South American Research Journal, 4(1), 21-25

https://www.sa-rj.net/index.php/sarj/article/view/53

ISSN 2806-5638

y cognitivo en la infancia. El objetivo de esta investigación

fue identificar las intervenciones del personal de enfermería

en el tratamiento de la desnutrición en pacientes pediátricos

en el Servicio de Pediatría de un hospital en el cantón

Machala. La metodología empleada fue cuantitativa,

descriptiva y de corte transversal. La muestra consistió en 8

licenciados en enfermería del Servicio de Pediatría del

hospital, abarcando la totalidad de la población en el área. Los

resultados revelaron que el 37,50% de los padres o cuidadores

reciben educación continua sobre cuidado nutricional infantil,

mientras que el 62,50% la recibe de manera ocasional. En el

plan de cuidados, el 100% de los enfermeros coincidieron en

la importancia de implementar un plan personalizado que

incluya nutrición parenteral o enteral, administración de

suplementos nutricionales y promoción de una alimentación

adecuada. La educación sobre nutrición infantil para padres y

cuidadores tiende a ser esporádica y desigual. Mejorar la

consistencia y accesibilidad de esta educación puede

optimizar el estado nutricional y el desarrollo de los menores.

Asimismo, todos los profesionales de enfermería elaboran

planes personalizados que abarcan nutrición parenteral y

enteral, así como suplementos nutricionales, lo que destaca su

compromiso con una recuperación efectiva y la mejora en la

calidad de vida de los pacientes pediátricos.

Nursing practices in the management of

pediatric malnutrition in a hospital in the

Machala canton

Prácticas de enfermería en la gestión de la

desnutrición pediátrica en un hospital del

cantón Machala

_K_a_r_e_n_M_o_r_a_-_P _e _ñ _a 1

_,_M_e_l_a_n_i_e_P_a_n_g_a_y_-_T_o_r_r_e_s1 , & Sara

Vera-Quiñonez¹

Universidad Técnica de Machala, Ecuador.

Correspondence: kmora16@utmachala.edu.ec

Reception: June 2, 2024 - Acceptance: August 2, 2024 -

Publication: August 19, 2024

ABSTRACT

Childhood malnutrition is a global issue that affects

children aged 0 to 5 years in various regions. This condition

results from an inadequate intake of essential macronutrients

and micronutrients, such as vitamins and minerals, crucial for

the physical and cognitive development of children. The aim

of this research was to identify the interventions by nursing

staff in the treatment of malnutrition among pediatric patients

in the Pediatric Service of a hospital in Machala canton. The

methodology employed was quantitative, descriptive, and

cross-sectional. The sample comprised 8 nursing graduates

from the hospital's Pediatric Service, representing the entire

population in the area. The findings revealed that 37.50% of

parents or caregivers received ongoing education on child

nutritional care, while 62.50% received it occasionally. In the

care plan, 100% of nurses concurred on the importance of

implementing a personalized plan that includes parenteral or

enteral nutrition, the administration of nutritional

supplements, and the promotion of adequate nutrition.

Education on child nutrition for parents and caregivers tends

to be sporadic and uneven. Enhancing the consistency and

accessibility of this education could optimize the nutritional

status and development of children. Moreover, all nursing

professionals develop personalized plans that encompass

parenteral and enteral nutrition as well as nutritional

supplements, highlighting their commitment to effective

recovery and the improved quality of life for pediatric

patients.

Palabras claves: desnutrición infantil, estado

nutricional, intervención de enfermería, plan de cuidados.

INTRODUCTION

Childhood malnutrition is a global challenge affecting

children aged 0-5 years in various regions. This condition

results from an insufficient intake of essential macronutrients

and micronutrients, including vitamins and minerals, crucial

for optimal physical and cognitive development in children.

Despite advances in healthcare and nutritional policies,

malnutrition remains a significant cause of morbidity and

mortality in the pediatric population (Álvarez, 2019). Often,

childhood malnutrition is closely linked to socioeconomic

factors, limited access to nutritious foods, inadequate feeding

and care practices, and lack of access to sufficient health

services (Rivera, 2022).

Childhood malnutrition arises from inadequate food

intake and infectious diseases. Underlying factors include

limited access to food, poor healthcare, and inadequate care

practices. The root causes are social, economic, and political,

such as poverty and low maternal education. The effects

include delays in growth and development, increased risk of

disease, and reduced physical capacity and academic

performance (Picbougoum et al., 2023; Cueva et al., 2021).

Recent studies have shown that food insecurity and

unfavorable living conditions exacerbate these issues,

perpetuating the cycle of poverty and malnutrition (Zhao et

al., 2020).

Keywords: child malnutrition, nutritional status,

nursing intervention, care plan.

In Ecuador, 26% of children between zero and five years

of age suffer from chronic malnutrition, with a higher

prevalence in rural areas, where it affects 35.7% of children,

and is even more pronounced among indigenous children,

with rates above 40%. Furthermore, a significant percentage

of children under five years of age experienced diarrheal and

acute respiratory diseases according to the Nutrition and

Health Survey (ENSANUT, 2018): 10.8% and 34.2%

RESUMEN

La malnutrición infantil es un problema global que

afecta a niños de 0 a 5 años en diversas regiones. Esta

condición se origina por una ingesta inadecuada de

micronutrientes esenciales, como

vitaminas y minerales, fundamentales para el desarrollo físico

macronutrientes

https://doi.org/10.5281/zenodo.13345438

South American Research Journal, 4(1), 21-25

https://www.sa-rj.net/index.php/sarj/article/view/53

ISSN 2806-5638

respectively, seven days before the survey (Flores and

Congacha, 2021; Carrasco, 2019). This underscores the need

for specific and sustainable interventions to combat

malnutrition in these vulnerable communities.

the nutritional health and development of malnourished

children in this specific context.

METHODOLOGY

Lack of adequate care for these diseases can lead to

serious or even fatal complications. To mitigate childhood

malnutrition, it is essential to promote a balanced, diverse,

and nutrient-rich diet, including a variety of whole grains,

legumes, and vegetables (Melgarejo et al., 2022).

Nutritional supplementation and education programs have

proven effective in improving the nutritional status of

children in various regions (Martínez et al., 2023). The

nutritional health of children is intrinsically linked to their

growth and development throughout their lives, which must

be assessed considering the adequate weight and height

growth that results from balanced nutrition. Addressing this

issue is a challenge, since from gestation to five years of

age, one of the most critical stages in the physical and

neurocognitive development of individuals occurs (Lovera

and Cáceres, 2023). Early interventions are key to

preventing irreversible damage to child development

The design of this research was quantitative,

descriptive, and cross-sectional. The sample consisted

of eight nursing graduates from the Pediatrics Service

of a hospital in the Machala canton. The inclusion

criteria included only nursing graduates, excluding

nursing interns, nursing assistants, and doctors in the

area. The sampling was non-probabilistic for

convenience.

survey was applied with a questionnaire

previously validated by experts. The experts selected for

the validation of the questionnaire had experience in the

area of pediatrics and child nutrition, with at least five

years of clinical practice and postgraduate academic

training in these areas. A rubric based on criteria of

clarity, relevance, and pertinence of the items was used

to ensure the validity of the instrument.

The questionnaire included nine closed questions

with trichotomous answers (yes, no, and sometimes) and

one open question, which was subsequently coded. The

variables evaluated were education, collaborative work,

and care plan. Ethical aspects of the study were taken

into account; prior to data collection, permission was

requested through a letter from the competent authority

of the institution. In addition, participants signed an

informed consent to participate voluntarily.

Data protection was ensured by anonymizing the

questionnaires, secure storage in an encrypted database,

and restricted access only to the research team. The data

collected were tabulated and analyzed using the IBM

SPSS Statistics program version 26. During the

statistical analysis, descriptive statistics were used to

summarize the information and nonparametric tests

were used to identify significant differences between

the variables studied.

(

Hernández et al., 2023).

In contexts where childhood malnutrition is prevalent,

nurses frequently care for children with severe malnutrition

in their daily clinical practice. Their main objective is to

protect and improve the health of children, providing

adequate nutritional guidance to the pediatric population. In

addition, nurses prioritize providing essential care in

children's nutrition, offering assistance, education,

guidance, and training from a family and social perspective

of the child (Alulema et al., 2023). Implementing effective

educational strategies can empower families and

significantly improve nutritional outcomes (Melgarejo et

al., 2022).

A comprehensive approach to caring for malnourished

children is vital; this involves not only treating malnutrition

but also addressing underlying causes and any

comorbidities. Education for families and coordination with

other health professionals are crucial components of this

comprehensive approach (Cuenca and Meza, 2020). Studies

have shown that interprofessional collaboration improves

health outcomes in malnourished children (Guamialamá et

al., 2021).

Nursing interventions to treat malnutrition in children

include monitoring nutritional status, educating caregivers

about proper diet, and administering nutritional

supplements when necessary. Additionally, the nursing role

includes checking for possible complications such as

infections and digestive problems that are common in

malnourished children (Guanga et al., 2022). Continuous

training of nurses in malnutrition monitoring and

management techniques is essential to improve the quality

of care (Paz et al., 2022).

There is a lack of understanding and detailed

documentation about specific nursing interventions and

their impact on the recovery of severely malnourished

pediatric patients in the Pediatrics service of a hospital in

the Machala canton. Although the importance of the role of

nurses in the management of childhood malnutrition is

recognized, there is a lack of studies that comprehensively

evaluate how these interventions contribute to improving

RESULTS

Nursing plays a pivotal role in addressing pediatric

malnutrition by administering nutritional supplements,

educating parents and caregivers, and closely

monitoring patient responses. Nurses are also crucial in

ensuring that patients receive adequate nutrition and

collaborate extensively with the medical team to fulfill

all nutritional requirements.

As illustrated in Table 1, a significant majority of

the professionals surveyed are women. This high

proportion of female nursing staff mirrors broader

trends within the profession and may impact work

dynamics as well as interactions with patients and their

families. Regarding the age distribution, there is a

notable diversity among the staff, with 37.50% aged

between 35 and 40 years. This mix of different ages

brings together varied levels of experience and

perspectives, potentially enriching the implementation

of nutritional interventions and the adaptation to

innovative practices.

https://doi.org/10.5281/zenodo.13345438

South American Research Journal, 4(1), 21-25

https://www.sa-rj.net/index.php/sarj/article/view/53

ISSN 2806-5638

Table 1. Sociodemographic data of participants

and 32% on child growth and development. This type of

guidance not only supports healthy child development but

also empowers mothers to make informed decisions

regarding their child’s care. Etchegaray and Bustos (2021)

highlight the critical role of nursing staff in ensuring that

mothers receive the necessary support from the outset, which

significantly contributes to the health and well-being of the

child. This underlines the importance of structured and

continuous educational efforts by healthcare professionals to

address and mitigate the challenges of childhood nutrition

effectively.

Items

Options

Masculine

Frequency

Percentage

12.5%

87.5%

12.5%

25.0%

37.5%

12.5%

0.0%

Sex

Femenine

5-30

0-35

5-40

0-45

5-50

Age

-3 years

75.0%

25.0%

0.0%

Work experience

4-7 years

More than 7 years

Table 3. Collaborative work

Items

Options

Frequency Percentage

The variability in work experience among nursing

professionals can significantly impact the effectiveness of

nutritional interventions in pediatric care. More seasoned

nurses are often better equipped to manage complex cases of

pediatric malnutrition due to their extensive experience.

According to a study by Moreta et al. (2019), it is crucial

for a licensed nurse specializing in pediatric care to possess

both solid theoretical and practical training, as well as a

genuine passion for working with children. The study's

findings reveal that 60% of the respondents have between 1

and 5 years of experience, 35% have 6 to 10 years, and 5%

boast more than 10 years in the field. These statistics

underscore the importance of robust training and a deep

interest in pediatric care. Furthermore, they highlight the need

to promote ongoing professional development within this

specialty. Continuous education and training are vital for

providing high-quality, comprehensive care to pediatric

patients, which must be tailored to their unique needs and the

evolving landscape of medical and nursing practices

Does the nurse work

closely with the medical

team, including

nutritionists, pediatricians,

and other specialists, to

ensure a comprehensive

approach to treating

malnutrition?

Yes

50.0%

0.0%

Sometimes

50.0%

Table 3 illustrates that 50% of the staff consistently

collaborates with specialists for the comprehensive

treatment of malnutrition, while the remaining 50%

does so occasionally. Ortiz et al. (2022) stress the

importance

collaboration

among

doctors,

nutritionists, pharmacists, physiotherapists, and nurses

in the clinical practice of nutritional support to deliver

effective care to patients at risk, emphasizing the pivotal

role

nursing.

Therefore,

interdisciplinary

collaboration is crucial for the comprehensive treatment

of malnutrition, as it allows for more complete and

coordinated care (Ríos et al., 2022).

(

Melgarejo et al., 2022).

The management of nutritional therapy for

critically ill children necessitates a comprehensive and

specialized approach due to the complexity and

sensitivity of these cases. Etchegaray et al. (2022)

underline the significance of such therapy being

managed by a multidisciplinary team, including a

nutritionist specializing in intensive nutritional care.

This specialization is essential to enhance and optimize

nutrient administration. These professionals possess

detailed knowledge about the specific nutritional needs

of critically ill children and are adept at designing and

adjusting nutritional plans that maximize nutrient

absorption and facilitate recovery (Martínez et al.,

2023). Moreover, their collaboration with other

specialists ensures ongoing supervision and the

necessary adjustments in nutritional therapy, adapting

to the patient's evolving conditions (Hernández et al.,

2023).

Table 2. Education

Items

Options

Frequency Percentage

Are the patient's parents or

caregivers routinely

Yes

37.5%

0.0%

educated by nursing staff

about the importance of

proper nutrition, nutritional

supplementation, and other

aspects of nutritional care?

Sometimes

62.5%

Table 2 reveals that only 37.50% of the patients' parents

or caregivers receive consistent education on infant

nutritional care, whereas 62.50% receive such education only

occasionally. This irregularity in educational support is

concerning given that childhood malnutrition continues to be

a widespread issue. Cuenca and Meza (2020) emphasize the

necessity of implementing educational programs targeted at

families to provide continuous guidance on infant nutrition.

These initiatives are critical for instilling effective nutritional

practices, which can significantly reduce the risks of

malnutrition and associated health issues in children. Thus, it

is imperative to enhance and regularize nutritional education

to ensure the healthy development of children.

Table 4 shows that 100% of the surveyed nurses

concur on the importance of implementing

personalized care plan that includes parenteral or enteral

nutrition, the administration of nutritional supplements,

and the promotion of adequate nutrition for the patient.

This unanimous agreement underscores the critical role

that nursing professionals play in the comprehensive

management of patient nutritional health, reflecting

their commitment to ensuring the best possible

outcomes for those under their care.

In a related study by Martínez et al. (2023), it was found

that 34% of surveyed mothers received information from

nursing staff about breastfeeding, which is crucial in the

initial days of an infant's life. Additionally, 16% received

advice on maternal weaning, 18% on complementary feeding,

https://doi.org/10.5281/zenodo.13345438

South American Research Journal, 4(1), 21-25

https://www.sa-rj.net/index.php/sarj/article/view/53

ISSN 2806-5638

Table 4. Care plans

information gathering, an essential activity to pinpoint

underlying causes of malnutrition and support evidence-

based decisions, while another 12.5% focus on care planning,

which is fundamental to structuring interventions and

establishing a clear action plan to guide nursing staff and the

team (Romero et al., 2019).

In a study by Cortez and Pérez (2023), nursing

professionals expressed their views on the essential

characteristics needed to address childhood malnutrition

effectively. Thirty-three percent consider that care should be

Items

Options

Frequency Percentage

Based on the

assessment, is a

personalized care plan

developed for the patient

including parenteral or

enteral nutrition,

administration of

nutritional supplements,

and promotion of

Yes

100.0%

0.0%

Sometimes

0.0%

adequate nutrition?

comprehensive

and

multidisciplinary,

addressing

Gathering

information

12.5%

biopsychosocial needs and coordinating actions with other

health areas. Seventeen percent believe that emphasis should

be placed on the prenatal and postnatal period, advocating for

systematic and periodic growth and development checks.

Fifteen percent state that encouraging breastfeeding, a proven

tool to prevent childhood malnutrition, is crucial. Thirteen

percent indicate that nutritional education should be

promoted for both mothers and fathers, making them part of

the process, and nine percent point out the importance of

conducting thorough follow-ups on malnutrition cases.

The insights from Cortez and Pérez (2023) provide a

comprehensive view of the necessary qualities and the

multidisciplinary approach required to effectively tackle

pediatric malnutrition. While the current study delves into

specific details on assessment, collaboration, and planning

practices, both studies reinforce the necessity for

comprehensive and well-coordinated care in the management

of childhood malnutrition (Guamialamá et al., 2021).

How does a nurse

Evaluating

nutritional

status

intervene in the event of

a possible complication

of malnutrition in a

pediatric patient?

50.0%

Planning

12.5%

25.0%

interventions

Collaborative

work

According to Etchegaray et al. (2020), the enteral route

is regarded as the most physiological, safe, and preferred

method for providing nutritional support to critically ill

children. The study further emphasizes that the selection of

an appropriate enteral formula should be personalized,

tailored to meet the specific nutritional needs and metabolic

alterations of each child. Given that each patient has a unique

metabolic profile, a standardized formula may not sufficiently

address all their needs (Picbougoum et al., 2023). Therefore,

personalized care is crucial to ensure the correct nutrients are

provided in appropriate amounts. This approach underlines

the significance of meticulously planned and executed

nutritional care, supported by a multidisciplinary team and

grounded in evidence-based practices (Moreta et al., 2019).

Research conducted by Paz et al. (2020) reveals that

Limitations

This study presents several limitations that must be

acknowledged to better understand its scope and constraints.

First, the sample was limited to eight nursing graduates from

the Pediatric Service of a single hospital in Machala canton,

which may not be representative of the broader population of

nursing professionals in different contexts or regions.

Additionally, the use of non-probabilistic convenience

sampling could introduce biases, affecting the

generalizability of the results.

Regarding the instruments used, although the

questionnaire was validated by experts, its trichotomous

nature and the inclusion of only one open question may limit

the depth and variety of responses obtained. This design

restricts the ability to capture more nuanced insights from

participants. The statistical analysis, primarily based on

descriptive statistics and non-parametric tests, may not

adequately capture the complexities of the variables studied.

Such methods are limited in their ability to explore deeper

relationships among variables.

Moreover, while data protection measures were deemed

adequate, they could have been bolstered by implementing

additional safeguards such as independent audits of data

management practices to ensure privacy and integrity.

Finally, the cross-sectional nature of the study precludes

the establishment of causal relationships, restricting the

findings to providing a descriptive snapshot of nursing

interventions in pediatric malnutrition. These limitations

should be carefully considered when interpreting the findings

and underline the need for future research. Future studies

should employ more robust designs and larger samples to

7% of professionals claim to understand the stages required

to implement a nursing intervention across different degrees

of malnutrition, indicating their capability to apply this

knowledge in practical settings with patients. Conversely, the

remaining 33% reported unfamiliarity with these stages,

highlighting the need for further training and capacity

building among professionals and staff to enhance their

expertise in this specialized area. It is essential to note that

inadequate preparation can directly impact clinical practice,

potentially affecting the quality of care and health outcomes

for malnourished patients. Hence, the development and

implementation of personalized care plans that promote

patient improvement and recovery are imperative (Alulema et

al., 2023).

In addressing possible complications of malnutrition in

pediatric patients, a variety of approaches and methods are

observed in professional practice. This diversity reflects the

varying perspectives adopted by respondents, which may be

influenced by context and experience, shaping how

complications of malnutrition are managed and addressed.

Half (50%) of the professionals conduct a nutritional

assessment, critical for identifying and quantifying

malnutrition, adjusting interventions, and monitoring patient

progress. A quarter (25%) of professionals prioritize

collaborative work, underscoring the importance of a

multidisciplinary approach to enhance intervention in

pediatric malnutrition and improve comprehensive patient

management. A small percentage (12.5%) engage in

https://doi.org/10.5281/zenodo.13345438

South American Research Journal, 4(1), 21-25

https://www.sa-rj.net/index.php/sarj/article/view/53

ISSN 2806-5638

validate and expand upon the results obtained, thereby

enhancing the reliability and applicability of the findings in

similar healthcare settings.

Chimborazo

(tesis

grado)

http://dspace.espoch.edu.ec/handle/123456789/15681

Guamialamá, J., Salazar, D., Portugal, C., & Tinoco, D. (2021). Evaluación

nutricionaldeniñosdeuno atres añosen laParroquiade Calderón en

Quito. Nutrición Clínica y Dietética Hospitalaria/Nutrición Clínica,

CONCLUSIONS

Dietética

Hospitalaria ,

41(1),

11-20.

https://doi.org/10.12873/411guamialama

Guanga, V., Miranda, A., Azogue, J., & Galarza, R. (2022). Desnutrición

infantil en Ecuador, emergencia en los primeros 1000 días de vida,

The study highlights a critical concern: the ongoing

education for parents and caregivers on child nutritional care

is sporadic and insufficient. This underscores the urgent need

to implement more consistent and accessible educational

programs to enhance the nutritional status and development

of pediatric patients. Such programs are vital for equipping

parents and caregivers with the knowledge necessary to

support their children's health effectively.

revisión

bibliográfica. Mediciencias

UTA, 6(3),

24-36.

https://doi.org/10.31243/mdc.uta.v6i3.1703.2022

Hernández, A., García, Hernández, D., & del Socorro, M. (2023). Proceso

del cuidado enfermero en una paciente lactante con desnutrición

aguda grave y consecuencia infecciosa. Investigación e Innovación:

Revista

Científica

Enfermería, 3(2),

163-177.

https://doi.org/10.33326/27905543.2023.2.174

The collaboration between nursing staff and other health

specialists also shows variability; while some professionals

engage actively in multidisciplinary teamwork, others

collaborate only occasionally. This inconsistency points to a

need for more structured and systematized approaches to

teamwork, ensuring comprehensive and coordinated care in

the treatment of childhood malnutrition. Strengthening this

collaboration could bridge gaps in care and leverage diverse

expertise to improve patient outcomes.

Furthermore, all nursing professionals surveyed

acknowledge the importance of implementing personalized

care plans, which include parenteral or enteral nutrition, the

administration of nutritional supplements, and the promotion

of adequate nutrition. This consensus reflects a recognition of

the effectiveness of personalized care plans in enhancing the

quality of life and accelerating the recovery of malnourished

pediatric patients. Personalized approaches are crucial as they

allow treatments to be tailored to the specific needs and

circumstances of each patient, thereby optimizing the efficacy

of nutritional interventions.

Lovera, L., & Cáceres, M. (2023). Nutritional status and nutritional support

strategies in Pediatric Intensive Care Cali-Colombia. Enfermería

Global, 22(1), 204-213. https://doi.org/10.6018/eglobal.512081

Martínez, M., Roque, J., &Salvatierra, J. (2023). Accionarde enfermería en

la prevención de la desnutrición crónica en niños menores de 5

años. Polo del Conocimiento: Revista científico-profesional, 8(7),

1063-1083.

https://polodelconocimiento.com/ojs/index.php/es/article/view/5827/

html

Melgarejo, G., Rivas, L., &Loli, R. (2022). Conceptualización y percepción

de enfermería sobre el cuidado del niño. Revista Cubana de

Enfermería , 38 (2)..

http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-

03192022000200017

Moreta, H., Vallejo, C., Chiluiza, C., & Revelo, E. (2019). Desnutrición en

Niños Menores de 5 Años: Complicaciones y Manejo a Nivel

Mundial

en Ecuador. RECIMUNDO , 3 (1), 345-361.

https://doi.org/10.26820/recimundo/3.(1).enero.2019.345-361

Ortiz, M., Parreño, D., Morejón, Y., & Juna, C. (2022). Alimentación

familiar e indicadores antropométricos en escolares de una unidad

educativa urbana, Quito, Ecuador. (2022). Eugenio Espejo, 16, 3.

https://doi.org/10.37135/ee.04.15.03

Paz, C., Toscano, F., Chuquimarca, R., & Arbeláez, G. (2020). Acciones de

enfermería en la prevención de la desnutrición en niños menores de

BIBLIOGRAPHY

cinco

Research , 5 (CININGEC),

https://doi.org/10.5281/zenodo.4437023

años

edad. Journal

Science

and

477-486

Alulema,A.,Vacas,K.,Rivadeneira,M.,&Moncayo,A.(2023).Incidencia

de desnutrición crónica y factores asociados en una cohorte de niños

menores de 5 años. Revista Ecuatoriana de Pediatría, 24(1), 79-89.

https://doi.org/10.52011/206

Picbougoum, T., Somda, M., Zango, S., Lohmann, J., De Allegri, M.,

Saidou, H., Hien, H., Meda, N., & Robert, A. (2023). Nutritional

statusofchildrenunderfiveyearsandassociatedfactorsin24districts

of Burkina Faso. PLOS Global Public Health, 3(7), e0001248.

https://doi.org/10.1371/journal.pgph.0001248

Ríos,L.,Chams,L., Valencia,N., Hoyos,W., &Díaz,M.(2022).Seguridad

alimentaria y estado nutricional en niños vinculados a centros de

desarrollo infantil. Hacia la Promoción de la Salud, 27(2), 161-173.

https://doi.org/10.17151/hpsal.2022.27.2.12

Rivera, J. (2022). El perfil de la desnutrición crónica infantil en Loja y el rol

de las políticas públicas. Revista Económica, 10(1), 45-53.

https://doi.org/10.54753/rve.v10i1.1291

Romero, V., Sánchez, M., & Sandoval, T. (2018). Atención de enfermería

aplicada al estado nutricional de los alumnos de una Unidad

Educativa. Revista Cubana de Medicina General Integral , 34 (3), 30-

ÁlvarezOrtega,L.(2019a).Desnutricióninfantil,unamiradadesdediversos

factores. 15–26.

https://doi.org/10.33554/riv.13.1.168

Carrasco, Y. (2019). La desnutrición infantil. Conciencia Digital, 2(2), 17-

6. https://doi.org/10.33262/concienciadigital.v2i2.941

Investigación

Valdizana,

13(1),

Cortez, D., & Pérez, M. (2023). Desnutrición crónica infantil y sus efectos

en el crecimiento y desarrollo. RECIAMUC , 7 (2), 677-686.

https://doi.org/10.26820/reciamuc/7.(2).abril.2023.677-686

Cuenca, M., & Meza, H. (2020). El rol de la familia en el estado nutricional

de los niños de 12 a 36 meses de edad Centro de Desarrollo Infantil

Rincón 191-212.

los

Ángeles. RECIAMUC , 4 (2),

https://doi.org/10.26820/reciamuc/4.(2).abril.2020.191-212

Cueva, M., Pérez, C., Ramos, M., & Guerrero, R. (2021). La desnutrición

39. http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-

infantil en Ecuador. Una revisión de literatura. Boletín de

21252018000300005

Malariología

salud

ambiental, 61(4),

556-564.

World Health Organization: WHO. (2024). Malnutrición.

https://www.who.int/es/news-room/fact-sheets/detail/malnutrition

Zhao, Y., Wang, J., & Singh, G. (2020). Macrosocial Inequality, Food

Insecurity, and Malnutrition: A Mediation Analysis. Current

https://doi.org/10.52808/bmsa.7e5.614.003

Etchegaray, K., & Bustos, E. (2021). Evaluación y apoyo nutricional en el

paciente pediátrico críticamente enfermo: Revisión de la

literatura. Revista

chilena

nutrición , 48(1),

95-102.

Developments

Nutrition,

https://doi.org/10.4067/s0717-75182021000100095

4(2). https://doi.org/10.1093/cdn/nzaa053_133

Flores, P., & Congacha, G. (2021). Factores asociados a la desnutrición

crónica infantil en Ecuador. Estudio basado en modelosderegresión

y árboles de clasificación. Escuela Superior Politécnica del

https://doi.org/10.5281/zenodo.13345438