ABSTRACT

Obesity is a condition of abnormal or excessive fat accumulation in the adipose tissue to the extent that health may be impaired. Globally it is estimated that about 155 million children are obese. Studies further reveal that childhood obesity has become a serious health epidemic, where more than a third of children aged between two to nineteen years are obese. The purpose of this study was to investigate the influence of obesity on pupil’s school attendance and participation in physical activities. The study objectives were to establish the prevalence of childhood obesity among pupils in lower primary schools; find out whether obesity influences pupils’ level of participation in physical activities; explore the influence of childhood obesity on pupils’ school attendance; find out the available physical facilities in schools for use during physical activities; and to establish strategies that schools have put in place to prevent childhood obesity among grade three pupils in Kasarani Sub County, Nairobi County. The study was guided by the Looking Glass Self Theory that was developed by Charles Horton Cooley (1902). Mixed method study design was employed in the study. The target population were headteachers, teachers, and grade three pupils in Kasarani sub-county. Simple random sampling and purposive sampling techniques were employed to select the sample schools and pupils respectively. From the 25 schools, 30% were selected giving a total sample of 8 schools in both Kahawa and Ruaraka educational zones. Interview schedules, anthropometric datasheets and questionnaires were used to collect data. Data were analyzed by both qualitative and quantitative procedures. Pearson Product Moment Correlation was employed to test the study variables. The significance level of 0.05 was used and the probability value was then established. Regression analysis was done using SPSS giving means, percentages and frequencies. Data was presented in tables and figures. The findings showed that the prevalence rate of childhood obesity was at 11.6 % (BMI). The findings indicated that childhood obesity did not influence pupils’ frequency on school attendance. There was also no statistical significance between childhood obesity and level of participation in physical activities and lastly, most schools were also keen on ensuring schools have at least four physical facilities or equipment. As for strategies employed by schools to mitigate childhood obesity; school feeding programs (considering nutritional value), timetabling of physical education lessons and mandatory school participation in games and sports by every pupil was reported in all the selected schools. The study recommends that a similar study can be done in other schools especially in rural areas and as well as establish intervention measures put in place to mitigate the problem.

CHAPTER ONE INTRODUCTION AND CONTEXT OF THE STUDY

        Introduction

This chapter presents an overview of the background to the study, statement of the problem, the purpose of the study, research objectives and research questions. It also presents the significance of the study, its delimitations and limitations, study assumptions, theoretical and conceptual frameworks. The key terms that were used in the study were also operationally defined.

        Background to the Study

Good nutrition can contribute to healthy children who are generally productive in different aspects of life. Good nutrition is also very important for any country’s general development, this is because children with good health tend to perform well in school learning activities, this would result into adults who are brilliant, dependable and productive socially, economically, and in other aspects of life. Obesity being one of the nutritional childhood illnesses may hinder such a child from achieving this. Studies have reported that the environment in which the child lives generally determines its food patterns and quality of nutrition consumed. Each household thus plays a key responsibility to feed a child, therefore the kind of food offered to the child influences the nutritional health nutrition of a child objectively. Tasher (1996) reported that a high intake of energy foods and refined foods may predispose an individual to obesity. Similarly, the provision of too much snacking has been largely associated with increased rates of obesity (Bagully, 2006). Therefore, there is a need

to ensure that children are free from childhood obesity by ensuring that proper nutrition and an active lifestyle is observed both at school and home.

Obesity is a health condition where an individual has abnormal or excessive fat accumulation in the adipose tissue which may impair a person’s health (World Health Organization, 1997). Childhood obesity is also defined as a Body Mass Index at or above the 95th percentile for children of the same sex and age according to the Centres for Disease Control, CDC (2009). To assess a child’s body weight, the BMI of the child has to be measured. BMI is calculated using a child’s weight and height. A child’s classification of body weight is then established based on age and sex percentiles. Hence, the BMI for children was measured to establish the prevalence  rate of obesity among the sampled population and, and to bring the attention of the teachers and parents on the ways to help these children.

Globally, childhood obesity has recorded increasing rates by years. It is becoming a global epidemic (World Health Organization, 2002); childhood obesity has further continued to be an epidemic according to Fairclough & Stratton, (2006). Similarly, as stated by the Committee on Nutrition (2003), the likelihood of childhood obesity continuing into adulthood is estimated to have increased from 20% at 4 years of age  to 80% by adolescence. The increased rate of obesity among children in recent years involves both its prevalence and development at earlier ages, this has led to increased occurrence of other lifestyle illnesses such as cardiovascular diseases, diabetes mellitus type2, and hypertension (Bauer and Maffeis, 2002). Further, studies have reported that obesity is also associated with diseases such as insulin resistance, hyperlipidaemia, respiratory problems, hypertension and orthopaedic complications

(Trost, Sirard, Dowda, Pfeiffer, & Pate, 2003). The current study, however, focused on the trends in obesity among young children and not related illnesses.

Research studies have reported that obesity not only affects the health of a child but also school learning processes. Naticchioni (2013) complemented this observation by stating that both young children and adolescents that are obese score generally low in test scores than those of average weight. They also tend to portray shorter attention spans, reduced mental flexibility, and low cognitive functioning than their counterparts of average weight and, that obesity does affect school-going children in multiple aspects of their academic learning and achievement. Obese children due to issues with weight may participate less in physical activities and frequent absenteeism that may affect their learning achievement.

Children should generally be encouraged to be physically active at all times, both at home and at school since if they are inactive, childhood obesity increases as well, proper nutrition is also advised. Within the past 20 years, rates of obesity in children have doubled, and currently, according to research, one in three children is either overweight or obese (American Heart Association, 2006). Research further indicates that childhood obesity may also affect cognition and therefore academic achievement and other school learning activities’ performance including participation in physical activities (Yau, 2012).

Regionally, trends of childhood obesity have also been observed as an indication that Africa has similar issues. For instance, studies conducted among the pre-school children from several African countries reported that South Africa had a prevalence

rate of 31.9%, Algeria 21.6%, Seychelles 25%, Malawi 8.4%, Mauritius 5.6% and Kenya 4.6% (Aballa, 2010). Desoite these revelations, there are limited representative data available in African countries for studying these trends on childhood obesity (IOTF, 2002). Therefore, the need to establish prevalence rates of childhood obesity objectively to the study area necessitated the current study.