Evaluation of nutritional status among school-aged children in rural Kwahu-eastern region, Ghana; anthropometric measures and environmental influences

Abstract

School-age children in developing countries are particularly vulnerable to undernutrition as the priority of nutritional interventions focus on fetal development and the first years of life. This study examines anthropometric indices of school-age children in five communities located in rural Kwahu-Eastern Region, Ghana, West Africa and discusses environmental influences that contribute to their nutritional and growth status. Anthropometric indices of heights and weights were obtained from 411 school- aged children, (5-12 years old) in 5 villages (Asakraka, Awiseasu, Miaso, Oframase and Oworobong) during June 2012. Anthropometric parameters and influences that contributed to nutritional status (environmental, health facilities, availability of markets and gender) were assessed. Factorial ANOVAs were conducted with age, gender and village as factors for the z-score for ‘BMI-for-age’ and the z-score for ‘height-for-age’. The z-score of ‘BMI-for-age’ showed a significant two-way interaction effect between ‘Age’ and ‘Village’, F (4, 391) = 6.06, p-value < 0.001, η2 = 0.06. The mean z-score for ‘BMI- for-age’ was significantly lower for older children in Oframase. The z-score of ‘Height-for-age’ showed a small but significant three-way interaction effect among ‘Age’, ‘Gender’, and ‘Village’, F (4, 391) = 3.79, p-value = 0.005, η2 = 0.04. The mean z-score for ‘Height-for-age’ was significantly lower in older children (ages 10-12 years) in all villages except Asakraka. Lower mean z-score for ‘Height-for-age’ in older children (ages 10-12 years) remains to be significant in boys in villages of Awiseasu and Oworobong and in girls in villages of Awiseasu, Miaso and Oframase. Children in isolated communities are at increased risk for lower z-scores in ‘Height-for-age’ and ‘BMI-for-age’. Communities with a clinic, paved road and established infrastructure did not demonstrate evidence of chronic malnutrition. Acute malnutrition in the form of lower z-scores was demonstrated in older children in Oframase. Gender disparities are present and increased awareness of the nutritional status of girls needs to be addressed.

Keywords: Nutrition, School children, Ghana, Environment