Malnutrition in Children Under Five Years of Age

Introduction

Malnutrition is a paramount health concern for children under five years of age in many developing countries. It mainly affects populations in resource-poor settings where access to nutrients is challenging. Individuals afflicted by the condition are susceptible to a variety of illnesses and experience a number of developmental challenges. Poor cognitive and physical growth negatively impact children’s academic performance. As a result, they have reduced opportunities to earn income which exposes them to poverty, thus worsening the region’s overall economic performance. In evaluating the impact of malnutrition on children in Babati District, it is essential to present a global epidemiological and policy context. This is necessary to understand the prevalence of the issue and the measures being implemented to address malnutrition around the world. Evaluating the region’s geographical and historical background will help contextualize the challenges faced by residents. In addition, a review of the interventions and their impact on the population will show why preventing malnutrition is vital. While policy interventions attempt to address malnutrition in children, its negative impacts necessitate the streamlining and prioritization of programs designed to address factors that promote the condition’s prevalence.

Global Epidemiological and Policy Context

Epidemiological Context

A vast majority of the world’s population suffers from the effects of malnutrition. Today, one in every nine people faces starvation, while one in every three is either overweight or obese (The Global Nutrition Report’s Independent Expert Group (GNRIEG), 2020). An increasing number of countries are facing challenges associated with under-nutrition, excess weight, and diet-related chronic illnesses. Approximately 25% of children under five across the globe are stunted, and only 8 of 194 countries are projected to meet four of the ten 2025 global nutrition targets (GNRIEG, 2020). Several countries across the world have taken vital steps to address malnutrition. This is because effective infant and child feeding guarantees proper growth and development. Ensuring that babies are breastfed reduces their risk of becoming obese or suffering from type 2 diabetes later in life (World Health Organization (WHO), 2018). In addition, they are more intelligent and perform well at school. Safeguarding child development and reducing health-related costs leads to economic benefits that impact every member of society.

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The prevalence of malnutrition and related illnesses across the globe is worrying. According to the World Health Organization, approximately 155 million children under five years of age are stunted, 15 million are wasted, and 17 million are severely wasted (Dukhi, 2020). Protein-energy malnutrition is a big problem for children between six months and two years of age because this period involves critical aspects of cognitive development (Dukhi, 2020). Both maternal and child malnutrition have contributed to an estimated 3.5 million deaths every year, and children under five years of age suffer a disease burden of 35% (Dukhi, 2020). In 2008 more than 8.8 million children died globally as a result of complications linked to being underweight, and 93% of these deaths occurred in Asia and Africa (Dukhi, 2020). In sub-Saharan Africa, one in every seven children is at risk of dying before their fifth birthday as a result of malnutrition. This is because the condition affects the immune system and increases susceptibility to infectious diseases.

The World Health organization’s member states have taken several steps to address the negative impacts of malnutrition. More than 80% of countries have initiated programs designed to promote breastfeeding counseling, complementary feeding initiatives, and growth monitoring (WHO, 2018). Regulating the marketing of breast-milk substitutes is important in all contexts. It is worth noting that by March 2016, 135 nations had implemented appropriate legal measures aimed at guiding the market (WHO, 2018). Specific populations suffer a malnutrition cycle where pregnant women fail to meet nutritional requirements meaning that they give birth to low birth weight babies. Infants fail to attain their growth potential, are susceptible to illnesses, and have high mortality rates. Studies conducted in Ethiopia, Sudan, and Bangladesh point to the fact that malnutrition is multi-faceted and includes dietary and environmental elements that impact children’s malnutrition risk (Dukhi, 2020). Some of the contributing factors included feeding practices, poor nutrition, and parent education (Dukhi, 2020). Evaluating the interconnected elements that define malnutrition risk in children under five years of age is critical to the formulation of solutions aimed at terminating the cycle.

Policy Context

The Sustainable Development Goals (SDGs) are guidelines that define comprehensive approaches that ensure feasible growth in all social, economic, and environmental contexts. The SDGs are interconnected, highlighting the importance of a multi-sectoral approach that aims to reach all people. The 2030 agenda stresses the contribution malnutrition makes to poverty and emphasizes its role in global policy frameworks designed to support imperishable progress (World Food Programme (WFP), 2017). It also shows the global community’s determination to complete tasks first presented in the Millennium Development Goals, emphasizing the underlying determinants of nutrition. These include health, food, security, and environmental sustainability (WFP, 2017). The global policy framework is designed to address the elements that contribute to the rise of malnutrition across the planet.

It is critical to define important terms with regard to nutrition and child health. Acute malnutrition refers to wasting characterized by rapid loss of weight or failure to gain weight (WFP, 2017). The weight-for-height nutrition index and the mid-upper arm circumference are important measures used to assess the condition in children. It is classified as either moderate or severe based on the aforementioned objective measures and clinical signs such as wasting and nutritional edema. Chronic malnutrition or stunting is a clinical state that develops over prolonged exposure to frequent infections and inadequate nutrition or both (WFP, 2017). It is assessed using the height-for-age index, and it presents in children under five years of age as incongruence between stature and age. It is vital to note that the condition’s clinical course involves a slow progressive process and may not be seen over the course of a few years. While the condition is impossible to reverse or treat, it can be prevented.

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Malnutrition is a complex malady that affects all aspects of a child’s growth and development. Another aspect is a micronutrient deficiency disease, which refers to a set of symptoms resulting from limited consumption, absorption, or utilization of essential minerals or vitamins (WFP, 2017). Overweight and obesity are the process through which excessive fat accumulation leads to impaired health (WFP, 2017). BMI is a universal measure used to assess the severity of the condition in affected individuals with high readings indicating increased risk for the development of non-communicable diseases. Evidence suggests that the condition is epidemic across the globe in all age groups. A Global Burden of Disease Study indicated that the prevalence of both overweight and obesity rose by 47.1% for children worldwide between 1980 and 2013 (Tluway et al., 2018). The developing world is believed to have contributed significantly to the rise. According to the World Bank, a 64% rise in mortality is expected between 2008-2030 as a result of non-communicable diseases in Sub-Saharan Africa, with overweight and obesity being earmarked as the main risk factors (Tluway et al., 2018). Countries such as Tanzania are currently in the midst of a nutritional transition that is negatively impacting child health.

Nutrition is a critical component of SDGs that impact several countries across the globe. The 2016 Global Nutrition Report notes that a minimum of 12 out of the 17 goals define indicators that are pertinent to nourishment (WFP, 2017). For instance, given that good nutrition impacts educational attainment and the ability to earn income, it has significant implications for the achievement of SDG 3 on health, SDG 4 on education, SDG 8 on sustainable growth, and SDG 1 on poverty (WFP, 2017). These fundamental connections are emphasized in SDG 2, which aims to end global hunger, encourage sustainable agriculture, achieve food security and improve nutrition for all. Target 2.2 aims to end all forms of malnutrition by 2030 and attain the internationally accepted World Health Assembly goals on wasting and stunting in children under five years old (WFP, 2017). It is vital to note that eliminating all forms of malnutrition will necessitate implementing a multi-faceted approach to address the burden of malnutrition among vulnerable populations.

The vast disparities in opportunity, wealth, and power pose a challenge in addressing global malnutrition. Focusing on people living in extreme poverty, those afflicted by HIV/AIDS, and those facing social and political discrimination is the only way to ensure vulnerable groups such as children are spared from the ravaging effects of malnutrition. In addition, addressing the evolving patterns and increasing intricacy of emergencies in addition to considering their connection to enduring nutrition outcomes will facilitate the eradication of malnutrition’s impact on children under five years of age. Therefore, prioritizing resilience-building is imperative because well-nourished people establish resilient communities and nations capable of creating opportunities for growth (WFP, 2017). In addition, they will be equipped to protect the health and nutritional status of the most vulnerable groups in society, which includes children under five years of age.

Global policies on the changing climate must address the impact of environmental transformation on food security. According to the Intergovernmental Panel on Climate Change (IPCC), the increasing climatic changes could lead to a 20% increase in the risk of malnutrition and hunger by 2050 (WFP, 2017). These changes pose a threat because they increase the prevalence of disease, limit food security and diminish water reserves. In addition, they destroy the nutritive value of crops, which negatively impacts their dietary quality. Both the World Health Organization and the IPCC note that malnutrition is one of the most critical health impacts caused by an evolving climate (WFP, 2017). For instance, children born in Zambia during drought conditions have a 12% risk of being below average height and weight compared to those born during the rainy season, while floods in Bangladesh are associated with reduced access to food leading to wasting and stunting (WFP, 2017). Therefore, it is essential that policy initiatives address disaster risk and the impact of a changing climate on vulnerable groups if malnutrition is to be comprehensively addressed.

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Regional Geographical and Historical Background

Tanzania is facing a variety of challenges associated with globalization and nutrition transition. The consumption of energy-dense foods, soft drinks, and high sugar content snacks, as well as drought caused by the changing climate, have had a significant impact on the population’s nutritional status. Babati District is located in Northern Tanzania and is mostly rural with a few urban centers (Tluway et al., 2018). Babati District Council and Babati Town Council make up Babati District. The neighboring districts include Monduli to the North, Mbulu to the West, Karatu to the North-West, Simanjiro to the East, and Kondoa to the South (Babati District Council, 2020). The Babati District council occupies 5608 square kilometers, which is 92.4% of the total landmass of Babati District (Babati District Council, 2020). The region’s topography features mountains, hills, and undulating land.

The district is located in the section of the Great Rift Valley divided by the Dabil-Dareda escarpment. Its lower flatlands are located next to Lake Manyara and Lake Babati, while the upper regions are located in the Magara escarpment (Babati District Council, 2020). It is worth noting that Babati District Council is divided into 4 Divisions, twenty-five wards, one hundred and two villages, and four hundred and eight sub-villages (Babati District Council, 2020). The most populous local ethnic groups in the area are Gorowa, Iraq, and Mbungwe. Many smaller groups of people have migrated to the area in search of livelihoods.

The Babati district council was established after Hanang’ district was divided into two administrative regions. The separation was officially documented in the government’s gazette number 403 in October 1985 (Babati District Council, 2020). The council gained autonomy in July 1986 before being divided into two separate administrative units in 2004, giving rise to the Babati Town Council (Babati District Council, 2020). The two units constitute Babati District and are the key facilitators of governance in the region.

Babati district receives a decent amount of rainfall all through the year. It ranges between 500mm and 2000mm annually and is divided into long and short rain periods (Babati District Council, 2020). The short season of rainfall is experienced between October and December, while the long rains are felt between February and May. The region’s average temperature ranges between 10 and 25 degrees Celsius. The lowlands are dominated by the Savannah, which features bushes and scattered trees, while the highlands are mainly forested. It is vital to note that most of the soil is fertile and volcanic in origin. The Babati region is home to a diverse group of people from various places in Tanzania. According to the 2016 council census, it is estimated that the district’s population is 358, 612 of which 176, 312 are female and 182, 300 are male (Babati District Council, 2020). The data collected from the region indicates that the population is growing at a steady rate.

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Malnutrition in Babati District

The nutritional status of the children in Babati District is a matter of great concern. For instance, it is estimated that 14.4% of the children in the region are underweight while 32.9% are stunted (The Mfumo was Uchambuzi was Uhakika was Chakula na Lishe ( MUCHALI ) Partners, 2017). The incidence of stunting is higher among boys at 35.5% compared to girls at 30.3% (MUCHALI, 2017). The difference is believed to be the result of the behavioral patterns of caregivers in the region who favor girls by giving them better quality food compared to boys. As a result, male children suffer higher rates of diarrhea and other illnesses, which contribute to chronic malnutrition. The above estimates differ slightly from the national average. For instance, it is estimated that 34.4% of children under five years of age are stunted, about 5% are wasted, and 4% are overweight (MUCHALI, 2017). The country’s Southern highlands report the highest rate of malnutrition at 44.7%, with Rukwa and Njombe recording the highest rates of stunting at 56.3% and 49.4%, respectively (MUCHALI, 2017). These figures are necessary to understand the context of malnutrition in the region of interest.

Overweight and obesity are prevalent among Tanzanian children in various regions of the country. The rate is estimated to be between 8.7% and 10.2%, with girls, children living in urban areas, and those attending private school being the most affected (Tluway et al., 2018). Other than the well-known risk factors, motorized transport, the type of food consumed at school, limited fruit and vegetable consumption, and skipping breakfast is thought to contribute to the problem. In a study conducted by Tluway et al. (2018) in Babati District, girls were more affected by overweight and obesity than boys. They identified increased physical activity as the leading cause of excess weight among children in the region. This is because most of the study participants engaged in compensatory behavior, which involved the overestimation of calories burnt during the day, which leads to the prevalence of high-calorie diets (Tluway et al., 2018). The researchers concluded that the condition was moderately prevalent in the semi-rural region of Babati in Tanzania.

Most people in the region consume cereals as a staple in their diet. Approximately 17% of the households included tubers, roots, and plantain, 5% consumed meat on a regular basis, and 17% consumed eggs (MUCHALI, 2017). It is evident that animal protein consumption is significantly low, with most individuals depending on grain to cover the dietary deficit. It is worth noting that 14.3% of Babati’s households consumed a single meal a day, which indicates that a large section of the population barely meets the daily caloric requirement for good health (MUCHALI, 2017). The high incidence of wasting and stunting in the region can be attributed to the lack of access to nutritious food.

Tanzania’s food supply is mainly obtained from local production and purchases from regional markets. The people that inhabit the Babati Council region primarily depend on agriculture as a means of sustenance. Approximately 24% of the council’s total land is arable, and the main food crops grown include beans, maize, bananas, potatoes, cassava, legumes, and millet (Babati District Council, 2017). The farmers in the area also keep animals such as cattle, sheep, and goats for the production of meat and milk. It should be noted that there is inadequate access to safe and clean water for use in Babati’s households. The available shallow wells, surface pumps, and dams meet the needs of 51% of the council’s population (Babati District Council, 2017). This means that almost half the people in the region must travel long distances in search of clean water or resort to using contaminated water to meet their daily needs.

Interventions, Results, and Responses

The Tanzania Development Vision 2025 outlines strategies and programs aimed at eradicating poverty and disease in the quest to become a middle-income country. Tanzania’s agricultural policy guides its food distribution and production initiatives. The National Multi-sectoral Nutrition Action Plan intends to improve nutrition financing in a bid to improve access to food (Alphonse, 2017). The most important intervention capable of addressing malnutrition is the improvement of the region’s health systems. For instance, the government strengthened nutrition services within its health institutions by creating costed care plans that can be scaled up to address all forms of malnutrition (GNRIEG, 2020). In addition, investments in human capital and the promotion of continuous medical education will facilitate the implementation of evidence-based interventions at various points of care.

There are several interventions designed to address malnutrition among children younger than five years of age in Tanzania’s Babati district. The first is deworming and vitamin A supplementation for children. Vitamin A deficiency is the main cause of preventable blindness and is caused by deficient dietary intake and frequent infections (United Republic of Tanzania & UNICEF, 2019). According to the WHO, children aged between 6 to 59 months in areas prone to malnutrition must consume a high dose capsule of vitamin A every four to six months (United Republic of Tanzania & UNICEF, 2019). The republic of Tanzania runs a program aimed at offering the vitamin twice a year at all health facilities. It is worth noting that 63.8% of children aged between 6-59 months received the vitamin in 2018 compared to 72.2% in 2014 (United Republic of Tanzania & UNICEF, 2019). The decline is indicative of the ineffectiveness of public health strategies applied with regard to child health and malnutrition.

Infestation with worms is the leading cause of vitamin A deficiency in children. The parasites cause malabsorption which worsens malnutrition and causes anemia which contributes to stunting. Treating worm infestations leads to a significant decline in child morbidity and mortality. Therefore, it is recommended that children aged between 12 to 59 months get treated because they stand a high risk of suffering from the illness (United Republic of Tanzania & UNICEF, 2019). Deworming is often conducted hand in hand with vitamin A supplementation in Tanzania. In 2018 59% of children aged between 12 to 59 months got dewormed, which is a significant decline from 70.6% in 2014 (United Republic of Tanzania & UNICEF, 2019). It is critical that public health policies in the region are reviewed to ensure that all children gain access to essential health services.

Infant feeding practice policy guidelines are essential in ensuring that malnutrition is contained. It is essential that infants are breastfed within one hour of life, and the practice should continue exclusively for six months, after which age-appropriate foods should be introduced (United Republic of Tanzania & UNICEF, 2019). Breastfeeding ensures that the baby is protected against gastrointestinal infections, which often cause malabsorption and stunted growth. It is vital to note that approximately 96.6% of children aged between 0-23 months in Tanzania were breastfed at some point in 2018, and 53.5% consumed breast milk within an hour of birth, while approximately 58% of infants under six months of age were exclusively breastfed (United Republic of Tanzania & UNICEF, 2019). Timely consumption of breast milk facilitates the intake of essential nutrients that are often absent in resource-poor settings such as Babati District.

Complementary feeding practices are an essential aspect of child nutrition. After six months, children require additional foods to meet the increased energy and nutrient needs. According to the United Republic of Tanzania & UNICEF (2019), complimentary diets were successfully introduced to 86.8% of children aged between six to eight months in 2018. In addition, only 35.1% of children aged between six to twenty-three months received food from a minimum of four food groups, indicating the lack of food dietary diversity in the region (United Republic of Tanzania & UNICEF, 2019). Access to food is an essential determinant of a child’s nutritional status. Limited resources in Babati District result in fewer food choices which promote the severity of malnutrition in the area.

A pregnant woman’s nutritional status is a key determinant of her child’s birth weight and overall health. Babies that receive limited nourishment in the womb stand a high chance of dying in the first few months after birth. The few that live are often stunted and susceptible to a variety of infectious diseases, in addition to facing numerous developmental challenges. Maternal malnutrition is associated with deficiencies in essential minerals necessary for normal fetal development. Programs designed to facilitate the distribution of folic and iron supplements have helped reduce maternal anemia in addition to reducing the incidence of low birth weight babies. In 2018, 28.5% of women between the ages of 15 and 49 years with children younger than five years old took iron and folic acid supplements for at least ninety days during their last pregnancy (United Republic of Tanzania & UNICEF, 2019). This low rate is a major contributor to malnutrition among children in the region.

Sanitation and hygiene are essential requirements when eradicating malnutrition in affected regions. The scarcity of clean and safe water is believed to cause life-threatening infections such as diarrhea which accounts for approximately 50% of child malnourishment (United Republic of Tanzania & UNICEF, 2019). Approximately 55% of Tanzanian households had no access to toilet facilities in 2018 (United Republic of Tanzania & UNICEF, 2019). As a result, the improper disposal of feces leads to contamination which is responsible for increased instances of diarrhea. It is vital to promote education on proper handwashing practices. The use of soap facilitates the elimination of diarrhea-causing agents on the skin. The availability of soap was estimated at 69.4% in Tanzanian households in 2018 (United Republic of Tanzania & UNICEF, 2019). However, most household members were unaware of the critical times soap was to be used during handwashing. Only 2.7% of people in the region reported having used soap two wash their hands at least twice during a twenty-four-hour period (United Republic of Tanzania & UNICEF, 2019). There is a need to educate the public on the importance of hygiene to help reduce the prevalence of malnutrition.

Advocating for a multi-sectoral approach in addressing malnutrition is essential. Approaches that target women’s socio-economic status and education are vital to facilitate the reduction of child undernutrition (Mgongo et al., 2017). In addition, interventions designed to facilitate health-seeking behavior for acute infections and anemia in pregnant women will facilitate the reduction of the incidence of low birth weight babies. Partnerships with institutions such as the World Food Program in reaching specific SDG goals are essential. The technical assistance provided by the organization will help strengthen national nutrition institutions tasked with addressing malnutrition. In addition, it will offer support and offer expertise on policy development to promote access to food and interventions for malnourished children.

Assessment of Malnutrition, Intervention Efforts, and their Impact on Local Communities

The Impact of Malnutrition on Children

Inadequate consumption of nutrients results in a variety of physiological adaptations such as stunting, the loss of visceral mass, and reduced energy expenditure. Acute malnutrition inadvertently impairs the functioning of organ systems in an affected child (Dipasquale et al., 2020). In addition, it causes a number of clinical syndromes with distinct symptoms. The most common is marasmus which occurs due to limited energy intake after a period of several months (Dipasquale et al., 2020). The body adapts to the lack of nutrition and resorts to subcutaneous fat and muscle metabolism to meet energy requirements. Children under five years old are the most susceptible given their increased energy demands and vulnerability to infectious diseases. Affected individuals are emaciated, lethargic, and weak, in addition to presenting with bradycardia, hypothermia, and hypotension (Dipasquale et al., 2020). Their skin is often wrinkled, loose, and xerotic due to the loss of subcutaneous fat deposits. It should be noted that muscle wasting often starts in the groin and axillary regions before progressing to other parts of the body.

Kwashiorkor is a severe illness associated with malnutrition in children. It is caused by inadequate protein intake in the face of normal caloric intake and was first reported in children who relied heavily on maize diets (Dipasquale et al., 2020). The illness represents a maladaptive response to starvation, and edema is its distinguishing feature. The swelling often starts in the feet before gradually progressing to the face, chest, and abdomen (Dipasquale et al., 2020). In addition, the children often have normal weights for age, hypopigmented hair, and distended abdomens. Marasmic Kwashiorkor refers to a clinical illness with features of both marasmus and Kwashiorkor. Affected children have significant wasting as well as edema in addition to mild hair and cutaneous manifestations.

Malnutrition predisposes children to a variety of infectious illnesses that pose a threat to their lives. For instance, the condition is linked to diarrhea caused by bacterial pathogens. The risk of mortality is four times higher in malnourished children with diarrhea than those without malnutrition (Walson & Berkley, 2018). Malnutrition has been linked with increased susceptibility to pneumonia which is often more severe and associated with high mortality (Walson & Berkley, 2018). The impairment of the immune system caused by malnutrition significantly limits an affected child’s ability to ward off infections.

Malnutrition negatively impacts children’s development, and the consequences are often long-lasting. Exposure to severe, acute malnutrition is associated with poor cognitive development, behavioral challenges, and poor academic performance (De & Chattopadhyay, 2019). Stunting and low birth weights also cause developmental delays that affect the child’s wellbeing. Undernourished children often carry the burden of stunting all through their lives and seldom get to achieve their full intellectual and physical potential (UNICEF, 2019). As a result, affected individuals have a limited capacity to earn a living which forces them into poverty, where the cycle of malnutrition is transferred to the next generation. The region’s economy suffers, further compounding the problem, thus exposing entire communities in Babati District to illnesses and developmental challenges.

Reviewing Intervention Efforts in the Community

Babati District is subject to the Tanzanian government’s initiatives to reduce malnutrition across the country. Based on findings from the second National Nutrition survey carried out in 2018, there has been a significant reduction in the number of children affected by malnutrition and stunting in the country (United Republic of Tanzania & UNICEF, 2019). According to the report, the rate of malnutrition has reduced from 34.7% in 2014 to 31.8% in 2018 (United Republic of Tanzania & UNICEF, 2019). The national nutrition programs and policies are designed to combat stunting, which has been identified as the country’s biggest challenge in so far as malnutrition is concerned. The initiatives include the National Multi-Sectoral Nutrition Action Plan, which aims to reduce the prevalence of stunting in the country from 34.5% to less than 28% by the end of 2021 has met its mid-term target of 32% (United Republic of Tanzania & UNICEF, 2019). The government intends to prioritize nutrition interventions in the most affected regions.

The government has increased efforts to ensure that all children under five years old have access to essential health services. For instance, vitamin A supplementation is a critical service offered in the nation’s healthcare facilities. However, it should be noted that coverage is still less than 90% across all regions of the country (United Republic of Tanzania & UNICEF, 2019). Some improvement has been witnessed with regard to breastfeeding practices in the region. In addition, the children have access to more diversified diets with better nutritive value. The government is also focused on strengthening interventions focused on improving maternal health and nutrition. As a result, more pregnant women are taking folic acid and iron supplements, with data indicating that the rate was at 3.5% in 2010 compared to 28.5% in 2018 (United Republic of Tanzania & UNICEF, 2019). Access to mineral supplementation for women is an essential step in breaking the cycle of malnutrition in Babati District.

The rise of overweight and obesity in Tanzania is an issue of concern. It is estimated that 31.7% of women aged between 15 and 49 years are overweight, while 11.5% were obese (United Republic of Tanzania & UNICEF, 2019). Excess weight is associated with detrimental pregnancy outcomes, and the diets consumed in households are often unsuitable for children, who more often than not become overweight or obese. This increases their susceptibility to illnesses such as type 2 diabetes, hypertension, and cardiovascular disease.

Several economic, social and environmental factors contribute to the prevalence of malnutrition. It is vital to adopt a multi-faceted view when proposing solutions to the problem. For instance, while a proper and balanced diet is key in preventing infections, hand washing initiatives offer more protection within households and should, therefore, be merged with nutrition interventions. It is vital to note that the lack of proper sanitation and access to clean water increases disease transmission. As a result, there was no discernible decline in the number of diarrhea cases reported in the national survey (United Republic of Tanzania & UNICEF, 2019). Emphasizing the importance of proper hygiene is essential if the burden of disease is to be lowered.

Recommendations

Children under five years of age in Babati District, like many parts of Tanzania, are affected by malnutrition and its associated complications. The government has taken crucial steps to address the situation. It is vital that the nation’s ministry of health continues promoting programs aimed at supporting the early initiation of breastfeeding. In addition, mothers should be encouraged to breastfeed exclusively for six months and continue offering their babies breast milk for at least two years, as recommended by the World Health Organization. This can be accomplished through nutritional education programs aimed at encouraging behavior change. It is crucial to scale up community-based initiatives that offer counseling on appropriate complementary feeding techniques. This will ensure that children are offered nutrient-rich diets that promote cognitive and physical development.

Communication campaigns are effective tools to ensure communities living in Babati District get informed on important preventive activities. For instance, they can learn the relevance of nutrition during pregnancy, prenatal visits, exclusive breastfeeding, and proper hygiene practices. It is critical that authorities increase the number of resources allocated to current nutrition programs such as the Community-based Management of Acute Malnutrition initiative to further eradicate illnesses associated with poor nutrition. Strengthening integrated child health days in Babati District’s healthcare institutions by improving the distribution of vitamin A and the assessment of children’s nutritional status is essential. In addition, the communities in the region should be mobilized to ensure that all children under five years of age attend regular clinics and get the help they need in the event they have a malnutrition-related illness.

Overweight, obesity and hygiene are important health issues that must be addressed urgently. It is vital to review strategic planning measures and policies aimed at reducing the prevalence of these conditions among children. Improving caregivers’ knowledge of the components of a balanced diet is critical to ensuring that children do not gain excess weight. It is essential to increase sensitization on the importance of washing hands using soap. This will facilitate the reduction of diarrhea in individuals afflicted with malnutrition. Finally, it is essential to conduct frequent nutritional surveys to evaluate progress and identify areas that need urgent attention.

Conclusion

It is evident that malnutrition has far-reaching consequences on the health of children under five years of age. It increases susceptibility to illnesses, causes developmental delays, and affects physical and mental growth. As a result, children are unable to compete favorably in school, which affects their ability to earn income. They are, in effect, plunged into poverty leading to poor regional economic performance. Despite the fact that malnutrition is prevalent in the Babati region of Tanzania, several programs have been implemented to help reduce the burden of disease. For instance, mothers are encouraged to take micronutrient supplementation to reduce instances of low birth weight. In addition, they have access to welfare clinics where they are taught the importance of breastfeeding and complementary diets. While these measures have resulted in some improvement, more needs to be done to ensure children are protected from the deleterious impacts of malnutrition. Strengthening existing programs through increased resource allocation and collaboration with international partners will help address the malnutrition-associated challenges in Babati District.

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