COMPARATIVE ANALYSIS OF NUTRITIONAL STATUS OF UNDER-5 CHILDREN OF PURDAH AND NON-PURDAH WOMEN IN NORTH-WEST ZONE OF NIGERIA

Abstract

Socio-economic, religious beliefs, nutritional knowledge, hygiene, health status and maternal demographic characteristics are determinants of malnutrition among under-five children. In Nigeria, higher prevalence of under-nutrition is found in the North-west zone where practice of purdah is predominant. However, the influence of purdah on malnutrition has not been well documented. The objective of this study was to compare the nutritional status of under-5 children of purdah and non-purdah women in North-west zone of Nigeria. Comparative cross-sectional survey was conducted among purdah and non-purdah women using 5-stage sampling techniques. North-west zone was randomly selected from the two zones in Northern Nigeria where purdah is more common; purposive selection of Kano and Sokoto States; five Local Government Areas were randomly selected through balloting from each state; random selection of 20 communities and 600 participants comprising 293 purdah and 307 non-purdah mother-child pairs were purposively selected. Data were collected using pre-tested semi-structured interviewer-administered questionnaire, containing wealth index parameter to determine the Socio-Economic Status (SES) of the mothers, health service utilisation; nutritional knowledge on a 48-point scale rated as poor (0.0-24.9) or good (25.0-48.0). A 24-hour dietary recall was used to determine the nutrient intakes of the children and compared with Recommended Dietary Intake (RDI). Nutritional status of the children was determined using Anthro-2005. Data were analyzed using descriptive statistics, Chi-square test, binary logistic regression and ANOVA. Ages of purdah and non-purdah women were 28.9±7.0 and 27.8±6.6 years respectively (p>0.05), while their children were 19.8±14.9 and 21.6±14.9 months, respectively (p>0.05). The SES was 43.3% in purdah and 29.6% in non-purdah (p<0.05). About 56.0% of purdah and 43.0% of non-purdah women had no formal education (p<0.05). Similar proportions of the children of purdah (9.9%) and non-purdah women (9.1%) received complete immunization. However, 33.8% of purdah and 21.8% non-purdah were not immunised (p<0.05). The proportion with good nutritional knowledge among purdah and non-purdah women were 54.3% and 53.1% respectively (p>0.05). Exclusive Breast Feeding (EBF) was 4 practiced by 17.7% of purdah and 16.6% of non-purdah (p<0.05). Mean energy and protein intakes of the children were 870.5kcal (75.7% RDI) and 12.4 g (65.3% RDI) in purdah and 896.1kcal (77.9% RDI) and 14.6g (76.8% RDI) in non-purdah respectively. Underweight in children of purdah and non-purdah women were 43.3% and 33.6% respectively (p<0.05). Stunting was 53.9% and 50.5% (p>0.05), while wasting was 12.6% and 13.7% (p>0.05) in children of purdah and non-purdah women respectively. Odds of being underweight (OR=6.678, 95%,C.I.=3.413-13.060), stunted (OR=5.697, 95% C.I.=2.937-11.051) and wasted (OR=3.211, 95% C.I.=1.250-8.253) were significantly higher among children from low socio-economic households. The EBF conferred protection on underweight (OR=0.298, 95% C.I.=0.112-0.795) and stunting (OR=0.179, 95% C.I.=0.066-0.0485). Nutritional status of under-5 children of purdah and non-purdah women did not differ significantly. However, women in purdah showed some inadequacies in child-care practices that may affect child nutritional status. Nutrition education intervention is advocated for women in the North-west Nigeria to improve the level of good maternal and child-care practices.