KNOWLEDGE, ATTITUDE, AND PRACTICES OF MOTHERS

ON CHILD-REARING AND FEEDING WITH THE

NUTRITIONAL STATUS OF THEIR CHILDREN

AGED 1-5 IN DARASA

SUBMITTED TO THE FACULTY OF THE

COLLEGE OF ALLIED HEALTH SCIENCES

FIRST ASIA INSTITUTE OF TECHNOLOGY AND HUMANITIES

IN PARTIAL FULFILLMENT OF THE REQUIREMENTS

FOR THE DEGREE OF

BACHELOR OF SCIENCE IN NURSING

DIANDRA IRICH RUTAQUIO CAPULE

DHEA YSABEL LATAYAN GONZALES

EVANGELINE PILAPIL MALVEDA

LEOVINCIO PACLIBAR RAMORES

JUNE 2023
 APPROVAL SHEET

This research, entitled “KNOWLEDGE, ATTITUDE, AND PRACTICES OF

MOTHERS ON CHILD-REARING AND FEEDING WITH THE
NUTRITIONAL STATUS OF THEIR CHILDREN AGED 1-5 IN DARASA”,
has been prepared and submitted by the candidates of Bachelor of Science in
Nursing as partial fulfillment and requirement for the subject Nursing Research,
has been examined, and is recommended for acceptance and approval for the oral
examination.

Candidates:
Diandra Irich Rutaquio Capule
Dhea Ysabel Latayan Gonzales
Evangeline Pilapil Malveda
Leovincio Paclibar Ramores
______________________________ ______________________________
MARIA ERICA P. LAT MARVIN S. SABATIN
Adviser Research Instructor
__________________________________________________________________

Approved by the panel of examiners with the grade of _____________________.

COMMITTEE
_________________________________________
DIANE CHERIE M. VELECINA
Chairman

_____________________________ ______________________________
KIM LEONARD G. DELA LUNA LADIELYN A. DUCAY
Member Member

__________________________________________________________________
Accepted and approved in partial fulfillment of the requirements for the subject
Nursing Research.
___________________________________
DIANE CHERIE M. VELECINA
Dean, College of Allied Health Sciences
 ACKNOWLEDGEMENT

We would like to extend our sincere gratitude and profound admiration to

the following persons who have contributed to and supported us in fulfilling this

study:

Foremost, to God Almighty for the knowledge and wisdom that He

bestowed upon us, the strength and good health in order to accomplish this research;

To the Nursing Department of the College of Allied Health and faculty for

their guidance, and for inspiring us to become individuals with dedication;

To Maria Erica P. Lat, RN, MAN, our research adviser, for devoting her

time and imparting valuable knowledge, and constant guidance and support in order

to accomplish this research;

To Ma. Lorena R. Babao RN, MAN, and Marvin S. Sabatin, LPT, RN,

MAN, our research instructor, for sharing his knowledge, expertise, and support;

To Diane Cherie M. Velecina, RN, MAN, the Dean of the College of Allied

Health Sciences (CAHS), Ladielyn A. Ducay, LPT, RN, MAN, MAEd, and Kim

Leonard Dela Luna, RND, MSPH, PhD, our panelists, for their time and effort to

read and give comment, guidance, and recommendation that resulted in a well-

written research;

To Gelyn R. Acar, MSM, our statistician, who shared her knowledge and

expertise in statistical data analysis for this research study which is greatly needed

and deeply appreciated;

To Isedora J. Adajar, MACA, our grammarian, for sharing her expertise in

checking the grammar of the study;

iii
 To Princess S. Gabinete, RND, Alyssa Marie P. Catapang, RND, and

Mabel M. De Las Alas, LPT, MAED for sharing their expertise in validating and

testing the reliability of the research questionnaire used in the study;

To the research respondents for their kind participation in answering the

survey-questionnaire and cooperation throughout the data-gathering procedure;

To the researchers’ families, for their unending love and support

emotionally, morally, spiritually, and financially; and

Lastly, we would like to express our gratitude towards BSN 3 BATCH 2024

for their support and willingness to help in order to accomplish this research.

DIRC

DYLG

EPM

LPR

iv
 TABLE OF CONTENTS

PAGE

Title Page i

Approval Sheet ii

Acknowledgement iii

Table of Contents v

List of Tables vii

List of Figures viii

List of Appendices ix

Abstract x

Abbreviations Xi

INTRODUCTION 1

Research Objectives 4

Research Hypothesis 5

Significance of the Study 5

Scope and Limitations 6

REVIEW OF RELATED LITERATURE 8

Theoretical Framework 26

Conceptual Framework 28

Synthesis of the Study 29

v
 PAGE

Definition of Terms 34

RESEARCH METHODOLOGY 38

Research Design 38

Setting of the Study 39

Sampling Size and Technique 39

Respondents of the Study 39

Data Gathering Instruments 40

Data Gathering Procedure 41

Statistical Analysis 42

Ethical Considerations 45

RESULTS AND DISCUSSION 47

SUMMARY, CONCLUSION, AND RECOMMENDATIONS 61

Summary 61

Conclusion 64

Recommendations 66

References 68

Appendices 80

vi
 LIST OF TABLES

TABLE PAGE

3-1 Interpretation on the level of Knowledge, Attitude, and 42

Practices of mothers on child-rearing and feeding with
the nutritional status.

3-2 Interpretation on the level of agreement and 43

disagreement.

4-1 Frequency distribution and percentage of the 47

demographic profile of the respondents.

4-2 Frequency distribution and percentage of the children’s 51

nutritional status.

4-3 Frequency of the respondents in terms of their level of 53

Knowledge, Attitude, and Practices of mothers on child-
rearing and feeding.

4-4 Relationship between demographic profile of the 56

respondents and their Knowledge, Attitude, and Practices
on child-rearing and feeding.

4-5 Relationship on Knowledge, Attitude, and Practices of 58

mothers on child-rearing and feeding with the nutritional
status of their children aged 1-5.

vii
 LIST OF FIGURES

FIGURE PAGE

2-1 Health Belief Model (HBM). 26

2-2 Conceptual paradigm of the study. 28

viii
 LIST OF APPENDICES

APPENDIX PAGE

A Validation Letter 82

B Certification Letter 87

C Letter to the Barangay Captain and City Health Officer 92

D Informed Consent Letter of the Respondents 94

E Research Questionnaire 103

F Statistical Computation 113

G Gantt Chart 119

ix
 ABSTRACT

In today’s world, malnutrition is known to be a contributing factor in about half of

all fatalities of children under the age of five. Toddlers and preschoolers belong to
these age groups and are considered to be a crucial phase for growth and
development. The study aimed to determine the relationship between the
Knowledge, Attitude, and Practices (KAP) of mothers on child-rearing and feeding,
and their nutritional status. Two hundred forty-five (245) mothers residing in
Barangay Darasa Tanauan City, with children aged 1-5 were surveyed in this study.
Spearman's rho was used to determine the significant relationship between the
mother's KAP on child-rearing and feeding with the child's nutritional status.
Results revealed that occupation and educational attainment of the mothers were
significantly correlated to their knowledge and practices, respectively. Meanwhile,
there was no significant correlation between the mother's KAP and their child's
nutritional status. Given these findings, it was recommended that mothers must
attend a health nutrition program to improve their knowledge about the importance
of good nutrition and to monitor their child's health status accordingly.

Keywords: knowledge, attitude, practices, child-rearing, child-feeding,

malnutrition, nutritional status

x
 ACRONYMS AND ABBREVIATIONS

CDC Center for Disease Control and

Prevention

HBM Health Belief Model

IYCF Infant and Young Child Feeding

KAP Knowledge, Attitude, and

Practices

NHS National Health Service

WHO World Health Organization

xi
 CHAPTER I

INTRODUCTION

Background of the Study

Toddlers and preschoolers age groups have a wide array of growth and

development, which present challenges for their parents. One of the factors that

influence their growth and development is nutrition. Food choices and daily food

consumption vary substantially across all age groups. After the first year of life,

growth drastically slows down, and a toddler's appetite is less than that of an infant.

Preschoolers are also less prone to have ravenous appetites because this is not the

period of rapid growth for them. Despite the fact that their appetites tend to decline

depending on their age groups, it is still critical that they consume enough nutrients

to meet their demands for energy. Hence, good nutrition must be on the priority list,

as this is an essential component that keeps children healthy. If neglected,

deficiencies may occur, leading to alterations not only in their physical

development but almost in all aspects of health. One of the possible conditions that

may arise from the deficiencies is malnutrition. These include undernutrition,

which can be categorized as wasting, stunting, underweight, mineral deficiencies;

overnutrition like overweight and obesity; and micronutrient-related malnutrition

(World Health Organization, 2021). All of these became and are still a public health

concern not only in the Philippines, but globally.

The World Food Program USA (2022) estimates that severe malnutrition

results in 45 million children that are affected annually around the world. Almost
 2

one out of three children under the age of five fall into that category. In today's

world, malnutrition is known to be a contributing factor in about half of all fatalities

of children under the age of five. In 2020, it was anticipated globally that 149

million children under the age of five were stunted (low height for their age), 45

million were wasted (low weight for their height), and 38.9 million were

overweight or obese. Undernutrition is considered to be a contributing factor in

approximately 45% of fatalities in children under the age of five (WHO 2021). In

relation to this, Statista (2022) states that the Global Hunger Index 2022 was

approved by the International Food Policy Research Institute, noted that Yemen

was having the highest levels of hunger and malnutrition, with an index of 45.1

Right behind is the Central African Republic with an index of 44. In accordance

with this, the Philippines is one of the top 10 countries in the world for having the

most stunted children, ranking 5th among nations in the East Asia and Pacific

region. In some areas, the proportion of people who are stunted is more than 40%.

Children under the age of 5 are stunted in the Bangsamoro Autonomous Region in

Muslim Mindanao at a rate of 45%, and in the Southwestern Tagalog Region

(MIMAROPA) at 41% (World Bank Group 2021). Meanwhile, based on the results

from the Expanded National Nutrition Survey conducted by the Food and Nutrition

Research Institute (FNRI) in 2019, the prevalence of overweight was relatively low

among children under the age of five (2.9%) and moderate among children aged

five to ten (9.1%). Anyone can experience malnutrition, but the most susceptible
 3

groups are women, infants, children, and adolescents, as well as immune-

compromised individuals and those who are struggling with poverty.

There are factors that give rise to the changes of the nutritional status of the

children. In fact, as stated in the study of Katoch (2021), the factors most

consistently linked to child malnutrition were maternal education, household

income, maternal nutritional condition, child age, family size, birth order in the

family, and child's birth weight. Child malnutrition is also influenced by parenting

styles, including breastfeeding and child-rearing, as well as sex and socioeconomic

status. In addition, the findings of the study of Purba (2019) showed that the

mothers’ knowledge and perception of nutritional status are linked to the nutritional

status of children under five (5) years of age. Hence, numerous factors must be

taken into consideration, in order to lower the chances of increasing cases of

malnutrition. Furthermore, mothers have a crucial part to fill for their children's

well-being.

The health of the people is an important matter that should be studied,

especially nutrition because it aids in discovering the factors that lead to deviations

in one’s nutritional status. In addition, the aforementioned empirical information

drives the researchers’ curiosity to study children’s nutrition, particularly those 1-

5 years of age, as this age group is the crucial phase for growth and development.

This study can provide pieces of well-grounded information regarding the

KAP’s of mothers and the factors affecting the nutritional status of children aged

1-5 that will guide the authorities to determine appropriate planning and

implementation of an action plan that can improve the situation of the children.
 4

Research Objectives

The main purpose of this study was to identify the relationship of

knowledge, attitude, and practices of mothers on child-rearing and feeding with the

nutritional status of their children aged 1-5 in Darasa. Specifically, this study aimed

to:

1. Identify the demographic profile of mothers with children aged 1-5 in terms of:

1.1 Age;

1.2 Educational Attainment;

1.3 Family Income Status;

1.4 Occupation; and

1.5 Household size.

2. Determine the nutritional status and prevalence of malnutrition between children

aged

1-5 in Brgy. Darasa according to:

2.1 Weight for Age;

2.2 Height for Age; and

2.3 Weight for Height.

3. Determine the level of Knowledge, Attitude, and Practices of mothers on child-

rearing and feeding.

4. Identify the relationship between the demographic profile and the Knowledge,

Attitudes, and Practices of mothers on child-rearing and feeding.

 5

5. Identify if there is a significant relationship between the Knowledge, Attitudes,

and Practices of mothers on child-rearing and feeding with the nutritional status of

the child.

Research Hypothesis

H01: There was no significant relationship between the demographic profile and the

Knowledge, Attitudes, and Practices of mothers on child-rearing and feeding.

H02: There was no significant relationship between the child's nutritional status and

the Knowledge, Attitudes, and Practices of mothers.

Significance of the Study

The results and findings of this research were beneficial to the following:

Mothers. This research is focused on mothers thus, this may be helpful for them to

have a better understanding of child-rearing and feeding in relation to the nutritional

status of their children. This may also help them to provide enough nutrition and

learn ways to improve the nutritional status of their children.

Children. This study may be beneficial for children engaged in this research as

this may help them to become aware of their nutritional needs towards good

nutrition.

Community leaders. This study may help the community leaders of Brgy. Darasa

to identify the factors that cause malnutrition in children and develop an action plan

to solve the malnutrition cases in the community.

 6

Community. The results of this study may allow the community specifically Brgy.

Darasa, to determine the relationship of knowledge, attitude, and practices of

mothers on child-rearing and feeding with the nutritional status of their children.

Through this research, the community may identify the factors that cause

deficiencies in the child’s nutrition.

Nutritionists. This study may serve as a guide as this may assist them in assessing

the nutritional status of the children and creating programs that aid in solving

nutritional-related problems.

Nursing Department of the College of Allied Health Sciences. This study may

be beneficial to the nursing department as the result will determine the

discrepancies in the Knowledge, Attitude, and Practices of mothers in terms of

proper nutrition. This may also help the nurses make a health teaching plan about a

healthy diet and nutrition.

Future Researchers. This study will serve as reference for future researchers for

further investigation of the gaps and problems regarding the correlation between

Knowledge, Attitude, and Practices of mothers on child-rearing and feeding, and

the nutritional status of their children.

Scope and Limitation

This quantitative research focused on determining the Knowledge, Attitude,

and Practices (KAP) of mothers on child-rearing and feeding with the nutritional

status of their children. The data collection was conducted and limited to mothers
 7

with children aged 1-5, who agreed to be part of the study and gave their consent,

and those who reside for at least six (6) months in Darasa, Tanauan City, Batangas.

Meanwhile, mothers with child/children under the age of 1 and 5 above, and

children without their biological mother were excluded from this study.

Furthermore, the study is limited to derive and describe the causal relationship

between independent and dependent variables because exposure and result are only

measured once in a cross-sectional study design. This can also be subject to biases

because the respondents might not remember or accurately describe their child-

rearing and feeding practices, which could have an impact on the validity of the

study. Accordingly, as the child's anthropometric measurements and dietary intake

were evaluated at a particular period in the study, there may be biases since the

persons involved in the study may experience changes in his or her nutritional status

dependent on the mother's KAP.

The time frame for conducting this study commenced from the first

semester and lasted through the second semester of the Academic Year 2022-2023.
 Chapter II

REVIEW OF RELATED LITERATURE

This chapter included the related literature and studies regarding the

Knowledge, Attitude, and Practices of mothers on child-rearing and feeding with

the nutritional status of their children aged 1-5. Further, this includes the theoretical

and conceptual frameworks of the study.

Age

Stunted and underweight children are more likely to be born to women in

the 35-49 age group than younger women (Pintu & Saha, 2022). Stunting is the

term used to describe children who are small for their age. Stunted growth is

accompanied by permanent physical and cognitive harm, from which children may

be suffering quite badly. Meanwhile, according to UNICEF (2020), stunting is

defined as "moderate and severe - below minus two standard deviations from

median height for age of reference population."

Wemakor et al. (2018) found that young mothers were more likely to have

an undernourished child because they feed for a shorter period of time than adult

mothers because they are less mature, insensitive to the needs of the child, and more

easily irritated. They gathered 150 teenage mothers and 150 adult mothers with a

total of 300 respondents for their study. Compared to adult mothers, they also lack

parenting education and are in lower socioeconomic standing. On the other hand,

results from the study by Wright et al. (2021) indicate that the mothers’ age and
 9

socioeconomic position have an impact on the children's feeding habits. The child's

food preferences, eating habits, and weight status are all clearly influenced by the

parent-child feeding relationship. Some mothers frequently force-feed their

children without taking into account how full and capable they are. Meanwhile, the

study by Khan et al. (2019), showed that children of mothers who are older than 18

years old and those who visit parental care clinics frequently or more than three

times during pregnancy are more likely to have children who are less stunted. In

line with this, as stated in the article reviewed by Brennan (2021), it was discovered

that an older mother is more likely to be stable and capable of caring for a

child/children than a younger one. Thus, a mother's experiences as she grows older

may help acknowledge and provide for her child/children’s needs.

According to Pintu and Saha (2022), in low and middle-income countries,

childhood malnutrition continues to be a serious public health issue. Nearly half of

all deaths in children under the age of five are caused by malnutrition. It makes

infections more common and serious, increasing the likelihood that children will

pass away from treatable conditions. Additionally, inadequate nutrition during

infancy has a negative impact on adult health and cognitive development.

Educational Attainment

Maternal education was a significant factor that predicted child stunting. In

this study, the significance was determined by the mother’s highest number of years

of schooling. Thus, higher educational levels or years of education among mothers

contribute to childcare knowledge and practices (Laput & Go, 2022). According to

Bras (2022) as cited by Semba et al. (2008), if the mothers are having high
 10

educational attainment, first, they have been found to wield a positive influence on

child health and nutrition because they have more knowledge of, and greater access

to information on child feeding and care practices, hygiene, and sanitation. Second,

higher-educated women are more likely to have better-paid jobs in the formal sector

and thus more resources to provide children with nutritious food and health care

(Brauner-Otto et al., 2019; Nankinga et al., 2019). Third, education has been found

to improve women’s bargaining position in the household, enabling them to

allocate more and/or better food and health care to children (Kunto & Bras, 2018).

As maternal education levels rose, the prevalence of childhood malnutrition

considerably declined.

Based on the study of Ishola and Oyeleke (2019), a mother's education level

influences a child's nutrition through her decisions and health-seeking abilities

linked to nutrition, hygiene, preventative care, and disease treatment. Under-five

child malnutrition is largely caused by the mother's obligation to take care of herself

during pregnancy and her child/children during the most vulnerable times of life.

Nutrition education is a technique for increasing knowledge and promoting positive

behavior change. The results of increasing the nutritional condition of children in

the majority of developing nations are also greatly influenced by mothers' limited

knowledge about food choices, feeding, and healthcare practices (Fadare, 2019).

Additionally, the findings of the study conducted by Dankyi et al. (2019) show that

the role conflict that student mothers experience has an impact effects on both their

performances at home and in academics. They struggled academically, finding it

difficult to routinely attend in-person classes and preparing poorly for tests, while
 11

at home they struggled to perform childcare responsibilities and provide for their

child/children's needs. In a nutshell, maternal education is an important factor in

child nutrition outcomes.

Family Income Status

One of the problems included in the Millennium Development Goals is

child undernutrition, which is related to poverty. According to Hassan et al. (2020),

financial stability in the home is a crucial enabling factor for children's nutrition.

For instance, household wealth provides power to assure the availability of nutrient-

dense foods and other items that improve household health. Meanwhile, negative

child health outcomes, such as malnutrition, are more likely to be manifested in

low-income families. Regarding the socioeconomic disparities in nutritional

effects, they discovered that low socioeconomic children were more likely to be

stunted and underweight, and these disparities differed throughout the areas of

Bangladesh.

The study of Ahmad et al. (2020), revealed the effects of socioeconomic

factors on malnutrition in children ages 0-5 in the Multan district of Punjab

province, Pakistan. The study found that there was a higher prevalence rate of

malnutrition due to lower socioeconomic status among major populations in the

community, specifically in rural areas. They suggested enhancing individual

economic resources, ensuring nutritional safety, increasing maternal education, and

improving child health policies.

Meanwhile, in the study conducted by Sisara et al. (2020), it was found that

the factors associated with the child’s healthy food consumption are food
 12

availability, nutritional knowledge of family or caregivers, and family income.

Families' purchasing power for nutritious food is influenced by family income

because the type of food purchased is determined by the level of income (Izah et

al., 2020). With a high income, it is feasible to meet the food demands of all family

members, whereas a family who has a low income leads to low household food

purchasing power. The low purchasing power of food products leads to inadequate

nutritional fulfillment of children under the age of five. Therefore, family income

has significantly influenced the family's ability to purchase healthy food and make

food choices for their children.

In the study of Yanti and Fauziah (2021), it was found out that 7 out of 35

respondents had family income less than the Regional Minimum Wage. There is a

total of 11.4% of the short height category for age (stunting). The results of the

study showed that there was a significant relationship between family income and

the incidence of stunting at Puspa Bangsa Kindergarten, Bogor City.

On the contrary, Xiaoying (2022) as cited by Wang and Sheikh-Khalil

(2014) found that authoritative parenting and parental participation were not

substantially correlated with family income. In addition, the study of Kilic, Kirk,

and Carletto (2018) revealed that family income has no significant correlation on

the nutritional status of their children.

Occupation

Malnutrition is a widespread problem that necessitates a solution.

However, the nutritional state of a child is affected by a variety of circumstances.

One of these factors is occupation, as having a well-paying and steady job can help
 13

ensure the family's access to food. In the analysis of Otele et al. (2019) about

mothers' perceptions of nutritional health and malnutrition among children under 5

in the Niger Delta, they found that 96.6% of their respondents held the belief that

parents' jobs have an impact on their children's nutritional health. Only 10.3% of

their respondents were civil servants, compared to 48.7% unemployed and 40.3%

farmers. The majority of unemployed mothers work as traders, farmers, or full-time

homemakers. Since they spend so much time in their professions and pay little

attention to their children's nutritional needs, these children are at risk of

malnutrition as a result of insufficient food intake. It is similar to the study of

Hossain et al. (2020), which highlights the significance of increasing

socioeconomic level since it reduces the malnutrition of children under the age of

five in Nepal. The findings demonstrated a considerable impact of parental

occupation on nutritional status. Compared to mothers who are employed and

receive a monthly paycheck from their jobs, mothers who are unemployed have

more children who are undernourished. Meanwhile, children of working mothers

are less likely to grow up in poverty since they can contribute to the family's

income. In addition, they stated that mothers' academic training should be

improved, otherwise, they would be stuck in unemployment or low-skilled, poorly

paying, and precarious jobs.

Meanwhile, Chowdhury et al. (2020) noted that combating malnutrition is

a top health concern in their study. In order to determine the key factors influencing

stunting, wasting, and underweight among 19, 874 children under the age of five in

Bangladesh, their study compared the prevalence of having only one form of severe
 14

malnutrition versus many kinds. It was reported that having one or more severe

kinds of child malnutrition was significantly influenced by the father's occupation

and if the mother is currently employed. Children of professionals were less likely

to suffer from numerous severe kinds of malnutrition.

On the other hand in Nigeria, the majority of rural households practice

subsistence farming with low returns, particularly among women, which affects the

nutritional status of the households, especially children five years old and under.

This was revealed in a study Ashagidigbi et al. (2022) regarding gender and

occupation of household heads as major determinants of malnutrition among

children. They claimed that the occupation of household heads has no impact on

child malnutrition. However, male-headed households are less likely than female-

headed households to have children with malnutrition. This difference may be

explained by the high number of mothers who lack a source of income, which

increases their financial burden on the family. They recommended that policy

changes be made to improve the work situation and income level of households

headed by women because doing so would be beneficial, increase their economic

emancipation, and make it possible for them to meet the nutritional needs of their

children.

According to the study of Bliznashka, Jeong, and Jaacks (2023), numerous

studies have examined the association between maternal employment and child

nutritional status and yielded mixed results. In some cases, maternal employment

is associated with improved child nutritional outcomes. However, Ketema, Bosha,

and Feleke (2022), different research studies reported that children of unemployed
 15

mothers were at increased risk of developing wasting. According to the Sustainable

Development Goals of the United Nations, maternal employment empowers

women economically and socially and is in line with the sustainable development

goal eight (8) which aims at promoting economic growth and productive

employment for all. Additionally, sustainable development goal two (2) aims at

(among others) ending hunger, achieving food security, and improving nutrition .

Meanwhile, according to Pieters and Rawlings (2020), associations differed

depending on which parent was employed: paternal unemployment was negatively

associated with child health, while maternal unemployment was positively

associated with child nutrition and health. On the other hand, in the study of Hasan

et al. (2018), occupation of the mother does not have any relations on their child’s

nutrition.

Household Size

Household size is the number of people in a home. The study of Ciptanurani

and Chen (2021) shows how the relationship between household size and children's

nutritional status varies by country of residence. The negative impact of larger

household size on a child's nutrition frequently explains that there is increased

competition for available household resources, and that these resources are given

in small amounts. In large families, resources must be divided among several

members, and fewer resources will be given per person. Thus, larger household size

is favorable when the members of the household can help and encourage the growth

of young children or rearing of children. Household size and the number of working

adults were higher in cities. Significantly associated with a lower risk of concurrent
 16

stunting and obesity in children. In a similar study of Drammeh et al. (2019)

household size causes sharing of limited foods among family members. A

household size places an additional burden on food consumption and makes a

household more likely to suffer from food insecurity than a small family size. Large

households, as a strategy, typically consume a poor quality or frequency of food,

without regard for diet quality. However, it exposes children to malnutrition,

resulting in a higher number of underweight children in Africa.

Malnutrition has been a global problem for almost two decades due to lack

of access and distribution of foods in a large number of households. The foods are

insufficient and sometimes unavailable that leads to physical and psychological

problems. The numerous household size is one of the major contributing factors in

Sub-Saharan Africa, resulting in widespread food insecurity such as inadequate

quantity, low-quality foods and limited dietary diversity leads to a low-quality diet

with poor vital nutrient content that becomes a public health threat to the nutritional

status of children. This problem accounts for children's poor overall health status

that affects their growth and development. However, according to Germain and

Siddiqi (2019), food insecurity can be caused by larger household size but later

found that it had no association with child growth and food security.

Nutritional Status

A person's nutritional status varies depending on gender, age, weight,

height, and even lifestyle. It is one of the benchmarks of developmental milestones

used to gauge the recommended nutritional requirements for children. According

 17

to the Dietetics department of Maastricht UMC+ (2022), the term "nutritional

status" deals with the state of the body by means of nutrient intake, its ability to

absorb, and its utilization of it, along with the impact of disease-related factors.

Nutrition should be emphasized as early as possible, especially to the parents of

children aged 1-5, since they were still the ones making food for them. Having a

good nutritional status will help a person to achieve normal growth and

development, and will speed up recovery from illness as their body systems are in

good shape.

The nutrient intake of a person may be an indicator of malnutrition, and this

happens when the food they eat does not contain an appropriate amount of nutrients.

According to the National Health Service (NHS) (2020), poor nutritional status may

refer to undernutrition, which occurs when nutrient consumption falls below the

recommended intake levels. Meanwhile, a person is considered to have a nutritional

status of overnutrition when the intake of nutrients exceeds what is required. There

are instances wherein a person excessively consumes food and nutrients, resulting

in the accumulation of body fat that deteriorates health. Overnutrition has short and

long-term health consequences. Overnutrition can be categorized into overweight

and obesity. Globally in 2020, 38.9 million children under 5 years old were

overweight or obese. Obesity alone probably has far less of an impact on health

than social factors which include poverty, discrimination, and the availability of

nutritious food. Meanwhile, according to the study by Mya, Kyaw, and Tun (2019),

a person with an insufficient supply of essential nutrients is a major issue facing

Myanmar. In addition, Obembe, Adenuga, and Asuzu (2018) found that wasting is
 18

associated with nearly one-third of children's deaths, which is related to illnesses

and food insecurity. All age groups are susceptible, but the effects are more severe

in infants and toddlers between the ages of 6-23 months since this is a crucial time

for development. However, a study by Wondu (2020) revealed no connection

between acute malnutrition (wasting) in children and household food insecurity.

Meanwhile, Chawla et al. (2020), stated that long-term undernutrition in children

has a number of negative effects, including delayed motor and skill, lower IQ,

higher risk of behavioral problems, lack of social skills, and a higher risk of

infectious diseases.

Among other methods, anthropometric and dietary assessment can be used

to determine nutritional status (Slowik et al., 2019). Anthropometric measurements

use height and weight measurements to assess the physiological state of the body.

On the other hand, dietary assessment involves estimating nutritional intakes

gleaned from the analysis and interpretation of diets, the availability of food, and

eating habits. This can be done through food recall or food frequency

questionnaires. Body mass index (BMI) is the most frequent and widely used tool

for determining nutritional status. It is important to assess nutritional status, as this

may help in formulating a specific plan of care for people who are having

nutritional deficiencies. According to the Centers for Disease Control and

Prevention (CDC) (2022), nutritional status indicators for the CDC Growth Charts

comprise obesity, overweight, underweight, and short stature. On a growth chart,

percentiles are utilized to categorize a person or groups and show where they belong

within the context of the reference population. In addition, Hannema and Sävendah
 19

(2019) claim that by measuring growth, a clinician may identify both typical and

unusual patterns of development in children. It is said to play a significant role in

nutritional evaluation. Additionally, in the study of Queally et al. (2018), findings

show that some mothers who have overweight and obese children showed poor

awareness with regard to their child's weight status. Therefore, increasing and

improving mothers' awareness and understanding regarding the nutritional status or

healthy body size of their children is a must.

Knowledge of Mothers towards Child-rearing and Feeding

Raising a child or children is a challenging responsibility for a parent. It cannot

be learned in just one sitting, but through full devotion to discovering certain

techniques applicable to their children. This requires ample time and perseverance,

as it does not come with a specific formula or instructions, as each child has his/her

own unique characteristics. Parents' responsibilities in terms of nutrition is to know

and understand the risk factors that cause malnutrition and how to avoid it so that

they can maintain the wellness of their children and provide them with nutritious

food and help them with proper eating habit. As malnutrition increases, child

mortality also increases. Some mothers think that malnutrition is only caused by

not eating enough nutritious food, but it is also when a child eats too much

unhealthy food. A study by Hasnidar and Mustar (2021), found that there was a

relationship between the mother’s knowledge, attitude, and behavior in the

nutritional status of the children under five, specifically the toddlers. The study

suggested that health workers and midwives should provide counseling to improve

understanding of the importance of meeting nutritional needs in toddlers, starting

 20

from age of two, and serving complementary food to prevent and handle stunting

cases. According to Save the Children Org (2022), poor maternal health can cause

malnutrition in children because mothers that are undernourished during their

pregnancy might experience complications in the delivery of the infant. Due to

undernourishment, a woman might have a small baby and problems in

breastfeeding the baby. Breastfeeding helps an infant a lot from birth and

adulthood. However, a malnourished mother is unaware that they cannot supply

enough nutrients to her baby that is why the infant is at high risk of being

malnourished. According to Kumara et al. (2020), literate mothers play an

important role in child well-being and development and it reduces the risk of infant

mortality.

According to Ismael et al. (2020), the incidence of nutritional problems in

children can be prevented if the mother has sufficient knowledge on how to select

and prepare the diet of children with healthy nutrition. Meanwhile, in the study of

Bimpong et al. (2020), the level of the mother’s education, the child/children’s sex,

age, type of residence, social status, and household wealth index are the factors that

affect weight among children. In a similar study of Doke et al. (2018), an

underweight child is associated with poor maternal education about child nutrition.

Some strategies must be improved and done to develop a better nutritional status of

children in which it will start from improving maternal education.

Understanding nutrition is essential for consuming a healthy diet. Studies

have demonstrated that knowledge of healthy nutrition can alter dietary attitudes,

food preferences, and dietary quality, which can therefore help prevent childhood
 21

and adolescent weight gain (Ul Haq, 2018; Kwol et al., 2020). It is necessary to

inform mothers about child health and nutrition. Giving out nutrient-rich food

through government programs is crucial, but so is making good use of those

programs. Mothers must be informed about their children's nutritional needs,

particularly during times of illness, if we want to improve their health.

Meanwhile, a study by Sangra and Nowreen (2019) indicates that the

majority of mothers had fair to good KAP in terms of under-five nutrition and

malnutrition prevention in rural settings. They recruited 300 mothers with children

under the age of five for their study. A questionnaire was created using the KAP

survey guidelines and earlier research. The study revealed that the attitude and

behavior of mothers in addressing nutritional health issues will be improved by

their adequate awareness of the eating habits of children under the age of five.

In Western Ethiopia, over 456 (93.8%) out of 486 mothers have a strong

understanding of infant and young child feeding, leading to better feeding practices

than mothers with poor knowledge (Assefa et al., 2021). The main reason for the

lack of knowledge is that, majority of the mothers in this study did not receive any

formal education on infant feeding. They recommend expanding the hospital

initiative as well as creating breastfeeding programs for the protection, advocacy,

and assistance of breastfeeding.

A study by Manohar et al. (2018) found that mothers' knowledge affects the

ways in which they care for their children. The study involves 120 mothers with

children aged 0-5 admitted to hospitals with severe malnutrition. The findings of

the study exhibit mothers' practices and knowledge of child nutrition have certain
 22

gaps. Although mothers are aware of the importance of healthy nutrition for their

children, this awareness can be increased by providing them with basic health

education and proper guidance from medical professionals.

A study conducted by Heliyon et al. (2022) revealed that there is no

association between the understanding of nutrition by mothers or caregivers and the

nutritional status of their children. However, the study found that as caregivers'

nutritional knowledge improved, the chances of their children suffering from

malnutrition decreased. This indicates that although there may not be a direct link

between caregiver nutrition knowledge and child nutritional status, increasing

caregiver nutrition education can still be beneficial for children's overall health and

well-being, specifically by reducing the risk of wasting. Therefore, the study

emphasized the importance of nutrition education for caregivers in improving the

health of children. According to Sichani (2018), there was no significant correlation

found between Body Mass Index (BMI), child height, and overall score of

nutritional knowledge.

Attitudes of Mothers towards Child-rearing and Feeding

Mothers' influence, experiences, knowledge, and cultural standards all have

an impact on attitudes. The study of Romanos-Nanclares et al. (2018), revealed that

parents' attitudes and views about diet were related to the quality of their children's

diet, stressing the crucial role of parental psychosocial factors. Children's eating

habits are greatly influenced by parents' attitudes about healthy eating more than

parental nutritional knowledge. Mothers' knowledge regarding healthy food and

nutritional information can help in making better decisions in their food choices,
 23

however, knowledge is meaningless without practice and an optimistic attitude.

Lack of attitude and practices regarding meeting nutritional needs may lead to

insufficient intake that may cause health problems. Another study in East Africa

revealed that longer breastfeeding is connected with favorable maternal attitudes

toward nursing and having a greater chance of successful breastfeeding (Bimpong

et al., 2020). Thus, a mother's attitude plays a great role in feeding their child and

nutritional status. In the study of Swetha et al. (2022), about the KAP on

complementary feeding of young mothers, it was revealed that the KAP of mothers

on child weaning and infant feeding were insufficient among notable respondents

and the timing and duration of complementary feeding were inappropriate. The

false belief and attitudes of the mothers tend to wean the child late.

According to the study conducted by Gadanya et al. (2020), there is no

correlation between maternal occupation and the nutritional status of under-five

children, with the exception of Dala, where there has been waste documented for

residents. This is consistent with studies, such as one conducted in Surabaya,

Indonesia, which found that factors like age, educational level, financial situation,

occupation, and household size do not significantly influence respondents' attitudes

toward feeding and raising children. In the study of Jansen et al. (2020), dietary

intake or the development of unhealthy eating habits of their children has been

associated with parent's attitude regarding the use of food as a reward for the child’s

good behavior. According to the study of Saaka et al. (2021), poor feeding habits

has been linked to childhood undernutrition that became a worldwide health

problem. Radio health was made in order to address the problem, however, the
 24

results found out that the positive attitude of mother’s does not show any significant

relationship to the nutritional status of children. Additionally, the study of Susanto

et al. (2019), the results showed that there is no significant correlation between

maternal attitude and child nutrition and feeding.

Practices of the Mothers towards Child-rearing and Feeding

Every child has different food preferences, and it is quite difficult to start

breastfeeding, and then move to preparing solid meals for children aged 1-5 for the

first time. According to Mya et al. (2019), the majority of children between ages of

6–23 months (85%) continued to be nursed, and 25% of children obtained the

necessary amount of dietary diversity (at least four food groups). According to CDC

(2020), the American Academy of Pediatrics proposes the initiation of

complementary foods at relatively 6 months of age. Primarily, complementary

foods should be given to infants 2-3 times per day between 6-8 months, increasing

to 3-4 times per day between 9-11 months and 12 to 24 months. Infants had a

considerably increased risk of undernutrition, particularly when they have low birth

weights and those whose mothers did not take iron-folic acid supplements during

the course of pregnancy. According to the WHO (2021), over 820,000 children

under the age of 5 could be saved every year, if they are all optimally breastfed

during 0-23 months. With that, mothers must acquire the knowledge being imparted

to them and apply it correctly in real-life situations.

Meanwhile, Locks et al. (2018) analyzed and assessed changes in infant and

young child feeding (IYCF) practices in two municipalities in Nepal as part of a

 25

post-pilot of an IYCF - Micro Nutrient Program. The result of their study indicated

that mothers who received counseling from a female community health volunteer

with regular contacts were significantly more inclined to participate in optimal

IYCF practices than mothers who did not receive counseling sessions. Additionally,

they are more likely to report starting solids around 6 months and giving the infant

a diet that meets minimum requirements for dietary diversity, an appropriate diet,

and meal frequency.

According to Tariqujjaman et al. (2022), children residing in South Asian

Countries (SACs) account for nearly half of all undernourished children worldwide.

Additionally, only half of the children in the study were introduced to

complementary feeding when they were between 6 - 8 months old. Unhealthy

feeding practices and inadequate quantity and quality of supplementary foods have

a negative impact on a child's health. Aside from that, low levels of education are

to account for the poor IYCF practices, and mothers from poorer households are

more likely to practice breastfeeding than mothers from wealthier households. In

terms of the mothers’ child-rearing practices, Padmini (2021) claims that child-

rearing activities encompass feeding practices and other traditional beliefs that have

a direct impact on the child’s health. The majority of respondents conduct proper

child parenting, while the minority do not; therefore, healthy practices must be

stressed, and the faulty ones must be amended by informing the people.

Meanwhile, a study by Elni and Juliant (2021) revealed that in West

Bangka Regency, there was no significant correlation between child feeding habits

and the prevalence of stunting in children under five. In relation, incidence of

 26

stunting, wasting, and underweight children is closely associated with insufficient

feeding practices for infants and young children (Anees et al., 2020). This implies

that a mother's actions might or might not have an impact on the nutritional

wellbeing of her child or children.

Theoretical Framework

Health Belief Model

Figure 2-1. Health Belief Model (HBM).

Source: Rosenstock, 1950

The Health Belief Model (HBM) was developed by Hochbaum,

Rosenstock, and other Public Health Service in the U.S. during the 1950s. The

model explains the people’s failure in adopting and participating in disease

prevention. It used the beliefs and attitudes of an individual regarding the health

condition. This model is one of the health behavior’s first theories and addresses

the perceived health threat and reduces it through action with proper prevention of

the disease.
 27

The model has six major concepts: First is the perceived susceptibility

which is the person’s belief of chances of having or developing a disease. When

people know that they have the chance to have the disease, they will make a way to

prevent it; second is perceived severity which is about the person’s knowledge on

the severity of the disease depending on how it can affect their daily lives; third is

perceived benefits which refers to their knowledge about the risk of having the

disease will be useful in reducing the risk and realizing the importance of having a

healthy lifestyle; fourth is perceived barriers, the thing that a person sees as a

hindrance in order to adopt in the changes and people must know how to overcome

those obstacles to improve the quality of their lives; fifth is cues to action which

pertains to the things or events that push a person to change behavior such as the

things that they need to do, motivation lines, and advice of other people; and lastly,

self-efficacy. This is the belief of a person about the ability to perform a certain

action in preventing the condition and their confidence of being able to overcome

the perceived threat to their health.

HBM was the foundation of this research as it encompasses the knowledge

and belief of a person, which is essential as it paves the way to understanding the

nutritional condition of their children. In line with this, the perceived susceptibility

and perceived severity of the possible nutritional deficiencies are the catalyst to

assess knowledge in terms of child-rearing and feeding. Subsequently, the mothers

recognize a threat to the health of their child/children, their perceptions about the

benefits prevailed over the perceived barriers. This leads to changes as to how

mothers view and think of the condition. Practices were greatly influenced by the
 28

knowledge and experiences and the factors that drive the alterations of the

nutritional conditions. Their self-efficacy guides them to have an optimistic attitude

toward maintaining good nutrition. The cues to action served as a springboard for

the mothers to engage and adapt to the preventive nutrition action. Once the

mothers perceive all these concepts, it plays its part as an eye-opener to enhance

their sense of responsibility towards achieving optimal health for their children.

Conceptual Framework

Figure 2-2. Conceptual Paradigm of the Study.

Figure 2-2 shows the demographic profile of the mothers in terms of age,

educational attainment, family income status, occupation, and household size as

 29

this study aimed to identify the relationship of the mothers’ demographic profile in

relation to mothers’ KAP, thus, explaining the arrow pointing towards the triangle.

The other box shows the child’s nutritional status according to weight for age,

height for age, and weight for height in order to determine the prevalence of

Malnutrition between children aged 1-5 in Brgy. Darasa.

The mother is indicated in the triangle as the primary source of knowledge

in determining the KAP, which are all interrelated as attitude affects practice and it

is also both affected by knowledge. An arrow from the KAP points toward the

child's nutritional status to determine how the KAP of the mothers affects the

nutritional status of their child. Afterwhich, the gaps were identified and analyzed.

Synthesis of the Study

Studies pertaining to the demographic profile of the mothers (age,

educational attainment, family income status, occupation and household size)

towards child-rearing and feeding are the medium to assess their KAP on the said

matter. The characteristics of children like weight for age, height for age, weight

for height, and the result of these represent the integral roles and responsibilities

that mothers should pay attention to.

Mothers aged 35-49 were more likely to have a child with malnutrition

according to Pintu and Saha (2022). It contradicts the study of Khan et al. (2019)

and Brennan (2021), which stated that mothers who are older than 18 years old and

those who visit parental clinics frequently have children who are less stunted, since

they are more stable and capable of caring for their child/children. On the other
 30

hand, Wemakor et al. (2018) claimed that young mothers were more likely to have

an undernourished child due to a shorter period of feeding than adult mothers since

they are less mature and insensitive to the needs of the baby. Compared to adult

mothers, they also lack parenting education and are usually in poor socioeconomic

standing. According to Wright et al. (2021), the mothers’ age and socioeconomic

status can have an impact on their child’s feeding style as the child's food

preferences, eating habits, and weight status are all clearly influenced by the parent-

child feeding relationship. On the contrary, in Journal of Marriage and Family

(2019), maternal age has no impact on positive parenting and childcare practices.

It is unquestionable that maternal education has an impact on a child's

nutrition, and an educated mother is the foundation of a healthy child. Fadare

(2019), for instance, found that the mother's knowledge on food preferences,

feeding techniques, and healthcare practices had a significant impact on the

nutritional status of the children. According to Laput and Go (2022), mothers with

higher levels of education tend to be more knowledgeable about child care, which

is consistent with Ishola and Oyeleke (2019) and Bras (2022) where educated

mothers tend to have a positive impact on their children's nutrition because they

have easier access to information about best practices for child feeding, care,

hygiene, and sanitation. Additionally, women with higher levels of knowledge can

allocate better food and have better-paying jobs that serve as a resource to buy

nourishing food (Brauner-Otto et al., 2019; Kunto & Bras, 2018; Nankinga et al.,

2019). Meanwhile, Dankyi et al. (2019), claimed that mothers who are students at

the same time, struggled academically while at home. They struggled to perform
 31

childcare responsibilities and provide for their child/children's needs resulting in

malnutrition. On the other hand, studies of Hassan et al. (2020) and Ahmad et al.

(2020) both suggested that children with poor socioeconomic levels are more likely

to be underweight. In fact, a study of Yanti and Fauziah (2021) has found that there

was a significant relationship between family income and incidence of stunting at

Puspa Bangsa Kindergarten, Bogor City. Additionally, there are factors associated

with the child’s healthy food consumption. Some of these are having a healthy

household, nutritional knowledge of the family or caregivers, and family income

that ensures the availability of healthy food; whereas poor households struggle with

food security (Hassan et al., 2020; Sisara et al., 2020; Izah et al., 2020). On the

contrary, a study of Kilic, Kirk, and Carletto (2018) revealed that family income

has no impact on the nutritional status of children.

In terms of occupation, it was revealed in the studies of Otele et al. (2019)

and Ketema et al. (2022) that employment has an impact on the nutritional health

of children. Respondents are composed of unemployed mothers and since they are

always at work and have little attention to their children's nutritional needs, their

children are at risk of malnutrition. Meanwhile, the study of Ketema et al. includes

more employed than unemployed mothers. Moreover, Hossain et al. (2020),

Chowdhury et al. (2020) and Bliznashka et al. (2023) concluded that occupation

has an influence on a child's nutritional status. Fathers with high paying jobs and

mothers who are employed are less likely to have a child with malnutrition than

mothers who are unemployed. It is in contrast to the study of Ashagidigbi et al.

(2022) in Nigeria which states that occupation of household heads has no impact
 32

on child malnutrition. However, male-headed households are less likely than

female-headed households to have children with malnutrition. This is explained by

the high number of mothers who lack a source of income, which increases their

financial burden. In contrast, Pieters and Rawlings (2020) study found that paternal

unemployment was negatively associated with child health, while maternal

unemployment was positively associated with child nutrition and health. However,

in the study of Hasan et al. (2019), maternal occupation is not associated with child

nutrition.

In the matter of household size, nutritional status of children is also affected.

Many studies have shown that a larger household size has a negative impact on the

nutritional status of children since they are getting a smaller amount of food and

resources compared to a small household size. This also means that children receive

low-quality foods with poor nutritional content that affects their growth and

development. However, it has been said that larger household sizes are also

beneficial in terms of child support or child rearing. (Ciptanurani & Chen, 2021;

Drammeh et al., 2019). On the other hand, household size has no association with

child growth even though it causes food insecurity (Germain & Siddiqi, 2019).

With regard to the nutritional status of children, poor nutrition may be

considered as undernutrition and overnutrition. It can be further categorized based

on the nutritional indicators for the CDC growth charts, which comprise obesity,

overweight, underweight, and short status (NHS, 2020; CDC, 2022; Chawla et al.,

2020). Being categorized into one of these is a problem, and it is supported by the

study of Mya,Kyaw and Tun (2019), which shows that having inadequate supply
 33

of nutrients is a major issue in Myanmar. Meanwhile, according to Queally et al.

(2018), other mothers are not aware of their children’s weight status that results in

children being overweight or obese. In addition, to become aware of their

nutritional status, some of the methods to be used are through assessing

anthropometric measurement and dietary recall in which clinicians used to

determine unusual patterns of development in children (Slowik et al., 2019;

Hannema & Sävendah, 2019).

Pertaining to knowledge, the majority of the studies show that the

knowledge of mothers has a big impact on child rearing and feeding with their

children’s nutritional status due to the fact that they are responsible for providing

proper nutrition and guidance to their children to achieve wellness. Mothers with

sufficient KAP about preparing and selecting the diet for their children under five

prevent malnutrition (Ismael et al., 2020; Ul Haq, 2018; Kwol et al., 2020; Sangra

& Nowreen, 2019; Manohar et al., 2018; Assefa et al., 2021; Hasnidar & Mustar,

2021). Meanwhile, some studies claimed that poor maternal health can cause child

malnutrition since undernourished mothers who breastfeed their child/children

can’t supply enough nutrients to the infant (Doke et al., 2020). According to

Bimpong et al. (2020), the level of the mother’s education, the child's sex, age, type

of residence, social status, and household wealth index are the factors that affect

children’s nutritional status.

For attitude, studies revealed that attitude affects a child's nutritional health.

Romanos-Nanclares et al. (2018) concluded that parents' attitudes and views about

nutrition were related to the quality of their children's diet, stressing the vital role
 34

of parental psychosocial factors. Mothers' awareness can aid in making healthier

eating decisions, but it is considered useless without practice and a positive attitude.

Meanwhile, a study in East Africa found a correlation between mothers' positive

attitude about breastfeeding which results in a higher likelihood of successful

breastfeeding (Bimpong et al., 2020). According to Jansen et al. (2020), maternal

attitudes that include giving food as a reward for good behavior of their children

can influence their dietary patterns and eating habits. In contrast, maternal attitude

has shown no correlation with nutritional status of children (Susanto et al., 2019;

Saaka et al, 2021).

With regard to practices, most mothers continue to breastfeed their children

up until 6-23 months, then start to provide complementary feedings by 6-8 months

(Mesham et al., 2019; Mya et al., 2019; Tariqujjaman et al., 2022; CDC, 2020).

Breastfeeding, if not initiated on time, and when there are insufficient

supplementary foods may also lead to unhealthy feeding practices, which in turn

affect the child’s health. Certain studies have shown that counseling encouraged

the mother to engage in optimal IYCF practices, whereas those who did not receive

counseling sessions and those who have low levels of education have poor IYCF

practices (Tariqujjaman et al., 2022; Locks et al., 2018; Padmini, 2021).

Definition of Terms

The following terms are defined conceptually and operationally, in order to

avoid misinterpretation and for better understanding of the concepts presented in

the research study.

 35

Age. This refers to the length of time that a person or things lived or existed

(Cambridge dictionary, n.d.) In this study, age is part of the demographic profile of

the mothers that could influence their Knowledge, Attitudes, and Practices toward

the nutritional status of children.

Attitude. It is the thought, feelings, or opinion about something or someone that

actually reflects on behavior (Cambridge dictionary, n.d.). In this study, attitude is

assessed to determine what is the respondents’ opinion towards nutrition. It was

assessed using Bloom’s cut-off point system with the following categories such as

poor, moderate, and good.

Child feeding. It refers to an occasion when a baby has something to eat or drink

(Cambridge dictionary, n.d.). In this study, the Knowledge, Attitude, and Practices

of mothers towards child feeding are assessed to determine how this affected the

nutritional status of their children.

Child-rearing. It refers to the process of caring for and raising children (Merriam

Webster, n.d.) In this study, the Knowledge, Attitude, and Practices of mothers

towards child-rearing are assessed to determine how these affect the nutritional

status of their children.

Height for Age. It is an index used to determine a child's height and compare it to

the expected height of a child of the same age and sex (Global Health eLearning

Center, n.d.). In this study, height for age is used as an indicator to determine if a

child is stunted and to determine past nutrition history.

 36

Household size. It is the total number of people who reside in one housing unit

(Law Insider, n.d.). In this study, the household size of a family is assessed to

determine if this affects the nutritional status of children ages 1-5.

Knowledge. It is defined as the understanding or knowledge of a person through

something that is based on his/her experience or education (Merriam Webster, n.d.).

In this study, knowledge pertains to the level of understanding of mothers regarding

proper nutrition and the nutritional status of their children. It was assessed using

Bloom’s cut-off point system with categories such as poor, moderate, and good.

Nutritional Status. It is defined as the condition of the body that is influenced by

a diet, the level of nutrients in the body, and the ability of those levels to maintain

normal metabolic integrity (Encyclopedia, 2023). In this study, the nutritional

status of children is assessed to determine if the child has any nutritional problems

or deficiencies.

Occupation. It refers to the activity by which a person regularly makes a living

(Merriam Webster, n.d). In this study, occupations of the parents with children aged

1-5 are assessed to determine if this factor affects the nutritional status of their

children.

Overweight. It refers to the weight that is above what is required or normal

(Merriam Webster, n.d). In this study, this refers to the child who has a BMI of 85th

to less than 95th percentile range.

Obese. It is defined as a person who is extremely fat that in extent is dangerous for

health. (Cambridge dictionary, n.d.). In this study, this refers to the child who has

a BMI of equal or greater than 95th percentile.

 37

Practices. It refers to the habit, tradition, or custom that a person usually does

(Cambridge dictionary, n.d.). In this study, the practices of mothers are determined

by how they feed and care for their children. It was assessed using Bloom’s cut-

off point system with categories such as poor, moderate,and good.

Undernutrition. It is defined as the lack of nutrients caused by insufficient food

containing the substances essential for growth and health (NHS, 2020). In this

study, it corresponds to nutritional deficiencies particularly inadequate nutrient

intake which makes children aged 1-5 vulnerable to diseases.

Weight for Age. It reflects the body weight relative to age that is influenced by

recent changes in health (CDC, 2022). In this study, weight for age is used as an

indicator to categorize children whether they are underweight, overweight, or

obese.

Weight for Height. It refers to the anthropometric index of a child that is weight

and height combined with their age (CDC, 2022). In this study, weight for height

is used to classify if children have normal weight for height, wasted, or severely

wasted.
 Chapter III

RESEARCH METHODOLOGY

This chapter presents the methodology that was used in conducting the

research study. Discussed here are the research design, research locale, sampling

size and technique, respondents of the study, research instrumentation, data

gathering procedure, statistical treatment of the data, and ethical considerations.

Research Design

The study used a descriptive quantitative research design. It was a research

methodology that refers to the procedure of methodically describing the

characteristics of a specific population or phenomenon. A deeper understanding of

a particular group's behavior, motivations, and characteristics will be attained

through this kind of research. In order to comprehend the nature and extent of a

problem, this design can identify relationships between variables (Hassan, 2022).

In particular, this study utilized a cross-sectional approach, a type of

research method where information is gathered simultaneously from a large number

of people through the use of surveys. Variables are observed in cross-sectional

research without being altered. The researchers used this method since this study

attempts to determine the relationship between Knowledge, Attitude, and Practices

of mothers on child-rearing and feeding with the nutritional status of their children

aged 1-5 in Barangay Darasa.

 39

Setting of the Study

This study was conducted in Brgy. Darasa, Tanauan City, Batangas. It is

one of the forty-eight (48) barangays in the city with a population of 24,680 or

12.37% of the total population of Tanauan City, Batangas. The data was as of June

2022.

Sampling Size and Technique

The respondents of the study were 245 mothers who reside in Barangay

Darasa, Tanauan City, Batangas. The sample size of the respondents were identified

through Raosoft Calculator, a software that computes a sample size or a margin of

error, including thorough explanations of the statistics and underlying algorithm.

The researchers used purposive sampling, which is considered as non-probability

sampling based on the knowledge and understanding of a researcher in selecting

the needed sample from a population for a study. This entails locating and choosing

individuals or groups of individuals who have particular expertise in or experience

with an interest in the phenomenon (Etikan & Babatope, 2019). In relation,

respondents were chosen based on the following parameters: 1) a mother who lives

in barangay Darasa for at least 6 months, and (2) has a child/children aged 1-5. This

helped the researchers to collect a manageable amount of data from the respondents.

Respondents of the Study

The researchers chose the mothers with children aged 1-5, and are residing

in Barangay Darasa as the study’s respondents. An informed consent form was

 40

provided prior to conducting the survey. This was to inform them of the purpose of

the study and emphasized their rights as respondents.

Data Gathering Instrument

The researchers used an adapted and modified survey questionnaire from

the previous study of Zakaria et al. (2022) entitled “Association of Mothers' Child

Feeding Knowledge, Attitude, and Practices with Nutritional Status of Children

under the Age of Five in a Malaysian Fishing Community: a Cross-sectional

Study”. The questionnaire was composed of five parts: 1) the demographic profile

of the mother, 2) the children's nutritional status, 3) the mothers' knowledge, 4)

attitude, and 5) practices on child-rearing and feeding of children aged 1-5.

The first part of the questionnaire asked for the respondents’ demographic

profiles in a multiple response format for age, educational attainment, family

income status, occupation, and household size. The second section comprised

questions about children's age, height, and weight, which served as a basis to

determine the child’s anthropometry assessment. The KAP questionnaire, in the

study of Zakaria et al. (2022) was also adapted from the Child Feeding

Questionnaire (Birch & Fisher, 2000) and Child Feeding Practices Questionnaire

(Musher-Eizenman & Holub, 2007) as well as from the KAP Manual Guidelines

for the evaluation of Knowledge, Attitude, and Practices associated to nutrition.

The KAP part was divided into three segments: the first segment includes sixteen

(16) statements that would identify the knowledge of mothers about child-rearing

and feeding; the second segment consists of sixteen (16) statements that assess
 41

attitudes; and the third segment has sixteen (16) statements that determine the child-

rearing and feeding practices of mothers. Some of the statements in the

questionnaire were constructed by the researchers. Likert scale with four-point

system was utilized to determine KAP.

Knowledge serves as a springboard for the mother's behavior, and it

influences the attitude and practices toward child-rearing and feeding. The tool was

created in the English language with its Filipino translation. The research

instrument was validated by professionals and experts in the area.

Data Gathering Procedure

The researchers used surveys to gather data and information for this

research. A letter signed by the Research Adviser, Research Instructor, and

Program Chair, and was approved by the Dean of the College of Allied Health

Sciences (CAHS), was given to the City Health Officer (CHO) and Barangay

Nutrition Scholar (BNS) in order to gather appropriate data. Also, a letter for the

Barangay Captain and to the chosen respondents was given which signified their

full consent to participate in the study. Included in the letter was a full disclosure

of information about data collection and processing. The researchers then utilized

an adapted and modified survey questionnaire, validated by experts in the health

field. Additionally, a pilot-testing was conducted to test the validity and reliability

of the survey questionnaire.

The data collection was carried out for four (4) weeks where the researchers

went to the respondents house to conduct a survey. In order to determine the

anthropometrics of the child, researchers measured their height and weight using a
 42

bathroom weighing scale and a meter stick. While having the survey with the

respondents, the researchers observed that all of them were able to answer the

questions mindfully. Each survey lasted 10 minutes or less to finish and was held

in an undisturbed place in their home to be able to focus more and arrive at the

answers that they really intended.

Given the acquired data, the researchers then encoded, tallied, analyzed, and

interpreted the data collected that imparted on the results and discussion of the

study. In order to ascertain the Knowledge, Attitude, and Practices regarding

nutritional status, the bloom cut-off score, equivalent percentages, and their

respective verbal interpretation were utilized. To illustrate, the data was presented

below.

Table 3-1. Interpretation on the level of Knowledge, Attitude and practices of

mothers on child-rearing and feeding with the nutritional status.

EQUIVALENT PERCENTAGE VERBAL INTERPRETATION

1-59% Poor

60-79% Moderate

80-100% Good

Statistical Analysis

The collected data were compiled and tabulated for analysis. All data were

classified and organized according to the specific points established in this study.
 43

The researchers used the following test to present the study findings in a systematic

manner.

Frequency and Percentage distribution

This is used to show the number of observations for each potential value of

a variable. It can depict absolute frequencies or relative frequencies of survey

responses. This is done by dividing the frequency of the population by the total

number of the population and multiplying it to 100. This was used in the study to

determine the distribution of the respondents depending on the demographic profile

of mothers with children aged 1-5 in terms of age, educational attainment, and

family income status.

Weighted Mean

This method is used to calculate the average by multiplying the weights with

their corresponding means and taking their sum. This procedure helped the study

to determine the level of agreement of the mothers regarding their Knowledge,

Attitude, and Practices towards child-rearing and feeding.

Spearman's Rank correlation coefficient

This is a non-parametric test that can be used to evaluate the monotonic

relationship between two variables and summarize the strength and direction

(negative or positive) of a relationship between two variables. This was used to

determine the relationship between the Knowledge, Attitude, and Practices of

mothers in child-rearing and feeding and their age, educational attainment, family

income status, and household size.

 44

Chi-square test

It can be used to analyze the relationship between categorical variables. It

is used to determine if there is a statistically significant relationship between the

variables. It calculates a p-value, which indicates the probability of obtaining the

observed results by chance. A p-value less than 0.05 is generally considered

statistically significant. This was used in the study to determine the relationship

between the Knowledge, Attitude, and Practices of mothers in child-rearing and

feeding and their occupation.

Likert Scale

It is a four-point rating system that is used in questionnaires that are

intended to measure the attitude, opinions, or feelings of a person. The respondents

choose from a range of possible responses to a specific question or statement. The

equivalent verbal interpretation is shown in Table 2.

Table 3-2. Interpretation on the level of agreement and disagreement

NUMERICAL RATING VALUE VERBAL DESCRIPTION RANGE

4 Strongly Agree 3.26-4.00

3 Agree 2.51-3.25

2 Disagree 1.76-2.50

1 Strongly Disagree 1.00-1.75

 45

Ethical Considerations

In conducting the study, the researchers followed ethical considerations

carefully. This ensured no harm or threat to the respondents.

Respect. The researchers fairly selected the respondents according to the

data that is needed in the research. The dignity and worth of the respondents were

respected as well as their cultural differences, beliefs, values, and economic status.

Informed Consent. The researchers explained everything about the study

to ensure that the respondents are well-informed regarding the potential risk,

benefits, purpose of their participation, and information about the study.

Respondents were given a letter of informed consent and allowed them to check the

box that corresponds to their answer to make sure that their participation in the

study is fully permitted.

Beneficence and Non-maleficence. In terms of collecting data, the adapted

and modified questionnaires were validated by experts before its distribution to the

respondents. This was done to ensure that the questionnaires did not pose any

unethical questions that would make the respondents feel uncomfortable.

Privacy and Confidentiality. The researchers assured the respondents that

all the data provided by them will be kept confidential and will be used only for the

purpose of the study. Their identity remained anonymous and the researchers are

fully aware that the privacy of the respondents should be respected. All data shall

be disposed accordingly once the study is completed.

 46

Self- Determination. The respondents were fully aware that they have the

right to refuse to participate in the study. All the information that would link to their

identity will be deleted and destroyed for privacy and confidentiality.

Transparency. The research ensured that the results of the study will be

presented to the respondents without any misleading information.

 CHAPTER IV
RESULTS AND DISCUSSION
This chapter presents the tabular data acquired and interpretation of the

findings based on the statistical treatments used. The data are presented in the same

order as the research objectives in Chapter 1.

Table 4-1. Frequency distribution and percentage of the demographic profile of

the respondents.

FREQUENCY PERCENTAGE (%)

(N=245)

Age
18-22 years old 29 11.8
23-27 years old 90 36.7
28-32 years old 69 28.2
33-37 years old 36 14.7
38-42 years old 15 6.1
43-47 years old 5 2.0
> 47 years old 1 0.4

Educational Attainment
Elementary Undergraduate 16 6.5
Elementary Graduate 29 11.8
High School Undergraduate 63 25.7
High School Graduate 92 37.6
College Undergraduate 30 12.2
Bachelor’s Degree Holder 15 6.1

Family Income Status (Monthly)

Less than 10,000 pesos 144 58.8
10,000 – 20,000 pesos 86 35.1
20,001 – 30,000 pesos 10 4.1
> 30,000 pesos 5 2.0

Occupation
Employed 85 34.7
Unemployed 160 65.3

Household Size
2-4 persons 85 34.7
5-7 persons 111 45.3
8-10 persons 45 18.4
> 10 persons 4 1.6
 48

Table 4-1 shows the frequency distribution and percentage of the

respondents based on their demographic profile namely age, educational

attainment, monthly family income, occupation, and household size. In terms of

age, the majority of the respondents were aged 23-27 years old that accumulates

36.7%. Mothers within these age brackets were deemed to be very fertile, which

implies that during their ages they already had a child/children. Moreover, at these

ages, there are first-time mothers, who may still depend on their parents and may

worry more if their child/children's needs are not met. In line with this, the study

conducted by Wemakor et al. (2018) discovered that young women were more

likely to have an undernourished child/children because they fed for shorter periods

of time due to being less mature, insensitivity to the needs of their child/children,

and heightened susceptibility to irritability. Meanwhile, 0.4% or 1 out of 245

mothers ages 47 years old and above have a child ages 1-5. This may indicate that

there are rare chances of getting pregnant within that age, since the menopausal

period often occurs between the ages of 45 to 55. Despite this, an older mother is

likely more stable and capable of caring for a child/children than when a mother is

younger (Brennan, 2021).

In terms of educational attainment, there were 92 (37.6%) mothers in Brgy.

Darasa with child/children aged 1-5 that are high school graduates. Some of the

reasons why most of them stopped at the secondary level may be attributed to taking

on new roles and obligations as mothers. Additionally, it can make it more difficult

for them to strike a balance between providing care and the needs of their

child/children and pursuing their education. The study of Dankyi et al. (2019),
 49

concluded that student mothers' performance at home and in their academic

endeavors is affected by role conflicts, which may increase as they advance in their

studies, leading to more demands and challenges. According to Bras (2022) as cited

by Semba et al. (2008), mothers with higher levels of education have been found to

have a favorable impact on child/children's health and nutrition since they have

greater knowledge and access to resources for child feeding and care practices.

With regard to monthly family income status, 144 or 58.8% of the total

population under consideration, have a monthly family income of less than 10,000,

while only a small percentage of the respondents have a higher monthly family

income of greater than 30, 000 pesos. The data shows that the majority of the

respondents have a relatively low family income which might increase the

possibility that a sizable section of the population is facing financial hardship.

According to Sisara et al. (2020), family income is one of the key factors that can

affect the child/children’s healthy food consumption. Families with higher income

may have more resources to provide a balanced and diverse diet for their

child/children rather than those with lower income.

For occupation, the result shows that the majority of the respondents were

unemployed (65.3%), whereas 34.7% were employed. This is a significant number

that may indicate an economic problem in the area. It could mean that there are

inadequate job opportunities or that the available jobs do not match the

qualifications and skills of the unemployed individual. According to Ketema et al.

(2022), maternal unemployment is a risk factor for child malnutrition, including

wasting. Therefore, interventions that address unemployment and its associated

 50

consequences, such as poverty, food insecurity, and poor health, may be necessary

to improve children's nutritional status and overall well-being. Meanwhile,

according to Bliznashka, Jeong, and Jaacks (2023), maternal employment can

impact child nutrition positively by supporting their needs. However, it can also

have negative consequences like having less time for meal preparation and

monitoring children's eating habits.

In terms of the distribution of household sizes among surveyed households,

the majority of the households surveyed comprising 45.3% had 5-7 persons living

in the household. Meanwhile, the smallest group, accounting for only 0.4% of the

included households, had greater than 10 persons living in the household.

According to Ciptanurani and Chen (2021), larger households increased

competition for limited resources, resulting in smaller portions per individual. This

strain on food consumption raises the risk of food insecurity compared to smaller

families. Overall, the evidence suggests that larger households are associated with

the poorer nutritional status of children. Therefore, interventions designed to

improve the nutritional status of children should consider household size as a

potential.
 51

Table 4-2. Frequency distribution and percentage of the children’s nutritional

status.

FREQUENCY (N=245) PERCENTAGE (%)

Weight for Age

Severely Underweight 5 2.0
Underweight 21 8.6
Normal 214 87.3
Overweight 4 1.6
Obese 1 0.4

Weight for Height

Severely Wasted 4 1.6
Wasted 10 4.1
Normal 208 84.9
Overweight 15 16.1
Obese 8 3.3

Height for Age

Severely Stunted 19 7.8
Stunted 49 20.0
Normal 174 71.0
Tall 3 1.2

Table 4-2 shows the frequency distribution and percentage of the children’s

nutritional status based on their weight for age, weight for height, and height for

age. The results of weight for age shows that 214 out of 245 children are considered

normal, which means that most of the children in Darasa aged 1-5 have good

nutritional status. As mentioned by Dietetics Department of Maastricht UMC+

(2022), a child's nutrition is crucial for their growth, development, and recovery.

"Nutritional status" refers to the body's state regarding nutrient intake, absorption,

and utilization. Emphasizing and implementing proper food preparation is essential

to ensure their child's optimal nutrition. However, 1 out of 245 children was

declared obese. According to NHS (2020), overnutrition happens when the intake
 52

of nutrients exceeds what is required. When a person consumes excessive amounts

of food and nutrients, it will result in the buildup of body fat that can affect the

health of an individual. Furthermore, in the study of Queally et al. (2018), some

mothers with overweight or obese children were unaware of their child/children’s

weight status. As a result, boosting and improving mothers' awareness and

understanding of their child/children's nutritional status or appropriate body size is

critical.

In the study that was conducted by the researchers, the weight for height

resulted in 208 out of 245 children being classified as normal, indicating that the

majority of children in Barangay Darasa who fall under the age of 1-5 do not suffer

from any malnutrition. In accordance with Chawla et al. (2020), long-term

undernutrition in children has negative effects such as delayed motor/skill

milestones, lower IQ, higher risk of behavioral problems, lack of socialization

skills, higher risk of infectious diseases, and poor academic

achievement/performance. As a result, children from Barangay Darasa are less

likely to have problems with their immune systems, delayed motor development,

or increased susceptibility to infectious diseases, all of which can lengthen the

duration and severity of infectious diseases as well as increase the likelihood of

death. However, 4 out of 245 children are deemed to be severely wasted. Obembe,

Adenuga, and Asuzu (2018) stated that wasting is associated with 1/3 of children's

deaths, related to illnesses and food insecurity. It affects children's survival, growth,

and development.
 53

Meanwhile, in terms of height for age, 174 out of 245 children fall under

the category of normal, and 3 children are considered tall. Hannema and Sävendah

(2019) claimed that by measuring growth, a clinician may identify both typical and

unusual patterns of development in children. In addition, it plays a significant role

in nutritional evaluation. Tall stature typically indicates that a person is taller than

usual. It can be caused by a variety of different genetic, hormonal, diseases, and

disorders. Even if a child's growth may be noticeably faster than average, they may

still be considered to have an excellent health condition.

Table 4-3. Frequency of the respondents in terms of their level of knowledge,

attitude, and practices of mothers on child-rearing and feeding.

FREQUENCY (N=245) PERCENTAGE (%)

Knowledge Score
Poor 16 6.5
Moderate 120 49
Good 109 44.5

Attitude Score
Poor 7 2.9
Moderate 64 26.1
Good 174 71

Practice Score
Poor 84 34.3
Moderate 141 57.6
Good 20 8.2

Table 4-3 shows that, majority of the knowledge scores of the respondents

fall into the moderate category, with a frequency of 120 or 49%. In contrast, the
 54

poor knowledge score category has the smallest frequency, with only 16%, which

accounts for just 6.5% of the data. It can be concluded that the majority of the

mothers evaluated had a moderate level of knowledge about child-rearing and

feeding. This means that they are moderately aware of what to provide to their

children, however, further improvement of their knowledge must continually be

done. According to Ismael et al. (2020), if mothers have sufficient knowledge

regarding proper food selection and preparation, the incidence of malnutrition in

children can be prevented. Similar to the study of Assefa et al. (2021), having a

strong understanding of proper feeding practices will lead to better feeding

practices rather than those mothers with poor knowledge. The insufficiency of

knowledge is because some mothers did not have a formal education regarding

feeding practices. In the study by Doke et al. (2020), it was stated that low maternal

education about child nutrition causes children to gain weight. Therefore, mothers

should be knowledgeable in terms of proper food preparation and the nutritional

status of their children to prevent health problems, particularly malnutrition.

In terms of attitude, 174 of 245 respondents have a good attitude score

towards child-rearing and feeding with a percentage of 71%. This indicates that the

majority of the respondents have a positive attitude towards caring and feeding their

children. Meanwhile, 7 mothers showed a poor attitude score equivalent to 2.9%.

Having a good attitude may convey that mothers are willing to engage in

taking care of their child/children, as well as feel at ease when providing and

preparing food for them. The study of Bimpong et al. (2020) highlighted that

although mothers show a positive attitude, it is still important to take note of the
 55

areas in which the majority of the mothers experience difficulties in terms of child-

rearing and feeding. On the other hand, a poor attitude may imply that a lack of

optimism about reaching nutritional demands may result in inadequate intake,

which might create health issues.

In terms of practices, 141 out of 245 respondents obtained a practice score

percentage ranging from 60-79%. This signifies that the majority of mothers exhibit

moderate practices toward child-rearing and feeding. The remaining 20 (8.2%)

mothers garnered score percentages ranging from 80-100%, denoting that they have

good practices towards child-rearing and feeding. These results reflect the need to

have a better foundation about child-rearing and feeding, in order to execute their

strategies towards child/children’s well-being.

In this study, most of the mothers have a moderate level of practice, which

means that they perform child-rearing practices and feeding in a manner that they

are somehow cautious and have a knowledge of what to do or provide. However, it

is still not sufficient to achieve a much higher level of practice, thus a consistent

amelioration of practices along with knowledge and attitude might help. A study

conducted by Padmini (2021) for example, claimed that child-rearing activities

involve feeding practices and other traditional beliefs that have a direct bearing on

the health of the child/children.

Meanwhile, only 20 mothers in this study who have good practice may

indicate that there are some factors that impede them from performing good

practices. According to Bimpong et al. (2020), several factors, such as maternal

education, income levels, and spouse work status, have been identified as
 56

contributing to the less-than-optimal rates of proper feeding. Therefore, it is

essential to consider some of the aforementioned elements in order to improve their

level of practice.

Table 4-4. Relationship between demographic profile of the respondents and their
Knowledge, Attitude, and Practices on child-rearing and feeding.

r; p-value
DEMOGRAPHIC
PROFILE Knowledge Attitude Practices

Age r=0.032; r=-0.025; r=-0.016;

p=0.619 p=0.701 p=0.800

Educational Attainment r=-0.042; r=-0.115; r=-.267**;

p=0.0.510 p=0.073 p=0.001

Family Income Status r=0.027; r=0.054; r=0.043;

p=0.673 p=0.400 p=0.501

Occupation r=0.454**; r=0.320; r=0.421;

p=0.033 p=0.721 p=0.107

Household Size r=-0.016; r=0.097; r=0.076;

p=0.798 p=0.129 p=0.239
*Correlation is significant at the 0.05 level (p-value).

Table 4-4 shows the relationship between the respondents’ Knowledge,

Attitude, and Practices on child-rearing and feeding, and their demographic profile

such as age, educational attainment, family income status, occupation, and

household size.
 57

In terms of the relationship between the mother’s knowledge and the

demographic profile, the null hypothesis mentioned in the study and tested at a =

0.05 was rejected. The occupation and knowledge show a significant relationship

with r-value of 0.454 and p value of 0.033. Thus, the occupation affects the

mother’s knowledge with regards to their child's nutritional status. As the majority

of the mothers are unemployed, they have more time and can focus on feeding and

caring for their child/children. In some cases, maternal employment is associated

with improved child nutritional outcomes, whereas in other cases maternal

employment is associated with poor child nutritional outcomes (Nankinga et al.,

2019). In addition, Pieters and Rawlings (2020) found that associations differed

depending on which parent was employed: paternal unemployment was negatively

associated with child health, while maternal unemployment was positively

associated with child nutrition and health.

In terms of attitude, results revealed that there is no significant correlation

between all the demographic profiles of the respondents and their level of attitude.

The study by Go and Laput (2022) discovered that mothers with greater levels of

education were a significant predictor of childcare knowledge and practices but had

no bearing on mothers' attitudes. Similar to the research by Xia (2022), which Wang

and Sheikh-Khalil (2014) mentioned, it was found that authoritative parenting and

parental participation were not substantially correlated with family income.

Therefore, factors such as age, educational attainment, income, occupation, and

household size do not significantly influence respondents' attitudes toward feeding

and raising children.

 58

In terms of practices, there is a significant correlation in terms of the

respondent’s educational attainment. According to Bras and Mandemakers (2022),

mothers with high educational attainment have been found to have a positive impact

on the nutritional status of their children since they have greater access to

information regarding child feeding and care practices as well as hygiene and

sanitation, which gives them an idea on how to put that information into actions. In

the current study, it shows that there is no significant correlation between practices

and the respondenst's age, family income, occupation, and household size. This is

similar with the findings of the study by Kilic et al. (2018); Hasan et al. (2019);

and Germain & Siddiqi (2019) which showed that these factors were not significant

predictors of the child/children’s care and feeding practices, as well as on their

nutritional status.

Table 4-5. Relationship on knowledge, attitude, and practices of mothers on

child-rearing and feeding with the nutritional status of their child aged
1-5.

r; p-value
NUTRITIONAL
STATUS Knowledge Attitude Practices

Weight for Age r=-0.065; r=-0.038; r=0.001;

p=0.309 p=0.553 p=0.986

Weight for Height r=-0.052; r=-0.012; r=-0.049;

p=0.422 p=0.853 p=0.447

Height for Age r=-0.101; r=-0.084; r=0.055;

p=0.115 p=0.189 p=0.394
*Correlation is significant at the 0.05 level (p-value).
 59

Table 4-5 revealed that there is non-significant correlation between all of

the nutritional status of the child/children and the mothers’ level of Knowledge,

Attitude, and Practices. According to Heliyon et al. (2022), there is no correlation

between the mothers' or caregivers' understanding of nutrition and the nutritional

status of their offspring. In contrast, there are varying findings in that study that are

opposed to the result of this study. For instance, the study did show that as

caregivers' nutritional expertise improved, so did the chance of youngsters

withering away. This finding implies that, despite the possibility of a lack of a direct

relationship between caregiver nutrition knowledge and child nutritional status,

raising caregiver nutrition knowledge may still benefit children's health by lowering

the risk of wasting. Hence, it emphasizes how critical nutrition education for

caregivers is to enhancing children's general health and well-being. Moreover, the

study conducted by Sichani (2018), showed that the Body Mass Index (BMI), child

height, and overall score of nutritional knowledge did not significantly correlate

with one another.

In the study of Susanto et al. (2019), it was also found that there is no

significant correlation between maternal attitude and child nutrition and feeding.

According to Saaka et al. (2021), in many parts of the world, childhood

undernutrition and poor feeding habits continue to be major public health issues,

and solutions have proven difficult to find. Therefore, they tried to implement radio

health that shows a greater effect towards a positive attitude. However, the results

showed that there is no significant relationship to the nutritional status of children.

 60

In terms of practices, a study by Elni et al. (2021) revealed that in West

Bangka Regency, there was no significant correlation between child feeding habits

and the prevalence of stunting in children under five. Additionally, Wondu (2020)

found no link between household food insecurity and acute malnutrition (wasting)

in children. There are contradictions in the literature, some of which go against the

findings of this study. Anees et al. (2020), for instance, demonstrated how the

prevalence of stunting, wasting, and underweight children is highly connected with

inadequate feeding practices for infants and young children. It also suggests that a

mother's practices may or may not have an influence on her child's or children's

nutritional health.
 CHAPTER V

SUMMARY, CONCLUSION, AND RECOMMENDATION

This chapter presents the summary of the findings and conclusions which

answer the research problems in Chapter I, and the recommendations that the

researchers offered.

Summary

The study was conducted to determine the relationship between the

knowledge, attitude, and practices of mothers toward child feeding and rearing with

the nutritional status of their child/children ages 1-5. Specifically, it sought answers

regarding the mother's demographic profile such as age, educational attainment,

family income status, occupation, and household size. Moreover, this study aimed

to determine the significant relationship between the mother's demographic profile

and their level of Knowledge, Attitude, and Practices on child feeding and rearing

and also if there is a significant relationship in their Knowledge, Attitude, and

Practices on child feeding and rearing with the nutritional status of their

[Link] study utilized a descriptive quantitative research.

The survey used was adapted and modified from a previous study that was

conducted in Malaysia. The questionnaire was divided into five parts: the

demographic profile of the mother, the children's nutritional status, the knowledge

of the mothers on child-rearing and feeding, the attitude of mothers, and the

practices of mothers.
 62

The respondents of the study were mothers residing in Barangay Darasa

Tanauan City, Batangas who met the specified qualifications set by the researchers.

The gathered data were inputted in Microsoft Excel and were organized, computed,

analyzed, and interpreted through frequency distribution and percentage, Spearman

Rho, Chi square, and Bloom’s cut-off.

Summary of Findings

Given the results of the study, the following findings were drawn:

1. Demographic Profile of the Respondents

a. In terms of age, the majority (36.7%) of the respondents were aged 23 - 27

years old.

b. In terms of educational attainment, the majority (37.6%) of the respondents

were high school graduates.

c. In terms of monthly family income, the majority (58.8%) of the

respondents have less than 10,000 pesos.

d. In terms of occupation, the majority (65.3%) of the respondents were

unemployed.

e. In terms of household size, the majority (45.3%) of the respondents have 5-

7 members in their household.

 63

2. Nutritional Status of their Child/Children

a. In terms of weight for age, most of the respondents' child/children have a

normal weight for their age.

b. In terms of weight for height, most of the respondents' child/children have

a normal weight for their height.

c. In terms of height for age, most of the respondents' child/children have a

normal height for their age.

3. Level of Knowledge, Attitude, and Practices of Mothers towards Child-

rearing and Feeding

a. With regard to knowledge, 120 respondents or 49% have a moderate level

of knowledge about child-rearing and feeding.

b. With regard to attitude, 174 respondents or 71% have a high level of attitude

about child-rearing and feeding.

c. With regard to practices, 141 respondents or 57.6% have moderate levels

of practices about child-rearing and feeding.

4. Significant relationship between the demographic profile and the

Knowledge, Attitude, and Practices of mothers on child-rearing and feeding.

a. Demographic Profile and Knowledge

There was a significant relationship between occupation and the

respondents’ knowledge of child-rearing and feeding.

b. Demographic Profile and Attitude

 64

There was no significant relationship between the demographic profile and

the attitude of the respondents.

c. Demographic Profile and Practices

There was a significant relationship between educational attainment and the

respondents' practices on child-rearing and feeding.

5. Significant relationship between Knowledge, Attitude, and Practices of

mothers and the nutritional status of their children

There was no significant relationship between the Knowledge, Attitude, and

Practices of mothers on child-rearing and feeding and the nutritional status of their

children.

Conclusion

Based on the analyzed and interpreted data, the researchers came up with

the following conclusions:

The majority of the mothers are between 23 - 27 years old, and most of them

are high school graduates, unemployed, with a family income of less than 10,000,

and a household size of 5 - 7 members.

Meanwhile, the nutritional status in terms of weight for age, weight for

height, and height for age, among the respondent's children aged 1-5 in Barangay

Darasa are mostly normal. It indicates that most of the children do not suffer from

severe malnutrition. Therefore, mothers in Barangay Darasa are knowledgeable,

have good attitudes and practices in child-rearing and feeding.

 65

Based on the findings of the study, it revealed that the mothers have

moderate levels of knowledge and practices. In terms of attitude, they have a high

level of attitude towards child-rearing and feeding. These findings indicate that

there’s a presence of discrepancy in mother's Knowledge, Attitude, and Practices

on child-rearing and feeding with regard to their child's nutritional status. Thus,

discussions and learning about the children's nutrition and proper practices will aid

in achieving a high level of knowledge and practice.

On the other hand, there is no significant relationship between the mother's

demographic profile such as age, educational attainment, family income and

household size, and mother's knowledge. However, there is a significant

relationship between knowledge and occupation which indicates that having a job

directly affects the knowledge of mothers in terms of child-rearing and feeding.

Meanwhile, there's no significant relationship between the mother's demographic

profile and attitude. This indicates that regardless of the demographic profile of the

respondents, they still have a good attitude towards child-rearing and feeding. In

terms of mother's practices, only educational attainment has a significant

relationship. This shows that mother's with a high level of educational attainment

are most likely to have better practices towards child-rearing and feeding.

Lastly, the result of the study showed that there was no significant

relationship between the knowledge, attitude, and practices of mothers on child-

rearing and feeding and the nutritional status of their children. Therefore, regardless

of the mother’s Knowledge, Attitude, and Practices, it does not directly affect the

nutritional status of their child.

 66

Recommendation

In consideration of the study’s findings, the following recommendations are

made:

For the mothers, attending health education programs should be done to

maximize their Knowledge, Attitudes, and Practices towards child rearing and

feeding which includes incorporating a balanced diet and proper food preparation

of the children’s meals. Also, regular check-ups for their children’s nutritional

status in order to monitor their health.

For the children, they should be encouraged to eat a balanced diet,

provided with a healthy and safe environment to play and exercise regularly. Their

growth should be monitored regularly and seek medical attention if there are any

concerns. It is important to maintain their body healthy and in good condition.

For the community leaders, they should create programs that support and

promote good nutrition and health practices. Along with the allocation of the

resource for health and nutrition programs in the community. The most important

thing is that they should encourage the involvement of the community in spreading

awareness or knowledge about having good nutrition and proper health practices.

For the community, supporting the health and nutrition programs that will

be implemented by the community leaders should be done to enhance their

knowledge regarding the importance of having good nutritional status.

Additionally, with the help of Barangay Nutritionist Scholars, they should help to

promote the consumption of nutritious foods and encourage physical activity and
 67

outdoor play among children. There should also be a distribution of leaflets and

brochures indicating the proper food preparation and child rearing practices.

For the Nutritionist, nutrition education programs that cater to the needs

of the community should be developed. Collaboration with other health

professionals is encouraged to provide a comprehensive approach to health and

nutrition. Furthermore, they should provide individualized nutrition counseling for

both mothers and children.

For the Nursing Department of College of Allied Health, the department

should establish further webinars regarding the importance of proper nutrition

specifically to children.

For the future researchers, they should conduct further research to identify

the underlying factors that affect the nutritional status of children in the community.

Also, investigate the effectiveness of different health interventions in improving the

nutritional status of children. In addition, they should evaluate the long-term impact

of early childhood nutrition on adult health outcomes

 REFERENCES

AHMAD, D., AFZAL M. & IMTIAZ, A. (2020). Effect of socioeconomic factors

on malnutrition among children in Pakistan - future business journal.
SpringerOpen. Retrieved from
[Link]

ANEES, M., UR-REHMAN, A., AHMAD, A.M.R., BUKHARI, S., SIDDIQUE,

M.H., FAROOQ, U., . . . & ANIS, R.A. (2020). “Persistent Inadequacies in
Infant and Young Child Feeding Practices and Their Determinants”.
Retrieved from [Link]

ASHAGIDIGBI, W.M., ISHOLA, T.M. & OMATAYO, A.O. (2022). Gender and
occupation of household head as major determinants of malnutrition among
children in Nigeria Retrieved from
[Link]

ASSEFA, D.G., WOLDESENBET, T.T., MOLLA, W., ZELEKE, E.D. & SIMIE,
T.G. (2021). Assessment of knowledge, attitude and practice of
mothers/caregivers on infant and young child feeding in Assosa woreda,
Assosa Zone, Benshangul Gumuz Region, Western Ethiopia: A cross-
sectional study. BioMed Central. Retrieved from
[Link]
00690-5

BIMPONG, K.A., CHEYUO, E.K-E., ABDUL-MUMIN, A., AYANORE, M.A.,

KUBUGA, C.K. & MOGRE, V. (2020). Mothers' knowledge and attitudes
regarding child feeding recommendations, complementary feeding
practices and determinants of adequate diet - BMC nutrition. BioMed
Central. Retrieved from
[Link]
0#ref-CR4

BLALOCK, S., BONE, L., BREWER, N., BUTTERFOSS, F., CHAMPION, V.,
EPSTEIN, R., . . . & WILSON, N. (n.d.) Health Behavior and Health
Education. Retrieved from [Link]
[Link]

BLIZNASHKA, L., JEONG J., & JAACKS L. (2023). Maternal and paternal
employment in agriculture and early childhood development: A cross-
sectional analysis of Demographic and Health Survey data. PLOS Global
Public Health 3(1): e0001116.
[Link]
 69

BRAS, H. & MANDEMAKERS, J. (2022). Maternal education and sibling

inequalities in child nutritional status in Ethiopia’s - Population Health,
Volume 17,2022, Retrieved from
[Link]
a%3Dihub

BRAUNER-OTTO, S., BAIRD, S. & GHIMIRE, D. (2019). Maternal employment

and child health in Nepal: The importance of job type and timing across the
child's first five years. Social Science & Medicine. Retrieved from
[Link]
1

BRENNAN, D. (2021). Pregnancy after age 50: Is it too late? WebMD.

Retrieved from [Link]
50#:~:text=

CAMBRIDGE DICTIONARY. (n.d.). Age. Cambridge English Dictionary.

Retrieved from [Link]

CAMBRIDGE DICTIONARY. (n.d.). Attitude. Cambridge English Dictionary.

Retrieved from
[Link]

CAMBRIDGE DICTIONARY. (n.d.). Feeding. Cambridge English Dictionary.

Retrieved from
[Link]

CAMBRIDGE DICTIONARY. (n.d.). Obese. Cambridge English Dictionary.

Retrieved from
[Link]

CAMBRIDGE DICTIONARY. (n.d.). Practice. Cambridge English Dictionary.

Retrieved from
[Link]
s

CENTERS FOR DISEASE CONTROL AND PREVENTION. (2022). About child

& teen BMI. Retrieved from
[Link]
hildrens_bmi.html

CENTERS FOR DISEASE CONTROL AND PREVENTION. (2018) Behavior,

environment, and genetic factors all have a role in causing people to be
overweight and obese. Retrieved from
[Link]
 70

CENTERS FOR DISEASE CONTROL AND PREVENTION. (2022). Using the

2000 & 2022 CDC Growth Charts. Retrieved from
[Link]
[Link]

CHAWLA, S., GUPTA, V., SINGH, A. K., GROVER, K., PANIKA, R.K.,
KAUSHAL, P. & KUMAR, A. (2020). Undernutrition and associated
factors among children 1-5 years of age in rural areas of Haryana, India:
A community based cross-sectional study. Journal of Family Medicine and
Primary Care, 9(8), 4240. Retrieved from
[Link]

CHIANG, K.V, HAMNER, H.C., LI, R. & PERRINE, C.G. (2020). Timing of
Introduction of Complementary Foods -United States, 2016–
2018. Retrieved from
[Link]

CHOWDHURY M.R.K., KHAN, H, MONDAL, M.N.I. & KABIR, R. (2021).

Socio-demographic risk factors for severe malnutrition in children aged
under five among various birth cohorts in Bangladesh. J Biosoc Sci. 2021
Jul;53(4):590-605. doi: 10.1017/S0021932020000425. Epub 2020 Aug 13.
PMID: 32787991.

CIPTANURANI, C. & CHEN, H. (2021). Household Structure And Concurrent

Stunting And Overweight Among Young Children In Indonesia. Retrieved
from [Link]
nutrition/article/household-structure-and-concurrent-stunting-and-
overweight-among-young-children-in-
indonesia/45799A64655C84EA7C3AFAB4FC5962DE

CLEVELAND CLINIC MEDICAL PROFESSIONAL (2022). BMI (body mass

index): What it is & how to calculate. Cleveland Clinic. Retrieved from
[Link]

DANKYI, J.K., DANKYI, L.A. & MINADZI, V.M. (2019) Struggles and Coping
Strategies of Student Mothers at the University of Cape Coast Distance
Education, Ghana. Creative Education, 10, 2484-2494. Doi:
10.4236/ce.2019.1011176.

DIETETICS DEPARTMENT OF MAASTRICHT UMC+. (2022). Nutritional

Assessment. Retrieved from
[Link]

DEPARTMENT OF HEALTH. (2021). Poor diets, Failing food systems and Lack
of physical activity are causing overweight and obesity in children.
 71

Retrieved from [Link]

food-systems-and-lack-of-physical-activity-are-causing-overweight-and-
obesity-in-children

DUKHI, N. (2020). Global Prevalence of Malnutrition: Evidence from Literature.

In M. Imran, & A. Imran (Eds.), Malnutrition. IntechOpen.
[Link]

ELNI, E. & JULIANTI, E. (2021). The Correlation between Feeding Habit Factor
and The Incidence of Stunting in Children Under Five Years. Jurnal
Keperawatan Padjadjaran, 8(3), 283–291. Retrieved from
[Link]

ENCYCLOPEDIA. (2023). Nutritional Status ." A Dictionary of Food and

Nutrition. Retrieved
from [Link]
pictures-and-press-releases/nutritional-status

ETIKAN, I. & BOBATOPA, O. (2019). A basic approach in sampling

methodology and sample size calculation. MedLife Clinics. Retrieved from
[Link]
[Link]

FADARE, O., AMARE, M., MAVROTAS, G., AKERELE, D. & OGUNNIYI,

A. (2019). Mother's Nutrition-Related Knowledge andChild Nutrition
Outcomes: Empirical evidence from Nigeria. PloS one, 14(2), e0212775.
[Link]

GADANYA, A.M., ABUBAKAR, S.M., AUWAL, M. & LAWAL, M. (2020).

Effect of Maternal Age and Occupation on Feeding Habits and Nutritional
Status of under Five Children in Kibiya and Dala Local Government Areas,
Kano Nigeria. Research Gate. Retrieved from
[Link]
_Maternal_Age_and_Occupation_on_Feeding_Habits_and_Nutritional_St
atus_of_under_Five_Children_in_Kibiya_and_Dala_Local_Government_
Areas_Kano_Nigeria

GERMAIN, A.F. & SIDDIQI, A. (2019). The Relation Between Household Food
Insecurity and Children’s Height in Canada and the United States: A
Scoping Review. Retrieved from
[Link]

GLOBAL HEALTH ELEARNING CENTER. (n.d.). Height-for-age (HFA).

Retreived from [Link]
 72

HANNEMA, S.E. & SÄVENDAHL, L. (2019). Encyclopedia of Endocrine

Diseases, Second Edition, Five Volume Set. Retrieved from
[Link]

HASAN, M.M., UDDIN, J., PULOK, M.H., ZAMAN, N. & HAJIZADEH, M.

(2020). Socioeconomic inequalities in child malnutrition in Bangladesh: Do
they differ by region? International journal of environmental research and
public health. Retrieved from
[Link]

HASNIDAR & MUSTAR. (2021). The relationship between mothers’ knowledge,

attitude and behavior to meet toddlers’ nutritional needs status at the work
area of UPT Puskesmas Ajangale 2021. International Journal of Science
and Healthcare Research, 6(4), 269–277. Retrieved from
[Link]

HASSAN, M. (2022). Correlational Research Design - methods, types. Research

Method. Retrieved from [Link]
design/

HEALTH BELIEF MODEL (HBM) (2020). Current Nursing. Retrieved from

[Link]

HOSSAIN, A., NIROULA, B., DUWAL, S., AHMED, S. & KIBRIA, G. (2020).
Maternal profiles and social determinants of severe acute malnutrition
among children under-five years of age: A case-control study in Nepal
Retrieved from
[Link]

ISHOLA, AJIBOLA, A. & OYELEKE, A.I. (2019). Maternal Education and

Nutritional Compliance among Mothers of Under-Five in Abeokuta, Ogun
State: Implications for Social Work Practice. Retrieved from
[Link]

ISMAEL, Z., MURTADHA, G., ADAI & HUSSEIN, Z.A. (2020) Relationship
between mother’s knowledge and nutritional status among preschool
children. Retrieved from
[Link]
en_mother%27s_knowledge_and_nutritional_status_among_preschool_ch
ildren

ISSAHAKU, I. & ALHASSAN, M. (2021). Nutrition knowledge, dietary practices

and nutritional status of non-academic staff at the Tamale campus of
University for Development Studies. Heliyon, 7(4), e06635.
[Link]
 73

IZAH N, ZULFIANA E, RAHMANINDAR N. (2020) Effect of Family

Characteristics on Stunting Events in Toddlers Aged 6-59 Months. J
Kebidanan Midwiferia; . Retrieved from
[Link]
2893/27379

JAKARIA, M., BAKSHI, R.K. & HASAN, M.M (2019). Is Maternal Employment
Detrimental to Children’s Nutritional Status? Evidence from Bangladesh.
Retrieved from
[Link]

JANSEN, P.W., DERKS, I.P.M., MOU, Y., RIJEN, E.H.M., GAILLARD, R.,
MICALI, N., VOORTMAN, T. & HILEGERS, M.H.J. (2020). Association
of Parent’s Use of Food as Reward with Children’s Eating Behaviour and
BMI in a Population-Based Cohort. Retrieved from
[Link]

KATOCH, O.R. (2022). Determinants of malnutrition among children: A

systematic review. Retrieved from:
[Link]
5

KETEMA, B., BOSHA, T. & FELEKE, F.W. Effect of maternal employment on

child nutritional status in Bale Robe Town, Ethiopia: a comparative cross-
sectional analysis. J Nutr Sci. 2022 Apr 18;11:e28. doi:
10.1017/jns.2022.26. PMID: 35573460; PMCID: PMC9066325.

KHAN, S., ZAHEER, S. & SAFDAR, N.F. (2019). Determinants of stunting,

underweight and wasting among children < 5 years of age: evidence from
2012-2013 Pakistan demographic and health survey. BMC Public Health
19, 358 [Link]

KUMARA, S., KUMARI, R. & SINGH, U. (2020). Impact of mother nutritional

knowledge on their child nutritional health status. International Journal of
Current Microbiology and Applied Sciences, 9(11), 255–260.
[Link]

KUNTO, Y.S., & BRAS, H. (2018). Women’s Empowerment And Gender

Inequality In Adolescent Nutritional Status: Evidence From The Indonesian
Family Life Survey. Journal of Biosocial Science, 50(5), 640-665.
doi:10.1017/S0021932017000566

KWOL, V.S., ELUWOLE, K.K., AVCI, T. & LASISI, T.T. (2020). Another look
into the knowledge attitude practice (KAP) model for Food Control: An
investigation of the mediating role of food handlers’ attitudes. Food
 74

Control, 110, 107025. Retrieved

from [Link]

LAPUT, J.G. & GO, G. (2022). Disentangling the Effects of Maternal Employment
on Child Stunting in the Philippines1. Volume 46 (2022) Number 1.
Retrieved from [Link]
[Link]/bitstream/handle/11540/14825/pidspjd46-2022-
[Link]?sequence=1

LAW INSIDER. (n.d.). Household size definition. Retrieved from

[Link]

LOCKS, L.M., DAHAL, P., POKHAREL, R., JOSHI, N., PAUDYAL, N.,
WHITEHEAD, R.D., . . . & JEFFERDS, M.E. (2018). Infant and young
child feeding (IYCF) practices improved in 2 districts in Nepal during the
scale-up of an integrated IYCF and Micronutrient Powder Program.
Current developments in nutrition. Retrieved from
[Link]

MANOHAR, B., SURENDRA, R.N. & SRAVYA S.P. (2018). Retrieved from
[Link]

MERRIAM-WEBSTER. (n.d.). Child-rearing definition &meaning. Retrieved

from [Link]

MERRIAM-WEBSTER. (n.d.). Knowledge definition & meaning. Retrieved from

[Link]

MERRIAM-WEBSTER. (n.d.). Occupation definition & meaning.

[Link]
[Link]/dictionary/occupation#:~:text=occupation%20implies%20wo
rk%20in%20which,as%20a%20result%20of%20training.&amp;text=calli
ng%20applies%20to%20an%20occupation%20viewed%20as%20a%20vo
cation%20or%20profession

MERRIAM-WEBSTER. (n.d.). Overweight definition & meaning. Retrieved from

[Link]

MESHRAM, I.I., MALLIKHARJUN K.R., BALAKRISHNA, N., HARIKUMAR,

R., ARLAPPA, N., SREERAMAKRISHNA, K. & LAXMAIAH, A.
(2019). Infant and young child feeding practices, sociodemographic factors
and their association with nutritional status of children aged <3 years in
India: Findings of the National Nutrition Monitoring Bureau survey, 2011–
2012. Public Health Nutrition, 22(1), 104-114.
doi:10.1017/S136898001800294X.
 75

MURARKAR, S., GOTHANKAR, J., DOKE, P., LAWANI, S., DHUMALE, G.,
QURAISHI, S., PATIL, R., . . . & MALSHE, N. (2020). Prevalence And
Determinants Of Undernutrition Among Under-Five Children Residing In
Urban Slums And Rural Area, Maharashtra, India: A Community-Based
Cross-Sectional Study | BMC Public Health | Full Text ([Link])

MYA, K.S., KYAW, A.T. & TUN, T. (2019). Feeding practices and nutritional
status of children age 6-23 months in Myanmar: A secondary analysis of
2015-16 Demographic and Health Survey. PLOS ONE, 14(1), e0209044.
Retrieved from [Link]

NANKINGA, O., KWAGALA, B. & WALAKIRA, E. J. (2019). Maternal

employment and Child Nutritional Status in Uganda. PLOS ONE, 14(12).
Retrieved from [Link]

NATIONAL HEALTH SERVICE (NHS, 2020). Malnutrition. Retrieved from

[Link]

OBEMBE, T.A., ADENUGA, W.U. & ASUZU, M.C. (2018). Determinants of

wasting among schoolchildren in a Southwestern state of Nigeria:
Implications to strengthen the nutritional component of primary health-care
model. Journal of Family Medicine and Primary Care.
[Link]

OTELE, D.O. & BUNU, S.J.(2020). Mothers' Perception Analysis on Nutritional

Health and Malnutrition among Children under 5 Years in the Niger Delta
Region. 2. 1-9. Retrieved
from [Link]
eption_Analysis_on_Nutritional_Health_and_Malnutrition_among_Childr
en_under_5_Years_in_the_Niger_Delta_Region

PADMINI, A.K. & VISWANATHAN, G. (2021). Child rearing beliefs and

practices among rural mothers in South Kerala. World Wide Journal of
Multidisciplinary Research and Development. Retrieved from
[Link]
practices-among-rural-mothers-in-south-kerala

PHILATLAS (2020) .Darasa, Tanauan City Batangas Profile. Retrieved from

[Link]

PIETERS, J. & RAWLINGS, S. Parental unemployment and child health in China.

Rev Econ Household 18, 207–237 (2020). Retrieved from
[Link]

PINTU, P. & SAHA, R., (2022). Is maternal autonomy associated with child
nutritional status? Evidence from a cross-sectional study in India. Retrieved
 76

from
[Link]

PURBA, I.E., PURBA, A. & SEMBIRING, R. (2022). Factors associated with

nutritional status of children under the age of 5 years in the working area
of Sadabuan Public Health Center. Retrieved from
[Link]
associated-with-nutritional-status-S1130862120300723

QUEALLY. M., DOHERTY, E., SIKAR, K.M., TOOMEY, E., CULLINAN, J.,
HARRINGTON, J.M. & KEARNEY, P. (2018). Do Mothers Accurately
Identify their Child’s Overweight/Obesity Status During Early Childhood?
Evidence from a nationally representative cohort study. Retrieved from
[Link]

ROMANOS, N.A., ZAZPE, I., SANTIAGO, S., MARÍN, L., RICO, C.A. &
MARTÍN, N. (2018). Influence of parental healthy-eating attitudes and
nutritional knowledge on nutritional adequacy and diet quality among
preschoolers: The Sendo Project. MDPI. Retrieved from
[Link]

SAAKA, M., WEMAH, K., KIZITO, F. & ZELEDON, I.H. (2021). Effect of
Nutrition Behaviour Change Communication Delivered Through Radio on
Mother’s Nutritional Knowledge, Child Feeding, Practices and Growth.
Retrieved from [Link]
nutritional-science/article/effect-of-nutrition-behaviour-change-
communication-delivered-through-radio-on-mothers-nutritional-
knowledge-child-feeding-practices-and-
growth/AC14414F381003DF1CB87CF46CD4033E

SANGRA, S. & NOWREEN, N. (2019). Knowledge, attitude, and practice of

mothers regarding nutrition of Under-five children: A cross-sectional study
in rural settings -. International Journal of Medical Science and Public
Health. Retrieved from [Link]

SAVE THE CHILDREN (2022). 4 causes of malnutrition in children and what you
can do about it. Save the Children. Retrieved from
[Link]
in-children

SHAHSANAI, A., FARAJZADEGAN, Z., SICHANI Z.H., HEIDARI, K. &

OMIDI, R. Assessment of the Relationship between Nutritional Knowledge
and Anthropometric Indices in Isfahan Children and Adolescent. Adv
Biomed Res. 2018 Jul 20;7:110. doi: 10.4103/abr.abr_1_18. PMID:
30123784; PMCID: PMC6071443.
 77

SISARA, F., MITCHELL, L., SILVA, R. & HARRIS, N. (2020). Factors

influencing the food choices of Urban Sri Lankan preschool children: Focus
Groups with parents and caregivers. Appetite. Retrieved from
[Link]

SŁOWIK, J., NIEDWOROK, E.G., PASZEK, I.M., KARDAS,

M., NIEWIADOMSKA E., TRYBUS M.S., . . . & IRZYNIEC T. (2019).
Nutritional Status Assessment in Children and Adolescents with Various
Levels of Physical Activity in Aspect of Obesity. Retrieved from
[Link]

STATISTA (2022). Global Hunger Index 2022: Countries most affected by hunger
Global Hunger Index 2022. Retrieved from
[Link]
hunger-in-the-world-according-to-world-hunger-index/

STATISTICS CANADA (2021). Frequency Distribution. Retrieved

from [Link]
[Link]

SWETHA, E., ANUSUYA, D.K. & HARINIVASHINI, M. (2022). Knowledge,

attitude, practice on complementary feeding of young mothers. Int J Home
Sci. DOI: 10.22271/23957476.2022.v8.i2e.1330

TARIQUJJAMAN, M., HASAN, M.M., MAHFUZ, M., AHMED, T. &

HOSSAIN, M. (2022). Between and within-country variations in infant and
young child feeding practices in South Asia. MDPI. Retrieved from
[Link]

UL HAQ, I., MARIYAM, Z., LI, M., HUANG, X., JIANG, P., ZEB, F., WU, X.,
FENG, Q. & ZHOU, M. (2018). A comparative study of nutritional status,
knowledge attitude and practices (KAP) and dietary intake between
international and Chinese students in Nanjing, China. International Journal
of Environmental Research and Public Health, 15(9), 1910.
[Link]

UNITED NATIONS INTERNATIONAL CHILDREN’S EMERGENCY FUND.

(2020). Nutrition. Retrieved from
[Link]

UNITED NATIONS INTERNATIONAL CHILDREN'S EMERGENCY FUND.

(n.d.). Maternal nutrition. UNICEF. Retrieved from
[Link]
 78

U.S. NATIONAL LIBRARY OF MEDICINE. (2022). Growth chart:

Medlineplus medical encyclopedia. MedlinePlus. Retrieved from
[Link]

WEMAKOR, A., GARTI, H., AZONGO, T., GARTI, H. & ATOSONA, A.

(2018).Young Maternal Age is a Risk Factor for Child Undernutrition in Tamale
Metropolis, Ghana. Retrieved from [Link]

WORLD FOOD PROGRAM USA. (2022). FAQ: The 6 Things You Need to Know
About Childhood Hunger. Retrieved from
[Link]
malnutrition

WONDU G.B. (2020), "Household Food Insecurity Predicts Childhood

Undernutrition: A Cross-Sectional Study in West Oromia (Ethiopia)",
Journal of Environmental and Public Health, vol. 2020, Article ID 5871980,
9 pages, 2020. Retrieved from [Link]

WORLDBANK (2021). Undernutrition in the Philippines: Scale, Scope, and

Opportunities for Nutrition Policy and Programming. Retrieved from
[Link]

WORLD HEALTH ORGANIZATION. (2021, June 9). Fact sheets - malnutrition.

World Health Organization. Retrieved from [Link]
room/fact-sheets/detail/malnutrition#

WORLD HEALTH ORGANIZATION. (n.d.). Complementary Feeding. Retrieved

from [Link]

WRIGHT, A.S., TULLOCH-REID, M., CHANG, S. & WALKER, S. (2021).

Maternal Characteristics Influence Infant Feeding Styles in Caribbean
women. Public Health Nutrition, 24(18), 6034-6045. Retrieved from
[Link]
nutrition/article/maternal-characteristics-influence-infant-feeding-styles-
in-caribbean-women/28DCA8A63C030F1100A82AD12D1DD933

XIA, X. (2022). Family Income, Parental Education and Chinese Preschoolers’

Cognitive School Readiness: Authoritative Parenting and Parental
Involvement as Chain Mediators. Front. Psychol. 13:745093. doi:
10.3389/fpsyg.2022.745093

YANTI, T. & FAUZIAH, D. (2021). The Effect of Family Income on Stunting

Incident in Preschool Children at Bogor City During COVID-19 Pandemic.
Indian Journal of Public Health Research & Development, 12(2), 407–412.
Retrieved from [Link]
 79

ZAHRA, H.S., SHAHSANAI, A., FARAJZADEGAN, Z., HEIDARI, K. &

OMIDI, R. (2018). Assessment of the Relationship Between Nutritional
Knowledge and Anthropometric Indices in Isfahan Children and
Adolescents. Retrieved from
[Link]

ZAKARIA, N.S., ASMA, A., ABDWAHAB, MR., LANI, M.N. & MELI, A.M.
(2022). Association of Mothers' Child Feeding Knowledge, Attitude, and
Practices with Nutritional Status of Children under the age of five in a
Malaysian Fishing Community: a cross-sectional study. Retrieved from
[Link]
640_zakaria.pdf.
.

APPENDICES
 81

APPENDIX A:

Validation Letter
82
83
84
85
 86

APPENDIX B:

Certification Letter
87
88
89
90
 91

APPENDIX C:

Letter to the
Barangay Captain
And City Health Officer
92
 93

APPENDIX D:

Informed Consent

FIRST ASIA INSTITUTE OF TECHNOLOGY AND HUMANITIES

COLLEGE OF ALLIED HEALTH SCIENCES

INFORMATION SHEET

INTRODUCTION

The researchers, 3rd year Nursing Students from FAITH Colleges, are inviting you
to partake in our research entitled “Knowledge, Attitude, and Practices of Mothers
on Child-rearing and Feeding with the Nutritional Status of their Children aged 1-
5 in Darasa.” Before deciding to participate, we wish to inform you that if you have
clarifications, or have encountered some words or concepts that are difficult to
understand, you may raise your questions freely at any time.

PURPOSE OF THE RESEARCH

Every year, malnutrition affects 45 million children worldwide (World Food

Program USA, 2022). Mothers' demographic profile, Knowledge, Attitudes, and
Practices can have an impact on their children's nutrition, which can result in
malnutrition. The child’s nutrition is mostly affected by their mothers as they are
primarily responsible for raising their children, especially during the first five years
of life. This period of a child's life is significant since it marks the beginning of
building a solid foundation for their future growth and development. Therefore, the
main purpose of this study is to identify the relationship of Knowledge, Attitude,
and Practices of mothers on child-rearing and feeding with the nutritional status of
their children aged 1-5.
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TYPE OF RESEARCH INTERVENTION

In this study, your participation will be in the form of answering a survey

questionnaire which will be provided by the researchers personally.

RESPONDENTS SELECTION

You are invited to take part in this research because your capability and cooperation
as a mother provides significant information with regard to Knowledge, Attitude
and Practices toward child-rearing and feeding.

VOLUNTARY PARTICIPATION

Please be guided that your participation in this study is purely voluntary. Your
decision will not be held against you. In addition, you are free to withdraw from
the study at any given time despite agreeing previously if you deem it necessary.

PROCEDURE

Once you agreed to participate in this research, a survey questionnaire will be given
by the researchers personally. The first section of the questionnaire includes your
demographic information while the other sections consist of statements that will
assess your knowledge, attitude, and practices toward child-rearing and feeding.
Rest assured that the statements and questions will only address the study's
objectives and will not dwell on unnecessary or unrelated topics. The researchers
will primarily be Ms. Diandra R. Capule, Ms. Dhea L. Gonzales, Ms. Evangeline
P. Malveda, and Mr. Leovincio P. Ramores, 3rd year Nursing students of FAITH
Colleges.
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We would like to inform you that, if you want to refrain from answering any of the
questions included in the survey questionnaire, we will allow you to move on to the
next question. The survey will remain confidential. All the information that will be
collected will be kept safely and once the research has been approved and
evaluated, it will be destroyed by deleting all the files related to the study.

DURATION

Answering the survey will last for approximately 30 minutes or less, depending on
every respondent.

RISKS

While answering the survey questionnaire, you may encounter questions that are
challenging to answer due to considering your personal perspective and opinions.
May it be known that you are free to disregard some questions if you wish so. If
you feel the questions are too personal or that responding would make you feel
uncomfortable, you are not required to provide a response.

BENEFITS

All the information that will be collected during your cooperation might help the
researchers to discuss the Knowledge, Attitude, and Practices of Mothers on Child-
rearing and Feeding with the Nutritional Status of their Children aged 1-5.
Furthermore, this study might be beneficial for the mothers, the children, the
community leaders, the community, the nutritionist, the nursing department, and
the future researchers with similar topics.
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TOKEN OF GRATITUDE

You will be given a token/goods as a way to express our gratitude for your time,
efforts, and participation in this research.

CONFIDENTIALITY

Your identity will be kept safe and only the principal investigators and advisers are
authorized to use the data that you will be providing. Please know that the
information that will be derived from you will only be utilized in concordance with
the purpose of this research. You will be pertained to in this research as respondents
or Mother with children aged 1-5.

SHARING THE RESULTS

You are entitled to the research findings. The research paper may be publicly
disclosed in order to contribute in supplementing knowledge and information for
people who are interested to learn more about a similar topic. You will receive a
summary of the research findings before it is made accessible to the public.

RIGHT TO REFUSE OR WITHDRAW

You may freely choose to refuse to participate in this research. If you have already
agreed to participate and then suddenly change your mind, you may withdraw at
any time. Your choices will not be held against you. Additionally, you will be
allowed to review your remarks and erase portions in the survey questionnaire.

WHO TO CONTACT

If you have more questions about any part of the research, you may send an email
to s2020103602@[Link] or contact Dhea Gonzales at 0915-227-1479 or
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via Messenger. If you have any other questions regarding the data privacy rights,
you may view our privacy policy at [Link]/privacypolicy or
contact the FAITH Colleges Data Protection Office at the 778-0656 local 124 or
dpo@[Link] to better understand with how the data will be handled.
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CERTIFICATE OF CONSENT

I have read the foregoing information in the informed consent. I had the opportunity
to ask questions about my concerns in participating in this study. In addition, the
researchers were able to satisfactorily answer my queries. Hence, I voluntarily
accept to participate as a respondent of the study entitled, “Knowledge, Attitude,
and Practices of Mothers on Child-rearing and Feeding with the Nutritional Status
of their Children aged 1-5 in Darasa.”

Yes, I consent to be a respondent.

No, I do not give my consent to be a respondent.

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Appendix D

Informed Consent

FIRST ASIA INSTITUTE OF TECHNOLOGY AND HUMANITIES

COLLEGE OF ALLIED HEALTH SCIENCES

INFORMATION SHEET

INTRODUKSYON

Ang mga mananaliksik , na nasa ikatlong antas ng kursong Batsilyer ng Agham ng

Narsing sa FAITH Colleges ay inaanyayahan kayong maging kalahok sa aming
pananaliksik na pinamagatang “Kaalaman, Saloobin, at Kasanayan ng mga Nanay
sa Pag-aalaga at Pagpapakain kasama ang Estado ng Nutrisyon ng kanilang Anak
na may edad 1-5 na naninirahan sa Darasa.” Bago magpasyang lumahok, nais
naming ipaalam sa iyo na kung mayroon kang mga paglilinaw, o nakatagpo ng
ilang salita o konsepto na mahirap maunawaan, maaari mong itanong ang iyong
mga tanong anumang oras.

LAYUNIN NG PANANALIKSIK

Bawat taon, ang malnutrisyon ay nakakaapekto sa 45 milyong bata sa buong

mundo (World Food Program USA, 2022). Ang demograpikong propayl,
Kaalaman, Saloobin, at Kasanayan ng mga ina ay maaaring magkaroon ng epekto
sa nutrisyon ng kanilang mga anak, na maaaring magresulta sa malnutrisyon. Ang
nutrisyon ng bata ay kadalasang naaapektuhan ng kanilang mga ina dahil sila ang
pangunahing responsable sa pagpapalaki ng kanilang mga anak, lalo na sa unang
limang taon ng buhay nila. Ang panahong ito ng buhay ng isang bata ay
makabuluhan dahil ito ang simula ng pagbuo ng matatag na pundasyon para sa
kanilang paglaki at pag-unlad sa hinaharap. Kaya naman, pangunahing layunin
 100

ng pag-aaral na ito na matukoy ang kaugnayan ng Kaalaman, Saloobin, at

Kasanayan ng mga nanay sa pag-aalaga at pagpapakain kasama ang estado ng
nutrisyon ng kanilang anak na may edad 1-5.

MGA URI NG INTERBISYON NG PANANALIKSIK

Sa pag-aaral na ito, ang iyong pakikilahok ay sa paraan ng pagsagot sa isang

sarbey na talatanungan na personal na ibibigay ng mga mananaliksik.

PAGPILI NG TAGASAGOT

Ikaw ay inaanyayahan na makilahok sa pananaliksik na ito dahil ang iyong

kakayahan at kooperasyon bilang isang ina ay magbibigay ng makabuluhang
impormasyon patungkol sa Kaalaman, Saloobin, at Kasanayan ng mga Nanay sa
Pag-aalaga at Pagpapakain.

BOLUNTARYONG PAGLAHOK

Mangyaring gabayan na ang iyong pakikilahok sa pag-aaral na ito ay boluntaryo

lamang. Ang iyong desisyon ay hindi gaganapin laban sa iyo. Bilang karagdagan,
malaya kang magpasyang umatras sa pag-aaral sa anumang oras sa kabila ng
pagsang-ayon dati kung sa tingin mo ay kinakailangan.

PAMAMARAAN

Kapag sumang-ayon ka na makilahok sa pananaliksik na ito, ang isang sarbey na

talatanungan ay ibibigay ng mga mananaliksik nang personal. Ang unang bahagi
ng talatanungan ay kinapapalooban ng iyong demograpikong profayl habang ang
iba pang sumusunod na mga bahagi ay binubuo ng mga pahayag na susuriin ang
iyong kaalaman, saloobin, at mga kasanayan sa pagpapalaki at pagpapakain ng
bata. Makatitiyak na ang mga pahayag at tanong ay tutugunan lamang ang mga
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layunin ng pag-aaral at hindi magtutuon sa mga hindi kailangan o walang

kaugnayang paksa. Ang mga mananaliksik ay pangunahing sina Bb. Diandra R.
Capule, Bb. Dhea L. Gonzales, Bb. Evangeline P. Malveda, at G. Leovincio P.
Ramores, mga mag-aaral na nasa-ikatlong antas na may kursong Narsing sa
FAITH Colleges.

Nais naming ipaalam sa iyo na, kung gusto mong pigilin ang pagsagot sa alinman
sa mga tanong na kasama sa sarbey na talatanungan, papayagan ka naming
magpatuloy sa susunod na tanong. Ang sarbey ay mananatiling kumpidensyal. Ang
lahat ng impormasyon na kokolektahin ay ligtas na mapapanatili at sa sandaling
maaprubahan at masuri ang pananaliksik, ito ay sisirain sa pamamagitan ng
pagtanggal ng lahat ng mga file na nauugnay sa pag-aaral.

TAGAL

Ang pagsagot sa talatanungan ay tatagal ng humigit-kumulang 30 minuto o mas

kaunti, depende sa bawat kalahok ng pag-aaral.

MGA PANGANIB

Habang sinasagot ang sarbey na talatanungan, maaari kang makatagpo ng mga

tanong na mahirap sagutin dahil sa pagsasaalang-alang sa iyong personal na
pananaw at opinyon. Mangyaring magkaroon ng kamalayan na malaya kang
balewalain ang ilang tanong kung nais mo. Kung sa tingin mo ay masyadong
personal ang mga tanong o ang pagtugon ay hindi ka komportable, hindi mo
kailangang magbigay ng tugon.

MGA BENEPISYO

Ang lahat ng impormasyon na kokolektahin sa panahon ng inyong

pakikipagtulungan ay maaaring makatulong sa mga mananaliksik na talakayin ang
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Kaalaman, Saloobin, at Mga Kasanayan ng mga Nanay sa Pag-aalaga ng Anak at

Pagpapakain kasama ang Estado ng Nutrisyon ng kanilang mga Anak na may edad
1-5. Higit pa rito, ang pag-aaral na ito ay maaaring maging kapaki-pakinabang
para sa mga nanay, mga bata, mga pinuno ng komunidad, komunidad,
nutrisyunista, departamento ng narsing, at mga susunod na mananaliksik na may
katulad na paksa.

TANDA NG PASASALAMAT

Bibigyan kayo ng token/goods bilang paraan upang ipahayag ang aming

pasasalamat sa paglalaan ng iyong oras, efforts, at pakikilahok sa pananaiksik na
ito.

KUMPIDENSYAL

Pananatilihing ligtas ang iyong pagkakakilanlan at ang mga punong imbestigador

at tagapayo lamang ang awtorisadong gumamit ng datos na iyong ibibigay.
Mangyaring malaman na ang impormasyong makukuha mula sa iyo ay gagamitin
lamang alinsunod sa layunin ng pananaliksik na ito. Ikaw ay makikilala sa
pananaliksik na ito bilang respondente o Nanay na may mga anak na may edad 1-
5.

PAGBABAHAGI NG RESULTA

Ikaw ay may karapatan sa mga natuklasan sa pananaliksik. Ang papel ng

pananaliksik na ito ay maaaring ibunyag sa publiko upang makapag-ambag sa
pagdaragdag ng kaalaman at impormasyon para sa mga taong interesadong
matuto nang higit pa tungkol sa parehong paksa. Makakatanggap ka ng buod ng
mga natuklasan sa pananaliksik bago ito gawing accessible sa publiko.
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KARAPATAN SA PAGTANGGI O PAG-WITHDRAWAL

Maaari mong malayang piliin na tumanggi na lumahok sa pananaliksik na ito.

Kung sumang-ayon ka nang lumahok at pagkatapos ay biglang nagbago ang iyong
isip, maaari kang umatras anumang oras. Ang iyong mga pagpipilian ay hindi
gaganapin laban sa iyo. Bukod pa rito, papayagan kang suriin ang iyong mga
komento at burahin ang mga bahagi ng sagot sa sarbey na talatanungan.

KANINO MAKIKIPAG-UGNAYAN

Kung mayroon ka pang karadagang katanungan tungkol sa anumang bahagi ng

pananaliksik, maaari kang magpadala ng email sa s2020103602@[Link]
o makipag-ugnayan kay Dhea Gonzales sa 0915-227-1479 o sa pamamagitan ng
Messenger application. Kung mayroon kang anumang iba pang mga katanungan
tungkol sa mga karapatan sa data privacy, maaari mong tingnan ang aming
patakaran sa privacy policy sa [Link]/privacypolicy o makipag-
ugnayan sa FAITH Colleges Data Protection Office sa 778-0656 local 124 o sa
dpo@[Link] upang mas maunawaan kung paano iingatan ang ang mga
datos.
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SERTIPIKO NG PAHINTULOT

Nabasa ko ang naunang impormasyon sa informed consent na ito. Nagkaroon ako

ng pagkakataong magtanong tungkol sa aking mga alalahanin sa paglahok sa pag-
aaral na ito. Dagdag pa rito, nasagot ng mga mananaliksik ang aking mga
katanungan nang kasiya-siya. Kaya naman, kusang-loob kong tinatanggap na
lumahok bilang isang respondente ng pag-aaral na pinamagatang, “Kaalaman,
Saloobin, at Kasanayan ng mga Nanay sa Pag-aalaga at Pagpapakain kasama ang
Estado ng Nutrisyon ng kanilang Anak na may edad 1-5 na naninirahan sa
Darasa.”

Oo, pumapayag akong maging respondente.

Hindi ako pumapayag na maging respondente.

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APPENDIX E:

Survey Questionnaire

Survey Questionnaire
(Sarbey Kwestyuneyr)

Name (Optional) (Pangalan) (Opsyunal):

________________________________

I. Profile of the Respondents

(I: Profayl ng mga Kalahok sa Pag-aaral)

Direction: Please mark (✓) the box that corresponds to your answer.

(Panuto: Punan ng markang (✓) ang kahon na katumbas ng iyong kasagutan.)

1. Age (Edad)

18-22 years old (18-22 taong gulang)

23-27 years old (23-27 taong gulang)

28-32 years old (28-32 taong gulang)

33-37 years old (33-37 taong gulang)

Specify (Tukuyin): _______________

2. Educational Attainment (Lebel ng Edukasyong Natapos)
Elementary Undergraduate (Hindi nagtapos ng elementarya)
Elementary Graduate (Nagtapos ng elementarya)
High School Undergraduate (Hindi nagtapos ng sekondarya)
High School Graduate (Nagtapos ng sekondarya)
College Undergraduate (Hindi nagtapos ng kolehiyo)
Bachelor’s Degree Holder (Nagtapos ng kolehiyo)

3. Family Income Status (Monthly) (Katayuan ng kita ng pamilya

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kada-buwan)
Less than 10,000 pesos (Mas mababa sa 10,000 piso)
10,000 – 20,000 pesos (10,000 hanggang 20,000 piso)

20,001 – 30,000 pesos (20,001 hanggang 30,000 piso)

Specify (Tukuyin): _______________

4. Occupation (Hanapbuhay):
If employed, please specify your job (Kung nagtatrabaho, mangyaring
tukuyin ang iyong trabaho)
Employed (May Trabaho):
Unemployed (Walang Trabaho)
5. Household size (Laki ng sambahayan):
How many people, including yourself, presently reside in your household?
(Ilang tao, kabilang ang iyong sarili, ang kasalukuyang naninirahan sa
iyong tahanan

2-4 (Dalawa hanggang apat)

5-7 (Lima hanggang pito)
8-10 (Walo hanggang sampu)
Specify (Tukuyin): _______________

II. Children’s Nutritional Status

(II: Estado ng Nutrisyon ng Bata)
Age (Edad): __________
Height in Meters (Tangkad sa Metro): __________
Weight in Kilograms (Timbang sa Kilo): __________

III. Knowledge, Attitude, and Practices of Mothers on Child-rearing and

Feeding with the Nutritional Status of their Children aged 1-5 in Darasa
(III: Kaalaman, Saloobin, at Kasanayan ng mga Nanay sa Pag-aalaga at
Pagpapakain kasama ang Estado ng Nutrisyon ng kanilang Anak na may edad
1-5 na naninirahan sa Darasa )

Direction: Listed below are the statements that consist of the knowledge,
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attitude, and practices about Child-rearing and feeding. Put a check mark (✓)
on the row that corresponds to your level of agreement and disagreement.
(Panuto: Nakatala sa ibaba ang mga pahayag na binubuo ng kaalaman,
saloobin, at kasanayan tungkol sa Child-rearing and feeding. Lagyan ng tsek
(✓) ang hanay na tumutugma sa antas ng iyong pagsang-ayon at hindi
pagpagsang-ayon.)

Pananda
4 - Strongly Agree (Lubos na Sumasang-ayon)
3 - Agree (Sumasang-ayon)
2 - Disagree (Hindi Sumasang-ayon)
1 - Strongly Disagree (Lubos na Hindi Sumasang-ayon)

Knowledge of Mothers on Child-rearing and Feeding (Kaalaman ng mga

Nanay sa Pag-aalaga at Pagpapakain ng kanilang Anak)

Knowledge 4 3 2 1
(Kaalaman)

1. If my child/children have poor energy it demonstrates a lack

of nutrition. (Kung ang aking anak/mga anak ay may
mahinang enerhiya ito ay nagpapakita ng kakulangan sa
nutrisyon.)

2. My child/children are undernourished as a result of the lack

of food.
(Ang aking anak/ mga anak ay nagkakaroon ng kulang na
nutrisyon bunga ng kakulangan ng pagkain.)

3. If my child/children are underweight, they are also

undernourished. (Kung ang aking anak/mga anak ay kulang
sa timbang, siya ay kulang din sa nutrisyon.)

4. When my child/children are overweight/obese, their risk of

chronic diseases increase. (Kapag ang aking anak/ mga anak
ay sobra sa timbang maaaring tumaas ang tyansa ng
pagkakaroon nila ng malubhang sakit.)

5. When my child/children are overweight/obese they have a

poor quality of life. (Kapag ang aking anak/ mga anak ay
sobra sa timbang siya ay nagkakaroon ng mababang kalidad
ng buhay.)
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6. To monitor my child/children’s growth, I can visit the

health center. (Upang masubaybayan ang paglaki ng aking
anak/ mga anak, bumisita ako sa pagamutan.)

7. When my child/children are exclusively breastfed he/she

can avoids undernutrition. (Kapag ang aking anak/ mga anak
ay eksklusibo kong pinapasuso siya ay nakaiiwas sa
kakulangan sa nutrisyon.)

8. My child/ children’s teeth decay if they consume foods high

in sugar, such as sweets, chocolates, and candies. (Ang mga
ngipin ng aking anak/ mga anak ay nabubulok/nasisira kung
sila ay kumakain mga pagkaing mataas sa asukal, tulad ng
mga matatamis na pagkain, tsokolate at kendi.)

9. When my child/children skip breakfast he/she have trouble

paying attention in class. (Kapag ang aking anak/ mga anak
ay hindi nakain ng umagahan siya ay nahihirapang umintindi
sa klase.)

10. My child/children's appetite is affected if I give excessive

amounts of candy and sweet treats before meals.
(Naapektuhan ang gana sa pagkain ng aking anak/mga anak
kung bibigyan sila ng labis na dami ng kendi at matatamis na
pagkain bago kumain.)

11. One of the causes of becoming overweight/obese is an

excessive intake of foods that are high in cholesterol and
calories. (Isa sa mga dahilan ng pagiging sobra sa
timbang/lusog ay ang sobrang pagkain ng mga pagkaing
mataas sa cholesterol at calories.)

12. Consuming more fruits helps avoid obesity and

overweight. (Ang pagkain ng mas maraming prutas at gulay
ay nakatutulong maiwasan ang labis na timbang at lusog.)

13. I am aware that I should breastfeed my child/children up

until 2 years of age or first 1000 days of life. (Alam ko na dapat
kong pasusuhin ang aking anak/mga anak hanggang 2 taong
gulang o unang 1000 araw ng buhay.)

14. I am aware of what food I should prepare for my

child/children according to their age. (Alam ko kung anong
mga pagkain ang dapat kong ihain para sa aking anak/mga
anak na nararapat para sa kanilang edad.)
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15. I am aware about the nutritional needs of my

child/children. (Alam ko ang mga nutrisyonal na
pangangailan ng aking anak/mga anak.)

16. I should limit my child/children's consumption of

processed fruit juices (e.g. zest-o, canned pineapple juice,
etc.) as this will cause tooth decay. (Dapat kong limitahan
ang pagkonsumo ng aking anak/mga anak ng mga
naprosesong katas ng prutas (hal. zest-o, de-latang pineapple
juice, atbp.) dahil magdudulot ito ng pagkabulok ng ngipin.)

Attitude of Mothers on Child-rearing and feeding (Saloobin ng mga Nanay sa

Pag-aalaga at Pagpapakain ng kanilang Anak)

Attitude 4 3 2 1
(Saloobin)

1. I am willing to teach my child/children new experience

eg. eating on their own. (Handa akong turuan ang aking
anak/mga anak ng bagong karanasan halimbawa kumakain
ng mag-isa.)

2. I support my child/children to decide on their own

regarding what food they want to consume. (Sinusuportahan
ko ang aking anak/mga anak na magpasya sa kanilang sarili
tungkol sa kung anong pagkain ang gusto nilang kainin.)

3. I build a good relationship with my child/children.

(Bumubuo ako ng magandang relasyon sa aking anak.)

4. I provide all of the food that my child/children wants, to

prevent the child/children from crying. (Ibinibigay ko ang
lahat ng gustong pagkain ng aking anak/mga anak upang
hindi sila umiyak.)

5. I commend my child/children everytime she/he eats every

food that I give her/him. (Pinupuri ko ang aking anak/mga
anak sa tuwing kinakain niya ang bawat pagkaing binibigay
ko sa kanya.)

6. I like to give sweets to my child/children as a

reward for their good behavior. (Gusto kong magbigay
ng matatamis na pagkain sa aking anak/mga anak
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bilang gantimpala sa kanilang mabuting pag-uugali.)

7. I am committed on monitoring my child/children sugar

intake. (Nakatuon ako sa pagsubaybay sa pagkain ng aking
anak/mga anak ng matatamis.)

8. When my child/children says, "I'm not hungry", I still feed

my child/children. (Kapag sinabi ng aking anak/mga anak na
"hindi ako nagugutom" ay pinapakain ko pa rin sila.)

9. When my child/children says, "I'm not hungry", I will not

force my child/ children to eat. (Kapag sinabi ng aking
anak/mga anak na "hindi ako nagugutom" ay hindi ko sila
pinipilit kumain.)

10. I like to feed my child/children first before my husband

eats. (Gusto ko munang pakainin ang aking anak/mga
anak bago kumain ang aking asawa.)

11. I am at ease when my child/children is eating vegetables

rather than processed food. (Ako ay komportable kapag ang
aking anak/mga anak ay kumakain ng gulay kaysa sa
naprosesong pagkain.)

12. I am happy when I prepare food for my child/children.

(Masaya ako kapag pinaghahanda ko ng pagkain ang aking
anak/ mga anak.)

13. I feel confident while preparing my child/children's plate

with food that contains proteins, vegetables, fruits, fats (good
fat) and carbohydrates. (Palagay ang loob ko tuwing
ihinahanda ang plato ng aking anak/mga anak na naglalaman
ng mga protina, gulay, prutas, fats (good fat) at
carbohydrates.)

14. I am at ease when my child/children eat fruits at least 3

times a week. (Ako ay komportable kapag ang aking
anak/mga anak ay kumakain ng prutas kahit 3 beses sa isang
linggo.)
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15. I am consistently feeding my child/children snacks

between meals. (Patuloy kong pinapakain ang aking
anak/mga anak ng meryenda sa pagitan ng mga pagkain.)

16. I like to serve balanced foods to prevent my child/children

of becoming malnourished. (Gusto kong maghain ng mga
balanseng pagkain upang maiwasang maging malnourished
ang aking anak/anak.)

Practices of Mothers on Child-rearing and feeding (Kasanayan ng mga Nanay

sa Pag-aalaga at Pagpapakain ng kanilang Anak)

Practices 4 3 2 1
(Kasanayan)

1. I am in charge of feeding my child or children. (Ako

ang namamahala sa pagpapakain sa aking anak o
mga anak.)

2. I provide my child/children with highly sweetened

beverages. (Binibigyan ko ang aking anak/ mga anak ng
matatamis na inumin.)

3. I feed my child/children foods that are high in fat.

(Pinapakain ko ang aking anak/ mga anak ng mga
pagkaing mataas sa taba.)

4. I record my child's/children's snack food

consumption. (Itinatala ko ang pagkonsumo ng
meryenda ng aking anak/ mga anak.)

5. I purchase street foods for my child/children. (Bumibili

ako ng street food para sa aking anak/ mga anak.)

6. When preparing meals for my child/children, I use too

much salt/salt substitutes/msg. (Kapag naghahanda ng
mga pagkain para sa aking anak/mga anak, gumagamit
ako ng masyadong maraming asin/salt substitutes/msg.)

7. I prepare the same meal each day.(Naghahanda ako

ng pare-parehong pagkain araw-araw.)
 112

8. When my child/children reject what is being offered, I

prepare something else. (Kapag tinanggihan ng aking
anak/mga anak ang iniaalok, iba ang aking inihahandang
pagkain.)

9. I give my child/children over two years old an

excessive intake of formula milk. (Binibigyan ko ang
aking anak/mga anak na higit sa dalawang taong
gulang ng labis na formula milk.)

10. I prepare a drink using unfiltered tap water.

(Naghahanda ako ng inumin gamit ang hindi na-filter na
tubig sa gripo.)

11. I allow my child/children to eat whatever they want.

(Pinapahintulutan ko ang aking anak/mga anak na kumain
ng anumang gusto nila.)

12. I advise my child/children to consume a variety of

foods. (Pinapayuhan ko ang aking anak/mga anak na
kumain ng iba't ibang pagkain.)

13. I have a set time when I will feed my child/children.

(May nakalaan akong oras kung kailan ko papakainin
ang aking anak/mga anak.)

14. I feed my child/children 3 or more times per day.

(Pinapakain ko ng 3 o higit pang beses ang aking anak/ mga
anak kada araw.)

15. I involve my child/children in meal planning and

preparation. (Isinasali ko ang aking anak/mga anak sa
pagpaplano at paghahanda ng pagkain.)

16. I have any strategies for encouraging my

child/children to try new food or increase their intake of
healthy foods. (Mayroon akong mga pamamaraan para
hikayatin ang aking anak/mga anak na sumubok ng mga
bagong pagkain o dagdagan ang kanilang pagkain ng
masusuntansyang pagkain.)

Adapted and modified from the study of Zakaria et al.,2022

[Link] fr-2021-
640_zakaria.
 113

APPENDIX F:

Statistical Computation

Appendix Table 1. Frequency Distribution and Percentage of the

Demographic Profile of the Respondents

Age Frequency Percent

18-22 years old 29 11.8
23-27 years old 90 36.7
28-32 years old 69 28.2
33-37 years old 36 14.7
38-42 years old 15 6.1
43-47 years old 5 2.0
> 47 years old 1 0.4
Total 245 99.9

Educational Attainment Frequency Percent

Elementary
16 6.5
Undergraduate
Elementary Graduate 29 11.8
High School
63 25.7
Undergraduate
High School Graduate 92 37.6
College Undergraduate 30 12.2
Bachelor’s Degree
15 6.1
Holder
Total 245 99.9

Family Income 0Status

Frequency Percent
(Monthly
Less than 10,000 144 58.8
10,000-20,000 86 35.1
20,001-30,000 10 4.1
>30,000 5 2.0
Total 245 100
 114

Appendix Table 1 continued . . .

Occupation Frequency Percent

Employed 85 34.7
Unemployed 160 65.3
Total 245 100

Household Size Frequency Percent

2-4 85 34.7
5-7 111 45.3
8-10 45 18.4
>10 4 1.6
Total 245 100

Appendix Table 2. Frequency Distribution and Percentage of the

Children’s Nutritional Status

Weight for Age Frequency Percent

Severely Underweight 5 2.0
Underweight 21 8.6
Normal 214 87.3
Overweight 4 1.6
Obese 1 0.4
Total 245 99.9

Weight for Height Frequency Percent

Severely Wasted 4 1.6
Wasted 10 4.1
Normal 208 84.9
Overweight 15 6.1
Obese 8 3.3
Total 245 100
 115

Appendix Table 2 continued . . .

Height for Age Frequency Percent

Severely Stunted 19 7.8
Stunted 49 20.0
Normal 174 71.0
Tall 3 1.2
Total 245 100

Appendix Table 3. Frequency of the Respondents in terms of their level of

Knowledge, Attitude, and Practices of Mothers on
Child-rearing and Feeding

n = 245
Weight for Age Percent
Frequency
Knowledge score
Poor 16 6.5
Moderate 120 49
Good 109 44.5
Total 245 100
Attitude score
Poor 7 2.9
Moderate 64 26.1
Good 174 71
Total 245 100
Practice score
Poor 84 34.3
Moderate 141 57.6
Good 20 8.2
Total 245 100
 116

Appendix Table 4. Relationship between Demographic Profile of the

respondents and their Knowledge, Attitude, and
Practices on Child-rearing and Feeding

Relationship between Demographic Profile of the respondents and

their Knowledge
Variable r-value p-value Interpretation
No significant
Age 0.032 0.619
relationship
Educational No significant
-0.042 0.510
Attainment relationship
Family Income No significant
0.027 0.673
Status relationship
Significant
Occupation 0.454 0.033
relationship
No significant
Household Size -0.016 0.798
relationship
Note: Correlation is significant at the 0.05 level (p-value).

Relationship between Demographic Profile of the respondents and

their Attitude
Variable r-value p-value Interpretation
No significant
Age -0.025 0.701
relationship
Educational No significant
-0.115 0.073
Attainment relationship
Family Income No significant
0.054 0.400
Status relationship
No significant
Occupation 0.320 0.721
relationship
No significant
Household Size 0.097 0.129
relationship
Note: Correlation is significant at the 0.05 level (p-value).
 117

Appendix Table 4 continued . . .

Relationship between Demographic Profile of the respondents and

their Practice
Variable r-value p-value Interpretation
No significant
Age -0.016 0.800
relationship
Educational Significant
-0.267 0.001
Attainment relationship
Family Income No significant
0.043 0.501
Status relationship
No significant
Occupation 0.421 0.107
relationship
No significant
Household Size 0.076 0.239
relationship
Note: Correlation is significant at the 0.05 level (p-value).

Appendix Table 5. Relationship on Knowledge, Attitude, and Practices of

Mothers on Child-rearing and Feeding with the
Nutritional Status of their Children aged 1-5

Relationship between Knowledge and Nutritional Status

Variable r-value p-value Interpretation
No significant
Weight for Age -0.065 0.309
relationship
Weight for No significant
-0.052 0.422
Height relationship
No significant
Height for Age -0.101 0.115
relationship
Note: Correlation is significant at the 0.05 level (p-value).

Relationship between Attitude and Nutritional Status

Variable r-value p-value Interpretation
No significant
Weight for Age -0.038 0.553
relationship
Weight for No significant
-0.012 0.853
Height relationship
No significant
Height for Age -0.084 0.189
relationship
Note: Correlation is significant at the 0.05 level (p-value).
 118

Appendix Table 5 continued . . .

Relationship between Practice and Nutritional Status

Variable r-value p-value Interpretation
No significant
Weight for Age 0.001 0.986
relationship
Weight for No significant
-0.049 0.447
Height relationship
No significant
Height for Age 0.055 0.394
relationship
Note: Correlation is significant at the 0.05 level (2-tailed).
 119

APPENDIX G:

Gantt Chart

AY 2022 – 2023 / First Semester

ID Task Start End Duration Year 2022

Aug Sept Oct Nov Dec
1 Orientation, Groupings 20
2 Conceptualization of title 8/21 8/31 10 days
3 Consultation with Adviser 9/1 9/12 12 days 13
4 Initial Review of Literature 9/13 9/25 12 days 26
5 Finalization of title 9/26 9/29 3 days 30
6 Submission of title
9/30 10/3 3 days 4
(instructor)
7 Submission of Proposed
10/4 10/7 3 days
Title to Panelist
8 Research Title Proposal 8
9 Second Review of
10/9 10/19 10 days 20
Literature
10 Chapter I - Introduction
and Background of the
Study, Statement of the
Problem, Objectives/ 10/21 11/1 10 days 2
Hypothesis,
Chapter II- Review of
Literature
11. Consultation with Adviser 11/2 11/8 6 days 9
12. Chapter III- Methodology
Research Design, Research
Locale, Respondent of the
Study, Instrumentation, 11/9 11/16 7 days 17
Data Gathering, Statistical
Analysis, Ethical
Consideration
13 Consultation with Adviser 11/17 11/23 6 days 24
14 Final Paper Submission for
oral Defense 11/25 11/26 2 days 27
15 Submission of Paper to
Panelist 11/27 11/28 3 days
16 Oral Defense 3
17 Submission of Final
Output
 120

AY 2022 – 2023 / Second Semester

ID Task Start End Duration Year 2023

Jan Feb Mar Apr May Jun Jul
1 Orientation, Assessment
23
2 Submission of the final
Research Proposal 24

3 Submission of Validated
Questionnaires to 1/2 1/31 11 days 31
statistician
4 Pre-Testing 2/1 2/5 5 days 6
5 Submission to
Statistician for checking 2/6 2/11 5 days 12
6 Collection of data 2/12 2/ 27 15 days 1
7 Encoding and
Consultation with 2/ 28 3/ 20 20 days 21
Statistician
8 Data Analysis 3/20 3/ 29 9 days 30
9 Consultation with the
3/30 4/ 9 10 days 10
adviser (analysis)
10 Writing of the Final
4/10 4/20 10 days 21
Paper
11 Consultation with
adviser for proofreading 4/21 4/ 31 10 days 1
of the final paper.
12 Submission of Final
Paper to the Course 5/1 5/ 8 7 days 9
Teacher
13 Sending of the Full
Thesis Paper (E-copy) to 5/9 5/ 11 12
the Panel Members
14 Final Defense 13
15 Start of Revision for the
final paper (whole
5/20 5/31 11 days
manuscript including the
abstract )
Post defense
16 consultation with the
Defense Panel / Adviser 6/1 6/ 15 15 days
for revisions of final
output
17 Consultation with the
assigned grammarian 6/16 7/1 15 days
18 Submission of Final
Manuscript for Signing 7/2 7/7 5 days
of approval sheet
19 Writing of IMRAD /
7/8 7/18 10 days
journal
20 Submission of
Hardbound Manuscript 7/20