What is Malnutrition?
Discuss about the causes of deaths in children.
Malnutrition is with no doubt one of the leading causes of deaths in children from low socio-economic status families in developing countries in Africa. According to the World Health Organization, Malnutrition is the most severe threat to global health. It results in an estimated 45% of mortality rates of children under the age of five. Despite the decline in the prevalence of malnutrition globally, around 60 million children in Africa remain affected (Shi & Singh, 2011).
Malnutrition refers to an illness where the body is unable to receive adequate nutrients for proper body functioning. It is caused by poor diet or lack of enough food. It also occurs when the nutrient intake is either too high, too low or in balanced. It may be mild, acute or severe. It can lead to starvation when an individual does not consume food with enough calories, or it may be associated with insufficiency of a specific nutrient such as Vitamin C deficiency. It may also manifest itself when an individual cannot absorb or digest nutrients from the foods he or she eats. It may also occur as a result of some medical conditions (Malnutrition, n.d.).
Poverty is the leading cause of malnutrition as it results in lack of food, an essential component in the development of children. Negligence of children also results in malnutrition. Ignorance of the pregnant women may also lead to the disease; this is because they may be unable to provide for their children as they also have the condition. Irregular consumption of foods can also cause malnutrition as the children should be given their meals at the right time always. Illiteracy and ignorance can also cause malnutrition as the parents are uninformed of the dietary needs of their children (Macdonald, 1992).
Malnutrition has numerous effects both on the body of children and the economy of the countries. It leads to the death of children under the age of five, negatively impacting on the economy due to lack of enough workforce. It also makes children vulnerable to diseases as a result of a weak immune system. Studies indicate that malnourished children often suffer from conditions such as pneumonia, diarrhea, HIV, Malaria, and Measles. The relationship between Malnutrition and disease manifestation is a circularity as it causes increased susceptibility to infections while the infections also lead to malnutrition. The infections result into loss of appetite, malabsorption of nutrients, urinary nitrogen loss, and redirection of nutrients for immune response and excessive damage of the immune system. This then leads to inadequate dietary intake and hence loss of nutrients (Oberhuber, 2013).
Causes of Malnutrition
Malnutrition results in kwashiorkor which is a type of protein insufficiency that is usual among the malnourished children. If left untreated it leads to loss of lives or coma. It also leads to marasmus, which is characterized by the deficiency of all the nutrients especially proteins and calories. Marasmus is also characterized by severe loss of weight and hair loss. It also leads to the inadequate amount of nutrients such as carbohydrates, proteins, vitamins, and minerals. Malnutrition also results in weight loss and impaired growth and development of the children hence making it difficult to attain their optimal size and physical potential as adults. The undernourished children often have lower intellectual capacities than that of the well fed children. This is due to the illnesses that manifest in the bodies hugely affecting their mental abilities. It also leads to the children’s slow recuperation to diseases.
Malnutrition presents a severe health burden on countries hindering development efforts. Countries spend more on treating malnourished children than on preventing the disease. Patients with the condition tend to spend more time in hospitals than the healthy ones. Studies indicate that malnutrition extends hospital stay by an estimated three days to a week. Malnutrition also leads to high admission rates; as a result, it is related to increased utilization of healthcare resources. Generally, more extended hospital stays are associated with the use of hospital resources. Treating the disease can increase the hospital’s costs by around 50-70%. It also reduces school attainment results and slow development growth. Lack of proper education and decreased skill-level of employed delays in the development of countries. Malnutrition also makes children prone to diseases in the future increasing the health care costs (Muscaritoli & Molfino, 2013).
Low socioeconomic status
Research indicates that low socioeconomic status has a great influence on the ability of a household to acquire enough, nutritious foods. Most of the African countries experience food insecurity and hence leading to malnutrition. According to the World Health Organization, food security exists when all populations have access to safe, adequate and nutritious food that satisfies their nutritional needs and food preferences for a healthy and active life. Firstly, food security is based on the availability of sufficient amounts of food. Secondly, it is focused on the access to enough resources to purchase quality food that meets the dietary requirements of an individual. Thirdly, it is based on the availability of clean water and proper sanitation and healthcare. Lastly, it is based on the ability of individuals to acquire adequate and nutritious food at all times (Talyor & Marandi, 2008).
Effects of Malnutrition on Children and the Economy
Lack of income makes it difficult for the children from low income families to have access to Nutritious foods compared to those from wealthy families. Lack of enough food, essential nutrients and macronutrients predispose children to conditions such as malnutrition and hence proper nutrition is required for the child’s growth and development. Low-socioeconomic status constrains the potential of families to purchase agricultural technologies and valuable assets leading to low agricultural efficiency. The families also lack transport to go to market facilities making it hard for them to get the foods (Braveman & Gottlieb, 2014).
They also tend to buy cheaper buys that are less dense and unhealthy and hence not meeting their daily nutrient requirements. The children may also go without food and water for days and thus contributing to the condition. They also lack clean water and inadequate sanitation, which helps to prevent infectious diseases such as diarrhea which leads to malnutrition (Factors Contributing to Health and Disease, 2016).
According to the World Health Organization, diarrhea claims the life of an estimated 1.8 million children globally, and it leads to more deaths compared to malaria and tuberculosis. Lack of access to healthcare is one of the main factors that contribute to mortality among children with malnutrition. This is because the condition makes them vulnerable to other diseases and may also lead to the progression of malnutrition in the body leading to death. It is mainly influenced by lack of resources to buy drugs and obtain other healthcare services (Tausch, 2012). Many children suffering from malnutrition do not have access to healthcare. This is a result of the high health care costs that they are unable to afford. They also lack transport to visit healthcare facilities that are mostly far from where they live. This results in poor health, the progression of the diseases and disabilities. It also leads to late detection of conditions such as diarrhea and malnutrition leading to deaths (Frimpong, 2014).
Expectant women also fail to visit the hospitals for the antenatal clinics where they usually are given nutritional supplements to ensure that they deliver healthy children. As a result, they give birth to malnourished children who develop low birth weights or even die. The children too miss out on the Dewormers and essential supplements they are required to take (Loewenberg, 2011). The facilities in their area also lack a sufficient number of healthcare professionals. The patients tend to wait for long and hence discouraging them from visiting the facilities. The hospitals also require enough drugs and essential medical equipment (Stolldorf, 2017).
Socio determinants of Health influencing Malnutrition in Africa
Research indicates that lack of income reduces access to quality education. This is because the low-income families lack resources to send their children to school. Well educated individuals tend to have low risk and high paying jobs making them have access to health care and quality food. This explains why their children have low malnutrition rates. They are also well informed on the nutritional requirements of their children and the importance of ensuring that they visit the clinic to acquire the vaccines and supplements (Middleton et al., 2018).
Health education and Malnutrition
Several studies have indicated that nutrition education helps reduce malnutrition. Its fundamental goal is to educate the families on the importance of consuming nutritious food alongside their nutritional requirements especially for the children and the elderly and the importance of practicing healthy lifestyles to promote and maintain their health. Families living in the remote areas of Africa lack proper education on proper nutrition practices. Mothers do not have an understanding of what comprises of a suitable nutritious diet for good health of their children. They also lack knowledge on the importance of taking the under-five children to clinics for the required nutrient supplementation (N, L, 2015).
Expectant women in the area lack knowledge on breastfeeding. Exclusive breastfeeding comes with a lot of benefits including ensuring proper growth, development, and survival of the child. Research shows that children who are exclusively breastfed live longer and are often not infected with life-threatening illnesses. Breast milk contains nutrients that have the right amount of water, sugar, protein, and fat. These nutrients are essential for good health and survival for the child. It results in the strengthening of the immune system making it difficult for children to acquire severe diseases as diarrhea and pneumonia. It also reduces the chances of the children being malnourished (Yoo & Kim, 2017).
They also lack adequate knowledge on the health effects of poor sanitation and hygiene which predisposes their children to diarrhea and other health illnesses. Diarrhea prevents a child from usually growing, while malnutrition leads to high incidence of the diarrheic events. The infections have a significant effect on the nutrition of the children by reducing the rate of intestinal absorption and appetite. They also increase digestion and prevent the intake of the micronutrients necessary for the growth and development of tissues (Putnam & Galea, 2008).
Government
The governments of the countries in Africa may reduce Malnutrition prevalence by ensuring that more resources are directed towards the prevention of the diseases as it is cheaper to prevent than treat diseases. They should improve access to clean drinking water, adequate sanitation and hygiene since they are critical to ensuring good health. According to the World Health Organization, an estimated 50% of all the malnutrition diseases are as a consequence of recurrent diarrhea or intestinal worms that are a result of inadequate water, sanitation, and hygiene. Many developing countries in Africa have increased water shortages which affect their health. The government can also come up with health education programs on proper hygiene and sanitation (The Impact of Water, Sanitation, and Hygiene on Key Health and Social Outcomes, 2016).
Low socioeconomic status
Research suggests that most endemic diarrheal diseases are not as a result of transmission of pathogens through contaminated water. Instead, they do occur as a result of lack of proper hygiene. Proper sanitation and hygiene can prevent under nutrition and stunted growth in children by reducing the occurrence of diarrheal and parasitic diseases that cause environmental enteropathy. I would teach the population more about the WASH programme and proper hygiene practices. This would have been achieved through the initiation of a sustainable technology that is commonly used by the people, culturally accepted and low maintenance costs to ensure that it is viable (Kemm, 2014).
The government can increase the number of hospitals and health centers to ensure that people have better access to healthcare. They can also increase the number of trained healthcare professionals such as the public health Nurses and community health workers in the facilities. This will ensure that the people can receive quality health care services. The hospital fees can also be reduced to make sure that there are no financial barriers to obtaining care. The government can also increase the amount of drugs and medical equipment in the hospitals. It should also consider allocating enough funds to the health department to ensure that diseases are prevented and that health care services are not affected due to lack of enough money (Macdonald, 1992).
The government can encourage people to practice more farming to ensure that the countries have maximum food security. This can be achieved through the provision of seedlings for planting and the use of appropriate technologies for agricultural purposes. Food policies that help in reducing food prices should be implemented to ensure that no household goes without food. Supplementing nutrients in commonly consumed foods may also help reduce the illness.
The governments can economically empower the people to ensure that they are free from poverty. This is possible through the creation of job opportunities by increasing productivity. The governments should create jobs that will be able to sustain them to the point where they can easily purchase quality food and access health services. The government can also offer micro-loans to the people in Africa to help them start small businesses they can rely on for income (Polack & Warwick, 2016).The government can also seek donor funding to obtain income to fund new businesses or already established ones to ensure that they are sustainable enough. They can also identify suitable market opportunities where business can easily thrive to ensure that they acquire maximum profits. The government can also offer training on income generating activities such as tailoring and food production. The people should also be advised on the benefits of saving part of their income for usage during harsh economic times (Polack & Warwick, 2016).
Food security and its importance
Public Health Professionals
Public health professionals can work with the government to ensure that clean water for cooking, drinking, and other household uses are provided. They can also ensure that there are proper construction and maintenance of latrines that are safe for usage at all times without posing a threat to the lives of the people. They can undertake active disease surveillance in the event of diseases outbreaks. They can also conduct various water tests to make sure that quality water is given to the people. They can also take part in proper management of solid and liquid waste to prevent the spread of diseases to both the children and the community members.
Public health professionals can work with the community health specialists to help in Changing the attitude and behavior towards sanitation and hygiene. This can be effective if the Transtheoretical model is used to ensure maximum behavior change. This model includes the pre-contemplation stage, where individuals do not have the intentions to change or unaware of the consequences of their behavior. At this stage, a person is educated on the benefits of behavior change. They are also taught on how to be mindful of their practices. The second stage is contemplation where the people are aware of the advantages of behavior change and intend to change. Here, the people learn how healthy they would be if they engaged in healthy practices. At this point, they should be encouraged on reducing their poor health habits. The third stage involves preparation where the people begin to take little steps that they think will help in practicing appropriate health behaviors. At this stage, it is crucial to engage some community members who are well informed about hygiene to encourage the others to adopt the behavior (Kemm, 2014).
The fourth phase is the action where the change in the behavior is evident among the people. At this stage, they need to learn how to keep up their commitments and avoiding situations that may make them revert to poor practices. The fifth phase is the maintenance were the situations that may cause the people return to older traditions are well known to them. Therefore, they are advised to spend more time with people who are practicing good practices. The last stage is the relapse where the people who successfully changed their behavior are required to ensure that their change will be the long-term change. This can be achieved through regular talks and meeting to discuss the changes the community has faced and the challenges they face (Sassen, 2017).
Lack of income and nutrient-dense food
The Public Health Professionals can also use the model to ensure that individuals change their perceptions about their health seeking behavior. This will help in ensuring that the people w also visit the health centers to ensure that the weight of their children is known alongside their BMI for early detection and prevention of the disease. It will also help in early treatment of the disease by reducing the number of deaths.
Nutritionists
The Nutritionists can help in ensuring that children are given vitamins, Dewormers, and other supplements. They can also encourage expectant mothers to visit antenatal clinics so that their pregnancy can be monitored and supplements delivered to prevent the birth of low weight children (Chan, 2018). They may also take part in mass supplementation, where the vitamins are given from door to door can also help reduce the prevalence of Malnutrition (Vilela, Brito & Vilela, 2018).
The Nutritionists may also ensure that the appropriate nutritional requirements of the children are made known to the parents. They can also take part in giving Nutrition education on the importance of proper nutrition on the health of their children. Nutritionists can also educate mothers on the importance of exclusive breastfeeding in preventing malnutrition and other illnesses. They can encourage them to breastfeed their children after the six months of birth without the introduction of different meals. The importance of personal hygiene and hand washing during this process would also be emphasized (Loewenberg, 2011).
Conclusion
Preventing the occurrence of malnutrition requires maximum collaboration between different sectors. More emphasis should be put on reducing the occurrence of the diseases to minimize the economic costs associated with it. Elimination of poverty, increasing access to healthcare and nutritious foods are key to ensuring that the prevalence of the condition reduces. Therefore, more urgency should be given on the issues to ensure that poverty decreases to a minimum level
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