Senthil Kumar, S K (2015) Nutritional status of Under-Five Children and Its determinants in a Tribal Community of Coimbatore District. Masters thesis, PSG Institute of Medical Sciences and Research, Coimbatore.
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Abstract
BACKGROUND: Under-five children are the most at risk segment in any population and their nutritional status is a sensitive indicator of their health status and nutrition. Malnourished children are more likely to become malnourished adults and they face increased risks of morbidity and mortality. In pace with the developing countries across the world regarding socio-economic and nutritional shift, India has also undergone remarkable improvement for the last ten years but undernutrition had always remained as a notable public health problem. According to World Health Organization (WHO) and National Family Health Survey (NFHS-3), one third of all children in India suffer from low height-for-age (stunting) and nearly half of the children from low weight-for-age (underweight). One in every third child who die in this world due to causes of malnutrition are described as mildly to moderately malnourished by nutritionists and they does not show any signs of their health problem to an informal observer. Out of the 12 million preschool children who die due to any cause in developing countries each year, mortality of over 6 million are related to their poor nutritional status either directly or indirectly. In underprivileged people like tribes these attributes are vastly prevalent. The tribal populations of India are recognized as socially as well as economically most underprivileged. Nutrition is one area in which traditional lifestyle of tribal and their lack of awareness plays a major role. Tribal population is at a higher risk of under nutrition because of their dependence on older methods of agricultural practices and irregularity of food supply. In South India, only few tribal based studies to determine the prevalence of malnutrition among under-five children has been carried out, with paucity of data regarding prevalence of malnutrition obtained as community based study in tribal areas of Tamil Nadu. Hence this community based study was done to find out the prevalence of malnutrition and its association with selected risk factors among children aged 0-59 months in the tribal hamlets of Periyanaickenpalayam block, Coimbatore district, Tamil Nadu. OBJECTIVES: 1. To find out the prevalence of malnutrition among under-five children in a tribal community. 2. To ascertain the determinants of malnutrition among them. METHODOLOGY: A cross- sectional study was carried among 206 children aged 0-59 months from the selected tribal hamlets of Periyanaickenpalayam block. Data was collected using Pre-tested semi structured Questionnaire by interview technique. Anthropometric measurements including weight and height were taken based on World Health Organization (WHO) standards with accuracy of 0.5 kg and 0.5cm. The 2006 WHO Growth Standards for Preschool Children was used to calculate nutritional status of the children and BMI was used to assess the nutritional status of the mothers. The possible risk factors selected to find out their association with malnutrition are age of the child, sex of the child, number of family members, mother’s education, father’s education, mother’s occupational status, father’s occupational status, socio-economic status, alcohol usage by family members, mother’s nutritional status, mother’s age at pregnancy, place of delivery of the child, term of delivery of the child, birth order of the child, birth weight of the child, time of initiation of breast-feeding, exclusive breast-feeding duration, total breast-feeding duration, energy and protein consumption of the child, immunization status, ICDS utilization by the child, distance of health facility from the house, recent illness, treatment for the illness, type of house, source of drinking water and toilet usage. Data was entered in Microsoft excel and analyzed using Stastical Package for the Social Sciences (SPSS) 19.0 version. Mean and Standard Deviation was calculated for height and weight of children and BMI of the mothers. Possible risk factors associated with malnutrition were analyzed using univariate analysis and then multivariate logistic regression analysis done to finally identify those that were truly associated with risk of developing malnutrition. RESULTS: Our study revealed an overall prevalence of malnutrition as 51%. These 51% (105) malnourished children consisted of 41.3% underweight, of which 11.2% were severely underweight. Prevalence of stunting was 32.5%, of which 6.3 % were severely stunted. About 21.8% children were wasted and 6.8% were severely wasted among them. In our study, factors like mother’s educational status, father’s educational status, mother’s occupational status, socio-economic status, total number of family members exceeding four, alcohol usage by any family member, mother’s nutritional status, mother’s age at pregnancy, place of delivery of the child, term of delivery of the child, birth weight of the child, time of initiation of breast-feeding, exclusive breast-feeding duration, total breastfeeding duration, energy and protein consumption of the child, supplementing with any other milk or milk formulas in children more than 6 months, child’s immunization status, ICDS utilization by the child, recent illness and treatment for that illness, type of house, source of Drinking water and toilet usage were found to be significantly associated with malnutrition on univariate analysis. However, when these associated risk factors were subjected to multivariate logistic regression analysis the variables which came significant were father’s educational status, mother’s occupational status, socio-economic status, birth weight of the child, time of initiation of breast-feeding and daily energy consumption of the child. CONCLUSION: This study establishes the extent of problem of malnutrition coupled with problems arising due to low SES which may be a consequence of illiteracy of father and nonemployment of mothers, LBW arising due to poor ante-natal history, faulty feeding practices like late initiation of breastfeeding and consumption of low calorie foods. Urgent attention to reduce the burden of malnutrition among under-five children thus preventing them from increased risk of disease morbidity and mortality in later life is needed at this hour. Most of these are known risk factors for malnutrition but the local factors influencing malnutrition should be kept in mind when planning future information education and communication programs in this area.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Nutritional status ; under-five children ; risk factors ; tribal. |
| Subjects: | MEDICAL > Community Medicine |
| Depositing User: | Punitha K |
| Date Deposited: | 06 May 2018 12:27 |
| Last Modified: | 06 May 2018 12:27 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7541 |
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