TABLE OF CONTENT
Title page
Approval page
Dedication
Acknowledgment
Abstract
Table of content
CHAPTER ONE
INTRODUCTION
1.1 Background of the study
1.2 Statement of problem
1.3 Objective of the study
1.4 Research Hypotheses
1.5 Research question
1.6 Significance of the study
1.7 Scope and limitation of the study
1.8 Definition of terms
1.9 Organization of the study
CHAPTER TWO
LITERATURE REVIEW
2.1 theoretical review
2.2 Conceptual review
2.3 empirical review
CHAPETR THREE
RESEARCH METHODOLOGY
3.1 sources of data collection
3.3 Population of the study
3.4 Sampling and sampling distribution
3.5 Area of the study
3.5 Validation of research instrument
3.6 Method of data analysis
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS AND INTERPRETATION
4.1 Introductions
4.2 Data analysis
CHAPTER FIVE
5.1 Introduction
5.2 Summary
5.3 Conclusion
5.4 Recommendation
Appendix
Abstract
The prevalence of HIV/AIDS in One local government area of River state is alarming. HIV and AIDS affect the livelihoods of the persons living with HIV/AIDS (PLWHA) and consequently their food security status. The country’s food security relies heavily on its agricultural production. Food insecurity that influences dietary practices affects more than 12% of the inhabitant of the affected hospitals of PLWHA (children) in One LGA especially in urban households and the presence of HIV and AIDS worsens the situation. There is limited data available on the magnitude of food insecurity among PLWHA in One LGA and the effect on consumption pattern and nutrition status. The main objective of this study was to assess the food consumption patterns and the nutritional status among children from HIV/AIDS affected hospitals in One LGA.
CHAPTER ONE
INTRODUCTION
1.1 Background of the study
The impact of HIV/AIDS on agriculture is enormous: labour shortage, reduction in farm size, substitution of cash crops for crops which require less labour and strength to produce, poor household nutrition, food insecurity, economic losses among others. According to USAID (2001), for every 1% decrease in the supply of labour, production will decrease by 0.3%. The World Health Organization also estimated that local losses in agricultural productivity from AIDS at the households or village level range from 10 to 15% in about ten sub-Saharan African countries, including Nigeria. Therefore, HIV goes beyond being a health issue as it has become more of a social and economic issue. The human immunodeficiency virus and acquired immune deficiency syndrome (HIV and AIDS) pandemic is a global crisis with adverse consequences. In 2013 Thirty five million people were estimated to be living with HIV globally and about 2.3 million people were newly infected with HIV (UNAIDS, 2013a). Sub-Saharan Africa remains most affected by the scourge with an estimated 24.5 million people living with HIV and AIDS (PLWHA) (WHO, 2014; UNAIDS, 2013a; UNAIDS 2013b). According to the KAIS report (2012), the HIV and AIDS prevalence in Nigeria is about 1.4% down from 2.8% in 2007. The same report showed that higher percentages (6.5%) of PLWHA are urban residents while 5.1% reside in rural areas. Poverty and poor living conditions among the urban poor compound the HIV and AIDS situation (NACC, 2014; Amuyunzu-Nyamongo & Taffa, 2004). Food security is an issue of global concern and in the past various targets to achieve a food secure population have been set. The most prominent is the goal to reduce the number of hungry people by halve by 2020, which is also contained in millennium development goals (MDGs). This far this goal is yet to be achieved and according to FAO, IFAD and WFP (2014), the rate of progress towards halving the hungry populations is slow for comfort. Currently about 805 million people globally are food insecure and face chronic hunger (FAO, IFAD & WFP, 2014). About 98% of them live in developing countries (Meade & Stacey, 2013). Nigeria is one of the developing countries whose food security is challenged. The statistics above indicates that urgent attention needs to be paid to support PLWHA and arrest the high rate of mortality among carriers of the virus. To achieve this, various studies (Castleman et al (2004) and FANTA (2004)) have shown that adequate food consumption pattern, nutritional status and dietary intake is the key. This is because adequate dietary intake helps keep the immune system strong, enabling one to better fight the disease and help the body of PLWHA process the many medications taken (Nanziri,2008). HIV/AIDS attacks the immune system making the body susceptible to opportunistic infections like fever, diarrhoea, tuberculosis, pneumonia, sores and blisters and has no cure. Therefore, efforts made by government and other concerned organisations must be augmented by the infected individual through proper and adequate dietary intake. This may help to delay rapid progression from HIV to AIDS and reduce high mortality as a result of HIV/AIDS. Poor nutritional intake for PLWHA inadequate dietary intake has dire consequences for an already compromised immune system. HIV infection compromises the nutritional status of infected individuals and, in turn, poor nutritional status can affect the progression of HIV infection. The infection itself and associated complications frequently have a tremendous effect on the nutritional status of an individual (Piwoz and Preble, 2000; Williams, 1990). Infections affect nutritional status by reducing dietary intake and nutrient absorption and by increasing the utilization and excretion o f protein and micronutrients as the body mounts its “acute phase response” to invading pathogens. Infections also result in the release of prooxidant cytokines and other reactive oxygen species. This leads to the increased utilization of “antioxidant” vitamins (e.g. vitamin E, vitamin C, beta-carotene) as well as the sequestration of several minerals (e.g. iron, zinc, selenium, manganese, copper) that are used to form antioxidant enzymes (Cimoch, 1997). “Oxidative stress” occurs when there is an imbalance between the pro-oxidants and antioxidants, causing further damage to the cells, proteins, and enzymes (Piwoz and Preble, 2000). Malnutrition associated with HIV infection has serious and direct implications for the quality of life o f HIV/AIDS patients. Weight loss is often the event that begins “a vicious cycle of increased fatigue and decreased physical activity, including the inability to prepare and consume food” (Piwoz and Preble, 2000).
1.2 STATEMENT OF THE PROBLEM
Nigeria is the most populous country in Africa, with a population of over 140 million (NPC 2006), a rapid population growth rate of 3.2 percent, and a large population of young people. The country also has one of the highest HIV prevalence rates in the world with a 3.6 percent prevalence rate in 2010 translating to an estimated 3.3 million people living with HIV (USAID 2011). In 2003, an estimated 800,000 children were reported to be orphaned by AIDS. In 2005, figures indicated that 1.3 million children had lost one or both parents to AIDS in Nigeria (UNAIDS 2006). Overall, there are an estimated 7.3 million orphans in Nigeria [Federal Ministry of Women Affairs and Social Development 2008]. Apart from HIV and AIDS, other causes of orphaning in Nigeria include road accident, maternal mortality, sectarian and ethnic conflict, poverty, and gender inequality. This situation is worsened by the general poor state of the health and nutrition of children. Nigeria has one of the highest under-five mortality rates in the world as one in every six children born in Nigeria is likely to die before their fifth birthday. Available data from the Nigerian Demographic and Health Survey (NDHS, 2008) indicate that only 23 percent of eligible children were fully immunised and that exclusive breastfeeding coverage was 13 percent, having declined from 17 percent in 2003. Sub-optimal feeding practices are rampant, as 34 percent of infants are not exclusively breastfed, but rather are given water and other foods before the age of 6 months. Malnutrition among children less than 5 years of age is very high in Nigeria, as 23 percent are underweight (low weight for age). Data also show that 41 percent are stunted (low height for age), indicating chronic malnutrition that causes life-long physical and cognitive deficits, and 14 percent are wasted or extremely thin (low height for weight), indicating acute malnutrition, often linked with illness (NDHS 2008).
1.3 OBJECTIVE OF THE STUDY
The main objective of this study is to examine the food consumption patterns and nutritional status among children from HIV/AIDS affected hospitals in One LGA of River state; but to aid the completion of the study, the researcher intend to achieve the following specific objectives;
- i) To determine the nutrient adequacy of the hospital diets and dietary supplements given to hospitalized HIV/AIDS patients in One LGA
- ii) To examine the effectiveness of dietary counseling that is given to hospitalized HIV/AIDS patients at Hospitals in One LGA of River state
iii) To ascertain if there is any significant relationship between food consumption pattern and nutritional status of Children living with HIV/AIDS in affected hospitals in One LGA
- iv) To evaluate appropriateness of food consumption pattern of hospitalized HIV/AIDS patients at affected hospitals.
1.4 RESEARCH QUESTIONS
The following research questions were formulated by the author to aid the completion of the study;
- i) How adequate is the nutritional content of the hospital diets and dietary supplements given to hospitalized HIV/AIDS patients in One LGA?
- ii) Has the dietary counseling that is given to hospitalized HIV/AIDS patients at Hospitals in One LGA of River state improve their nutritional status?
iii) Is there any significant relationship between food consumption pattern and nutritional status of Children living with HIV/AIDS in affected hospitals in One LGA?
- iv) Is the food consumption pattern of hospitalized HIV/AIDS patients at affected hospitals appropriate?
1.5 RESEARCH HYPOTHESES
The following research hypotheses were formulated by the researcher to aid the completion of the study;
H0: there is no significant relationship between food consumption pattern and nutritional status of Children living with HIV/AIDS in affected hospitals in One LGA
H1: there is a significant relationship between food consumption pattern and nutritional status of Children living with HIV/AIDS in affected hospitals in One LGA
H0: food consumption pattern of hospitalized HIV/AIDS patients at affected hospitals is not appropriate
H2: food consumption pattern of hospitalized HIV/AIDS patients at affected hospitals is appropriate
1.6 SIGNIFICANCE OF THE STUDY
This study has generated information that indicates how HIV has impacted on food security. The role played by food security in influencing the food consumption pattern and nutritional status has also been studied. The study findings show the relationship between consumption pattern and nutritional status. The generated information adds to the existing body of knowledge in the field of nutrition and dietetics. The results are useful to stakeholders in food security to developing appropriate strategies geared towards the improvement of general livelihoods and food safety nets of PLWHA. Findings are useful in the generation of new policy and improve existing policies geared towards reducing the effects of HIV and AIDS on food security. The findings of this study are useful to stakeholders in food security to scale up research in HIV and AIDS contexts.
1.7 SCOPE AND LIMITATION OF THE STUDY
The scope of the study covers food consumption pattern and nutritional status among children from HIV/AIDS affected hospitals in One LGA of Rivers state. This study focused on children in affected/infected who were on Anti-Retroviral Treatment as those not on ART may have a difference in immune system. This study did not focus on PLWHA with chronic health conditions as this would aggravate the nutrition status. The study was carried out in One LGA of River state in Nigeria hence results of this study may only be generalized to similar set-up
1.8 OPERATION DEFINITION OF TERM
Food
Food is any substance consumed to provide nutritional support for an organism. It is usually of plant or animal origin, and contains essential nutrients, such as carbohydrates, fats, proteins, vitamins, or minerals.
Consumption
Consumption, defined as spending for acquisition of utility, is a major concept in economics and is also studied in many other social sciences. It is seen in contrast to investing, which is spending for acquisition of future income. Different schools of economists define consumption differently.
Nutrition
Nutrition is the science that interprets the interaction of nutrients and other substances in food in relation to maintenance, growth, reproduction, health and disease of an organism
HIV
HIV stands for human immunodeficiency virus. It weakens a person's immune system by destroying important cells that fight disease and infection. No effective cure exists for HIV.
AIDS
AIDS, but strict adherence to antiretroviral regimens (ARVs) can dramatically slow the disease's progress as well as prevent secondary infections and complications.
1.9 ORGANIZATION OF THE STUDY
This research work is organized in five chapters, for easy understanding, as follows
Chapter one is concern with the introduction, which consist of the (overview, of the study), historical background, statement of problem, objectives of the study, research hypotheses, significance of the study, scope and limitation of the study, definition of terms and historical background of the study. Chapter two highlights the theoretical framework on which the study is based, thus the review of related literature. Chapter three deals on the research design and methodology adopted in the study. Chapter four concentrate on the data collection and analysis and presentation of finding. Chapter five gives summary, conclusion, and recommendations made of the study
