Date Published: February 28, 2019
Publisher: Public Library of Science
Author(s): Olusegun Fadare, Mulubrhan Amare, George Mavrotas, Dare Akerele, Adebayo Ogunniyi, Sukumar Vellakkal.
Nutrition outcomes among young children in Nigeria are among the worse globally. Mother’s limited knowledge about food choices, feeding, and health care seeking practices contributes significantly to negative nutrition outcomes for children in most developing countries. Much less is known about the relationship between mother’s nutrition-related knowledge and child nutritional outcomes in rural Nigeria. This paper investigates therefore: (i) the association of mother’s nutrition-related knowledge with nutrition outcomes of young children living in rural Nigeria, where access to education is limited, and (ii) whether mother’s education has a complementary effect on such knowledge in producing positive child nutrition outcomes in such settings.
Using the Demographic and Health Survey data for Nigeria, we employ both descriptive and regression analyses approaches in analyzing the study’s objectives. In particular, we apply ordinary least square (OLS) to investigate the association of mother’s nutrition-related knowledge with child HAZ and WHZ while controlling for maternal, child, household and regional characteristics. An index was constructed for mother’s nutrition-related knowledge using information on dietary practices, disease treatment and prevention, child immunization, and family planning.
We found that mother’s knowledge is independently and positively associated with HAZ and WHZ scores in young children. Higher levels of mother’s education, typically above primary, have a significant, positive association with child HAZ and WHZ scores. We argue that mother’s knowledge of health and nutrition may substitute for education in reducing undernutrition in young children among populations with limited access to formal education. However, the present level of mother’s education in rural Nigeria appears insufficient to reinforce knowledge in producing better nutrition outcomes for children.
This study suggests promotion of out-of-school (informal) education, such as adult literacy and numeracy classes where women without formal education can gain health and nutrition knowledge, and practices that could enhance child nutrition outcomes in Nigeria.
Child nutrition outcomes, stunting and wasting in particular, are recognized as key indicators for tracking the nutrition and health status of children in a population . More countries now recognize the need to give priority to policies and programs that improve mothers’ ability to provide optimal care for young children, especially during the period from pregnancy to a child’s second birthday . This period presents a critical window of opportunity for parents to use both human and material resources for child growth and cognitive development [3–5]. Empirical evidence, however, suggests that availability of resources such as food and health facilities, and their accessibility, including location advantage, are not sufficient to produce child health [6–8].
This section presents the results: first, of the descriptive statistics of key variables used in analysis; second, of the bivariate association between child’s nutritional outcomes, mother’s knowledge and mother’s education; and third, of the determinants of child nutrition outcomes as measured by HAZ and WHZ.
Stunting prevalence among the sample is about the national average, however, wasting prevalence is almost double the national average for under-fives. From the magnitude of the association of mother’s knowledge with child HAZ and WHZ in our analysis, it is evident that mother’s knowledge of nutrition and health is very helpful in safeguarding young children from occasions that reduce children HAZ and WHZ scores. Occasions such as diarrhea episodes in children as a result of poor hygiene and early introduction of liquid substances other than breastmilk to young children, poor complementary infant feeding, and more under-fives per mother due to limited knowledge of family planning methods all produce stunting and wasting in young children. These results are consistent with some studies in developing countries. For example, Webb and Block [49, 50] found a significant association between maternal nutrition knowledge and wasting in Indonesia but not stunting. Likewise, Appoh and Krekling  in Ghana found associations between mother’s nutrition knowledge and underweight, which measures both stunting and wasting. Mothers with above primary level education can significantly increase HAZ scores, (stunting reduction) in children and WHZ scores (wasting reduction) in children.
The determinants of child nutrition outcomes explored in this study have great policy implications for Nigeria and are also applicable to other countries with similar characteristics. The findings emanating from this study improve our understanding of the independent role that mother’s nutrition-related knowledge can play on child nutrition outcomes. Mother’s knowledge of food choices, feeding, and health care seeking are vital for producing good nutrition outcomes for young children. The present level of mother’s educational attainment in rural Nigeria is not sufficient to reinforce knowledge in producing better nutrition outcomes for children. In such populations with limited access to formal education, mother’s knowledge of health and nutrition may substitute for education in reducing undernutrition in young children. Particular effort should therefore be made to ensure this knowledge is rightly acquired. Other means of knowledge acquisition for mothers who do not have a formal education or cannot complete education above primary school should be employed. More importantly, programs should identify which child care practices should be encouraged to enhance maternal and child nutrition and health; promoting such could mitigate the negative association of mother’s lack of education with children’s health. Finally, adult education through behavioral change communications would be an effective means for reaching out to poor and less educated Nigerian women.