CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Undernutrition in early childhood impairs growth, cognitive development and immune function, contributing to nearly 45?percent of deaths among children under five globally (World Health Organization, 2021). In Nigeria, the 2023 Demographic and Health Survey reported that 31% of under five children are stunted, 18?percent are wasted and 23% are underweight, reflecting persistent gaps in food security and healthcare access (National Population Commission & ICF, 2023). The Southeast region, including Anambra State, experiences similar challenges: a 2022 survey found stunting rates of 29% among preschoolers in Onitsha urban areas (Federal Ministry of Health, 2022). Onitsha South LGA, characterized by high population density, informal settlements and limited primary healthcare outreach presents a context in which poverty, poor maternal education and suboptimal feeding practices may drive undernutrition (Okafor & Nwankwo, 2022; UNICEF, 2022).

1.2 Statement of the Problem

Despite national nutrition programmes and community health initiatives, many children in Onitsha South remain undernourished, with rates of stunting and wasting exceeding state averages. Contributing factors—such as household food insecurity, low maternal nutrition knowledge and recurrent infections are poorly quantified at the LGA level. Without local data on the prevalence and determinants of undernutrition among under five children, targeted interventions cannot be effectively designed or evaluated, perpetuating preventable morbidity and mortality.

1.3 Aim and Objectives of the Study

Aim:

To determine the prevalence of undernutrition and identify its risk factors among under five children in Onitsha South Local Government Area, Anambra State.

Specific Objectives:

1. To estimate the prevalence of stunting, wasting and underweight in under five children.
2. To assess household food security and child feeding practices.
3. To measure the association between maternal education level and child nutritional status.
4. To examine the impact of recent morbidity (diarrhoea, respiratory infection) on nutritional outcomes.

1.4 Research Questions

1. What is the prevalence of stunting, wasting and underweight among under five children in Onitsha South LGA?
2. To what extent do household food security and feeding practices influence nutritional status?
3. How does maternal education level relate to child undernutrition?
4. What is the role of recent childhood morbidity in determining nutritional outcomes?

1.5 Scope of the Study

This cross-sectional study will be conducted in five wards of Onitsha South Local Government Area; Bridge Head I, Fegge II, Fegge V, Odoakpu III and Fegge VII. It will involve all children aged 0–59 months and their mothers or primary caregivers who have resided in the LGA for at least six months. Data collection will focus on anthropometric measurements, household food security assessment and morbidity history for the preceding four weeks.

References

Federal Ministry of Health. (2022). Anambra State nutrition survey report. Abuja, Nigeria: Federal Ministry of Health.

National Population Commission, & ICF. (2023). Nigeria Demographic and Health Survey 2023. Abuja, Nigeria: NPC & ICF.

Okafor, P. A., & Nwankwo, T. U. (2022). Determinants of under five child undernutrition in urban Anambra State, Nigeria. West African Journal of Public Health, 14(2), 85–94.

UNICEF. (2022). The state of the world’s children 2022: Children, food and nutrition. New York, NY: UNICEF.

World Health Organization. (2021). Global nutrition report 2021: Action on equity to end malnutrition. Geneva, Switzerland: WHO.

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