Case Study on Nutritional Status of School Aged Children

This case study explores the nutritional status of school age children, identifies causes and consequences of malnutrition, and analyzes successful programs to address the issue. It examines the UNICEF Framework, evidence-based interventions, and health and nutritional data to understand the challenges and solutions.

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CASE STUDY ON THE NUTRITIONAL STATUS OF SCHOOL AGED CHILDREN
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Abstract
The objective of this case study is to investigate the nutritional status of school age
children and identify the cause and consequence of the problem and analyze a successful
program that will help to address school age children. UNICEF Framework was used to
identify the cause of over or under nutrition in school aged children. Evidence based
interventions were analyzed and successful programs that have helped to solve the issue
were also analyzed. Health and nutritional data was used to obtain statistics on the
challenges that result in malnutrition. The UNICEF framework was also used to find a
solution to the nutritional status. The results showed that malnutrition is caused by
several factors that begin from the societal level to family level and finally to the
individual who us the school aged child. The outcome of these factors is an under
nourished school going child. The child is not able to obtain the required nutrients from
the food they eat and the end up falling sick. Diseases can also result in an under
nourished child. The consequence of malnutrition are mostly felt at the societal level. The
community spends more resources on medical costs to treat the diseases arising from
under nutrition. There are evidence based programs which can help the community
improve its nutritional status and prevent under nutrition of school aged children. One of
the solutions is helping the parents or guardians obtain a source of income. School going
children are the most vulnerable in any population. It is therefore the responsibility if the
entire community to ensure that their nutritional status is good. This can be done through
implementing the evidence based programs in the community.

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Introduction
Currently , the nutritional status of several populations in the world is very poor. Most
individuals suffer from under nourishment. However, a percentage of the population
suffer from over nourishment. School age children are the most vulnerable towards
malnutrition in any population. This is because they have a low immunity and they are
exposed to potential diseases, especially when they go out to play. School aged children
spend a large percent of their day at school and they interact with several other children
from different backgrounds and this exposes them to a variety of diseases (Desai,
Kurpad, Chomitz and Thomas 2015). Contracting a disease influences the way the body
processes the nutrients and this results in malnutrition. They face a variety of nutritional
issues such us underweight, anorexia and malnutrition. On the other hand, there are
children who suffer from obesity, overweight and lifestyle related diseases. Children
enjoy eating junk food such as cakes; cookies, fries among others. These foods are high
in fat and calories and pose a serious effect to the health of the school aged child (Talsma
et al. 2015).
Method
The UNICEF Framework for under nutrition was analyzed to obtain details on the causes
of malnutrition and some if the consequences of malnutrition. Through this framework, a
solution was obtained and analyzed. The current evidence based programs was analyzed
to determine the effectiveness. Health and nutritional data on school going children was
analyzed to find out more information about malnutrition (Pernas et al.2015).
Results

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Nutritional data was obtained from different databases. For example, Vitamin and
Mineral Nutrition Information System (VMNIS), WHO Global Database on Child
Growth and Malnutrition, and WHO Global Database on Body Mass Index. WHO
Global Data Bank on Infant and Young Child Feeding (Berezowitz, Bontrager Yoder
and Schoeller 2015). The following health and nutritional data was obtained. In south
East Asia, Africa and Latin countries, the prevalence of underweight children was
reported to be 10%. More than half of the reported cases of Anemia reported were
moderate and 40% of the reported cases had severe aenemia. 20 to 30% of the reported
cases of malnutrition suffered from a deficiency of iron, zinc, iodine or vitamin A. The
school aged children who were overweight were 20% of the total population of children.
In an average school going child, 40% of the calories us from empty calories consisting
of sugars and solid fat. This is obtained from soda, pizza, grain desserts, dairy desserts,
fruit based drinks and milk. A large number of school aged children do not meet the
recommended number of cups of water in a day. Although older school aged children are
open to eating fruits and vegetables, they still do not consume a sufficient amount to meet
their nutritional needs (Vilchis-Gil, Galván-Portillo, Klünder-Klünder, Cruz and Flores-
Huerta 2015).
Discussion
The poor nutritional status of school age children has major consequences which can be
divided into health, social and economic. Health consequences for poor nutrition is
diseases. There are several lifestyle diseases that develop due to poor nutrition; they are
classified according to over nutrition and under nutrition. Over nutrition results in
diabetes, obesity, high blood pressure and cardiac complications. Diabetes is caused by a
high intake of sugar. The body is unable to produce enough insulin that will breakdown

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the sugar resulting in type 1 diabetes (van Schoor and Lips 2018). Consumption of large
quantities of food rich in calories results in obesity. Most school age children have a good
appetite and tend to consume a lot of foodstuffs especially junk food, which makes them
gain weight. The Body Mass Index (BMI) increases and the child is said to be
overweight. High blood pressure is caused by eating unhealthy foods. Children at this age
tend to eat foods that look appetizing regardless of the nutritional benefit. This habit
results in high blood pressure which in turn causes many cardiac issues and eventually
heart failure (Patel et al. 2015).
On the other hand, under nutrition also has consequences. Most school children are picky
with their meals. If this behaviour is not controlled, the child may end up lacking the
required nutrients. The parents may also be unable to provide the child with the required
nutrients due to lack of resources. This can lead to diseases such as Marasmus.
Kwashiakor may occur in children who do not take enough proteins. Other health issues
that arise include child fatigue, loss of body weight and the eyes become pale. The brain
development is also affected by poor nutrition and the school age child may become
retarded (Berezowitz, Bontrager Yoder and Schoeller 2015).
Social consequences of poor nutrition are seen in the way the school child interacts with
other children. Poorly nourished children usually lack the energy to be as active as others.
They spend most of their time napping instead of playing. The child tends to be irritable
and other children avoid spending time with them. In addition, the child is unable to
focus well in class and they end up performing poorly in academics. The diseases caused
by malnutrition can make the child miss several lessons at school affecting their
academic performance (Kaur, Lamb and Ogden 2015).
The economic consequence of poor nutrition is felt by the entire population. A lot of
resources are spent on treating the diseases that have occurred. The parents and guardians

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spend a lot of money on treatment plans. The school age children are not as productive as
they should be and as a result they tend to bring down the population. The population
does not grow since are not well educated or retarded due to the diseases. The children
therefore are not innovative and cannot help solve some of the emerging issues. Many
malnutrition school age children die before maturity ( Taylor-Robinson et al. 2015).
The causes of malnutrition can be divided into two, causes of over nutrition and causes of
under nutrition. Over nutrition is a lifestyle disease caused by taking too much junk food
or good high in calories such as cookies and pizza. Most school aged children have a
good appetite that should be controlled to prevent the over nutrition. The amount of junk
food around the house should be regulated (Ning et al. 2015).
According to the UNICEF framework, under nutrition is an outcome of a conceptual
framework. In the environment today, there are many potential resources in the
environment and in technology. However, politics, social and religious systems limit the
utilization of the resources. The government that is in charge if distributing the resources
does not fulfil its task. Social systems opt for construction of malls instead of allocating
the space to farming. The quality and quantity of the human resource is limited in its
distribution. Discriminating attitudes and lack of knowledge play a huge role in
contributing to malnutrition at societal level. At the family level ,the major cause of
malnutrition is insufficient access to food, which is usually caused by the society (Jarpe-
Ratner, Folkens, Sharma, Daro and Edens 2016). The parent or guardian is unable to
obtain the money necessary for providing the family with the required nutritional foods.
Malnutrition is also caused by lack of maternal care especially for school age children.
School age children without proper monitoring tend to eat unhealthy foods or fail to eat
completely resulting in malnutrition. Inadequate health services play a role in
contributing to under nutrition at the family level. The school aged child contracts
diseases due to poor sanitation in the area around them. Diseases make the individual

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have under nutrition. When the child is too weak to eat the body will begin to lack some
nutrients (Liu et al. 2015).
Considering some of the evidence based programs , the priority for action to address the
nutritional problem is ensuring that the school aged child obtains food. If the under
nutrition child can obtain food the problem of malnutrition will be controlled. This is
done at the society level. At this level, there is poor distribution of resources. (Jarpe-
Ratner, Folkens, Sharma, Daro and Edens 2016). According to the UNICEF, lack of
access to the resources limits the amount of food that the child will receive. Evidence
based programs aim at increasing the sources of income for the parents and guardians.
Most programs train the adults on small skills such as bead work, tailoring, metal work
and making of peanut butter and jam. With this skill the adult can be able to obtain
income and help to provide food for their family (Wolde, Bahran and Chala 2015).
In our population, one method that has helped improve the nutritional status is a program
aimed at teaching individuals how to make peanut butter and jam. Through obtaining this
skill the program has empowered the parents to obtain a secondary source of income
which they can use to buy their school aged children the necessary foods that they require
(Kordas et al. 2016). This program is successful because the individuals only need to pay
a small fee to be taught the skills. Opening up a business with the skills obtained allows
then to access a resource that would have been impossible. With the business they are
free to grow and expand as they wish (Aiken, Davey, Hargreaves and Hayes 2015).
The nutritional knowledge that is obtained through teaching the parents how to make the
peanut butter or jam is applied to other sectors. The parent is able to analyze the foods
that they give to the school aged child and determine whether it is nutritious to them or
not. This way they prevent diseases like kwashiakor. The child is able to obtain the

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necessary nutrients and even additional ones that help them to grow and develop (Hakim,
Talukder and Islam 2015).
The peanut butter and jam making program links up with other programs in the
population that aim to improve the nutritional status of the school aged children. There
are other programs that educate the parents on the importance of giving a child a proper
balanced diet. This program educates the parent on which foods the school going child
should feed on and why they should eat it. Once the parent has this knowledge they begin
to look for a way to access the reduce and be able to provide for the child the nutrients
they learned through the program. It is at this point that the peanut butter and jam making
program is involved. The parents sign up for this program and they are able to improve
the nutritional status (Degarege, Degarege & Animut 2015).
There are other evidence based programms that have been developed to help solve the
problem of malnutrition. Children are being taught in school the importance of nutrition.
Most classes have displayed charts explaining the importance of good nutrition. This
charts are colourful and attract the attention of the students. One common chart is the
plate chart. This is a chart that explains what the plate should contain in every meal. The
plate should contain a lot of vegetables followed by proteins. Carbohydrates should be
the least amount in the plate. In some schools, the children are given plates that are pre
partioned to use during lunch time. These plates help the approximate the amount of food
to serve for each type. This method encourages the school child to eat a balanced diet in
the right quantities (Jarpe-Ratner, Folkens, Sharma, Daro and Edens 2016).
There is a breasfeeding program that was recently launched. This program is aimed at
encouraging mothers to breast feed their young ones until the age of two years. Breast
milk contains all the necessary nutrients for growth. If the child feeds on breast milk
only, they will obtain all the necessary nutrients regardless of whether they take any

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additional nutrients. The program meets with lactating mothers and pregnant mothers
when they attend the clinic. After the mother has visited the doctor for their monthly
check up, a nutritionist talks to them on the importance of breastfeeding. The nutritionist
also explains some of the foods they can give to the child during weaning and how to
ensure that the child remains healthy even after they stop breasfeeding. Mothers are
educated on which food to give the child as they begin school. These foods provide the
child with energy througout the day (Oliveira, Ferreira, Atouguia, Fortes, Guerra and
Centeno-Lima 2015).
Recommendations
In order to improve the nutritional status of the community; it is recommended to
educate the school going child. Despite educating the parents and the community around
them, the child us partly responsible for what they put in their mouth. Educating the
school going child on which foods they should eat, and why they should eat them will
help to improve the nutritional status. In the school, nutritionists should be deployed to
educate the children. The effects of junk food should also be explained to the children.
The nutritionist should find a way to explain to the child the nutritional benefits in a
manner that is simplified and the child will be able to understand (Marí-Bauset et al.
2015).
Another recommendation is that the root cause of malnutrition should be addressed. The
main cause of malnutrition is unequal distribution of resources such as technology and
environment. The political, social, religious systems should assemble together and
attempt to distribute the resources equally. The leaders of the population should strive to
develop a program that will ensure all the available resources are distributed fairly.
Everybody in the population should be able to access good education and land should be

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allocated equally. This will allow the parents to utilize the resource and provide for their
child the necessary nutrients (Prentice et al. 2016).
To solve the issue of over nutrition, the first strategy us to educate the parents on the
complications associated with over nutrition (Oliveira, Ferreira, Atouguia, Fortes, Guerra
and Centeno-Lima 2015). The parents or guardians should understand the effects of their
school aged child being over weight. The parent or guardian will be able to understand
the necessity to control the problem of over nutrition. Secondly, the parents should
regulate the amount of junk food that the school aged child has access to during the day.
This involves reducing the number of trips to the fast food restaurants or bakery and
limiting the portions of food that the child takes. In addition, the parent or guardian
should reduce amount of junk food that is found in the house (Belizario et al. 2015).
Conclusion
Although some if the evidence based programs do not address the problem completely,
they contribute significantly to the broader multi sectoral approach. With the little change
that is programs implement they are able to improve the nutritional status of school going
children. All countries should implement some of these evidence based programs
regardless of their nutritional status is poor or average. This will ensure that all school
going children have an equal opportunity to access resources as children from
communities that are from a good nutritional status (Corvalánet al 2017).

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