Abstract
Childhood malnutrition imposes a heavy burden on already vulnerable communities. Malnutrition, both in the form of undernutrition and overnutrition, has been associated with an elevated risk of mortality, morbidity, and cognitive and social-emotional impairment. Although undernutrition traditionally has been a major risk factor in developing countries, overnutrition is increasingly becoming a burden with more children experiencing the adverse effects of overweight. Malnutrition not only leads to adverse psychosocial outcomes but also has been associated with a host of psychosocial antecedents. This current chapter attempts to synthesize existing empirical evidence from Africa so as to identify research gaps and potentially useful points of intervention. The reviewed literature indicates that, other than economic factors which limit access to food, psychosocial factors such as maternal depression, maternal (un)employment, and stimulation provided at home impact children’s nutritional status. Limited research evidence exists on antecedents of overnutrition in the African context; however, eating habits, degree of physical activity, socioeconomic status, and area of residence seem to contribute to the development of overnutrition. Interventions that focus on both biomedical (i.e. nutritional supplementation and prevention of ill health) and psychosocial aspects seem to be the most promising in tackling undernutrition. Similarly, a broad-based approach, which focuses on changing eating habits and encouraging physical activities, holds promise in halting current trends in obesity. In conclusion, this review further emphasizes the crucial role played by psychosocial factors in the emergence of childhood malnutrition.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Aboud, F. E., & Alemu, T. (1995). Nutrition, maternal responsiveness and mental development of Ethiopian children. Social Science & Medicine, 41, 725–732.
Abubakar, A. (2008). Infant-toddler development in a multiple risk environment. Ridderkerk: Ridderprint.
Abubakar, A., Holding, P., Mwangome, M., & Maitland, K. (2011). Maternal perceptions of factors contributing to severe under-nutrition among children in a rural African setting. Rural and Remote Health, 11, 1423.
Abubakar, A., Holding, P., Newton, C. R., van Baar, A., & van de Vijver, F. J. (2009). The role of weight for age and disease stage in poor psychomotor outcome of HIV-infected children in Kilifi, Kenya. Developmental Medicine and Child Neurology, 51(12), 968–973.
Abubakar, A., Holding, P., Van de Vijver, F., Bomu, G., & Van Baar, A. (2010). Developmental monitoring using caregiver reports in a resource-limited setting: The case of Kilifi, Kenya. Acta Paediatrica, 99, 291–297.
Abubakar, A., Van Vijver, F. J. R., Van Baar, A. L., Kalu, R., Mbonani, L., Newton, C. J. R., et al. (2008). Socioeconomic status, anthropometric status and psychomotor development in a resource limited setting in Kenya: A path analytic study. Early Human Development, 84, 613–621.
Adegoke, S. A., Olowu, W. A., Adeodu, O. O., Elusiyan, J. B., & Dedeke, I. O. (2009). Prevalence of overweight and obesity among children in Ile-ife, south-western Nigeria. West African Journal of Medicine, 28, 216–221.
Adewuya, A. O., Ola, B. O., Aloba, O. O., Mapayi, B. M., & Okeniyi, J. A. (2008). Impact of postnatal depression on infants’ growth in Nigeria. Journal of Affective Disorders, 108, 191–193.
Alderman, H. (2007). Improving Nutrition through Community Growth Promotion: Longitudinal Study of the Nutrition and Early Child Development Program in Uganda. http://www.sciencedirect.com/science/journal/0305750X Go to World Development on SciVerse Science Direct World Development. 35, 2007, 1376–1389. doi.org/10.1016/j.worlddev.2007.04.003
Alderman, H., & Engle, P. L. (2008). The synergy of nutrition and ECD interventions in Sub-ÂSaharan Africa. In M. Garcia, A. Pence, & J. L. Evans (Eds.), Africa’s future, Africa’s challenge: Early childhood care and development in sub-saharan Africa (pp. 353–367). Washington, DC: World Bank.
Amuna, P., & Zotor, F. B. (2008). Epidemiological and nutrition transition in developing countries: Impact on human health and development. Proceedings of the Nutrition Society, 67, 82–90.
Armstrong, M. E. G., Lambert, M. I., Sharwood, K. A., & Lambert, E. V. (2006). Obesity and overweight in South African primary school children – the Health of the Nation study. South African Journal of Medicine, 96, 439–444.
Aubuchon-Endsley, N. L., Grant, S. L., Berhanu, G., Thomas, D. G., Schrader, S. E., Eldridge, D., et al. (2011). Hemoglobin, growth, and attention of infants in southern Ethiopia. Child Development, 82, 1238–1251.
Avan, B., Richter, L. M., Ramchandani, P. G., Norris, S. A., & Stein, A. (2010). Maternal postnatal depression and children’s growth and behaviour during the early years of life: Exploring the interaction between physical and mental health. Archives of Disease in Childhood, 95, 690–695.
Bangirana, P., John, C. C., Idro, R., Opoka, R. O., Byarugaba, J., Jurek, A. M., et al. (2009). Socioeconomic predictors of cognition in Ugandan children: Implications for community interventions. PLoS One, 4, e7898.
Bass, J. K., Ryder, R. W., Lammers, M. C., Mukaba, T. N., & Bolton, P. A. (2008). Post-partum depression in Kinshasa, Democratic Republic of Congo: Validation of a concept using a mixed-Âmethods cross-cultural approach. Tropical Medicine & International Health, 13, 1534–1542.
Ben Slama, F., Achour, A., Belhadj, O., Hsairi, M., Oueslati, M., & Achour, N. (2002). Obesity and life style in a population of male school children aged 6 to 10 years in Ariana (Tunisia). La Tunisie Medicale, 80, 542–547.
Bhargava, A. (2000). Modelling the effects of maternal nutritional status and socioeconomic variables on the anthropometric and psychological indicators of Kenyan infants from age 0-6 months. American Journal of Physical Anthropology, 111, 89–104.
Bhargava, A., & Fox-Kean, M. (2003). The effects of maternal education versus cognitive test scores on child nutrition in Kenya. Economics and Human Biology, 1, 309–319.
Black, M. M., Baqui, A. H., Zaman, K., El Arifeen, S., & Black, R. E. (2009). Maternal depressive symptoms and infant growth in rural Bangladesh. American Journal of Clinical Nutrition, 89, 951S–957S.
Black, M. M., & Ramakrishnan, U. (2009). Maternal and child mental health: Role of nutrition. Introduction. American Journal of Clinical Nutrition, 89, 933S–934S.
Bloss, E., Wainaina, F., & Bailey, R. C. (2004). Prevalence and predictors of underweight, stunting, and wasting among children aged 5 and under in western Kenya. Journal of Tropical Pediatrics, 50, 260–270.
Bogale, A., Abebe, Y., Stoecker, B. J., Abuye, C., Ketema, K., & Hambidge, K. M. (2009). Iodine status and cognitive function of women and their five year-old children in rural Sidama, southern Ethiopia. East African Journal of Public Health, 6, 296–299.
Boukthir, S., Essaddam, L., Mazigh Mrad, S., Ben Hassine, L., Gannouni, S., Nessib, F., Bouaziz, A., Brini, I., Sammoud, A., Bouyahia, O., & Zouari, B. (2011). Prevalence and risk factors of overweight and obesity in elementary school children in the metropolitan region of Tunis, Tunisia. La Tunisie Médicale, 2011(89), 50–54.
Bradley, R. H., & Corwyn, R. F. (1996). Life at home: Same time, different places. Early Development and Parenting, 5, 251–269.
Bruss, M. B., Michael, T. J., Morris, J. R., Applegate, B., Dannison, L., Quitugua, J. A., et al. (2010). Childhood obesity prevention: An intervention targeting primary caregivers of school children. Obesity (Silver Spring), 18, 99–107.
Burgoine, T., Alvanides, S., & Lake, A. A. (2011). Assessing the obesogenic environment of North East England. Health & Place, 17, 738–747.
Caldwell, B. M., & Bradley, R. H. (2001). Home inventory administration manual. Little Rock, AR: Center for Research on Teaching & Learning.
Chang, S. M., Walker, S. P., Grantham-McGregor, S., & Powell, C. A. (2002). Early childhood stunting and later behaviour and school achievement. Journal of Child Psychology and Psychiatry, 43, 775–783.
Davison, K. K., Lawson, H. A., & Coatsworth, J. D. (2011). The Family-centered Action Model of Intervention Layout and Implementation (FAMILI): The example of childhood obesity. Health Promotion Practice, 13(4), 454–461.
de Benoist, B., Andersson, M., Igli, I., & Takkouche, B. (Eds.). (2004). Iodine status worldwide: WHO global database on iodine deficiency. Geneva: WHO.
de Benoist, B., McLean, E., Egli, I., & Cogswell, M. (Eds.). (2008). Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia. Geneva: WHO.
de Onis, M., & Blossner, M. (2000). Prevalence and trends of overweight among preschool children in developing countries. American Journal of Clinical Nutrition, 72, 1032–1039.
de Onis, M., Blossner, M., & Borghi, E. (2010). Global prevalence and trends of overweight and obesity among preschool children. American Journal of Clinical Nutrition, 92, 1257–1264.
de Onis, M., Blossner, M., Borghi, E., Frongillo, E. A., & Morris, R. (2004). Estimates of global prevalence of childhood underweight in 1990 and 2015. Journal of the American Medical Association, 291, 2600–2606.
de Vries, M. W. (1994). Kids in context: Temperament in cross-cultural perspective. In W. B. Carey & S. C. McDevitt (Eds.), Prevention and early intervention. New York: Bruner/Mazel.
de Vries, M. W. (1999). Babies, brains and culture: Optimizing neurodevelopment on the savanna. Acta Paediatrica Suppl, 88, 43–48.
Delpeuch, F., & Maire, B. (1997). [Obesity and developing countries of the south]. Med Trop (Mars), 57, 380–388.
Drewett, R., Wolke, D., Asefa, M., Kaba, M., & Tessema, F. (2001). Malnutrition and mental development: Is there a sensitive period? A nested case-control study. Journal of Child Psychology and Psychiatry, 42, 181–187.
Engle, P. P., Menon, P., & Haddad, L. (1999). Care and nutrition: Concepts and measurement. World Development, 27, 1309–1337.
Falkner, N. H., Neumark-Sztainer, D., Story, M., Jeffery, R. W., Beuhring, T., & Resnick, M. D. (2001). Social, educational, and psychological correlates of weight status in adolescents. Obesity Research, 9, 32–42.
Galal, O., & Hulett, J. (2003). The relationship between nutrition and children’s educational performance: A focus on the United Arab Emirates. Nutrition Bulletin, 28, 11–20.
Galasso, E., & Yau, J. (2005). Improving nutritional status through behavioural change: Lessons from the SEECALINE program in Madagascar. Development Research Group: World Bank.o. Document Number
Gardner, J. M., Powell, C. A., Baker-Henningham, H., Walker, S. P., Cole, T. J., & Grantham-ÂMcGregor, S. M. (2005). Zinc supplementation and psychosocial stimulation: Effects on the development of undernourished Jamaican children. American Journal of Clinical Nutrition, 82, 399–405.
Gewa, C. A., Weiss, R. E., Bwibo, N. O., Whaley, S., Sigman, M., Murphy, S. P., et al. (2009). Dietary micronutrients are associated with higher cognitive function gains among primary school children in rural Kenya. British Journal of Nutrition, 101, 1378–1387.
Giskes, K., van Lenthe, F., Avendano-Pabon, M., & Brug, J. (2011). A systematic review of environmental factors and obesogenic dietary intakes among adults: Are we getting closer to understanding obesogenic environments? Obesity Review, 12, e95–e106.
Grantham-McGregor, S. (1993). Assessments of the effects of nutrition on mental development and behaviour in Jamaican studies. American Journal of Clinical Nutrition, 57, 303S–309S.
Haidar, J., Abate, G., Kogi-Makau, W., & Sorensen, P. (2005). Risk factors for child under-Ânutrition with a human rights edge in rural villages of North Wollo, Ethiopia. East African Journal of Medicine, 82, 625–630.
Harpham, T., Huttly, S., De Silva, M. J., & Abramsky, T. (2005). Maternal mental health and child nutritional status in four developing countries. Journal of Epidemiology and Community Health, 59, 1060–1064.
Kariger, P. K., Stoltzfus, R. J., Olney, D., Sazawal, S., Black, R., Tielsch, J. M., et al. (2005). Iron deficiency and physical growth predict attainment of walking but not crawling in poorly nourished Zanzibari infants. Journal of Nutrition, 135, 814–819.
Ketema, L., Abate, G., & Jabar, M. (2003). Correlates of children’s cognitive skills in an Agrarian community with mixed crop-livestock production systems, Ghinchi, central Ethiopia. Ethiopian Journal of Medicine, 41, 151–161.
Kikafunda, J. K., Walker, A. F., Allan, E. F., & Tumwine, J. K. (1998a). Effect of zinc supplementation on growth and body composition of Ugandan preschool children: A randomized, controlled, intervention trial. American Journal of Clinical Nutrition, 68, 1261–1266.
Kikafunda, J. K., Walker, A. F., Collett, D., & Tumwine, J. K. (1998b). Risk factors for early childhood malnutrition in Uganda. Pediatrics, 102, E45.
Kimani-Murage, E.W., Kahn, K., Pettifor, J.M., Tollman, S.M., Dunger, D.B., Gomez-Olive, X.F., & Norris, S.A. (2010). The prevalence of stunting, overweight and obesity and metabolic disease risk in South African Children. BMC Public Health, 25, 158. doi: 10.1186/1471-2458-10-158.
Kogi-Makau, W. (1992). Risk indicators of nutritional status of households of a Kenyan semi-arid population. East African Journal of Medicine, 69, 560–562.
Kruger, H. S., Puoane, T., Senekal, M., & van der Merwe, M. T. (2005). Obesity in South Africa: Challenges for government and health professionals. Public Health Nutrition, 8, 491–500.
Kwena, A. M., Terlouw, D. J., de Vlas, S. J., Phillips-Howard, P. A., Hawley, W. A., Friedman, J. F., et al. (2003). Prevalence and severity of malnutrition in pre-school children in a rural area of western Kenya. The American Journal of Tropical Medicine and Hygiene, 68, 94–99.
Liu, J., & Raine, A. (2006). The effect of childhood malnutrition on externalizing behavior. Current Opinions Paediatrics, 18, 565–570.
Liu, J., Raine, A., Venables, P. H., & Mednick, S. A. (2004). Malnutrition at age 3 years and externalizing behavior problems at ages 8, 11, and 17 years. American Journal of Psychiatry, 161, 2005–2013.
Medhin, G., Hanlon, C., Dewey, M., Alem, A., Tesfaye, F., Lakew, Z., et al. (2010). The effect of maternal common mental disorders on infant undernutrition in Butajira, Ethiopia: The P-MaMiE study. BMC Psychiatry, 10, 32.
Monyeki, K. D., van Lenthe, F. J., & Steyn, N. P. (1999). Obesity: Does it occur in African children in a rural community in South Africa? International Journal of Epidemiology, 28, 287–292.
Mosha, T. C. E., & Fungo, S. (2010). Prevalence of overweight and obesity among children aged 6-12 years in Dodoma and Kinondoni Municipalities, Tanzania. Tanzania Journal of Health Research, 12, 6–16.
Mukuddem-Petersen, J., & Kruger, H. S. (2004). Association between stunting and overweight among 10-15-y-old children in the North West Province of South Africa: The THUSA BANA Study. International Journal of Obesity and Related Metabolic Disorders, 28, 842–851.
Mwangome, M., Prentice, A., Plugge, E., & Nweneka, C. (2010). Determinants of appropriate child health and nutrition practices among women in rural Gambia. Journal of Health, Population and Nutrition, 28, 167–172.
Nagwa, M. A., Elhussein, M. A., Azza, M., & Abdulhadi, N. H. (2011). Alarming high prevalence of overweight/obesity among Sudanese children. European Journal of Clinical Nutrition, 65, 409–411.
Ndokera, R., & MacArthur, C. (2011). The relationship between maternal depression and adverse infant health outcomes in Zambia: A cross-sectional feasibility study. Child: Care, Health and Development, 37, 74–81.
Nyakeriga, A. M., Troye-Blomberg, M., Chemtai, A. K., Marsh, K., & Williams, T. N. (2004). Malaria and nutritional status in children living on the coast of Kenya. American Journal of Clinical Nutrition, 80, 1604–1610.
Olney, D. K., Kariger, P. K., Stoltzfus, R. J., Khalfan, S. S., Ali, N. S., Tielsch, J. M., et al. (2009). Development of nutritionally at-risk young children is predicted by malaria, anemia, and stunting in Pemba, Zanzibar. Journal of Nutrition, 139, 763–772.
Olney, D. K., Pollitt, E., Kariger, P. K., Khalfan, S. S., Ali, N. S., Tielsch, J. M., et al. (2007). Young Zanzibari children with iron deficiency, iron deficiency anemia, stunting, or malaria have lower motor activity scores and spend less time in locamotion. Journal of Nutrition, 137, 2756–2762.
Omigbodun, O. O., Adediran, K. I., Akinyemi, J. O., Omigbodun, A. O., Adedokun, B. O., Esan, O. (2010). Gender and rural-urban differences in the nutritional status of in-school adolescents in south-western Nigeria. http://www.ncbi.nlm.nih.gov/pubmed/20529411 Journal of biosocial science. Journal of Biosocial Sciences.;42, 653–76. doi:10.1017/S0021932010000234.
Omuemu, V. O., & Omuemu, C. E. (2010). The prevalence of overweight and its risk factors among adolescents in an urban city in Edo State. Nigerian Journal of Clinical Practice, 13, 128–133.
Patel, V., DeSouza, N., & Rodrigues, M. (2003). Postnatal depression and infant growth and development in low income countries: A cohort study from Goa, India. Archives of Disease in Childhood, 88, 34–37.
Renzaho, A. M. N. (2004). Fat, rich and beautiful: Changing socio-cultural paradigms associated with obesity risk, nutritional status and refugee children from Sub-Saharan Africa. Health & Place, 10, 105–113.
Rodrigues, M., Patel, V., Jaswal, S., & de Souza, N. (2003). Listening to mothers: Qualitative studies on motherhood and depression from Goa, India. Social Science & Medicine, 57, 1797–1806.
Schmutzhard, E., Poewe, W., & Gerstenbrand, F. (1986). Separation from mother at time of weaning. A rarely discussed aspect of the aetiology of protein energy malnutrition. Tropical Doctor, 16, 176–177.
Senbanjo, I. O., & Adejuyigbe, E. A. (2007). Prevalence of overweight and obesity in Nigerian preschool children. Nutrition and Health, 18, 391–399.
Senbanjo, I. O., & Oshikoya, K. A. (2010). Physical activity and body mass index of school children and adolescents in Abeokuta, Southwest Nigeria. World Journal of Pediatrics, 6, 217–222.
Sigman, M., McDonald, M. A., Neumann, C., & Bwibo, N. (1991). Prediction of cognitive competence in Kenyan children from Toddler nutrition, family characteristics and abilities. Journal of Child Psychology and Psychiatry, 32, 307–320.
Sigman, M., Neumann, C., Baksh, M., Bwibo, N., & McDonald, M. A. (1989a). Relationship between nutrition and development in Kenyan toddlers. Journal of Pediatric, 115, 357–364.
Sigman, M., Neumann, C., Jansen, A. A., & Bwibo, N. (1989b). Cognitive abilities of Kenyan children in relation to nutrition, family characteristics and education. Child Development, 60, 1463–1474.
Stephenson, L. S., Latham, M. C., & Ottesen, E. A. (2000). Global malnutrition. Parasitology, 121(Suppl), S5–S22.
Stewart, R. C., Umar, E., Kauye, F., Bunn, J., Vokhiwa, M., Fitzgerald, M., et al. (2008). Maternal common mental disorder and infant growth – a cross-sectional study from Malawi. Maternal & Child Nutrition, 4, 209–219.
Stoltzfus, R. J., Albonico, M., Tielsch, J. M., Chwaya, H. M., & Savioli, L. (1997). Linear growth retardation in Zanzibari school children. Journal of Nutrition, 127, 1099–1105.
Tomlinson, M., Cooper, P. J., Stein, A., Swartz, L., & Molteno, C. (2006). Post-partum depression and infant growth in a South African peri-urban settlement. Child: Care, Health and Development, 32, 81–86.
Ukwuani, F. A., & Suchindran, C. M. (2003). Implications of women’s work for child nutritional status in sub-Saharan Africa: A case study of Nigeria. Social Science & Medicine, 56, 2109–2121.
UNICEF. (1990). Strategy for improved nutrition of children and women in developing countries. New York: United Nations Children’s Fund: Nutrition Section.
Vella, V., Tomkins, A., Borghesi, A., Migliori, G. B., Adriko, B. C., & Crevatin, E. (1992). Determinants of child nutrition and mortality in north-west Uganda. Bulletin of the World Health Organization, 70, 637–643.
Wachs, T. D. (2008). Multiple influences on children’s nutritional deficiencies: A systems perspective. Physiology and Behaviour, 94, 48–60.
Wachs, T. D., Creed-Kanashiro, H., Cueto, S., & Jacoby, E. (2005). Maternal education and intelligence predict offspring diet and nutritional status. Journal of Nutrition, 135, 2179–2186.
Wachs, T. D., Moussa, W., Bishry, Z., Yunis, F., Sobhy, A., McCabe, G., et al. (1993). Relations between nutrition and cognitive performance in Egyptian toddlers. Intelligence, 17, 151–172.
Walker, A. F. (1990). The contribution of weaning foods to protein-energy malnutrition. Nutrition Research and Review, 3, 25–47.
Walker, S. P., Chang, S. M., Vera-Hernandez, M., & Grantham-McGregor, S. (2011). Early childhood stimulation benefits adult competence and reduces violent behavior. Pediatrics, 127, 849–857.
Wamani, H., Astrom, A. N., Peterson, S., Tumwine, J. K., & Tylleskar, T. (2006). Predictors of poor anthropometric status among children under 2 years of age in rural Uganda. Public Health Nutrition, 9, 320–326.
Wamani, H., Astrøm, A. N., Peterson, S., Tumwine, J. K., & Tylleskär, T. (2007). Boys are more stunted than girls in sub-Saharan Africa: A meta-analysis of 16 demographic and health surveys. BMC Pediatrics, 7, 17.
Wandel, M., & Holmboe-Ottesen, G. (1992). Women’s work in agriculture and child nutrition in Tanzania. Journal of Tropical Pediatrics, 38, 252–255.
Whaley, S. E., Sigman, M., Espinosa, M. P., & Neumann, C. G. (1998). Infant predictors of cognitive development in an undernourished Kenyan population. Journal of Developmental and Behavioural Pediatrics, 19, 169–177.
Xi, B., Wang, C., Wu, L., Zhang, M., Shen, Y., Zhao, X., et al. (2011). Influence of physical inactivity on associations between single nucleotide polymorphisms and genetic predisposition to childhood obesity. American Journal of Epidemiology, 173, 1256–1262.
Zhao, J., & Grant, S. F. (2011). Genetics of childhood obesity. Journal of Obesity, 2011, 845148.
Acknowledgments
I would like to thank Fons van de Vijver and Patricia Kitsao Wekulo for their comments and feedback on the earlier version of this chapter. I would also like to acknowledge my colleagues at KEMRI-CGMR: Kilifi with whom our work together has helped shaped some of the ideas in this chapter. In this regard, special thanks to Penny Holding, Martha Mwangome, and Kath Maitland, and I also would like to acknowledge the editorial assistance of Anne B Giordani Ph.D., ELS.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Abubakar, A. (2013). Psychosocial Aspects of Malnutrition Among African Children: Antecedents, Consequences, and Interventions. In: Boivin, M., Giordani, B. (eds) Neuropsychology of Children in Africa. Specialty Topics in Pediatric Neuropsychology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6834-9_9
Download citation
DOI: https://doi.org/10.1007/978-1-4614-6834-9_9
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-6833-2
Online ISBN: 978-1-4614-6834-9
eBook Packages: Behavioral ScienceBehavioral Science and Psychology (R0)