Nurses' Perspectives on Parental Education and Anthropometric Diagnosis in the Management of Malnutrition among Preschool Children in Northwest Nigeria

AbstractBackground: Malnutrition remains a leading contributor to illness and death amongpreschool children in Northwest Nigeria, the geopolitical zone with the highest burden ofstunting in the country. Nurses are central to identifying and managing affected children, yetlittle is known about how they interpret the role of caregivers' education or how closely theirdiagnostic reasoning follows international criteria.Objective: To assess nurses' perspectives on the influence of parental education on themanagement of malnutrition, their endorsement of diagnostic and anthropometric criteria, andthe relationship between the two domains.Methods: A cross-sectional survey was conducted among registered nurses in nine stateowned general hospitals selected by multistage sampling across three Northwest states. Avalidated 4-point Likert questionnaire (Cronbach's α = .974) was administered to 370 nurses;352 usable responses (95.1%) were analysed. Item means were judged against a criterion of2.50, composite scores were tested against the criterion with one-sample t tests, and theassociation between domains was examined with Pearson's correlation.Results: The parental education composite fell below the criterion (M = 2.32, SD = 0.88;t(351) = -3.74, p< .001). Nurses endorsed links between low parental education and highermalnutrition prevalence (M = 3.30), poor recognition of danger signs (M = 3.33), weakerdecision-making (M = 2.92), immunisation use (M = 3.26) and colostrum refusal (M = 3.00),but rejected links with cultural beliefs, superstition, refusal of hospital care, early weaning,non-exclusive breastfeeding and purchasing power. The diagnosis and measurementcomposite exceeded the criterion (M = 2.74, SD = 0.88; t(351) = 5.10, p< .001). Mid-upperarm circumference, bilateral oedema and body mass index were strongly endorsed, whereasweight-for-height below -3 SD was not (M = 2.27). The two domains were stronglycorrelated (r = .955, p< .001).Conclusion: Nurses view parental education mainly through a knowledge and service-usepathway and broadly accept anthropometric diagnosis, but gaps around weight-for-height and age-appropriate indices point to a need for targeted in-service training alongside caregiverfocused nutrition education.