|Year : 2012 | Volume
| Issue : 2 | Page : 61-64
Effect of maternal literacy on nutritional status of children under 5 years of age in the Babban-Dodo community Zaria city, Northwest Nigeria
Mu'awiyyah Babale Sufiyan, Sulaiman Saidu Bashir, Ahmad Ayuba Umar
Department of Community Medicine, Faculty of Medicine, Ahmadu Bello University, Zaria, Nigeria
|Date of Web Publication||7-Mar-2013|
Mu'awiyyah Babale Sufiyan
Department of Community Medicine, Faculty of Medicine, Ahmadu Bello University, Zaria
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: Worldwide, about a half of mortalities in children are directly or indirectly attributable to malnutrition. In Nigeria, malnutrition has also been reported to be associated with increased morbidity and mortality, such that 30-40% of deaths in the preschool age group are associated with malnutrition. Therefore, assessing the factors attributing to malnutrition is central to reducing and preventing these high mortalities. One attributable factor to malnutrition is the level of maternal literacy.
Objective: The study aimed to assess the effect of maternal literacy on the nutritional status of children under 5 years of age in Babban-dodo, Zaria, Northwestern Nigeria.
Methodology: A cross-sectional descriptive study of 300 children aged less than 5 years and their mothers/caregivers was conducted, using a multistage sampling technique. The study involved collecting information on the sociodemographic characteristics of the respondents and the anthropometric measurements (weight, height, mid-upper arm circumference) of the eligible children. The data were analyzed using statistical software SPSS 19.0 and Epi-Info version 6.0.
Result: Out of the 300 children studied, 87 (29%) were found to have under weight, 21 (7%) were wasted, and 93 (31%) were stunted. The majority (65%) of the mothers/caregivers have no form of formal education. There was a significant statistical association between maternal literacy status and occurrence of malnutrition (specifically stunting) among the children studied. (X 2 = 26.2, df = 1, P < 0.05).
Conclusion: Maternal literacy has a significant relationship with the nutritional status of children. Therefore, there is the need to promote and encourage female/girl child education in the communities in order to empower them to know the right type of food and the right way to give it in the right quantity. This will help to prevent the occurrence of malnutrition among children, especially those under the age of 5 years.
Keywords: Malnutrition, maternal literacy, nutritional status, under fives
|How to cite this article:|
Sufiyan MB, Bashir SS, Umar AA. Effect of maternal literacy on nutritional status of children under 5 years of age in the Babban-Dodo community Zaria city, Northwest Nigeria. Ann Nigerian Med 2012;6:61-4
|How to cite this URL:|
Sufiyan MB, Bashir SS, Umar AA. Effect of maternal literacy on nutritional status of children under 5 years of age in the Babban-Dodo community Zaria city, Northwest Nigeria. Ann Nigerian Med [serial online] 2012 [cited 2019 Mar 20];6:61-4. Available from: http://www.anmjournal.com/text.asp?2012/6/2/61/108110
| Introduction|| |
Malnutrition is a pathological state resulting from inadequate nutrition. It is broadly classified as undernutrition, as a result of insufficient intake of energy and other nutrients, and overnutrition due to excessive consumption of energy and other nutrients.  While nearly 12 million children under five die each year in developing countries mainly from preventable causes, the death of over 6 million (55%), are either directly or in directly attributable to malnutrition; mainly under nutrition.  In Nigeria, malnutrition has, been reported to be associated with increased morbidity and mortality, such that 30-40% of death in the preschool age group are associated with malnutrition.  The major causes of childhood mortality in Nigeria include malaria (30%), vaccine preventable diseases (22%), diarrhea (19%), acute respiratory tract infections (16%), etc., with malnutrition underlying about 60% of these childhood deaths. 
Therefore, assessing the factors attributing to this malnutrition is central to reducing and preventing these high morbidities and mortalities. One of these factors is the maternal literacy level. While a mother is a provider of primary care that the child needs during the first 6 years of its life, the type of care she provides depends to a large extent on her knowledge and understanding of some aspect of basic nutrition and healthcare.  Furthermore, it has been documented that children born of educated mothers have lower mortality risk because educated mothers tend to delay and have their child at a later age than uneducated women. In addition, they are more likely to be assertive and to play greater role in intrafamily decision making in favor of their children's need. In addition their husbands tend to be more economically better off, than husbands of uneducated women. ,, While educated women have earlier and more effective use of health service, evidence has been documented that maternal education is an important determinant of infant and child mortality. , More still, the National Demographic and Health Survey (NDHS) in 2008 revealed a strong relationship between maternal literacy and nutritional status of the children surveyed. It was reported that, while literacy levels have continued to increase, the urban areas have fared better relative to rural areas.  Similarly, a report of the mid-point assessment of the attainment of the MDG's further revealed that female literacy lag behind males and more severely in primary school completion rate, mainly due to gender inequality among other reasons. 
On the other hand, growth assessment is the single measurement that best describes the health and nutritional status of children; because disturbances in health and nutrition, regardless of their etiology, invariably affect child growth. Consequently, it is based on combination of these body measurements that anthropometric indices are constructed. Children whose weight-for-age (W/A), children whose Height-for-age (H/A) and children whose weight-for-height (W/H) is below -2 standard deviations from the median of the reference population are considered to be underweight, stunted, and wasted, respectively. 
| Objective of the Study|| |
The objective of this study is to assess the effect of maternal literacy on the nutritional status of children under 5 years of age in Babban-dodo, Zaria, Northwestern Nigeria.
| Materials and Methods|| |
The study was carried out in the Babban-Dodo community of Zaria, Northwestern Nigeria. It is a semiurban community of 29,200 population, who are predominantly subsistent farmers, petty traders, and Quranic/Islamic school teachers.
A cross-sectional descriptive study of 300 children aged less than 5 years and their mothers/caregivers was carried out in April 2008. A multistage sampling technique was employed for selecting the survey respondents in which stage one all the wards in Zaria LGA were listed and Anguwan Juma ward was selected through balloting. In the second stage all the houses in the selected ward were numbered and list of all the household numbers in each of the houses was obtained. From the household lists all the eligible child-mother/caregiver pair were selected to obtain the required sample size. The selection of the child-mother/caregiver pair was irrespective of gender, ethnicity, and religion. A house where there were no eligible respondents was automatically skipped to the next house. The youngest child under the age of 5 years was selected from each household. If a person had more than one wife, the youngest child of either wife was randomly selected and enrolled. If there were eligible twins, one of them was randomly selected. The exclusion criteria were children more than 5 years of age and those less than 1 year of age, children with congenital deformity, and children with chronic diseases/disorders (e.g., tuberculosis, sickle cell anemia, etc.). Parents who did not consent were also excluded.
Tools for data collection included a pretested, structured interviewer-administered questionnaire, which was used to seek information on the sociodemographic characteristics of respondents, other information about the child and household (including maternal literacy level), and anthropometric measurement of the enrolled child. The age of the child was confirmed by correlating the date of birth with Islamic date/events (such as Eid or Ramadan), local events, and political events. A weighing scale having a maximum weight capacity of 20 kg was used and the children were weighted with minimal clothing, while the weight was recorded to the nearest 0.1 kg; during the measurement of height, each child was made to stand in front of a wall and his/her height was measured using a measuring tape and recorded to the nearest 0.1 cm.
Ethical clearance was obtained from Ethical and Scientific Committee of Ahmadu Bello University Teaching Hospital Shika-Zaria. Permission was obtained from the Primary Health Care (PHC) Department of Zaria LGA, and verbal consent was also obtained from all the respondents before data were collected. Any participant who did not consent to participate in the study was excluded.
| Results|| |
The total number of children included in the study was 300, 117 (59%) being males; frequency distribution of the age of these children shows 146 (48.7%) to be in the age group 12-23 months, while 30 (10%) were in the age group 48-59 months [Table 1]. Regarding the educational status of the mothers, majority of them 159 (53%) were illiterate and lacked any form of formal education while 141 (47%) were literate with one form of formal education or the other. Out of the literate mothers, 36 (12%) could read and write in Arabic, 75 (25%) had primary education, 30 had secondary education, while none had any tertiary education [Table 2].
|Table 1: Sociodemographic characteristics of respondents in the Babban-Dodo district of Zaria LGA, Kaduna State. (n = 300) |
Click here to view
|Table 2: Educational status of mothers in the Babban-Dodo district of Zaria LGA, Kaduna State |
Click here to view
Mothers of the under fives were put into two groups: those that had formal education and those that had no formal education, and then the relationship between the education of the 300 mothers and the nutritional status of their children was analyzed separately for the three anthropometric indices of underweight, stunting, and wasting.
It was found that there was significant difference, with regard to stunting, between the children whose mothers were literate and had formal education and those whose mothers had no formal education (x 2 = 26.2, P < 0.05), but no significance was found between the two groups as regards underweight and wasting [Table 3].
|Table 3: Educational (literacy) status of mother by the type of malnutrition in the Babban-Dodo district of Zaria LGA, Kaduna State |
Click here to view
The proportion of malnourished children was higher among those who were abruptly weaned than gradually weaned children. This finding was found to be statistically significant, P < 0.05, [Table 4].
|Table 4: Weaning methods by nutritional status in the Babban- Dodo district of Zaria LGA, Kaduna State |
Click here to view
| Discussion|| |
The mean prevalence of underweight malnutrition, from this study, was found to be 67%, i.e., 67 per 100 children examined, far wide of the 28.5% in the same age group as reported from the NDHS 2008.  In addition, this study has established that maternal literacy affects the nutritional status of children; as children of illiterate mothers (with no formal education) have increased risk for development of malnutrition in children under the age of 5 years especially for stunting. This is similar to findings reported by Chen,  Bhuiya,  Abidoye. , All of them have identified the illiteracy of mothers as a risk factor for malnutrition among their children. Some of the possible reasons that account for the difference in the nutritional status of children of literate mothers from those of illiterate mothers are as follows: literate mother knows how to prepare the right kind of food to give to her children, she knows the right time to feed the child, and she understand and obey simple instructions on what to do when a child is sick.
Similarly, Terra de Souza  found out in another study that female literacy, participation in growth monitoring, and the degree of urbanization were all positively associated with the prevalence of inadequate weight gain. As such, any effort at improving maternal literacy will improve the growth and development of children, who are the leaders of tomorrow.
The findings from this study among the (nonliterate) mothers with no formal education of 8.7%, 41%, and 29% of their children with wasting, stunting, and underweight, respectively; further corroborates the findings of 7.0%, 40.6%, and 23.1%, respectively, in the NDHS 2008. 
Equally, the finding from an intervention study conducted by Sabitu et al.,  which also established a significant association between maternal literacy and malnutrition, has further given hope, since the educational intervention put in place has resulted in a statistical significant reversal of the nutritional indicators.
| Conclusion|| |
Maternal literacy has a significant association with malnutrition in under fives. Concerted effort must be made to improve girl-child/female education. This will not only empower them, help prevent the occurrence of malnutrition among children, especially the under fives, but will also enhance the attainment of other development objectives: MDGs 1, 2, 3, 4, and Vision 20:20:20 agenda. 
| References|| |
|1.||Young H, Susanne J. Nutrition matters: People, food and famine. 1 st ed. London: Intermediate Technology Publications; 1995. p. 17. |
|2.||UNICEF. Malnutrition- silent emergency. State of the World's children, UNICEF. New York: Oxford University Press; 1998. p. 9-11. |
|3.||Asindi AA, Ibia EO, Udo JJ. Mortality pattern among Nigerian children in the 1980s. J Trop Med Hyg 1990;94:152-5. |
|4.||FMOH. National Child health policy. Nigeria: Federal Ministry of Health (FMOH); 2006. |
|5.||Chen LC. Primary health care in developing countries: Overcoming operational, technical and social barriers. Lancet 1986;2:1260-5. |
|6.||Bhuiya A, Zimicki S, D'sonza S. socioeconomic determinmants in child nutritional status: Boys versus girls. Food Nutr Bull 1986;8:3-7. |
|7.||Victtora CG, Vaughan JP, Kirkwood BR, Martinez JC, Barcelos LB. Risk factors for malnutrition in Brazilian children: The role of social and environmental variable. Bull World Health Organ 1986;64:299-309. |
|8.||Caldwell JC. Maternal education as a factor in child mortality. World Health Forum 1981;2:75-8. |
|9.||National Populations Commission (NPC) [Nigeria] and ICF Macro. Nigeria Demographic and Health Survey 2008. Abuja, Nigeria: National Populations Commission and ICF Macro; 2009. |
|10.||Government of the Federal Republic of Nigeria. Mid-point assessment of the Millennium Development Goals in Nigeria 2000-2007. The office of the senior special assistant to the president on MDG's, The presidency, Abuja, Federal Capital Territory. |
|11.||WHO. Physical status: The use and interpretation of anthropometry. Report of a WHO technical report series No.854. Geneva: WHO; 1995. |
|12.||Abidoye RO, Ihebuzor NN. Assessment of nutritional status using anthropometric method on 1-4 year old children in an urban ghetto in Lagos, Nigeria. Nutr Health 2001;15:29-39. |
|13.||Abidoye RO, Sekabofori . A study of the prevalence of protein energy malnutrition among 0-5 years in rural Benue state, Nigeria. Nutr health 2000;13:235-47. |
|14.||de Souza AC, Peterson KE, Cufino E, Gardner J, Craveiro MV, Ascherio A. Relationship between health services, socioeconomic variables and inadequate weight gain among Brazillian children. Bull World health Organ 1999;77:985-905. |
|15.||Sabitu K, Iliyasu Z, Hassan SS, Mande AT. Evaluation of a community level nutritional information system for action in a rural community of Zaria, northern Nigeria. Ann Afr Med 2004;3:120-5. |
|16.||National Technical Working Group on Health (NTWGH), Vision 20:2020. Report of NTWGH. Federal Government of Nigeria, July 2009. |
[Table 1], [Table 2], [Table 3], [Table 4]