Abstract

The main objective of this study was to assess dietary and nutritional status of children below 18 years, determine their implication and propose recommendations to improve on the welfare of children below 18 years in four orphanages in Fako Division: HOTPEC, GOD’s Grace Philanthropic Foundation, Saint Glory and Bright land.

Specific objectives were to: examine the nutritional status in the sampled orphanages in Buea, determine the relationship between local food consumed by the children in the orphanages and the prevalence of malnutrition and  propose measures to improve on the feeding habit of the children.

In order to achieve the study, 160 questionnaires were administered using semi-structured technique. Two components of nutritional assessment were used to assess the nutritional status of the children namely; anthropometry measures focusing on weight, height and body mass index (BMI); and dietary assessment of locally consumed food products. Descriptive (z-scores) statistics and inferential statistics (Chi-Square) of variables were calculated at p< 0.05 level.

Findings revealed that there is a moderately high prevalence of malnutrition (40.9%) among the orphanages in Buea. Nutritional status revealed that about 34% of the children were underweight, with greater prevalence occurring in God’s Grace Foundation and Saint Glory Orphanage. Analytical results of Body Mass Index show that 30% of the children have lower BMI than normal, with greater observation in God’s Grace Foundation and Saint Glory Orphanage.

Daily local food consumed by children at orphanages includes grains/cereals, little vegetables, meat and to a lesser extent dairy product such as milk, soya beans, and eggs. It was concluded that malnutrition is highly prevalent among children and adolescents under residential care and this need as to be addressed. This study equally observed that boys were more likely to be malnourished than girls in the orphanage.

This vulnerability in boys could be explain by the fact that they are more expose to physical exercises accompanied by low energy food consumption thus greater risk of exposure than females. It was therefore recommended that relevant health care authorities, NGOs, and donor agencies should initiate nutritional intervention programs in order to counter the extent of malnutrition among orphans, particularly as there is an influx of children into the orphanages in recent times.

CHAPTER ONE

GENERAL INTRODUCTION

1.1 Background to the Study

Most African countries are endowed with abundant resources which could sustainably be exploited to improve the welfare of their inhabitants. Unfortunately, a large proportion of their population is wallowing in poverty marked by widespread malnutrition and infant mortality. Since children naturally have low resilience, a good number of them often suffer from poor feeding and when such a situation becomes protracted, they become vulnerable to diseases and death.

According to the Sun Movement Progress Report in 2012, malnutrition problem affects about 180 million children under five years old by causing stunting effect and this results from chronic deficiency in nutrients from pregnancy to the age of two years. As a corollary, it damages a child’s physical and mental development. UNICEF reports that, in the least developed countries, 42% of children are stunted and 36% are underweight as a result of poor nutrition or under nutrition.

Africa is one of the few remaining continents in the world where most of its children are malnourished (WHO, 2017).

For a child born in Sub-Saharan Africa, the probability of dying before the fifth birthday was 1.9 times higher than in South East Asia, 6.3 times higher than in Latin America and the Caribbean, and 24 times higher than in industrialized countries (UNICEF, 2010).

In sub-Saharan Africa, more than 10 million children die each year mainly from preventable causes. Of these, 37% die from malnutrition-related causes (Cohen, 2009). The WHO/UNICEF Global Strategy for Infant and Young Child Feeding emphasizes total exclusive breastfeeding (EBF) from birth up to six months (WHO/UNICEF, 2003).

This feeding has been documented to contribute much in control of diarrheal disease in children (Wright et al., 2016). It further documents on the timely introduction of complementary foods when the child is at least six months of age.

Complementary feeding is the period when a child transits from breastfeeding to the introduction of weaning foods. This feeding is important and should contain all the nutritional constituents that allow healthy child growth (Motee et al., 2013). Most commonly used food sources during complementary feeding are home-made and commercially available food cereals from shops. This is also the stage when they are still developing body immunity (FAO, 2011).

Furthermore, this is the period when the children experience optimal growth and development, hence good nutrition status is most crucial at this growth stage. Therefore, safe, nutritious food supply and increased frequency of feeding become important for proper development of children at this developmental stage. Inappropriate complementary feeding has been seen to directly influence the occurrence of malnutrition in under-five children (Saaka et al., 2016).

In Cameroon, malnutrition is common both in towns and villages. The situation has been observed in HOTPEC, GOD’s Grace Philanthropic Foundation, Saint Glory and Bright land orphanages in Fako Division of the South West Region which form the principal focus of this study.

1.2 Statement of Problem

Many children have been suffering from different nutritional problems in Cameroon and the situation is quite glaring in the selected orphanages in Fako Division. Most orphanages are formed and run by well-wishers or philanthropists who seek to take care of down trodden children.

They often rely on external support for their sustenance and in a situation where such supports do not come; the only survival strategy is to feed the children with sub-standard meals. Such malnourishment is depicted in the skinny physical appearance of the children. Such children often suffer from the following: nutrient inadequacy, stunted growth and underweight and these are adducible in the four orphanages under study.

A second category of the problem relates to the limited data on documented local recipes used for the feeding of the children in the orphanages. It is therefore difficult for one to quantify or keep a track record of the feeding nature in the orphanages and this brings to question the nutrients level of the food given to the children.

In the orphanages, complementary feeding often begins too early or too late and the foods are often low in energy and micronutrients. For example in GOD’s Grace and Saint Glory orphanages, much focus has been on maize and rice as staple food  but this has resulted to nutrient inadequacy due to over-dependence on starch-based diets during complementary feeding. Consequently, children become malnourished and suffer many lifelong consequences.

This is manifested in impaired developmental milestones and well-being of the children. Nutritional care and support are not well adhered to regarding the different food types and feeding regimes.

The study has been structured to answer the following research questions

1.3 Research Questions

In order to enhance the study, three research questions were posed, and they include:

1. are the children below 18 years in the selected orphanages in Buea malnourished?
2. which food are locally consumed by the children below 18 years in the selected orphanages?
3. How can malnutrition be overcome in the selected orphanages?

1.4 Research Objectives

1.4.1 Main Objective

The main objective of this study is to assess dietary and nutritional status of children below 18 years, determine their health implication and propose recommendations to enhance proper culinary management or feeding in the orphanages in Buea Municipality.

1.4.2 Specific Objectives

The specific objectives are;

1. to evaluate the nutritional status of children below 18 years in the sampled orphanages in Buea,
2. determine the relationship between local food consumed by children below 18 years in the selected orphanages and the prevalence of malnutrition.
3. Propose measures to improve on the feeding habit of the children in the selected orphanages.