Indian Journal of Community Medicine

ORIGINAL ARTICLE
Year
: 2007  |  Volume : 32  |  Issue : 4  |  Page : 264--267

Effect of maternal factors on nutritional status of 1-5-year-old children in urban slum population


A Mittal, J Singh, SK Ahluwalia 
 Government Medical College, Patiala (Punjab), India

Correspondence Address:
A Mittal
Department of Community Medicine, M.M. Institute of Medical Sciences and Research, Mullana (Ambala), Haryana - 133 203
India

Abstract

Objective: To study the effect of various maternal factors on the prevalence of underweight and stunting among 1-5-year-old children in urban slum population. Design: Cross-sectional study. Materials and Methods: The study was carried out in three urban slums of Tripuri Town, Patiala. All 1-5-year children living in these slums were included, whose mother«SQ»s demographic profile, weight and height were recorded. Results: Out of 482 children who participated in the study, 185 (38.38%) had low weight for age whereas 222 (46.06%) had low height for age. Both kinds of malnutrition were common in females than in males. Prevalence of malnutrition was more where mother«SQ»s age was less than 20 years. Children of educated mothers were better nourished as compared to illiterate ones. Conclusion: Maternal factors significantly affect a child«SQ»s nutritional status, thus encouraging the improvement in the social status of women so as to have healthy children and thereby a healthy future.



How to cite this article:
Mittal A, Singh J, Ahluwalia S K. Effect of maternal factors on nutritional status of 1-5-year-old children in urban slum population.Indian J Community Med 2007;32:264-267


How to cite this URL:
Mittal A, Singh J, Ahluwalia S K. Effect of maternal factors on nutritional status of 1-5-year-old children in urban slum population. Indian J Community Med [serial online] 2007 [cited 2020 Dec 5 ];32:264-267
Available from: https://www.ijcm.org.in/text.asp?2007/32/4/264/37691


Full Text

Protein energy malnutrition, which is manifested as decrease in weight for age or height for age or weight for height, is the most widely prevalent form of malnutrition among under-five children. Nutritional status of children is an indicator of nutritional profile of the entire community. Studies conducted worldwide show that 150 million (26.6%) are underweight, while 182 million (32.5%) are stunted all over the world.[1] More than half of the world's undernourished people live in India. Fifty-four percent children are underweight, 52% are stunted, while 17% are wasted.[2] Factors which are responsible for the higher prevalence of malnutrition in south Asian countries including India comprise low birth weight, maternal health problems, delay in introduction of complementary feeds, faulty child care and other poor environmental conditions which are again more prevalent in slums.[3] These factors are in turn influenced by various factors like age at marriage, child bearing, child spacing, family size patterns, level of education, economic status, customs and beliefs, role of women in society etc. The mental and social development of the child is dependant on the mother and if the mother dies, the child's growth and development are affected. The mother is also the first teacher of the child, and that is why the mother and child are treated as one unit.[4] Hence, the present study was conducted in slums to assess the nutritional status of 1-5-year-old children and to study the influence of various maternal factors on their nutritional status.

 Materials and Methods



Nutritional status of 1-5-year children was assessed by population-based cross-sectional examination conducted during January 2004 to June 2004 in three slums viz Indira colony, Purani basti, Guru Nanak nagar situated in Tripuri town of Patiala City where healthcare is mainly provided by Government Medical College, Patiala through its Maternal and Child Care Centre. A slum is defined as an area where buildings are in any respect unfit for human habitation and are by reason of overcrowding, faulty arrangement of streets, lack of ventilation, light or sanitation facilities or a combination of these factors are detrimental to safety, health and morale.[5] Hence, these three areas are designated as slums by Municipal Corporation of Patiala. The survey intended to include all children of 1-5 years of age residing in these three slums. Every house was visited once but if anyhow mother and child could not be contacted during the first visit, a second visit was given and if somehow the second visit also gave no results, the house was excluded from the study. The study instrument was a questionnaire with two sections. Section I obtained information about the socio-demographic variables of the child and the mother. Section II included the recording of height and weight of the child. During door-to-door survey, the mother was briefed about the study and her consent was obtained for the same. The weight and height were compared with NCHS Standards. Classification given by Indian Academy of Pediatrics was used for grading of weight for age (WFA).[6] Height for age (HFA) was graded as normal (HFA > –1SD), mild stunting (HFA 30 years. Similarly, prevalence of stunting also decreased with increasing mother's age, i.e. it was 87.5%, 46.31%, 40.22% and 40.3% in the same age groups [Table 4]. Chi-square testing of the differences showed them to be highly significant.

Mother's education seemed to play a protective role against child's malnutrition. Overall 70.75% of the mothers were literate though up to different levels. Prevalence was the highest where mothers were illiterate (60.9%) vs value of 21.2% where mother had education more than high school. Similarly, figures for stunting were 65.25% where mother was illiterate and 31.3% where education level was more than high school. Differences were statistically significant for both the cases.

Only 8.1% (39/481) mothers were engaged in some kind of employment and that too as daily wager or domestic servant. Mother's occupation did seem to affect the nutritional status of the child as 46.15% were underweight and 58.97% were stunted where the mother was working as compared to 37.8% were underweight and 44.8% were stunted where the mother was a housewife. But statistical analysis showed that the difference was insignificant.

 Discussion



Nutritional assessment was done in three urban slums, namely, Indira colony, Purani basti and Guru Nanak nagar and included 272 males and 210 females of 1-5 years of age.

Overall 38.38% children were found to be underweight where 26.76% had Grade I undernutrition and 0.83% had Grade IV undernutrition, thus revealing that there is marked decrease in the severe grades of undernutrition.[6] More males (35.29%) were affected with lower grades than females (32.85%), whereas severe grades were common in females (5.71%) than in males (2.94%). The findings were consistent with the studies conducted by Dwivedi et al., in urban slums.[8] The 12-23-month age group had maximum number of underweight children (40.74%). These findings were similar to the study conducted in Bolivian children by Blount et al.,[9] whereas Reifen et al. found the peak prevalence in the age group of 24-35 months.[10]

Mother's age showed highly significant (P = 0.001) effect on the prevalence of undernutrition, i.e. where mother's age was 30 years. However, the data was not adjusted for parity.

Education of mother significantly influenced the nutritional status of under-fives as the prevalence of undernutrition was 60.9% where mother was illiterate and it was only 21.2% where education level was more than high school.

Chances of being underweight increased if the mother was employed (46.15%) than the group where the mother was unemployed (37.8%).

Stunting, i.e. low HFA was more common in females (49.05%) than in males (43.75%). The peak prevalence of stunting was seen in 36-47-month age group (51.9%), whereas studies conducted by Saleh and El Sherif showed that it was the commonest in 24-35-month age group.[11]

Stunting was commonest where mother's age was <20 years (87.5%) as compared to prevalence of 40.3% where the age was more than 30 years.

Mother's education was inversely related to the prevalence of stunting, as it was lowest (31.3%) where schooling was more than high school as compared to prevalence of 65.25% where mother was illiterate.

Mother's engagement in some occupation adversely affected child's growth as shown by the results that 58.97% were stunted where mother was employed as compared to prevalence of 44.8% where mother was a housewife.

The above results reveal that prevalence of low WFA was less than the values of NFHS survey where it was found to be 47%. Stunting was found to be equally prevalent as it was depicted by the NFHS survey, i.e. 46%.[12]

High prevalence of undernutrition of both kinds among under-fives highly suggests that there is a strong need for educating the mothers about timely weaning and weaning foods which are easily available in the local market, that too at low cost. Effect of mother's age on prevalence of undernutrition clearly favours the promotion of delaying marriage of females and further delaying the birth of the first child. The work in this field can be handled by local leaders, NGOs with much more effectiveness.

Better nutritional profile of under-fives of educated mothers indicates that right to have education and to achieve 100% literacy will help in promoting the nutritional status of children as educated mothers are more aware of the health services available and also the acceptance to utilize the same is better among them.

Poor nutritional status of children of working mothers suggests that working places should be provided with crθches/playways where kids can be taken care of while the mother is at work. In the same way, strengthening of anganwadis and balwadis will also help as they help in taking care of the child, and educating the child along with providing meals which complement the child's diet, thus improving their nutritional status.

References

1Alhaji M, Allen S. Paediatric review: Management of severe malnutrition-time for a change? Africa Health 2002;24:21-3.
2Mishra VK, Lahiri S, Luther NY. Child nutrition in India. National Family Health Survey Subject Reports, International Institute of Population Sciences: Mumbai, India; 1999. p. 39.
3Ramalingaswami V, Jonsson U, Rhode J. Malnutrition: A south Asian enigma. Malnutrition in South Asia: A regional profile, UNICEF Regional Office for South Asia. ROSA Publication: Kathmandu, Nepal; 1997. p. 11-22.
4Park K. Preventive medicine in Obstetrics. Pediatrics and Geriatrics. Park's Textbook of Preventive and Social Medicine. 17th ed. M/S Banarsidas Bhanot: Jabalpur; 2002. p. 380.
5Narain MK. Problems of slums in India. Contemp Soc Work 1997;14:65-71.
6Ghai OP, Gupta P, Paul VK. Protein Energy Malnutrition, Nutrition and Macronutrient disorders, Ghai Essential Pediatrics. 6th ed. CBS Publishers and Distributors: New Delhi; 2004. p. 101-7.
7Prahlad Rao N, Reddy V. Textbook of Human Nutrition. Oxford IBH Publishing Company Pvt Ltd: New Delhi and Calcutta; 1996. p. 287-97.
8Dwivedi SN, Banerjee N, Yadav OP. Malnutrition among children in an urban Indian slum and its associations. Indian J Matern Child Health 1992;3:79-81.
9Blount BW, Krober MS, Gloyd SS, Kozakowski M, Casey L. Nutritional status of rural Bolivian children. Mil Med 1993;158:367-70.
10Reifen R, Haftel L, Manor G, Sklan D, Edris M, Khoshoo V, et al. Ethiopian-born and native Israeli school children have different growth patterns. Nutrition 2003;19:427-31.
11Saleh SM, El Sherif MA. Growth and nutritional status of rural preschool Children in El Minia governorate. New Egypt J Med 1993;8:820-3.
12Available from: http//www.nfhsindia.org/factsheet.html.