HomeAboutusEditorial BoardCurrent issuearchivesSearch articlesInstructions for authorsSubscription detailsAdvertise

  Login  | Users online: 184

   Ahead of print articles    Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size  


 
 Table of Contents    
ORIGINAL ARTICLE  
Year : 2020  |  Volume : 45  |  Issue : 4  |  Page : 483-486
 

Assessment of nutritional status of children between 6 months and 6 years of age in Anganwadi centers of an urban area in Tumkur, Karnataka, India


1 Department of Community Medicine, ESI Medical College, Bengaluru, Karnataka, India
2 Department of Community Medicine, Sri Siddhartha Medical College, Tumkur, Karnataka, India

Date of Submission19-Dec-2019
Date of Acceptance15-Jun-2020
Date of Web Publication28-Oct-2020

Correspondence Address:
Dr. Chandana Krishna
Department of Community Medicine, Sri Siddhartha Medical College, Agalkote, Tumkur, Karnataka
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijcm.IJCM_523_19

Rights and Permissions

 

   Abstract 


Objectives: Nutritional status is the sensitive indicator of a child's health, and they constitute the most vulnerable segment of any community. Undernutrition causes a great deal of physical, mental, and emotional suffering. Anganwadi is a part of the Integrated Child Development Services program started to combat child hunger and child malnutrition. This study was undertaken to assess the nutritional status of the children (6 months–6 years) in Anganwadis and determine the sociodemographic factors associated with malnutrition and to assess their dietary intake. Materials and Methods: This cross-sectional study was undertaken among 580 children in Anganwadis in the urban field practice area of a Medical college in Tumkur. Results: In this study, the overall prevalence of underweight, stunting, and wasting was found to be 34.14%, 45.52%, and 35.52%, respectively. Age, socioeconomic status, immunization status, religion, and mother's education was associated with undernutrition. The deficient intake of calorie and protein was seen in 90% and 64.8% of the study participants. Conclusion: The present study showed that there is still a high prevalence of undernutrition among the Anganwadi children aged 6–72 months. Socioeconomic factors have a significant role in child nutrition, which manifests itself as poor development.


Keywords: Anganwadi, nutritional assessment, sociodemographic factors, undernutrition


How to cite this article:
Das SR, Prakash J, Krishna C, Iyengar K, Venkatesh P, Rajesh S S. Assessment of nutritional status of children between 6 months and 6 years of age in Anganwadi centers of an urban area in Tumkur, Karnataka, India. Indian J Community Med 2020;45:483-6

How to cite this URL:
Das SR, Prakash J, Krishna C, Iyengar K, Venkatesh P, Rajesh S S. Assessment of nutritional status of children between 6 months and 6 years of age in Anganwadi centers of an urban area in Tumkur, Karnataka, India. Indian J Community Med [serial online] 2020 [cited 2020 Nov 27];45:483-6. Available from: https://www.ijcm.org.in/text.asp?2020/45/4/483/299444





   Introduction Top


A better-nourished world is a better world. The global community is grappling with multiple burdens of malnutrition. Eighty-eight percent of countries face a serious burden of either two or three forms of malnutrition.[1] The World Bank estimates that India is one of the highest-ranking countries in the world for the number of children suffering from malnutrition. The prevalence of underweight children in India is among the highest in the world and is nearly double that of Sub Saharan Africa with dire consequences for mobility, mortality, productivity, and economic growth.[2]

The 2017 Global Hunger Index report ranked India 100 out of 119 countries with a serious hunger situation. India trails behind only a few countries such as North Korea, Bangladesh, and Iraq. The country's serious hunger level is driven by high child malnutrition and underlines the need for stronger commitment to the social sector.[3] Freedom from hunger and malnutrition is a basic human right, and their alleviation is a fundamental prerequisite for human and national development.[4]

Almost as shocking as the prevalence of malnutrition in India is the country's failure to reduce it much, despite rapid growth. Since 1991 Gross Domestic Product has more than doubled, while malnutrition has decreased by only a few percentage points.[5] Malnutrition continues to be the biggest health problem of our country today even after a lot of efforts put in by the Government towards eradicating it. Malnutrition commonly affects all groups in a community, but infants and young children are the most vulnerable because of their high nutritional requirements for growth and development.[6]

Nutritional status is the sensitive indicator of a child's health, and under-five children constitute the most vulnerable segment of any community.[7] The assessment of the nutritional status of this segment of the population is essential for improving overall health; prime determinant of health status in an adult is their nutritional status in childhood.[8] Adequate nutrition is a necessary first step in the improvement of quality of life. Nutrition plays a key role in the physical, mental, and emotional development of children, and much emphasis has been given to provide good nutrition to growing populations, especially in the formative years of life.[9] The growth rate is maximal during the first 6 years of life; hence malnutrition has a direct impact on infant mortality rate and under-five mortality rates, which are prime indicators of the health status of a country.[10]

Despite several achievements that the Integrated Child Development Services scheme has witnessed during its three decades of implementation, there remain some major challenges with regard to the high burden of child malnutrition in the country.[11]

National Nutrition Mission also called as Poshan Abhiyaan, is a flagship under Ministry of Women and Child Development was commenced from 2017 to 2018. The Mission targets reduction in the level of under-nutrition and other related problems by ensuring the convergence of various nutrition-related schemes. The Mission will address malnourishment through the life cycle concept by adopting a synergized and result oriented approach.[12]

Despite all these efforts, malnutrition is still prevalent in our country. There are many studies in the burden of malnutrition, but a comprehensive study is lacking, which takes into consideration the sociodemographic factors, dietary intake, physical and systemic examination, and anthropometric measurements of children.

Taking the above facts into consideration, the present study was taken up to assess the nutritional status of children of 6 months to 6 years of age in Anganwadi centers of this region.

Objectives of the study

  1. To assess the nutritional status of the children (6 months-6 years) in Anganwadis and to find out the prevalence of malnutrition
  2. To determine the socio-demographic factors associated with underweight, stunting, and wasting in children attending Anganwadis
  3. To assess the dietary intake of children attending the Anganwadis.



   Materials and Methods Top


This cross-sectional study was conducted between November 2016 and May 2018 in the urban localities in the urban field practice area of a medical college, which have a total population of 18,000. Twelve Anganwadi centers located in the area were included for the data collection. Children aged 6 months–6 years in Anganwadis were the study subjects. Systematic random sampling was the sampling method used.

Sample size



With the prevalence of 40% (NFHS-3 data)[13] and relative precision of 10%, the sample size obtained was 580.

Methodology

Systematic random sampling was used to select a total of 580 children from 12 Anganwadis. All the children enrolled in all the 12 Anganwadis were line-listed, and every 3rd child in the list was selected for the study. Selected children were examined and mothers were interviewed using a pre-tested questionnaire to collect data regarding sociodemographic factors, dietary practice, and the health status of the children. Anthropometric measures were recorded in the Anganwadis. The standard measuring tape was used to measure height, and Salter's scale was used to record the weight of the children. Infantometer was used to measure the length of infants. After collecting the data, mothers were educated regarding the healthy food habits, hygiene, and factors affecting malnutrition. WHO Anthro and Anthro-plus software were used to calculate the weight for age, weight for height and height for age. WHO Z-scores were used. 24-h recall method was used to collect the diet history. Calculation of both the calories and proteins was done using two software applications “Healthify Me” and “Nutrify India Now” which follows the “National Institute of Nutrition” guidelines.

Data collected were entered on MS Excel spreadsheet (version 2010, Mahalaksmi computers, Tumkur, Karnataka, India). The data collected were analyzed and interpreted using the Epi Info version 7. Descriptive statistics (mean and proportions) and Chi-square test were employed. P < 0.05 was considered statistically significant.


   Results Top


In the study, 38.62% belonged to age group 6–36 months and 61.38% belonged to age group 37–42 months. 50.34% were male and 49.66% were female children. 284 (48.97%) mothers studied till high school, 135 (23.28%) till middle school, and only 15 (2.59%) were illiterates. 80.52% belonged to nuclear families and only 3.10% to joint families. About 66.72% belonged to the Muslim religion and remaining belonged to Hindu religion. According to Modified Kuppuswamy Scale 2017, 23 (3.97%) belonged to the lower middle class, 436 (75.17%) belonged to the upper lower class, and 121 (20.86%) belonged to lower class. 465 (80.17%) had birth weight of 2.5–3.5 kg, 91.21% of children were completely immunized and 46.21% were exclusively breastfed for 6 months.

In our study, the overall prevalence of underweight, stunting, and wasting were found to be was 34.14%, 45.52% and 35.52%, respectively.

There was a statistically significant association between underweight and mother's education, family type, religion, and birth weight; between stunting and family type, socioeconomic status, and immunization status; between wasting and age, mother's education, religion, birth weight, and immunization status [Table 1].
Table 1: Association between various sociodemographic factors and malnutrition

Click here to view


In the age group of 6–36 months, most of the children (89.29%) had a deficiency of calories and 64.73% were deficient in terms of protein intake. In the age group of 37–72 months, about 90.45% had a deficiency of calories, and about 64.89% had a deficiency in proteins.


   Discussion Top


In our study, 356 (61.38%) children belonged to age group 37–72 months and 224 (38.62%) children belonged to age group 6–36 months. A study conducted in Goa (2015) showed 64% belonged to age group 6–36 months, and only 36% belonged to 37–72 months.[14] In the study, 45.52% of children were stunted, 35.52% were wasted, and 34.14% were underweight. In studies in Gadag[15] and Mangalore[10] stunting varied from 35% to 55%, underweight varied from 24% to 60%, and wasting varied from 11% to 60%.

In our study, age was not associated with stunting and underweight, which was similar to the study in other parts of the country.[16],[17],[18],[19] In the present study, the age of the child had a significant association with wasting, which was in agreement with various other studies[17],[18],[19] and in contrast with the study in Jaipur.[16] In our study, gender was not associated with undernutrition (stunting, underweight, and wasting), which correlates with similar studies carried out in various parts of India[17],[18],[19] but in contrary to study done in Jaipur.[16] In our study, mother's education was significantly associated with underweight and wasting, which was identical to other studies[17],[19],[20] and in contrast with a few other studies.[18],[21] In this study, stunting was not associated with the education of mother, which is similar to studies done in other parts of India[15],[21],[22] and disagrees with few studies done.[17],[19],[20] In this study, the family type was associated with stunting and underweight in agreement with studies conducted in Mumbai[17] and contrary to studies.[18],[19],[22]

Socioeconomic status was found to be associated with stunting, which correlated with various studies done in India[16],[17],[19] and not in agreement with a few other studies.[18],[22] In the present study, religion was associated with underweight and wasting in agreement with a study carried out in the urban area in India.[18] In the present study, birth weight was associated with underweight, which correlated with various other studies[21],[22] but contrast to a study conducted in Mumbai.[17] Birth weight was also found to be associated with wasting contrast to studies in Mumbai and Pune.[17],[21]


   Conclusion Top


The present study shows that there is still a high prevalence of undernutrition among the Anganwadi children aged 6–72 months. About 34.14% were underweight, 45.52% of children were stunted, and 35.52% of children were wasted. Socioeconomic factors such as mother's education, type of family, socioeconomic status, religion, birth weight, and immunization status had a significant association with undernutrition. Improving mothers' education, improved socioeconomic status, proper antenatal care, immunization of children under UIP should be focused on to prevent malnutrition.

Recommendations

Enhancement of education of mothers and caretakers regarding increased nutritional intake with increasing age, proper child-rearing and feeding practices, and improving hygiene and sanitation forms the basis of child's good health.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Development Initiatives. Global Nutrition Report 2017: Nourishing the SDGs. Bristol, UK: Development Initiatives; 2017.  Back to cited text no. 1
    
2.
World Bank. World Bank Annual Report 2017. Washington, DC: World Bank; 2017.  Back to cited text no. 2
    
3.
Von Grebmer K, Bernstein J, Hossain N, Brown T, Prasai N, Yohannes Y, et al. Global hunger index: The Inequalities of Hunger. Washington, DC: International Food Policy Research Institute; Bonn: Welthungerhilfe; and Dublin: Concern Worldwide; 2017.  Back to cited text no. 3
    
4.
WHO. Nutrition for Health and Development. Available from: http://www.who.int/nutrition/nhd/en/. [Last accessed on 2018 Aug 08].  Back to cited text no. 4
    
5.
Pada G. Putting the SmallestFirst. The Economist; 23 September, 2010. Available from: https://www.economist.com/briefing/2010/09/23/putting-the-smallest- first. [Last accessed on 2018 Aug 08].  Back to cited text no. 5
    
6.
Navya N, Udayakiran N. A comparative study of anthropometric measurements of children attending urban and rural Anganwadi centres of a coastal district in Karnataka, India. Int J Community Med Public Health 2017;4:91-5.  Back to cited text no. 6
    
7.
Renuka M, Jagadish K, Praveen K, Khyrunissa B, Gangadhar MR. Malnutrition among under-five children of Kadukuruba tribe: Need to reach the unreached. J Clin Diagn Res 2014;8:1-4.  Back to cited text no. 7
    
8.
Shivaprakash NC, Joseph RB. Nutritional Status of Rural School-Going Children (6-12 Years) of Mandya District, Karnataka. Int J Sci Stud 2014;2:39-43.  Back to cited text no. 8
    
9.
Roopadevi V, Aravind K. Nutritional status assessment of under five children in urban field practice area of Mysore. J Prev Med Holistic Health 2016;2:1-3.  Back to cited text no. 9
    
10.
Srinivasa SB, Dnyaneshwar B, Ajay U. Anthropometric measurement of weight for assessment of nutritional status of Anganwadi Children in Urban Mangalore – A cross sectional study. Anat Physiol 2017;7:259.  Back to cited text no. 10
    
11.
Shanawaz M, Nasir AA, Sunder S, Khan M, Rani S, Padmanabha BV. An evaluation of nutritional status of children in Anganwadi Centre of Hyderabad district of Andhra Pradesh stateusing WHO z- score technique. Glob J Med Public Health 2013;2:1-6.  Back to cited text no. 11
    
12.
Ministry of Women and Child Development. National Nutrition Mission: Administrative Guidelines 2017. Available from: http://wcd.nic.in/sites/default/files/Administrative_Guidelines_NNM-26022018.pdf. [Last accessed on 2018 Aug 12].  Back to cited text no. 12
    
13.
International Institute for Population Sciences. National Family Health Survey (NFHS-4), 2015–16: India. Vol. 1. Mumbai, India: International Institute for Population Sciences; 2017. Available from: http://www.rchiips.org/nfhs/report.shtml. [Last accessed on 2018 Jul 05].  Back to cited text no. 13
    
14.
Silva VG, Silva SG. Nutritional Status of Anganwadi Children under the Integrated child development services scheme in a rural area in Goa. Int J Sci Stud 2015;3:217-21.  Back to cited text no. 14
    
15.
Kotabal R, Dasar P, Sonavane R. Study on prevalence and determinants of malnutrition among Anganwadi children of Nagavi Primary Health Centre area, Gadag. Natl J Res Community Med 2018;7:32-5.  Back to cited text no. 15
    
16.
Yadav A, Dixit A. A study to assess the prevalence of malnutrition among under 5 year children at selected Anganwadi centres of Jaipur district with a view to develop an information booklet for parents. Int J Med Health Res 2017;3:78-9.  Back to cited text no. 16
    
17.
Sahoo DP, Dehmubed A, Jajulwar MB. An epidemiological study of acute malnutrition in children of age 6 months to 5 years in an Urban Slum of Mumbai, Maharashtra. J Datta Meghe Inst Med Sci Univ 2017;12:181-6.  Back to cited text no. 17
  [Full text]  
18.
Ahmed MA, Yadav SK, Reddy A. Prevalence and epidemiology of under nutrition amoug preschool children in a selected area. Int J Contemp Med Res 2016;3:1797-802.  Back to cited text no. 18
    
19.
Gautam SK, Verma M, Barman SK, Arya AK. Nutritional status and its corelates in under five slum children of Kanpur Nagar, India. Int J Contemp Pediatr 2018;5:584-90.  Back to cited text no. 19
    
20.
Meena S, Kaushal R, Saxena DM. Nutritional status of children under five year of age in Anganwadi Centres in Kolar area of Madhya Pradesh. Natl J Community Med 2015;6:114-9.  Back to cited text no. 20
    
21.
Mamulwar MS, Rathod HK, Jethani S, Dhone A, Bakshi T, Lanjewar B, et al. Nutritional status of under-five children in urban slums of Pune. Int J Med Public Health 2014;4:247-52.  Back to cited text no. 21
  [Full text]  
22.
Priyanka R, Vincent V, Jini MP, Saju CR. An assessment of the nutritional status of underfive children in a rural area of Thrissur district, Kerala, India. Int J Community Med Public Health 2016;3:3479-86.  Back to cited text no. 22
    



 
 
    Tables

  [Table 1]



 

Top
Print this article  Email this article
           

    

 
   Search
 
  
    Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
  Related articles
    Article in PDF (327 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  


    Abstract
   Introduction
    Materials and Me...
   Results
   Discussion
   Conclusion
    References
    Article Tables

 Article Access Statistics
    Viewed183    
    Printed6    
    Emailed0    
    PDF Downloaded33    
    Comments [Add]    

Recommend this journal

  Sitemap | What's New | Feedback | Copyright and Disclaimer
  2007 - Indian Journal of Community Medicine | Published by Wolters Kluwer - Medknow
  Online since 15th September, 2007