Assignment Sample on Malnutrition

Introduction

Malnutrition among children appears as a major clinical issue impacting health in major developing countries. Aspect of growth and development among children is largely regulated by infant and child nutrition in addition to maternal diet. Malnutrition in children is identified through possible indicators in terms of wasting, overweight, underweight and stunting. Child growth is an important indicator internationally identified for determination of health status and nutritional criteria of populations (World Health Organisation, 2021). These factors serve as possible factors of nutritional imbalance along with involving inadequate education, sanitation and lactation. Nutritional status of mothers plays an additional critical factor towards determining the malnutrition aspect of children.

Malnutrition is a probable clinical issue that can impact children of all age groups, however young children have been identified to be the most vulnerable ones. As malnutrition is identified as a dietary deficiency resulting in poor health conditions, it can involve under-eating as well as over eating for children (Save the Children, 2021). Poverty is among the most observed factors that contribute towards malnutrition among children in the developing countries. Depending on the same, aim of the following study is to engage in shedding light on the aspect of malnutrition among children under 5, specifically stressing on Indian data. Following this would be a brief focus on literature review and search strategy along with critical evaluation of research paradigms and designs that would make it beneficial for future research proposals.

Literature Search Strategy

The entire literature search strategy concerning this study has been based on obtaining information relating to health background only. In addition with the “secondary data collection” approach, the study has made use of Boolean operators “AND” and “OR” to align the credibility of relevant searching methods. It has referred to authentic databases for data collection in terms of “Google Scholar, Springer, Research Gate, PubMed, SciHub” along with relevant website access that provides information regarding malnutrition among children. It has further laid stress on UWS Library and reference list searches for the following study. Furthermore, the common key search words that have been accessed for the following consultancy report are “malnutrition, children, nutrition status, stunting, developing countries, India, nutrition program, public health” among many others. The study has further covered an inclusion and exclusion criteria as follows. Information has been accessed from relevant journals and websites on a recent basis. However, old journals and websites have not been accessed for the following research.

Journals and websites that render access to the complete information have been accessed for the following research and consultancy report. Moreover, journals and websites that do not render access to the complete information have not been accessed for the following research and consultancy report. For an overall count, five hundred and three articles have been searched for the following study. Peer reviewed journals have been assessed to ensure credibility and reliability of the obtained and presented findings. The language employed for the following study is English to ensure accessibility with ease from diverse backgrounds. This would be productive for reaching out to diverse readers and enhance the scope of future research work conductance. Keywords have been used as titles of articles thereby resulting in twenty-six studies for reviewing and analysing. Most appropriate and reviewed articles had been shortlisted for accessing using the “CASP CHECKLIST”.

Literature Review

The literature review here has stressed on an ethnographic form of study to evaluate the effect of malnutrition in children under 5 in developing countries. Holt et al. (2018) asserted that ethnographic study leverages the scope of identifying and analysing unexpected issues associated with clinical factors. Moreover, it helps in elucidating cultural logics that drive health related behaviour along with making unexamined assumptions. Ottrey et al. (2018) noted that conductance of an ethnographic study for malnutrition among children would be productive towards making distinct contributions to public policy and perceptions. Additionally, possessing unique access to marginalised groups along with having the ability of analysing the quality of life generates significant edge for analysing the impact of malnutrition in developing countries at a community level.

Malnutrition among children appears as a major clinical issue impacting health in major developing countries. Aspect of growth and development among children is largely regulated by infant and child nutrition in addition to maternal diet. Malnutrition in children is identified through possible indicators in terms of wasting, overweight, underweight and stunting. Child growth is an important indicator internationally identified for determination of health status and nutritional criteria of populations (World Health Organisation, 2021). These factors serve as possible factors of nutritional imbalance along with involving inadequate education, sanitation and lactation. Nutritional status of mothers plays an additional critical factor towards determining the malnutrition aspect of children.

Malnutrition is a probable clinical issue that can impact children of all age groups, however young children have been identified to be the most vulnerable ones. As malnutrition is identified as a dietary deficiency resulting in poor health conditions, it can involve under-eating as well as over eating for children (Save the Children, 2021). Poverty is among the most observed factors that contribute towards malnutrition among children in the developing countries. According to Kumar et al. (2021), pregnant women along with lactating mothers significantly suffer from malnutrition, thereby yielding in low birth weight and premature babies. This further has the tendency of excelling the condition of malnutrition among children. It has been observed that potential opportunity for growth and sustainability of the health of a child occurs within the first 1000 days involving the span of pregnancy to next pregnancy (Save the Children, 2021). It has further been observed that undernourishment among mothers yields in difficulty regarding breastfeeding the newborns thereby further resulting in malnutrition among the children.

Poor diet quality further ads to the aspect of enhanced cases of malnutrition among children under 5. It has been estimated by the World Health organisation that malnutrition serves as a single dangerous threat with respect to global public health accounting for death cases of 45% that is 3.1 million children (World Health Organisation, 2021). This has further been identified toi generation of lasting damages or disorders among millions of infected children as a side effect of malnutrition. Aspect of stunting or chronic malnutrition adds to generation of devastating and permanent impact on the cognitive and physical abilities of children fewer than 5 in the developing countries. As per the views of Ooi et al. (2020), malnutrition among children in developing countries has most commonly been found to yield in sarcopenia with prominent symptoms of reducing “skeletal muscle mass (SMM)”. Children impacted by primary acute malnutrition are recommended interventions focussing on satisfactory nutrition while secondary acute ones are suggested inpatient treatment.

Critical Evaluation of two research paradigm

Paradigm has been considered as a collaborative assumption which is shared by the research community. Positivism and interpretivism are two paradigms that get involved in applied methodology. Paradigm focuses on the concept of belief about reality that is involved in influencing an individual regarding construction of a sensible concept. As opined by Kaushik and Walsh (2019), philosophical assumption support in generation of beliefs that support in guiding them for execution of actions. Alignment of general knowledge with reality helps in understanding situations. On the other hand, allocation of specific knowledge which is supports critically analysing situations through thinking multiple perceptions. Complexities of real world have been determined by researchers through delivering equal values to beliefs that develop after practical implication of knowledge for conduction of actions.

Truth from different perceptions has been identified in an objective manner and it is considered as positivism philosophy. Measurement of perceptions becomes easier while implicating the mentioned type of philosophy. On the other hand, subjective overview has been collected through utilizing experiences of an individual and it is considered as interpretivism philosophy. As claimed by Walsh (2019), historical juncture has been analysed through evaluation of conceptual variables within perceptions and it has been analysed through application of critical theories. Factual knowledge has been gained by an individual through observing characteristics of participants who are providing information. Apart from this, creative actions of an individual have been evaluated through evaluation of social research that is conducted by researchers.

Scientific investigation has been executed by researchers through collecting information from experimenting with current data through aligning with previous existing data. Compared with previous context, quantitative research gets highlighted while choosing positivism belief by researchers in terms of focusing on scientific method. Subject understanding has become the main prospect of interpretivism approach as information that is analysed by experts. As mentioned by Cardenas et al. (2018), information that is present within theories is interpreted through knowledge which are developed by an individual from computational science. Mentioned two paradigms are having different ontological positions that make differentiation within data structure. Estimation of interrelationship between two variables has been evaluated through development of data models.

Human perceptions have been included in interpretivism philosophy which supports researchers in execution of qualitative research methods. Alternatively, previously recorded perceptions that are published through making research of situation of that time are analysed to take less time to conduct this research study. Apart from this, clarity with data which is used for conduction of research gets enhanced through implication of both qualitative and quantitative methods. Applications of quantitative researcher get a scope to include statistical data with study. Primary data has been collected involving participants who provide their perception real time and current information is analysed. Moreover, secondary data are also evaluated through focusing on statistical information which is available in an annual report, case studies. However, qualitative research highlights over incorporation of descriptive information that is considered as subjective data. As discussed by Rahman et al. (2017), research study which is highlighting over both stated research methods it has been considered as a mixed method. In addition, selection of research topics is another factor that creates impact on selection of relevant paradigms.

Research questions are structured based on epistemological stances that are present with research. Compared with previous context, detection of nature through estimation of reality supports researchers in conduction of research actions. As suggested by Abakpa et al. (2017), empirical enquiry has been conducted through implications of positivism philosophy. Additionally, realism is the ontological status of a positivist concept as it focuses on external reality that is not dependent on a specific belief of a person. However, idealism prefers multiplication of subjective information for making conclusions of descriptive ideas. Epistemology has been considered as a philosophical study that originates from human knowledge. Different reasons behind limitations of knowledge that are gathered by humans and issues are estimated by an individual through application of principles of different theories. Authors belonging from specific backgrounds provide delta information about practical implication of theories within real-life issues.

Mentioned research questions would fit with the interpretivism paradigm so that researchers get a scope to incorporate existing information that is available in journal articles. Credibility has been maintained through highlighting over journal articles that are published within 5 years. Malnutrition has become a major issue and its different risk factors are analysed from existing information present in articles. About five hundred and three articles are searched for selecting about twenty six reviewed articles so that reliability with data is maintained by researchers. As mentioned by Moharić (2017), secondary information has been collected in an easy manner through analysing existing information. Additionally, English language has become the main inclusion criteria which are focused on making a selection of articles for malnutrition.

Personal bias has been declined through application of interpretivism philosophy in terms of not involving participants while collecting information from data. Moreover, experiences of participants get highlighted which may reduce validity of data. Wrong selection of participants may create issues in handling data that are provided by participants. On the other hand, objectives are interlinked between reality and experiments that support in conduction of in-depth understanding. As commented by Cardno (2019), personal biases are controlled through highlighting over statistical data that helps in extending study rigour. Compared with previous context, emotions have been incorporated while conveying perception of participants during execution of a survey which may reduce reliability of data. On contrary, it has been identified that result credibility has been maintained through implication of subjective information in study. On the other hand, quality of data is extended through implication of self-awareness which supports in generation of trustworthy relationships.

Ethnography theory gets included while execution of qualitative research method which involves in depth understanding of interlink between two variables in terms of interpreting recorded data. However, themes are generated based on secondary information that is available from the database. As claimed by Williams and Moser (2019), categorization has been executed through conduction of coding that supports researchers in construction of themes. Validity has been maintained while execution of research through implication of journal articles that ensures validity of recent data. Documenting process is vital which provides opportunity for future learners in understanding information that is present within journal articles.

Various factors which are creating malnutrition to child and mothers have been identified from medical journal articles after searching in Google scholar who ensures quality of research. On the other hand, impacts that are faced by children due to experiencing malnutrition have been identified from perceptions that are enlisted by clinical experts. However, this study gets proper time to finish the task due to not conducting a survey which increases time to collect statistical data. On contrary, excess time is needed to generate close-ended questions by evaluation of capability of participants who are involved in delivering their responses. As discussed by Alase (2017), subjectivity skill is required for analysing data that support in making exposure of data. Options are provided to participants that may reduce clarity in data which are implicated in research. Lack of time, this research has not conducted mixed methods that support in controlling budgets that are allocated for research.

Critical evaluation of two research designs

Randomised controlled trials (RCT) have a direct link between the positivist paradigms that engages in random allocation of more than one group. Solution has been identified through involving one group but fails to allocate accurate information through engaging another group. Thus, researching skill needs to be extended for estimation of trail groups and facilitates in making difference within findings that are recorded in a statistical manner. As described by McGrath et al. (2019), selection of participants in a random manner is main criteria for maintaining internal validity. However, treatment that needs to be provided to patients has been evaluated from conduction of this approach. Additionally, RCT is a technique which involves maintaining higher frequency regarding monitoring data. Outcome of study gets improved through highlighting over participants awareness that provides an opportunity to maintain trial validity.

P-value which is also known as probability value which makes evaluation of null value that provides accurate justification regarding reporting. Non-significant results have been identified through application of Fragility Index that ensures proper information about the number of service users. Moreover, outcome after implication of intervention has been evaluated by researchers through estimation of accurate nature of study. As observed by Mohajan (2018), collection of non-numerical data helps in understanding social life by interpreting overviews that are provided by targeted populations. Compared with previous context, using local knowledge for making clarification is as natural settings for selecting study sample. Sequencing of randomly selected participants helps in controlling biases that are through controlling manipulating data which are placed by participants.

RCT

RCT has been considered as a study that involves allocation of people for collection of ideas regarding estimating interventions that improve health conditions. Clinical practice which is considered as a solution to clinical issues that provides an opportunity in conduction of standard practice. Multiple perceptions have been incorporated within study so that accuracy has been maintained through cross-checking of data. Objective information has been collected from participants while implication of quantitative data collection. Percentages have been analysed through graphical presentations. As conveyed by Phillips et al. (2019), adverse events have been clarified by researchers through application of RCT which provides an efficient effect on medical journals. Compared with previous concepts, report practice has been conducted for concluding research question of this study. In addition, information loss creates challenges in increasing quality of data that are provided by participants.

Questionnaires have been developed by researchers for collecting answers from participants who have enough knowledge regarding described topics. Construct this mentioned fact, it has been estimated that poor researching and conceptualising skill may create issues in developing accurate questions. Improper structuring of questions may decline opportunities for participants in delivering accurate responses to participants. As reported by Connolly et al. (2018), systematic review has been conducted by researchers through conduction of evidence based practices which may decline the rate of criticism. Rational underpinnings are measured through estimation of progress rate of participants within their participation in research. Quality of data that is collected from them gets improved through offering them assurances regarding maintaining privacy while gathering data from them.

Statistical tests have been conducted within research through gathering information from accessing accounts that are offering data. Criticism with evidence provides critical views that need to be highlighted in research work. New theories have been constructed by researchers through researching a specific topic. Moreover, preclinical and clinical research are efficiently executed by researchers through incorporation of logics. Generalisation of information has become a major limitation of this study that provides proper clinical significance. Presence of poor capability to avail clinical services makes limitation in delivering proper information to research work by participants. However, expensive treatment helps participants in offering proper treatment to people who are suffering from health issues.

Positivism philosophy gets connected with experimental research designs for proving hypotheses. Previous data that are supporting fact behind cause and effect of mentioned disease are not focused in discussed study. However, manipulation of responses has been conducted by implication of survey results by collecting data from patients for medical workers. Systematic elaboration may not be executed within research work due to not using secondary data which are proved by performing through involving experts. As consulted by Hujoel et al. (2018), poor collaboration within groups who are involved in delivering accuracy in a research studies. Conduction of false sense is elaboration of data which creates issues in handling intervention that is suggested by medical workers.

Depression of service users is influenced by responses that are provided by participants. Statistical error has been experienced by a researcher due to conduction of manipulation in task. However, information has been supported through application of published paper so that issues are solved. Additionally, software can be incorporated for making justification of statistical data and it was analysed by application of graphical presentations. Poor educational knowledge of researchers may create issues in structuring themes. Sensitivity has been tested by researchers through application of RCT based on situations that are faced by participants.

As alleged by Malik et al. (2018), current incidents are analysed through estimation of health issues and challenges are determined from morbidity rate. Current situations of child and mothers for malnutrition are estimated through reviewing articles in a systematic manner.

Clinical trials have been eliminated by researchers in terms of using RCT design that offers multiple perceptions by answering questions. As highlighted by Jolliffe et al. (2019), conflictory results are discarded by the author through performing meta-analysis techniques which create an evaluation of different varieties of data. On the other hand, social value gets declined due to not investigating primary information. Ethical challenges have been experienced by participants due to poor maintenance of confidentiality that may reduce effectiveness of data for future. Selection of a wider population may create extrapolation which has become a major weaken area of RCT

Internal validity is maintained through development of new theories that support in making a clarification of reports of patients. However, prediction of medical issues after facing health challenges is identified through communicating with respondents. Analysing study which highlights over RCT faces barriers due to poor idea regarding application of clinical practice. As analysed by Richards et al. (2019), accessing complex datasets provides an opportunity in handling complex intervention that increases the value of social life in terms of offering accurate solutions to issues that are faced by community. Trail communities get involved for offering accurate guidance to construction or set-up for participants which increases conformity in delivering their overview based on their experiences.

Phenomenology

Interpretivist paradigm has been implicated for an implication of previously studied material which is established by experts for execution of qualitative research and it is known as Phenomenology. Experiences of an individual help in alignment of information best of knowledge that makes an extension of quality of analysis. Causal link has been identified through determination of patterns of data that are gathered from books. Subjective experiences have been analysed by author through collaborating perceptions that are used in daily life. As commented by Neubauer et al. (2019), implication of health profession educations helps in proper position of experiences. Execution of research works through application of personal overview so that various categories in variables are determined. Compared with perception, finding research gets alternated due to making differentiation within experiences so hat different decisions are generated by author.

Interviews may be executed for relating primary data which support research work in terms of offering information regarding current situations. Moreover, information has been collected from descriptions that are offered by participants during the interview session. Deep data has been implicated so that risk while interpretation of data is controlled. Topic validity may face limitation due to not following structured processes regarding interpretation of perception from an interviewee. As suggested by Qutoshi (2018), intellectual engagement has been conducted through interpreting conceptions of authors. Involvement of nurses so that issues faced by individual are determined and its causative agent are determined. Hawthorne effects that appeared while utilizing RCT are controlled by discarding limitations that appeared while collecting responses during interview.

Phenomenology has been used in research for highlighting mental state of interview so that experiences of an individual are properly structured. Representative samples are not used for conduction of comprehensive analysis that helps in making interpretation of larger data. Meaning of data is maintained through execution of this mentioned type of analysis. Thematic analysis creates issues in terms of not having relevant skill for making codes of themes which may alternate meaning of information. As reported by Campbell and Neumann (2019), a calculation has been eliminated through implication of qualitative research that incorporates descriptive information. Interview approach has been considered as a unique part that reduces chances of losing data. Moreover, reliability rate is high for interviews and study has an opportunity to interfacing results.

Modification of behaviour through conduction of observation is known as Hawthorne Effect through conduction of experiments. Sundler et al. (2019) discussed in an article that offering opportunities to share experiences which bring clarity in data by offering versatile perceptions in study. On a similar note, this approach is time consuming but provides a different overview regarding research topics which helps in making answers to research questions through integrating variable connectivity. Apart from this, data rectification opportunities have been provided that makes facilitates in losing of study. Misinterpretations are checked through execution of rigorous actions by finding proper information.

Ethics in Research

Research ethics fosters the advantage of abiding by possible ethical norms and refrain from hurting any possible segment through the research topic. Son et al. (2020) highlighted that ethical research furnishes the advantage of expanding knowledge along with engaging in respecting morals and values the research topic and conductance approach. Through consideration of ethical aspects, the research has ensured maintaining relevant referencing of the data sources accessed. Furthermore, it has ensured that the research findings are confirmed by “Copyright, Designs and Patents Act 1988 (c. 48)” and “Data Protection Act 2018 (c.12)”. The essay has also abided by ethical consideration in alliance with the code of policies and ethics of the respective University. Anonymity and confidentiality tends to be among the most addressed factors of research taken into account by researchers.

Consideration of ethics is an essential practice in terms of preserving research approach and involved sentiments. Abiding by research ethics further aids in making specific mention of the right and wrong aspect involved with the topic of conductance (Resnik, 2020). This further helps in moral development through phases of growth and maturity among individuals. According to Leclercq-Vandelannoitte (2017), ethical norms are ubiquitous with the temptation of being regarded as “simple common sense”. Distinct research ethics are applied with respect to any research with the aim of ensuring good research practice. However, each of the research study and approach possesses its own ethical implications with some being predominant with relation to the type of design. Additionally, research participants possess extensive right to privacy while conducting the research study.

Direct harm can bring about the state of participants having to discuss and engage in reliving through sensitive experiences or subjects. Moreover, indirect harm may occur as a result of incomplete mentioning of confidentiality on behalf of the participants. This has the scope of leading to future harassment, embarrassment or victimisation because of disclosure of the opinions to third parties. As identified by Hail et al. (2020), lack of internal confidentiality results in failure of research outcomes when conducted within close knit or small communities. Additionally, conducting research with a poor design tends to be of limited value thereby being considered as unethical. This is because participants are asked to undertake tasks that lack value to them and to society. Moreover, research with lack of capability towards new knowledge is also considered unethical. This is because although being well designed it fails to add any new knowledge to the existing forms.

Conclusion

Consumption of nutritional food maintains balance within nutrients that makes health promotion through discarding chances of malnutrition. Lack of knowledge regarding a balanced diet may generate high chances of malnutrition that leads to delay in growth. Additionally, weight of an individual gets declined due to not in taking a proper amount of food based on height and age. Insufficient in taking vitamins and minerals may increase chances of long or short term health issues which make barriers in recovering wounds. Infection caused within individual takes a longer time scale for making recovery from that disease due to poor activating immune system. Vision issues have been experienced by an individual due to poor consumption of vitamin A. Scurvy is another health complication that appeared and is extend chances of mental issues for not in taking fruits and vegetables. Based on case, malnutrition has been observed among children belonging under age group of 5 for poor nutritional status of mothers. Moreover, poor sanitation increases the rate of growth de retardation among children that becomes a major impact of this malnutrition issue.

This study focuses on a qualitative study. Journal articles have been implicated for making estimation of various symptoms and risk factors of malnutrition. Evidence based has been executed through highlighting over interpretivism paradigm. Moreover, an intervention that needs to be adopted by individuals for making prevention from disease that may introduce malnutrition. Issues are faced by individual for social challenges such as gender discrimination while offering foods to them. Moreover, premature birth of a child makes a barrier in transferring nutrition to children from mothers.

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 Appendix: Search Strategy

Keywords: Malnutrition, Children, Nutrition Status, Stunting, Developing Countries, India, Nutrition Program, Public Health

Database: CASP CHECKLIST

Restrictions: English Language, 2017 to present, full text, peer reviewed

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