Abstract
Background
Undernutrition is unacceptably high in developing countries, with Sub Saharan Africa featuring second to South-east Asia. Malawi, like many other countries, is experiencing unacceptably high undernutrition levels, especially in poor communities in the rural areas. Our study was conducted in the rural community of the southern region of Malawi, where the majority of the people speak Yao. This study is carried out under the large collaborative study of the University of Malawi and the Universities in Norway supported by the Norwegian Programme for Development, Research and Education (NUFU). Data analysis was based mostly on secondary data collected under this collaboration. However, I collected some community level data to help explain why there is undernutrition in the community.
Main objective
The main objective is to describe health services, socio-economic, infrastructure, educational services and the agricultural factors at individual, household and community level and assess their association with the nutritional status of the under five in different villages of Lungwena community.
Methods
A cross sectional household study was conducted in which only 6 villages were sampled out of the total 26 villages spread across the community. Four of the sampled villages are along the lake and the other two are close to the mountainous area. Villages were also subdivided into intervention and control groups for prevention activities. Using the household listings in the census data collected earlier before the baseline surveys, households were selected for interviews. In the analysis, only the baseline data sets have been used. However, the households in the baseline study did not match with the under five nutritional data: 186 children from 424 households and 78 children in the merged file. Sample sizes varied for the baseline data sets but these differences are sorted out in a merged file, which aimed at associating nutritional status with other variables of potential influence.
Results
Of the 186 under five children, 31.7%, 21.5% and 8.1% were stunted, underweight and wasted, respectively. Severe forms were also alarming: 9.1%, 10.8% and 2.7% in the same order. About 79% of the children had low Hb status (Hb < 11g/dl). Children in the mountain group had a higher percentage of undernutrition than their counterparts along the lake. Similarly, children in the intervention group had a higher percentage of undernutrition than in the control group. Households in Milombwa village had less access to services available and a higher proportion of undernourished children in the community. Social services were in general lacking in villages and those services accessed outside their villages were far away. A child whose household head was a farmer, exclusive breast feeding period was 6 months or longer and being a female child was associated with more risks of undernutrition(p<0.05).
Conclusion
Levels of undernutrition are in general not unusual but severe forms of undernutrition are threatening. Due to small sample size, many socio-demographic independent variables did not have any effects on nutritional status as expected. The study would rather be considered exploratory, which suggests a follow up study with sufficient sample size.