NAKURU COLLEGE OF HEALTH SCIENCE AND MANAGEMENT

MATHEW RAISI GALORA

NCHSM/ DCH /1003/01/22

FACTORS CONTRIBUTING TO MALNUTRITION AMONG CHILDREN UNDER FIVE

YEARS IN NYALA LOCATION, LAISAMIS SUB COUNTY, MARSABIT COUNTY,
KENYA.

2024

i
 ACKNOWLEDGEMENT
My foremost gratitude goes to the Almighty God for giving me strength, Knowledge and the gift of
life to accomplish this research proposal activity, are special thanks goes to my Field Supervisor Mr
Mashood Abiola for the Professional, encouragement, support and the sacrifice he made to guide me
throughout the research proposal activity. I also thank my Head of Department Madam Magdalene
koech and Mr Josh Wamalwa for their efforts that they made by assisting me to get a topic of
discussion.

Lastly, I thank my parents, brothers and relatives for their support they gave me to finish my research
proposal activities.

ii
 DECLARATION
I declare that this is my original written research proposal that I did it during my research activities
and to the best of my knowledge. It has never been presented to any institution (college) for the
academic qualifications.. This research has been written for Academic purpose activities.

STUDENT NAME:

MATHEW RAISI GAIORA

SIGN…………………………. DATE........................................

SUPERVISOR NAME:

MR MASHOOD OBIOLA

SIGN........................................ DATE........................................

iii
 DEDICATION
I wholeheartedly dedicate this research proposal to Nakuru College of Health Sciences and
Management, Department of Community Health, The Principal Madam Suzan Nyamai and the entire
Nakuru College of Health Sciences and Management Fraternity and my parents for supporting me
both financially, socially, mentally and prayers.

iv
 LIST OF ABBREVIATIONS

WHO ------------World health organization

UNICEF----------United nation international children education funds

DOH............... Department Of Health

v
 ABSTRACT
The study was aimed at investigating the factors contributing to malnutrition among children
under five years in Nyala Location ,Laisamis Sub County .it sought to identify those factors
cause malnutrition and preventive measures among those children under five years.the researcher
conduct the research in order to bring the picture of the problem that actually affect those
Children under five years in Nyala location.The researcher used surveys research designed and
purposive techniques to identify those most affected children under five years.the researcher
have capability of accessing the targetd children by conducting interviews and structure
questionnaires to collect informations on socio economic and dietary practices.After data
collection the researcher used statistics to analyze data used frequency distribution tables,graphs
and also pie chart to present data.By understanding all these factors that lead to malnutrition ,the
researcher was able to recommend and suggest various ways of preventing malnutrition among
children under five years in Nyala location.The effective intervention can be developed to
improve the nutritional status of those children under five years and also improve access to
health services and help to reduce malnutrition rate among those children under five years in
Nyala location.

vi
 TABLE OF CONTENT

ACKNOWLEDGEMENT...............................................................................................................ii
DECLARATION............................................................................................................................iii
DEDICATION................................................................................................................................iv
LIST OF ABBREVIATIONS..........................................................................................................v
ABSTRACT...................................................................................................................................vi
TABLE OF CONTENT................................................................................................................vii
CHAPTER ONE..............................................................................................................................1
1.1 Introduction of the Study.......................................................................................................1
1.2 Background Of The Study.....................................................................................................1
1.3 Problem Statement.................................................................................................................2
1.4 Objectives Of The Study........................................................................................................2
1.4.1 General Objectives..........................................................................................................2
1.5 Specific Objectives................................................................................................................3
1.6 Research Questions................................................................................................................3
1.7 Justification of the Study........................................................................................................3
1.8 Significance of the Study.......................................................................................................3
1.9 Limitation of the Study..........................................................................................................4
1.9.1 Scope of the Study..........................................................................................................4
CHAPTER TWO.............................................................................................................................5
LITERATURE REVIEW................................................................................................................5
2.0 Introduction............................................................................................................................5
2.1 Review of related Studies......................................................................................................5
2 .2 Summary...............................................................................................................................6
CHAPTER THREE.........................................................................................................................7
3.0 RESEARCH METHODOLOGY..............................................................................................7
3.1 Introduction............................................................................................................................7

vii
 3 .2 Research Design....................................................................................................................7
3. 3 Study Area.............................................................................................................................7
3.4 Population And Sample........................................................................................................7
3.4.1the Target Population.......................................................................................................7
3.5 Accessible Population............................................................................................................7
3 .6 The Sample Techniques/Procedures.....................................................................................7
3.7 Data Collection Tools............................................................................................................8
3.8 Data Collection Procedures....................................................................................................8
REFERENCES OF THE STUDY...................................................................................................9

viii
ix
 CHAPTER ONE
1.1 Introduction of the Study
Malnutrition is a critical issues affecting millions of children worldwide,particularly those
children under five years .It refer to the imbalance between the intakes of essential nutrients and
the body”s demand for them,often resulting in severe health consequences.It’s actually affect
children under five years ,This is because those children are vulnerable to malnutrition due to
rapid growth and development during that period.They require a balance diet comprising,
carbohydrates, proteins,fats,vitamins and mineral salts to supports their physical and cognitive
growth,However ,many factors contributes to malnutrition among children under five
years ,including poverty, food insecurity,inadequate breastfeeding practices and lack of access to
clean water and sanitation facilities.

1.2 Background Of The Study

Malnutrition among children under five years is a global health problems that affects millions of
children worldwide.it refers to condition where a child diet lack essential nutrients,leading to
stunted growth,weakened immune system and cognitive impairments, according to the World
Health Organization(WHO), United Nations International Children Education
Funds(UNICEF),malnutrition is responsible for nearly half of all deaths among children under
five years old, making it major contributor to child mortality rates.They approximately
149milliom children under age of five years were affected by stunted growth in 2020.The
problem is most prevalent in arid and semi arid region because the area experience freguent
drought,limited rainfall and unreliable water sources,particularly in Nyala location ,laisamis sub
county ,Marsabit county .Several factors contribute to the high prevalenceof malnutrition
among young children under five years.Insufficient intakes of essential nutrients such as
proteins,vitamins,and minerals ,can occur due to poverty ,food shortages,inadequates access to
nutrious food,clean water .Poor maternal nutrition and inadequate breastfeeding practices also
play a role as they can results infants not receiving the necessary nutrients during the critical
first years of life.Furthermore ,infectious diseases such as diarrhea,pneumonia and malaria can
exacerbate malnutrition. These diseases are more common in areas with poor sanitation ,limited
access to healthcare and inadequate hygiene practices.However,malnutrition has severe
consequences on a child health and development ,including growth and development delays

1
because malnourished children often experience stunted growth ,impaired cognitive
development and reduce learning capacity and this may affect the future productivity.Acute
malnutrition characterized by wasting ,can results in weakened immune system,increasd
mortality rates and long term developmental issues.

The socioeconomic factors actually associated with childhood malnutrition in Nyala location,
laisamis sub county ,marsabit county ,Kenya.(Ali A,mohammed,S adan,2017 )Nyala location
has limited economic opportunities that can affect household income and lead to insufficient
resources for proper nutrition and healthcare.

Additionally ,some children may also suffer from micronutrients deficiencies,such as vitamins
A,Iron,iodine,zinc and others.these deficiencies can cause specific health problems and impair
the overall well being of a child. The burden of the malnutrition among children under five
years in Nyala location, Laisamis Sub County,Marsabit County is agreater health problem
today,continuing socioeconomic factors and poverty in Nyala Location has inhibited the
progress in implementing effctinve malnutrition control measures.

1.3 Problem Statement

Malnutrition is persistence problem known globally children under five years in Nyala
location .It is significant risks to their health and well being of the individuals.Despite effects to
address this issues,several factors contribute to the high malnutrition among children under five
years,including limited access to nutritious food ,inadequate health care services and lack of
enough water sanitation and hygiene and this will likely increases the complication for those
children who have been affected most .According to World Health Organization (WHO)it
required actions to implement comprehensive intervention that prioritize access to nutritious
food, healthcare services ,clean water sanitation and hygiene and create awareness about proper
child feeding practices so as to improve the nutritional status and overall well being of Children
in Nyala Location.

1.4 Objectives Of The Study

1.4.1 General Objectives
To determine factors contributing to malnutrition among children under five years in Nyala
location

2
1.5 Specific Objectives
 To identify the socioeconomic factors that contribute to malnutrition among children age
five to ten years in Nyala Location.
 To determine the dietary patterns and nutritional practices in Nyala Location
 To evaluate the impact of drought and desertification that may impact to lower food
production in Nyala Location

1.6 Research Questions

1. What are the socioeconomic factors that contribute to malnutrition among children
under five years in Nyala location?
2. What are the dietary patterns and nutritional practices in Nyala location?
3. What are the impact of drought and desertification that may impacts to lower food
production in Nyala location?

1.7 Justification of the Study

Malnutrition is a very serious health problems among children under five years inhale
location. this problem is increasing rapidly among children under five years in Nyala
communities. The most affected children are those found in areas where this limited
agricultural productivity, reliance on seasonal rainfall for crop production and limited access
to healthcare services. The community leaders, stakeholders and government collaborate
together by working closely in order to provide adequate nutrition services and promoting
proper feeding practices and address socio economic and environmental challenges to
prevent and reduce malnutrition among those Children under five years in Nyala Location.

1.8 Significance of the Study

 The study helps in providing accurate information to the county ministry of health
 The study also assist in mitigating morbidity and mortality caused by malnutrition
among children under age in Nyala location
 The study also assist the people especially those living arid and semi arid areas to
understand the impact of drought and desertification in Nyala location that can lead to
lower food production

3
1.9 Limitation of the Study
Lack of proper education and awareness of nutrition and feeding practices for young children

Lack of proper access to health facilities and trained of medical professionals.

The culture beliefs and practices also contributing to malnutrition to young children in the
families

1.9.1 Scope of the Study

The study was carried out at Nyala location ,Laisamis sub county ,Marsabit county,Kenya.
The study specifically determined the factors contributing to malnutrition among children
under five years in Nyala location .Factors contributing to malnutrition in Nyala location
includes socioeconomic factors,inadequate health care services and frequently drought and
desertification that hinder production of agricultural products in the area

4
 CHAPTER TWO

LITERATURE REVIEW
2.0 Introduction
Malnutrition among children under five years of age is a persistent global health issue with
severe consequences for both individuals well being and societal development. It is complex
issue influenced by a variety of factors including socioeconomic factors,environmental
changes and limited to access to healthcare services and dietary factors.Despites significant
advancement in healthcare and nutritions,millions of children worldwide continue to suffer
from various forms of malnutrition , including under nutrition and micronutrient deficiencies.

Understanding these factors contributing to malnutrition among under age is essential for
developing effective interventions and policies to address and prevent children malnutrition
in areas affected by drought and limited healthcare services .This literature review aims to
explore and critically analyze the vavious factors contributing to malnutrition among children
under five years of age.Children experience malnutrition are at higher risks of stunted growth
,cognitive impairments, weakened immune systems and increased vulnerability to diseases
such as kwashiorkor.

2.1 Review of related Studies

Malnutrition among children under five years is a complex issue influenced by various
factors ,including socioeconomic factors,environmental conditions such as drought and
desertification, dietary patterns and nutritional status.This literature review aims to explore
and understand to malnutrition in this children under five years of age.

Numerous studies have highlighted the significasnt impact of socioeconomic factors on child
malnutrition,poverty,low education levels, unemployment and limited access to healthcare
services are some of the key socioeconomic factors contributing to among children under
five years .A study conducted in India found that children from households with lower
socioeconomic status were more likely to be malnourished (Rao et al., 2020)similarly ,a
study conducted in Nigeria revealed that low maternal education and poverty were associated
with increased risk of malnutrition among children(Ogbo et al.,2018)

5
 Drought and desertification have a profound impact on food production and
availability,leading to reduced dietary diversity and nutritional quality.These climatic
changes and environmental factors can cause crop failures ,loss of livestocks and limited
access to water resources ,resulting in food scarcity and inadequate nutritional deficiencies
among children of under age.

In a study by Hoddinott et al. (2018),It was found that prolonged drought and desertification
can lead to decreased agricultural productivity, lower food availability and increased food
prices,ultimately exacerbating food insecurity and malnutrition among children in affected
regions.

Dietary patterns and nutritional status also play a crucial role in the prevalence of
malnutrition among children under five years.The world health organization(2013) highlights
the importance of adequate dietary intake and micrcnutrients rich food in preventing
malnutrition and it is adverse effects on child growth and development.poor dietary
dversity,inadequate breastfeeding practices and lack of access to essential nutrients have all
been identified as contributing factors to malnutrition among young children ,particularly in
resources constrained setting (Black et al.,2013)

2 .2 Summary
The socioeconomic factors, drought and desertification impact and dietary patterns all
contribute to the high prevalence of malnutrition among children under five years. By
understanding these factors ,reqires a multifaceted approach ,including effective
interventions aimed at addressing these complex issues are essential to improving the
nutritional status and well being of children in affected communities. These may include
poverty alleviation programs,climate resilient agricultural practices and nutrition and
education initiatives to promote optimal feeding practices and dietary diversity among
caregivers and efforts to mitigate the impact of environmental factors such as drought and
desertification.It is essential for policy makers ,healthcare providers and international
organizations to collaborate with governments and non profits organizations and
communities to address the complex and interconnected factors contributing to malnutrition
to Children under five years

6
 CHAPTER THREE

3.0 RESEARCH METHODOLOGY

3.1 Introduction
This chapter consists of research design, the target population, accessible population, sample
size, sampling procedures and techniques, data collection tools, data analysis and other
methods that were used to analyze and present the data collected.

3 .2 Research Design
The researcher used the survey design in carrying out the research where the questionnaire
sought to investigate the factors contributing to malnutrition and effects of it among children
under five years, it is effective and easy way to conduct and accessing information or data .It
help them in assessing opinion and trends

3. 3 Study Area
Nyala Location is located in Laisamis constituency .It has a population of
20187(census2019) and an areas of 13998 kilometer square .people in Nyala location
practices pastrolism and trading in livestock and clothes. The study considered that factors
contribute to malnutrition among Children under five years in Nyala Location in marsabit
south

3.4 Population And Sample

3.4.1the Target Population
The target population involves all children under five years in Nyala location ,Laisamis sub
county ,marsabit county .

3.5 Accessible Population

Accessible population involves all Children under five years in Nyala Location, Laisamis
Sub County, Marsabit County.

3 .6 The Sample Techniques/Procedures

The researcher used purposive sampling technique in the study. This help him /.her to capture
a wide range of perspective and a wide range of sampling techniques can be used e.g.

7
 qualitative research designs. The researcher also got information from the ministry of health
tools such as MOH 513, MOH 514 and MOH 100 tools.

3.7 Data Collection Tools

The researcher administered questionnaire forms with both opened ended and closed ended
questions to the respondents and obtains information from them.

The researcher also conduct interviews by providing respondents a room where the
interviews to be conducted. The researcher also conduct surveys where he /she carrying out
observation of the socioeconomic factors and dietary patterns and nutritional status of the
people.

3.8 Data Collection Procedures

Simple statistical procedures were used such as Microsoft excel to analyze the data and
presented through pie charts, tables and bar graphs.

8
 REFERENCES OF THE STUDY

Ali.A,Mohammed .S, Adan H.The association of limited socioeconomic factors that affect the
households income and lead to insufficient resourses for proper nutrition and health
care(2017)

R.E,Victora,C,G,Walker, black et al,(2013)inadequate breastfeeding practices and lack of

access to essential nutrients have all been identified as contributing factors to malnutrition
among youngchildren ,particularly in resources constrained setting.

Hoddinot et al,(2018) It was found that prolong drought and desertification can lead to
decrease agricultural productivity lower food availability and increased food
prices ,ultimately exacerbating food insecurity and malnutrition among children is affected
regions

WHO,UNICEF malnutrituion is responsible for nearly half of all deaths among children
under five years old ,making it major contributor to mortality rates and this may affect the
stunted growth (2020).