Introduction
George (2005) defined nutrition as a science that deals with all the various factors of which food are compose and the way in which proper nourishment is brought about. He stated that the average nutritional measurement characteristics such as; age, sex, height, weight, degree of activity and rate of growth. Food according to him is everything solid and liquid that has a chemical composition which enable it when swallowed to provide the body with the material to allow growth, maintenance, repair or reproduction of proceed, supply substance which normally regulate the productivity of energy or the process of growth.
King (2010) also stated that nutrition requires a satisfactory diet which is capable of supporting the individual consuming it in a state of good health by producing the required amounts. It must provide the right amount of food to execute normal physical activity if the total amount of nutrients in the diet is insufficient; a state of under nutrition will develop. The America Medical Association (AMA) (2006) defined nutrition as the science of foods, the actions, interaction and balance in relation to health and disease. According to William (2010) nutrition is the science of the area of knowledge regarding the role of food in the maintenance of good health. Thus, nutrition is the study of food at work in our body. Nutrition is the key to developing and maintaining a state of health that is optimal for anyone. In addition, inadequate diet couple with a sedentary lifestyle are known to be risk factors for life threatening, chronic disease and death, stroke, hypertension, diabetes and some forms of cancer, together, these diseases account for two third of all death in united states.
Richard (2004) stated that, human nutrition is the provision to human to maintain the material necessary to support life. Furthermore, human can survive for two to eight weeks without food depending on stored body fluid. Survival without water is usually limited to three or four days. Lack of food remains a serious problem. About thirty-six (36) million humans are starving to death every year. Finally, Morris (2007) said that obesity is caused by consuming more calories that are mainly attributing nutritional science investigation to the metabolic and physiology response of the body to diet with evidence in the field. The study of nutrition is increasingly concerned with metabolism and metabolic pathways. The sequence of biochemical steps through which substance in living things change from one to another shows that there is relevance in nutritional education most especially to mothers in order to avert the causes of infant and child mortality.
Conceptual framework
Thomas (2003) defined nutrition as the science that deals with the various factors of which food is composed and the way in which proper nourishment is brought about. She stated that the average nutritional requirement of group of people are fixed and depends on such measureable characteristics such as age, sex, height, weight, degree of activity and rate of growth. Food is anything solid or liquid that has a chemical complication which enables it when swallowed to do one or more of the following;
- Form of energy.
- Provide material to allow growth maintenance, repair or reproduction to proceed.
- Slipping substances which normally regulate the production of energy or the process of growth, repair or reproduction.
King (1972) stated that good nutrition requires a satisfactory diet, which is capable of supporting the individual consuming it in a state of good health by providing the desired nutrient in required amount; it must provide the right amount of food to execute normal physical activities. If the total amount of nutrients provided in the diet is insufficient, a state of under nutrition will develop.
The American Medical Association AMA (1986) defined nutrition as the science of food, the nutrient and the substance therein, their actions interaction and balance in relation to health and diseases. Nutrition science is the area of knowledge regarding the role of food in the maintenance of good health thus nutrition is the study of food at work in our body. AMA further asserts that nutrition is the joy of developing and maintains a state of health that is optimal for you. In addition, inadequate diet couples with a sedentary lifestyle are known to be risk factors for the threatening chronic disease and death, heart disease, stroke, hypertension, diabetes and some forms of cancer.
According to Williams (2001) together, these diseases account for two thirds of all death in United States. The major health problem in the United States is largely caused by excessive energy intake where there are no enough physical activities. According to Oxford Advanced Learners’ Dictionary (1997) nutrition is the process by which living thing receive food necessary for their growth and to be healthy.
Richard (2004) stated that human nutrition is the provision to human to obtain the materials necessary to support life in general; human can survive for two to eight weeks without food depending on stored body fat. Survival without water is usually limited to thrive for four day. Lack of food remain a serious problems about thirty six (36) millions human starving to death every year.
History of infant mortality
According to Free Encyclopaedia (2009) from Wikipedia stated during ancient times and middle age, the infant mortality rate was about 200 death per 1000 live birth and the under 5 mortality was about 300 deaths per 1000 live birth. The encyclopaedia further stated that in the time past, infant mortality claimed a commendable percentage of children born, but the rate has significantly declined in the west in modern time mainly due to improvement in basic health care through high technology medical advances etc. Infant mortality refers to numbers of infants death per 1000 live births neonatal mortality is defined as the death of an infant that occurs before the infant is 28 days old. The neonatal intensive care unit (NICU) facilities have greatly reduced this number since 1950. Post–neonatal mortality refers to infant death that occurs between the 28th and 36th days of life. Most death 66% occur during the neonatal period and 34% occur in the post-neonatal period. The infant mortality rate in the US was 7.1 in 1997 some reduction in infant mortality is due to more available parental care and increase availability of programme for women, infant and children which provides relevant information for mothers that drastically reduce infant deaths.
Infants death have devastating effects on the families of the lost infant, infants mortality is directly related to the mother’s health, the quality and access to public medical care and social economic status. There is some disparity between the infant mortality rate for white babies and bodies of other race. In 1977 the white infant mortality rate was 7.2 economic and social factors are blamed for disparity.
According to Gatto (2001) mortality is the rate of death and mortality is calculated by the number of death per year in a particular population as a whole. Analyzing mortality rates in different countries or among specific groups in the same country provides information for the study of death.
Causes of infant mortality
Jonathan and Kano (2009) opined that the principle causes of mortality among children are acute respiratory infection especially pneumonia, diarrhoea, septicemia, meningitis, tuberculosis birth asphyxia, haemoglobin-empathies and severe anaemia. The free encyclopaedia also asserted that the most common cause of infant mortality worldwide has traditionally been dehydration from diarrhoea. It further stated that the most common cause currently is pneumonia and other causes include congenital malformation, infections, STDs insecticide, child abuse, child abandonment, neglect and illiteracy.
According to the National Centre for Health Statistics (NCHS 2009), the single most reliable predictor of infant mortality is poverty and not race or ethnicity. It seems that the individual is least able to gain access to private and public health is the cause of the highest mortality rate especially in developing countries. According to Federal Ministry of Health/UNICEF (2001) every year 120 of every 1000 children born in Nigeria die from childhood disease before they reach the age of one. A large proportion of those who survive become disabled for life. It further stated that some of these diseases include measles, poliomyelitis, pertusis etc. all those diseases can be prevented through immunization. When our children are immunized properly the child mortality and morbidity will be reduced. Report by Tee (2002) stated that another cause of infant mortality is illiteracy which should be done away by educating the adult especially female folks.
Literacy empowered women and automatically helps to reduce infant mortality and improve nutrition. Another cause of the infant mortality rate is that lack of improvement in access to medical care often accompanied by lack of improvement in registration of birth and deaths.
Effects of infant mortality
Infant mortality has devastating effect on the families of the lost infant. The effect of infant mortality is directly related to the mother’s health, the quality and access to public medical care and socio-economic status. The national health plan (1086) reported that out of every 10 children born would die before one year and at least one more than before reaching 5 years of age, this means that 20% of new-born are not to celebrate their 5th birthday or start school.
Gotto (2001) indicates and analyzed the effect of sudden infant death (SID) by staying that sudden death results from a variety of causes. Some causes of sudden death remain speculative for example infant death syndrome. SIDs occurs during sleeping in infants’ under one year of age nearly all (SIDs) who occurs when an infant is sleeping without any warning signs or symptoms.
The cause is unknown, however there are so many theories as to why lit occurs. It is commonly believed among researchers that babies who die of SIDs are born with many numbers of conditions that makes them particularly subtle to stress occurring in the life of an infant. Most researchers believe that SIDs does not have one cause but several. Some deaths according to Gotto are associated within appropriate feeding practices, which occurs during the first year of life, and by the time children reach their second birth day if under nourished they could suffer irreversible physical and cognitive damages impacting their health, economic well-being and welfare.
The consequences and insufficient nourishment continue into adulthood and past onto the next generation and undernourished grille and women give birth to babies with low birth weight which constitutes a serious health effect in infant mortality rate.
Infant mortality rates in global incidence
Ellen and Gups (2009) argue that the apparently, deteriorating health levels during the past years is largely illusory. They base their change on an assertion that the USSR 7.3% drops reported mortality between 1970 and 1971 was a highly unusual effect. They further stated that birth and death registration in the Muslim area in the early 1970s hence it could lead to a rise in reported rate of infant mortality even as actual health condition was improving. In view of Jonathan and Kano records of incidence and disease pattern and mortality rate in the tropics are rough estimates since they are based on hospital records which they are considered with a particular disease. The disease pattern may change as a result of human and economic progress. There is therefore a need for agree criteria for measuring the level of child’s well-being and its rate of change. According to Wikipedia (2009) for the world and for both Less Developed Countries (LDCs) and More Developed Countries (MSCs) infant mortality rate declined significantly between 1960 and 2001. However, infant mortality remained higher in LDCs and MDCs made dramatic reduction in infant rates reduction in LDCs are on average much less than those among more developed countries.
Infant mortality rates in other countries
According to UNICEF, infant mortality rate is the number of new-born dying under a year of age divided by the number of live birth during the year. It is also the number of death that occurs in the year of life per 1,000 live births.
Infant mortality rate is a good indicator of a country’s level of health or development; it is a component of the physical quality of the index. Some claim that method of calculating IMR may vary between countries based on the way they define a live birth. WHO defined a live birth as any born human being who demonstrates independent sign of life, including breathing, voluntary muscle movement on heartbeat
According to the National Health Plan (1986) and UNICEF the worst under 5 mortality rate is 184 in Sierra Leone (that is 28% of all children born die before they turn 5 years old). US news and World Report (2006) claims that infant mortality is more rapid in the United States because they count all birth as live, if they show any sign of life, regardless of permittivity on size average of 2 every second and another child under the age of five die every three seconds.
In Australia and Germany must be at least 500mg (1 pound) to count as life birth. In Europe such as Switzerland, the foetus must be at least 30cm (12 inches)n long in Belgium and France, birth at least more than 200 weeks of pregnancy are registered as lifeless. Thus the US is sure to report the highest infant mortality rate. Ashley Coale find but that Hong Kong and Japan report still birth, which is a pattern that is consistent with the high recorded sex rates as birth in these countries. Jonathan and Kano further stated that is has been estimated in most countries that 70% of deaths occur in children under the age of 5 years in contrast to the above 5% in developed countries because of the high and unregulated fertility rate.
Implication for health care delivery system
According to Clifford (2009) antenatal and post-natal services in the state are provided by the (TBA), primary health care, secondary health facilities. Presently, over 50% of the obstetric population only resort to patronize TBAs and prayer house while few resort to orthodox health centres when complication set in, by the time health is sought for it care is usually too late to be effective. Clifford sees this as a background that the state Government embarked on the free pregnancy, care of legible pregnant woman and free medical care for children between 0-5 years of ages.
Millennium Development Goals (MDGs) for child survival stated that the major contributor to infant mortality is infection, majority of the death occurs at home without coming to medical attention. Currently, recommendation of hospitalization and parental therapy for managing neonatal infection are inadequate followed in developing countries.
Antenatal Care (ANC) is theoretically a good channel for new born intervention which requires considerable investment. Measures will need to be put to place to ensure this basic quality for institution delivery and new-born care, and to change staff attitude and practice, postnatal visit should include the case of the body referred and counselling of the promotion optimal danger signs in addition to promoting optimal care practices. The health level of recognition of asphyxiated babies “at risk” babies and low weight babies.
MDGs further stated that under nutrition large prevention causes of over one thirds of 10 million child health annually. So to achieve optimal health, development survival of infants and young children, all infant should exclusively breastfed for the first six month of birth followed by introduction of complementary feeding along with costumed breastfeeding for two years and beyond with reference to PHC (2007)which states that health workers have been identified to have the unique opportunity to provide services such as prenatal visits, delivery and immediate post-partum visits, post-natal visit, immunization visit well child visit and sick-child care visit. Also, the Frère Encyclopaedia stated that the community based management approaches to improve survival from neonatal infection has been published since 1990 from developing countries.
Some reports state that, infect ion may be responsible for 8% to 80% of all neonatal deaths, and as many as 43% of death in the first week of life. By the time children get to their second birth day. If under nourished, they could suffer irreversible physical and cognitive damage impacting their future health economic well-being and welfare. The consequences of insufficient nourishment continue into the adulthood and are passes on to the next generation and under nourished girls and women produce babies with low birth weight.
It is indisputable fact that the major causes of nutritional disorder are gross insufficiency of the required food and uneven distribution of the available food items. Apart from taking food that are not balance, indigestion and malnutrition leads to infant’s death. Therefore proper care should be taken in respect to balance diet. The mortality rate that is associated with nutritional problems is indeed too high we should not fold our hands to the problems.
Therefore, the intervention to reduce neonatal mortality needs to start during pregnancy not only to promote birth preparedness and institutional delivery, but also to start the process of change concerning early new-born and practices. As opined by Imoke (2009) the infant or maternal mortality rate is significantly high in cross river state. It is not something to be proud of but it is something to address urgently and that is why free health programme for pregnant women have been introduced in the state. Referral services and immunization services has also been provided. WHO (1991) stated that the aim of NPI within PHC is to reduce morbidity and mortality rates among children by providing immunization against the six major killer disease include; measles, tetanus, meningitis, whooping cough, poliomyelitis and diphtheria. With reference to Ibrahim (2003) modern clinical medicine is able to alleviate pain and reduce mortality without fundamentally altering the determinant of disease in the country. Also, clinical medicine helps to consolidate the group already covered and cause further improvement so that, the effect was cumulative, such as changes are occurring in the developing world and a review of strategy is necessary. Further stated that, health care for mother and children is sufficiency developed to provide a uniform standard of health surveillance almost everywhere.
According to Edet (2009) the aim of free health care programme is to ensure reduction to preventable infant mortality by availing the group with preventive measures and adequate health care as well as the financial burden of health care on parents. Edet further stated that, another aim of having the free health programme is to have health care personnel to deliberately involve in taking health care initiatives to people where ever they love to work.
WHO also emphasize that, the aim of health care delivery system is to prevent death and disability resulting to common disease and injuries so that all children can have the opportunity of health growth and development. Therefore, effort should be made by PHC workers to ensure that family food is adequately affordable and balanced in nutrients. Also, parents should be health educated and immunization services, antenatal rate will be reduces.
Mothers should also be health educated in daily basic concerning the type of nutrients that should be given to infants and children in order for infant’s mortality rate to reduce. Conclusively, the course of child health care aim at providing the worker the necessary skills needed to provide service to ensure that fewer and children will die and more will live to go to school (Ejeba, 2009).
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