DETERMINATION OF THE NUTRITIONAL STATUS, GROWTH AND BODY MASS INDEX OF CHILDREN IN ANAMBRA STATE USING VERTICAL ANTHROPOMETRIC MEASUREMENTS

ABSTRACT

Nutritional assessment in the community is essential for accurate planning and implementation of intervention programmes to reduce morbidity and mortality associated with undernutrition. Growth monitoring is an important standard component of the child health service programme, used to assess the growth pattern and nutritional status of school children.This study was carried out to determine the nutritional status, growth and body mass index of school children aged 3 17 years using vertical anthropometric measurements in Anambra state. In line with the purpose of the study, sixteen research questions and six research hypotheses were formulated. Pertinent and related literatures on the nutritional status using anthropometric measurement were reviewed. The population of the study include all school children in the nursery, primary and secondary schools inapproved public schools in Anambra state. The schools were categorized into nursery, primary, junior and senior secondary schools in urban and rural locations and studied schools were selected by simple random sampling. The classes werealso selected through simple random sampling. In each class selected, a stream of class was selected and all the pupils were measured. The weight and height were recorded for each pupil, and converted to nutritional indices of body mass index, weight for age, weight for height and height for age. Data were analyzed usingfrequencies and percentages for research question while tTest was used for thehypotheses. The mean indicators of nutritional status for school children were found to be within normal range. Children in urban location had higher weight and height than their rural counterparts. Female children indicated higher BMI than their male counterparts. The weight, height and BMI of the children of the study were greater than that of WHO/NCHS recommended standard for their age and gender.This therefore calls for health education of parents and care givers on the need for adequate nutrition and elimination of some of the factors that contribute to low dietary intake especially in the rural areas. There is also need for growth monitoring of school children in order to identify and reduce the risk of inadequate nutrition.

TABLE OF CONTENTS PAGES

TITLE PAGEi

APPROVAL PAGE ii

CERTIFICATION PAGE iii

DEDICATIONiv

ACKNOWLEDGMENTSv

ABSTRACTvii

TABLE OF CONTENTSviii

LIST OF TABLESxi

LIST OF FIGURESxiii

LIST OF APPENDICESxv

CHAPTER ONE: INTRODUCTION 1

Background to the Study 1

Statement of the Problem 8

Purpose of the Study 10

Significance of the Study 13

Scope of the Study 14

Research Questions 15

Hypotheses 17

CHAPTER TWO:REVIEW OF RELATED LITERATURE 19

Nutritional Status 19

Normal Human Growth 20

Aetiology of Abnormal Growth Curves 35

Body Mass Index BMI 38

Anthropometry 40

WHO/NCHS recommended Growth Standards 47

Theoretical Framework 49

Banduras Social Cognitive Theory48

Empirical Studies 53

Summary of Literature Review 75

CHAPTER THREE: METHOD 80

ResearchDesign 81

Area of the Study 81

Population of the Study 82

Sample and Sampling Technique83

Instrument for Data Collection85

Validation of Instrument 85

Reliability of Instrument 86

Method of Data Collection 87

Method of Data Analysis 88

CHAPTER FOUR: PRESENTATION OF RESULTS 90

Summary of Results 118

CHAPTER FIVE: DISCUSSIONS, CONCLUSIONS AND

RECOMMENDATIONS 123

Discussions 123

Conclusions 135

Implications of the Study 136

Recommendations 139

Limitations of the Study 140

Suggestions for Further Research 141

REFERENCES 142

APPENDICES 157

APPENDICES

Appendix A

BMIforage Boys 5 to 19 years z scores 157

Appendix B

BMIforage z scores, 5 to 19 years Boys 158

Appendix C

BMIforage z scores, 5 to 19 years Boys 159

Appendix D

BMIforage z scores, 5 to 19 years Boys 160

Appendix E

BMIforage Girls 5 to 19 years z scores 161

Appendix F

BMIforage z scores, 5 to 19 years Girls 162

Appendix G

BMIforage z scores, 5 to 19 years Girls 163

Appendix H

BMIforage z scores, 5 to 19 years Girls 164

Appendix I

Weightforage Boys 2 to 5 years z scores 165

Appendix J

Heightforage Boys 2 to 5 years z scores 166

Appendix K

Weightforheight Boys 2 to 5 years z scores 167

Appendix L

Arm circumferenceforage boys 3 months to 5 years percentiles 168

Appendix M

Weightforage Girls 2 to 5 years z scores 169

Appendix N

Weightforage Girls 2 to 5 years z scores 170

Appendix O

Weightforage Girls 2 to 5 years z scores 171

Appendix P

Arm circumferenceforage girls 3 months to 5 years percentiles 172

Appendix Q

Sampled nursery schools/classes used for the study 35 years 173

Appendix R

Sampled primary schools/classes used for the study 611 years 174

Appendix S

Sampled secondary schools/classes used for the study 1217 years 175

Appendix T

Nutritional Assessment toolanthropometry 176

Appendix U

Body Mass Index BMI children 177

Appendix V

Permission to collect data 178