A number of risk factors leading to malnutrition were investigated among 400 mothers of malnourished children in the middle belt of Nigeria. Poverty, family instability, poor environmental sanitation, faulty weaning practices, illiteracy, ignorance, large family size and preventable infections are the main factors responsible for malnutrition. The strategies for intervention are in the area of health education emphasizing the importance of breastfeeding, family stability, responsible parenthood and small family sizes through culturally acceptable family planning methods. There is need to improve weaning methods through nutrition education, growth monitoring and food demonstration with community participation. Political will is needed to improve literacy status, farming methods and general living conditions.
PIP: 400 mothers of children (aged 6-72 months; 233 males and 167 females) with severe protein energy malnutrition (PEM) attending Jos University Teaching Hospital, Plateau Hospital, and Plateau State Nutritional clinics in the city of Jos, Nigeria, were interviewed between October 1989 and September 1990 using a semistructured scheduled questionnaire. Mothers of 500 well-nourished children were also interviewed during this period. 176 (44.0%) of the children had marasmic kwashiorkor, 150 (37.5%) had kwashiorkor, while the remaining 74 (18.5%) had marasmus. 250 (62.5%) were residing in high-density urban areas, primarily in a slum in Jos. The control group consisted of 324 boys and 176 girls aged 12-54 months. 368 (73.6%) of them were from the urban area and 132 (26.4%) from the rural areas. 258 (64.5%) of the mothers of the malnourished children had no formal education and none had postsecondary education. In the control group, 142 (28.4%) had no formal education, while 143 (28.6%) had postsecondary education. The difference was statistically significant (p 0.001). The difference in the earnings between the parents of the malnourished and well-nourished children was significant (p 0.001). In the malnourished group, 60.5% of the mothers breast-fed their babies for 13-24 months, In the control group, the majority (74%) stopped breast-feeding by 18 months. Halting breast-feeding before the age of 6 months significantly contributed to malnutrition (p 0.05). 251 (62.8%) of the mothers of malnourished children gave only maize-gruel to their children; 149 (37.3%) supplemented with milk or cereal. In the control group milk-mixture was given to 404 (80.8%) of the children. This difference contributed significantly to malnutrition (p 0.001). 9 mothers would not give fish and 8 others would not give eggs to avoid inducing their children to steal. 126 (32.0%) mothers believed malnutrition was caused by lack of good food, while 86 (21.5%) thought it was an act of God. 67.3% associated diarrhea and 35.8% associated bronchopneumonia with malnutrition.