.2,4.7 and 3.7 respectively malnutrition is one of the most important causes of death and pathogenicity in children , which is usually cause by poor or inappropriate food intake . Malnutrition contributes significantly to mortality in children under 5 years and in 2011 it was estimated that about 45% of child deaths could be attributed to Malnutrition (Black RE et al., 2012 ) Marasmus and kwashiorkor are both forms of severe malnutrition and have especially high mortality rate ( Talbert A et al., 2017) while marasmus is characterize by Oedema and the aetioelogucal of the disease is still uncertain . Child malnutrition in the form of stunting wasting, underweight and severe malnutrition has significant implications for healthy human development in terms of motor skills and cognitive and social development (Grantham S, et al., 2016) . There are several pathway on malnutrition , Poor diet and illness have been identify as an immediate factors that contribute to the development of malnutrition, food insecurity has been identify as immediate factors and socioeconomic condition as underlying Causes ( Bellamy C, 2010 ). Growing social inequalities and determinant of health attracted special attention during the last decades (Marmot M, et al., 2011 )

Malnutrition continue to be a major health problem in developing countries. It is the most important risk factor for the burden of diseases causing about 300.000 deaths per year directly and indirectly responsible for more than half of all deaths in Children (  Muller M, 2005 ) in South Sudan it is the main cause of mortality in infants and children under 5 years of age among other disease ( Demissie S and Worku A, 2013) In South Sudan malnutrition especially among young children is not minnorrin in improvement in food security because of high rate of disease , lack of safer water and lack of access to basic health care. Diarrhea and other illness prevent children from absorbing nutrients so even where there is improve access is food children can still be dangerously malnourished. Those Inconflict areas especially the 1.4 million people who are internally displaced more than half of whom are children are the most at risk (UNICEF, 2014 ) .

 1.2 Problem of the Statement      

An estimated 230 million under five children are believed to be chronologically malnourished in developing countries; similarly, about 54% of deaths among children of this age group are believed to be associated with malnutrition in developing countries (WHO, 2015). In Sub- Saharan Africa , 41% of under five children are malnourished and dead from malnutrition increasing on a daily basis in the region ( UNICEF, 2011 )  Malnutrition continues to be a major health problem in developing countries. It is the most important risk factor for the burden of diseases causing about 300.000 deaths per year directly or indirectly (WHO, 2015 ) as there’s observed to be limited knowledge on the causes and prevention of malnutrition within the area of study so therefore, this study seeks to explore the causes and prevention of malnutrition in children ( 0-5 years ) at the muea community.

1.3 Research Questions

1)    What are the Causes of Malnutrition in children (0-5 years) in the Muea community?

2)    What are the preventive measures used by mothers of malnutrition in Children (0-5 years in the Muea community?

3)     What are the challenges faced by mother’s in the prevention of malnutrition in Children 0-5 years in the Muea community?

1.4 Research Objective

1.4.1 General Objectives

To explore the Causes and prevention of malnutrition in Children (0-5 years) among mother’s in the Muea community

1.4 .2 Specific Objectives

1. To assess the knowledge on the causes of malnutrition in children (0-5 years) in the Muea community.
2. To identify measures used by mother’s in the prevention of malnutrition in children (0-5yrs) in the Muea community.
3. To examine the challenges faced by mother’s in the prevention of malnutrition in children (0-5yrs) at the Muea community.