Abstract

Nutrition remains a major aspect of growth and health, better nutrition is associated with improving infant, child and maternal health, robust immune systems, harmless pregnancy and childbirth, low risk of non-communicable sicknesses and longevity. This paper presented some factors affecting the status of nutrition in primary school pupils aged 5-19 years in Kwara, Nigeria. A descriptive method of the survey type was used for the study. The population size of 818,554 out of which 1,322 were sampled by applying a multi-stage sampling procedure. The instruments employed in the study were adopted from the 2007 World Health Organization Nutrition Survey to identify the nutritional status of the pupils. Nutritional status by z‐scores of height‐for‐age (HAZ), weight‐for‐height (WHZ) and weight‐for‐age (WAZ), estimating the prevalence of stunting, wasting, underweight and overweight. Frequency counts and percentages were used to organize the demographic variables while chi-square and Pearson’s Product Moment Correlation Coefficient were used to test the hypotheses at 0.05 level of significance. The data from 1,320 respondents who duly completed and returned the questionnaire were analyzed and reported. The findings showed that 66.7% of the primary school pupils in Kwara State, Nigeria were underweight, while 29.9%, 3.1% and 0.2% were normal, overweight and obese respectively on comparing their BMI distribution with the World Health Organization reference survey using z score for ages 5-19. In addition, stunting and wasting were shown to persist (among the underweight children, 66.7%); proposing that other nutrient deficits or risk factors may be constraining linear growth for a substantial proportion of pupils. Furthermore, all the risk factors have a very strong positive relationship with the pupils’ nutritional status with 0.942, 0.833, 0.735, 0.475, 0.426 for intestine parasitic infection, parental nutrition knowledge, parental education, parental income, birth order, while food security had a weak positive relationship of 0.297. Based on the findings, it was recommended that health educators, health workers and nutritionists should sensitize parents, especially mothers on stunting, wasting and underweight rates of their children and provide specific information as regards healthy lifestyle changes in their dietary patterns, which may help improve their children’s nutritional status.

1. Introduction

Over the decades, food nutrition has been identified as a major health challenge in developing economies, including Nigeria ^{1, 2}. Nutrition in Nigeria presents a complex predicament; the problem of nutritional deficiencies is not only a result of insufficient food; but also a result of poor food choices among those who can afford to buy them ³. Nutrients are constituents of food that perform important functions in the body ⁴. Sufficient nutrition in early stages and early childhood is essential to the development of each child’s full potential ^{5, 6}. If all important nutrients are available in the correct amounts and proportions as required by the body, this is referred to as optimum nutrition or adequate nutrition ⁷. Optimum nutrition is needed to keep up good health. If a person does not get enough of any nutrient in the diet in sufficient amounts or gets too much of a nutrient over time ⁶, the person may exhibit signs of under-nutrition or over-nutrition respectively ^{8, 9}.

Problems with nutrition are generally not given thoughtfulness until a severe stage or noticeable clinical symptoms happen ¹⁰. The primary-aged children’s nutrition (age 5-19 years) requires so much consideration since they are in the growing phase of life where growth is fast and the nutrient needs are relatively high. The children's appropriate growth and development depend on the quality of food consumed. Adequate and balanced diets are required for the functioning of proper cells, good immune system development and normal functioning of the brain in children. Many disorders in the growth of some pupils may be a result of the nutrients that are deficient or taken abundantly. Survival and avoidance of malnutrition in a child require appropriate nutrition and satisfactory health care during the first few years of life ¹¹.

Malnutrition is predicted to have been responsible for over one-third of most child deaths, even if it is barely documented as the direct cause ¹². Globally, technology and science inventiveness are necessary to decide on the listed problems like high food costs, recession in the economy, higher struggle for climate change and natural resources. Kwara State is situated in the north-central of Nigeria on the western border of Nigeria with Benin with16 local government areas (LGAs), it had 3.1 million population in 2016. Men accounted for 57% (1.55 million) of this population. The state is largely rural having more than 80% of the population living in rural areas. Kwara State has abundant natural resources and good climatic conditions suitable for agriculture.

The major occupation in the state is peasant farming and petty trading. Most staple foods are imported from neighboring states as food production and trading (the main occupation in rural areas) have noticeably reduced due to the effects of rural-urban migration. These developments have increased nutritional deprivation among many communities in Kwara State, where there is a serious struggle by parents to sustain three square meals for their children, which they need for growth and development. These further gathered by the researcher are affecting the pupils’ food consumption in both government and private primary schools in Kwara State. This paper focused predominantly on factors affecting the status of nutrition for primary school children in Kwara State, Nigeria.

Over the decades, good nutrition has been identified as a major health challenge in developing economies, including Nigeria ¹. Nutrition in Nigeria presents a complex predicament; the problem of nutritional deficiencies is not only a result of insufficient food; but also a result of poor food choices among those who can afford to buy them. Nutrients are constituents of food that perform important functions in the body ⁴. Sufficient nutrition in early stages and early childhood is essential to the development of each child’s full potential ⁶. If all important nutrients are available in the correct amounts and proportions as required by the body, this is referred to as optimum nutrition or adequate nutrition ⁷. Optimum nutrition is needed to keep up good health. If a person does not get enough of any nutrient in the diet in sufficient amounts or gets too much of a nutrient over time ⁶, the person may exhibit signs of under-nutrition or over-nutrition respectively ⁹.

Problems with nutrition are generally not given thoughtfulness until a severe stage or noticeable clinical symptoms happen ¹⁰. The primary-aged children’s nutrition (age 5-19 years) requires so much consideration since they are in the growing phase of life where growth is fast and the nutrient needs are relatively high. The children's appropriate growth and development depend on the quality of food consumed. Adequate and balanced diets are required for the functioning of proper cells, good immune system development and normal functioning of the brain in children. Many disorders in nutrition grow as a result of the nutrients that are deficient or taken abundantly. Survival and avoidance of malnutrition in a child require appropriate nutrition and satisfactory health care during the first few years of life ¹¹.

Malnutrition is predicted to have been responsible for over one-third of most child deaths, even if it is barely documented as the direct cause ¹². Globally, technology and science inventiveness are necessary to decide on the listed problems like high food costs, recession in the economy, higher struggle for climate change and natural resources. Kwara State is situated in the north-central of Nigeria on the western border of Nigeria with Benin with16 local government areas (LGAs), it had 3.1 million population in 2016. Men accounted for 57% (1.55 million) of this population. The state is largely rural having more than 80% of the population living in rural areas. Kwara State has abundant natural resources and good climatic conditions suitable for agriculture.

The major occupation in the state is peasant farming and petty trading. Most staple foods are imported from neighboring states as food production and trading (the main occupation in rural areas) have noticeably reduced due to the effects of rural-urban migration. These developments have increased nutritional deprivation among many communities in Kwara State, where there is a serious struggle by parents to sustain three square meals for their children, which they need for growth and development. These further gathered by the researcher are affecting the pupils’ food consumption in both government and private primary schools in Kwara State. This paper focused predominantly on how to assess the risk factors affecting the status of nutrition for primary school children in Kwara State, Nigeria.

2. Methodology

This study assessed the factors affecting the status of nutrition for primary school pupils in Kwara State, Nigeria. The study considered the following stepwise phase: study design, the population of the study, sample and sampling technique, data collection instrument, validation of the instrument, reliability of the instrument, data collection procedure and data analysis.

To assess the factors affecting the status of nutrition among primary school pupils in Kwara State, Nigeria, a descriptive design survey type was used for the study. Patrick ¹³ observed that this design will allow the researcher to define an event, condition or phenomenon as it is at the time of the study. The study submitted that this research design focuses on people, their beliefs, attitudes and behaviour and it also helps the researcher to systematically document current opinions and information on his work. The design was appropriate for this study because it permitted the gathering of information from a large population in a relatively quick and inexpensive way.

The population of this study consisted of all the pupils in both public and private primary schools in Kwara State, Nigeria. The total population of the pupils as of the 2017/2018 academic session was estimated to be 818,554 pupils (Kwara State Ministry of Education, 2018).

The total sample that was used in this study consists of 1,322 pupils. This is in line with the Research Advisors (2006) which suggested that for a population of 500,000 people, 384 respondents will be adequate as a sample of the study. However, in this study, 1,322 respondents participated so that the study can cover as many respondents as possible that will make the sample truly representative. To select the required sample for this study, a multi-stage sampling procedure was used. First, the state consists of 16 local government areas, i.e. Asa, Baruten, Edu, Ekiti, Ifelodun, Ilorin East, Ilorin South, Ilorin West, Irepodun, Isin, Kaiama, Moro, Offa, Oke-Ero, Oyun and Patigi. In each local government, a simple random sampling technique of the hat-drawn method was used to select two primary schools (One Public and One Private Primary school). That is, the names of the Primary Schools in Kwara State were written on slips of paper. The slips were then folded and put in a container. After thorough shuffling, the researcher requested a neutral person outside the study population to dip his hand into the container and picked one slip at a time from each zone. The slips were unfolded and the local government it contains was recorded. This process was repeated until the required numbers of primary schools were drawn (two from each local government area). The reason for that was to ensure that the study cut across all the primary schools in Kwara State without any preference. Secondly, a proportionate sampling of 50 percent (Ratio 1:2) was then used to select the respondents from each of the selected schools. This is further to ensure that a representative number of samples are obtained. Pupils in the upper basic (Primary 4, 5 and 6) were eligible to participate in the study because they fell between the ages of 5-19 years, which are the recommended ages by the World Health Organization.

The researcher developed a questionnaire on Factors Affecting Nutritional Status among Primary School Pupils in Kwara State, Nigeria, (RFNSP-Q). The questionnaire was categorised into the following sections: A, B, C, D, E and F

Section A: sought information on demographic data of the respondents.

Section B: sought information on parental income as a factor affecting nutritional status

Section C: sought information on parental education as a factor affecting nutritional status

Section D: sought information on parental nutritional knowledge as a factor affecting nutritional status

Section E: sought information on food security as a factor affecting nutritional status

Section F: sought information on birth order as a factor affecting nutritional status

A modified Likert Scale of Strongly Agree, Agree, Disagree and Strongly Disagree was used to collect data for sections B to F, i.e.

Strongly Agree (SA)-4 points, Agree (A)-3 points, Disagree (D)-2 points, Strongly Disagree (SD) -1 point. The decision criteria used in this study was 2.5 mean score respondents below this is deemed to have a negative response, while those with 2.5 mean scores and above were deemed to have a positive response.

The validity of the instrument was ascertained after four (4) copies of the questionnaire were given to four lecturers in the Department of Physical and Health Education, Bayero University, Kano for vetting. Their corrections, advice, suggestions and criticisms were incorporated into the final draft of the questionnaire to the satisfaction of the researcher's supervisor before testing.

Approval was acquired from the appropriate establishments in the studied school. Oral permission was obtained from their class teachers before the commencement of the study. Assent of the respondents and consent of their parents were also implored and gotten to carry out and publish this study. All authors hereby declare that the study has been duly examined and approved by the Department of Physical and Health Education, Faculty of Education, Bayero University, Kano State, Nigeria.

3. Results and Discussion

The paper assesses the factors affecting the status of nutrition of primary school pupils in Kwara State, Nigeria. One Thousand Three Hundred and Twenty-Two (1322) copies of the questionnaire were distributed. A total of 1320 copies of the questionnaire were properly filled while 2 copies (0.01%) were not properly filled and hence could not be used for the analysis. The analysis was presented in tables and explained thereafter. Table 3 showed the frequencies and percentages of demographic characteristics of the respondents. Table 4 to Table 9 presented answers to the six research questions with the use of descriptive statistics of mean, the pupils’ BMI distribution, weight, height readings and standard derivations. While other tables presented the result of the hypotheses tested to assess the factor variables relating to the existing nutritional status of children between 5-19 years. All hypotheses were tested at 0.05 level of significance.

Table 3 shows that as far as school type is concerned, Four Hundred and Ninety-Three (37.30%) were from private schools, while Eight Hundred and Twenty Seven (62.7%) were in public schools, this shows that the majority of the respondents used were from the public primary. Nine Hundred and Forty-Eight (71.8%) of the pupils were from schools located in urban areas, while Three Hundred and Seventy-Two (28.2%) were from schools located in rural areas, that is the majority of the school used were from urban settlements. Six Hundred and Sixty Nine (51.4%) were male pupils, while Six Hundred and Forty-One (48.6%) were female pupils, this shows that the study was distributed across males and females with a difference of 38 numbers boys over female respondents. Pupils’ ages range from 1 to 5, using age distribution intervals of 5, 6, 7 (1); 8, 9, 10 (2); 11, 12, 13 (3); 14, 15, 16 (4); and 17, 18, 19 (5) respectively, this shows that the respondents between age bracket 8, 9 and 10 have the highest population of 68%, while aged 11, 12 and 13; 5,6 and 7; 14, 15 and 16 and 17, 18 and 19 had 2^nd, 3^rd, 4^th and 5^th in population position respectively. With respect to mother’s level of education, it was observed that 149 (11.3%); 311 (23.6%); 393 (29.8%); 467 (35.4%) of the mothers possess no schooling, have primary education, secondary education, tertiary education respectively while 215 (16.3%), 463 (351%); 343 (26.0%); 299 (22.7%) of the fathers possess no schooling, but have primary education, secondary education, tertiary education respectively. The frequency and percentage distribution of parental economic status reveal that a large number, 494 (37.4%) are unemployed, the majority 579 (43.9%) are farmers/traders, while 211 (16.0%) have shops where they sell goods and services.

Research Question 1: Is parental nutrition knowledge a factor in nutritional status among primary school pupils in Kwara State, Nigeria?

Table 4 shows the parent's nutrition knowledge and the pupil’s nutritional status. This reveals the frequency and percentage scores of parents’ responses on nutrition knowledge.240 parents, who represented 18.8% agreed to know food classification, while 1080 (81.2%) were not knowledgeable. 304 (23%) agreed to know about feeding based on health needs, while 1016 (77%) were not knowledgeable. 568 (43%) agreed to know food guides, while 752 (57%) were not knowledgeable. 509 (38.6%) agreed that milk is not important for child growth, while 811 (61.4%) agreed that milk is important for child growth and 322 (24.4%) agreed to know the importance of fruits, while 998 (75.6%) were parents that do not know the health benefit of fruit to child health respectively. This implies that a lack of nutrition knowledge contributes to a high rate of underweight disorders among primary school pupils in Kwara state. Hence, parental nutrition knowledge is a risk factor affecting the nutritional status of primary school pupils in Kwara State.

Research Question 2: Is parental income a factor of nutritional status among primary school pupils in Kwara State, Nigeria?

Table 5 shows the parent income and the pupil’s nutritional status. 742 (56.2%) were parents who could not afford quality food based on their low income, while 578 (43.8%) could afford quality food. 611 (46.3%) were parents that have many burdens on their income, while 709 (53.7%) were that have a light burden on income. 846 (64.1%) believe that fresh fruit is expensive based on their low income, while 474 (35.9%) believe that fruits are not expensive. 672 (51%) were parents who could afford to buy imported food based on a low income, while 648 (49%) could afford to buy important food nutrients and 568 (43%) could not afford three –square meals for their child based on their low income, while 752 (57%) able to afford three-square meals for their child. This implies that low parental income contributes to the high rate of underweight disorder among primary school pupils in Kwara state. Hence, parental nutrition knowledge is a risk factor affecting the nutritional status of primary school pupils in Kwara State.

Research Question 3: Is parental education a factor in nutritional status among primary school pupils in Kwara State, Nigeria?

Table 6 shows the parental education and the pupil’s nutritional status. 856 (64.8%) were parents that have no education, while 464 (35.2%) were educated parents who responded that education influences child growth. 652 (49.4%) were parents that have no education, while 668 (50.6%) were educated parents who responded to the influences of education on their food choice. 801 (60.7%) were parents that have no education, 519 (39.3%) were educated parents that responded to the influence of education on food proportion, 715 (54.2%) were parents with no education, while 605 (45.8%) were educated parents that response to the influence of education on food process. 689 (52.2%) were parents with no education, which influences their food culture. 464 (35.2%) were educated parents, which influences the child's growth. 668 (50.6%) were educated parents, which influences their choice of food. 519 (39.3%) were educated parents that influence their food proportion, while 631 (47.8%) were educated parents who responded to the influence of education on food culture. This implies that low parental education contributes to the high rate of underweight disorder among primary school pupils in Kwara state. Hence, parental nutrition knowledge is a risk factor affecting the nutritional status of primary school pupils in Kwara State.

Research Question 4: Is food security a factor of nutritional status among primary school pupils in Kwara State, Nigeria?

Table 7 shows the food security and the status of pupils’ nutrition. 876 (66.4%) of the parents have no secure source for quality food, while 444 (33.6) were parents that have secure sources of food. 826 (62.6%) of the parents have no access to fresh food within their compound, while 494 (37.4%) have a fruit garden within their compound. 758 (57.4%) of the parents have no secure source of clean water, while 562 (42.6%) were parents that have a secure source of clean water. 694 (54.8%) of the parents have no secure source for affordable food, while 626 (45.8%) were parents that have access to affordable food. 594 (45%) have fear of getting food, while 726 (55%) were parents that have no fear of getting food. This implies that food insecurity contributes to the high rate of underweight disorder among primary school pupils in Kwara state. Hence, parental nutrition knowledge is a risk factor affecting the status of nutrition for primary school pupils in Kwara State.

Research Question 5: Is intestinal parasitic infection a factor of nutritional status among primary school pupils in Kwara State, Nigeria?

Table 8 shows the intestinal parasitic infection and the pupil’s nutritional status. 358 (27.1%) were parents that have not treated worm infections within the past three months, while 962 (72.9%) were parents that have treated worm infections for their child within the past three months. 417 (3.6%) were parents that have not been treated for diarrhea infection for the past three months, while 903 (68.4%) were parents that have been treated for diarrhea infection for their child in the past three months. 352 (26.7%) were parents whose children are not always complaining about stomach upset, while 968 (73.3%) were parents whose children always complain about stomach upset. 449 (34%) were parents who have not been admitted to the hospital for the past three months, while 871 (66%) were parents whose children have been admitted to the hospital within the past three months. 298 (22.6%) were parents whose children are not on medication, while 1022 (77.4%) were parents whose children are on continuous medication. This implies that intestinal parasitic infection contributes to a high rate of underweight disorder among primary school pupils in Kwara state. Hence, parental nutrition knowledge is a risk factor affecting the status of nutrition of primary school pupils in Kwara State.

Research Question 6: Is birth order a factor of nutritional status among primary school pupils in Kwara State, Nigeria?

Table 9 shows birth order and the pupil’s nutritional status. 458 (34.7%) were the parent that agreed to distribute appropriately among their child, while 862 (65.3%) were parents that disagreed with distributing appropriately among their children. 342 (25.9%) were parents that have no preference for a particular sex child, while 978 (74.1%) were parents that have a preference for a particular sex child. 329 (24.9%) were parents who disagreed that many children are an investment, while 991 (75.1%) were parents who agreed that many children are an investment. 382 (28.9%) were parents that believe in child spacing practice, while 938 (71.1%) were parents that do not believe in child spacing practice. 413 (31.3%) were parents that support childbirth control practice, while 907 (68.7%) were parents that do not support childbirth control practice. This implies that intestinal parasitic infection contributes to a high rate of underweight disorder among primary school pupils in Kwara state. Hence, parental nutrition knowledge is a risk factor affecting the status of nutrition for primary school pupils in Kwara State.

(i) Major Hypothesis:

There is no significant relationship between the factors and nutritional status of primary school pupils in Kwara State, Nigeria.

The multiple linear regression was conducted to investigate whether risk factors of nutritional status could predict the nutritional status of primary school pupils in Kwara State, Nigeria. Correlation Coefficient result (r) is .042, while the p-value is 0.001 and the total number of cases was 1319. Since r = .042, there exists a weak relationship between the risk factors and nutritional status. This implies that risk factors cannot predict nutritional status by an increase of 42%. Since the p is 0.001 is < 0.05 level significance, the null hypothesis is rejected on the account that a weak significant relationship exists between the risk factors and the nutritional status. since r is .042, there exists a weak relationship; r² is a coefficient of determination is 0.002. The amount of variation explained the risk factors contribute 2% to nutritional status, while the remaining 98% is the contribution of other factors not included in this study. Adjusted r² test goodness of fit equal to -.003 is negative fit, sp from ANOVA is .889 F(6, 1313) equal to .385. All the risk factors did not contribute to nutritional status p > 0.05. Multiple regression was run to predict nutritional status from parental nutrition knowledge, parental income, parental education, food security, intestinal parasitic infections and birth order. These variables did not predict the nutritional status of primary school pupils F (6, 1313) =. 385, p > 0.05, R²= .002.

(ii) Sub-Hypothesis 1

Parental nutrition knowledge is not a significant factor in nutritional status among primary school pupils in Kwara State, Nigeria. Summary of Chi-Square Analysis on Parental Nutrition Knowledge as a factor of nutritional status among primary school pupils.

Table 13 summarizes the Chi-Square analysis of parental nutrition knowledge as a factor of nutritional status among primary school pupils. The table shows that 240(18.2%) of the parents have nutrition knowledge, while 1080 (81.8%) have no nutritional knowledge. Statistical analysis indicated a χ2 value of 791.351, at df=1 and since P < 0.05, the null hypothesis is therefore accepted. This implies that parental nutrition knowledge is not a significant risk factor for nutritional status among primary school pupils in Kwara State, Nigeria. This was earlier shown in Table 4, that parents without nutrition knowledge have 742 (56%) of their children stunted/wasted, and only 304 (23%) are considered of normal weight/height. Therefore, the test result shows that parental nutrition knowledge is a weak risk factor for the status of nutrition for primary school pupils in Kwara State, Nigeria.

(iii) Sub-Hypothesis 2

Parental income is not a significant factor in nutritional status among primary school pupils in Kwara State, Nigeria. Summary of Chi-Square Analysis on Parental Income as a factor of nutritional status among primary school pupils.

Table 14 summarizes the Chi-Square analysis of parental income as a factor of nutritional status among primary school pupils. The table shows that 282 (21.4%) of the respondents’ parents are having a moderate income while 1038 (78.6%) are having a low income. Statistical analysis indicated χ2 value of 726.259, at df=1 and P < 0.05. The null hypothesis is therefore rejected. This implies that Parental income is a significant risk factor for nutritional status among primary school pupils in Kwara State, Nigeria. The data indicated that pupils from low-income parents suffer more nutritional status problems. Therefore, there is a significant difference in the observed and expected frequencies. Therefore, the test result shows that parental income is a weak risk factor for the status of nutrition for primary school pupils in Kwara State, Nigeria.

(iv) Sub-Hypothesis 3

Parental education is not a significant factor in nutritional status among primary school pupils in Kwara State, Nigeria. Summary of Chi-Square Analysis on Parental Education as a factor of nutritional status among primary school pupils.

Table 15 summarizes the Chi-Square analysis on parental education as a factor of nutritional status among primary school pupils. The table shows that 412 (31.2%) of the respondents’ parents are educated while 908 (68.8%) are not educated. Statistical analysis indicated χ2 value of 734.063, at df=1 and P < 0.05. The null hypothesis is therefore accepted. This implies that parental education is not a significant risk factor for nutritional status among primary school pupils in Kwara State, Nigeria. Therefore, the test result shows that parental education is a significant risk factor for the status of nutrition for primary school pupils in Kwara State, Nigeria.

Table 16, summarizes the Chi-Square analysis on food security as a factor of nutritional status among primary school pupils. The table shows that 315 (23.9%) of the respondents’ parents are having secured means of food while 1005 (76.1%) are having an unsecured source of food. Statistical analysis indicated χ2 value of 765.084, at df=1 and P < 0.05. The null hypothesis is therefore accepted. This implies that food security is a significant risk factor for nutritional status among primary school pupils in Kwara State, Nigeria. Therefore, the test result shows that food security is a weak risk factor for the status of nutrition for primary school pupils in Kwara State, Nigeria.

(iv) Sub-Hypothesis 5

Intestinal parasitic infection is not a significant factor in nutritional status among primary school pupils in Kwara State, Nigeria.

Summary of Chi-Square Analysis on Intestinal Parasitic Infection as a factor of nutritional status among primary school pupils.

Table 17 summarizes the Chi-Square analysis of Intestinal Parasitic condition as a factor of nutritional status among primary school pupils. The table shows that 211 (16.0%) of the respondents were not treated for Intestinal Parasitic related diseases in the past three months ago, while 1109 (84.0%) were treated for nutritional-related diseases recently. Statistical analysis indicated χ2 value of 769.000, at df=1 and P < 0.05. The null hypothesis is therefore rejected. This implies that the Intestinal Parasitic condition is a significant risk factor for nutritional status among primary school pupils in Kwara State, Nigeria. This was earlier shown in Table 5., that 737 (56%) were pupils that have been treated for intestinal parasitic infections within the last three months and shown stunted/wasted growth, while only 340 (26%) were normal growth. Therefore, there is a significant difference in the observed and expected frequencies. Table 6 and Table 7 show the relationship between intestinal parasitic infection and pupils’ nutritional status, where r is 0.942, which measures the strength and direction of a linear relationship between intestinal parasitic infection and pupils' nutritional status. The test result shows that intestinal parasitic infection is a risk factor for the status of nutrition for primary school pupils in Kwara State, Nigeria.

Birth order is not a significant factor in nutritional status among primary school pupils in Kwara State, Nigeria. Summary of Chi-Square Analysis on Birth Order as a factor of nutritional status among primary school pupils

Table 18 summarizes the Chi-Square analysis on birth order as a factor of nutritional status among primary school pupils. The table shows that 324 (29.8%) of the respondents are among the last born of their family, while 926 (70.2%) are among the firstborn of their family. Statistical analysis indicated χ2 value of 779.019, at df=1 and P < 0.05. The null hypothesis is therefore rejected. This implies that those pupils born among the last birth order suffer a high rate of nutritional-related problems since care and attention have been drawn away from them, however, poor birth spacing, poor childbirth control or poor family planning increases the nutritionally related problem, while less care and attention were given. Therefore, the test result shows that birth order is a risk factor for the status of nutrition for primary school pupils in Kwara State, Nigeria.

4. Conclusion

Nutrition is the biochemical and physiological process by which a person uses food to support his or her life, this contains ingestion, absorption, assimilation, biosynthesis, catabolism and excretion. This paper assessed and identified the relationship between risk factors that influenced the nutritional status of primary school pupils in Kwara State, Nigeria. The frequencies and percentages of demographic characteristics of the respondents on the age, sex, birth order, class, school status, parent’s level of education and socioeconomic status. Six research questions with the use of descriptive statistics of mean and standard Derivations were conducted. The result relates to the relationship of risk factor variables with the existing nutritional status of children between 5-19 years. All hypotheses were tested using ANOVA at 0.05 level of significance. The population of the study was 740,945 pupils aged 5-19 years (Kwara State Ministry of Education, 2017). The sample size of the study was 1320 primary school pupils. Multi-stage sampling technique was used to select participants for the study. These were stratified random, proportionate and purposive sampling techniques. Three different instruments were used for data collection. An adapted questionnaire titled risk factors of nutritional status of primary school pupils in Kwara states, Nigeria was purposively distributed to pupils to information about their demographic information, a weighing scale was also used to measure weight and an infant meter/height meter was also used to measure the length/height of the pupil. Frequency counts and percentages were used to describe the demographic characteristics of respondents. Means and standard deviations were used to answer the research questions. The data generated were analyzed using ANOVA to determine the relationship of the risk factor variables of parents’ levels of education, nutritional knowledge, income, intestinal parasitic infection, food security and birth order on primary school pupils' nutritional status. Six sub-hypotheses were formulated and tested at 0.05 alpha levels. Findings showed that 66.7%, 29.9%, 3.1% and 0.2% were underweight, normal, overweight and obese respectively. Furthermore, several social and economic variables that positively influenced children’s nutritional status were identified.

References