Prevalence of Malnutrition and its Associated Factors regarding Malnutrition among under five in selected slum area of Ludhiana, Punjab

 

Kanika, Jyotika

Department of Community Health Nursing, Shaheed Kartar Singh Sarabha College of Nursing,

Sarabha, Ludhiana - Punjab.

*Corresponding Author E-mail: kanika.sharma155@gmail.com

 

ABSTRACT:

Malnutrition refers to deficiencies, excesses or imbalances in a intake of energy and nutrient. Malnutrition is not only an important cause of childhood mortality and morbidity, but also leads to permanent impairment of both physical and mental growth of those who survive. The objectives of the study were to assess the prevalence of malnutrition in under five, to explore its associated factors regarding malnutrition among under five, find out the association of prevalence with selected demographic variables. A quantitative research approach was used to conduct the study on children under five in selected slum area of Ludhiana. The sample consisted of 120 children by non probability-consecutive sampling technique. Data was collected by using Gomez classification to assess the prevalence of malnutrition and self-structured questionnaire to explore the associated factors among children under five. Data was collected by self report (interview) method. The result showed that the mean age with standard deviation of participants was mean age ±SD= 2.28 ±0.9. According to Gomez classification out of 120 children, 50(41.6%) of children are properly nourished, 45(37.5%) have a mild level of malnutrition followed by 24(20%) with moderate malnutrition and 1(0.8%) with severe malnutrition.

 

KEYWORDS: Prevalence, Malnutrition, Associated factor, Under five children.

 

 


INTRODUCTION:

Child is valuable to whole world nation especially to parents and family members. Children are the source of happiness to the family. Hence the child should not suffer from any disease. A report by Indian Council of Medical Research (ICMR), Public Health Foundation of India (PHFI) and National Institute of Nutrition (NIN) revealed that 2 of 3 child deaths in India are due to malnutrition.1

 

Children are the foundation of any nation. Children residing in slum areas belong to lower socio-economic strata and live in crowded unhygienic environment.

 

They are more vulnerable to malnutrition and associated morbidity and mortality. Inappropriate feeding practices like early initiation of complementary feeds, late weaning and inadequate amount of complementary feeds in the later months are the leading causes of protein energy malnutrition.2

 

STATEMENT OF PROBLEM:

A Study to assess the prevalence of malnutrition and its associated factors regarding malnutrition among under five children in selected slum area of Ludhiana Punjab.

 

 

 

OBJECTIVES:

1.     To assess the prevalence of malnutrition in under five.  

2.     To explore its associated factors regarding malnutrition among under five.

3.     To find out the association of prevalence with selected demographic variables.

4.     To develop and implement the IEC material in the form of health education activity regarding preventions of malnutrition among mothers of under five.

 

NEED FOR THE STUDY:

Malnutrition affects physical growth, morbidity, mortality, cognitive development, reproductive and physical work capacity, and it consequently impacts on human performance, health and survival. It is estimated that that 150 million children under 5 years are underweight and more than 20 million suffer from severe malnutrition.3

 

Nutritional status plays a vital role in deciding the health status in children. Nutritional deficiencies give rise to various morbidities, which in turn, may lead to increased mortality. Malnutrition apart from impairing growth and development of the child increases his or her susceptibility to infections like Diarrhoea and Pneumonia. It acts in two ways to cause high mortality and morbidities in under five children.4   Hence, the present study was undertaken with the objectives to identify the malnourished children in the selected community and identify the associated factors of the malnutrition.

 

RESEARCH METHODOLOGY:

A quantitative research approach was used to conduct the study on children under five in selected slum area of Ludhiana. The sample consisted of 120 children by non probability-consecutive sampling technique. Data was collected by using Gomez classification to assess the prevalence of malnutrition and self-structured questionnaire to explore the associated factors among children under five. Data was collected by self report (interview) method. Data was analyzed by using descriptive and inferential statistics.

 

 

FINDINGS OF THE STUDY:

Section- I

 

Table 1: Frequency and percentage distribution of under five children according to socio-demographic characteristics. N=120

Sr. No

 Socio-demographic variable

f(%)

1.       

Age of child (in years)

<2

2-3

3-4

>4

 

24 (20.0)

53(44.1)

29(24.1)

14(11.6)

2.       

Gender of child

Male

Female

 

62(51.6)

58(48.3)

3.       

Birth order

1

2

3 or more

 

28(23.3)

68(56.6)                  24(20.0)

4.       

Birth weight of child (Kg)

<1

1-3

> 3

 

11(9.1)

70(58.3)

39(32.5)

5.       

Educational status of mother

Illiterate

Primary school certificate

Secondary school certificate

High school certificate

Graduate or above

 

105(87.5)

13(10.8)

2(1.6)

0(0.0)

0(0.0)

6.       

Socio economic status

As per kuppuswamy scale

Upper Class (I)

Upper Middle Class (II)

Lower Middle (III)

Upper Lower (IV)

Lower (V)

 

 

1(0.83)

0(0.0)

3(2.5)

16(13.3)

100(83.3)

Mean age ±SD=2.28+0.91

 

Section- II

Table-2: Frequency and percentage distribution on prevalence of malnutrition. N=120

Malnutrition

f(%)

Yes

70(58.3)

No

50(41.6)

 

Table-3:  Prevalence of malnutrition According to Gomez Classification N=120

Malnutrition grade

Weight\ Age(%)

f(%)

Normal

>90%

50(41.6)

Grade I (Mild)

75-89%

45(37.5)

Grade II(Moderate)

61-74%

24(20.0)

Grade III(Severe)

<60%

1(0.83)

 

SECTION-III

Table 4: Item wise analysis of associated factors regarding malnutrition among under five children. N=70

Sr. no.

Factor 1- (Weight of mother)

f(%)

1.       

Weight gained during pregnancy

Yes

No

 

60(86)

10(14)

Factor 2- (Antenatal History)

2.       

Age (years) at child’ s birth

15-20

21-29

>30

 

42(35.0)

27(22.5)

01(0.83)

3.       

Supplements during pregnancy (folic acid, calcium).

Yes
No

 

 

50(41.6)

20(16.6)

4.       

Level of Hb during pregnancy.

High

Low

Normal

 

0(0.0)

13(10.8)

57(47.5)

Factor-3 (Breastfeeding Pattern)

5.       

Colostrum be fed to baby.

Yes

No

 

59(49.1)

11(9.1)

6.       

Exclusive breast feeding to the child for the first 6 months.

Yes

No

 

 

56(46.6)

14(11.6)

7.       

How often breastfeed baby for six months.

Once a day

Twice a day

Thrice a day

More

 

 

1(0.83)

3(2.5)

44(36.6)

2(1.6)

FACTOR-4 (IMMUNIZATION HISTORY)

8.       

Immunization status as per age.

Complete

Partial

 

49(40.8)

21(17.5)

FACTOR-5 (DIETARY HISTORY OF CHILD)

9.       

Age of weaning.

6 months

1 year

2 year

 

57(47.5)

9(7.5)

4(3.3)

10.    

Type of weaning food provide to child.

Banana

Rice

Khichdi

Daal

 

18(15.0)

33(27.5)

9(7.5)

10(8.3)

11.    

How often your child eat meals in a day.

< 3 times

3-5 times

> 5 times

 

36(30.0)

34(28.3)

0(0.0)

12.    

Child substitute the meals along with candies, chocolates etc.

Yes

No

 

 

18(15.0)

52(43.3)

 

Table 5: Association between prevalence of malnutrition with selected demographic variables N=120

Socio-demographic variables

N

       Malnutrition

Chi square and df

p value

      No(f)

    Yes(f)

Gender

Male

Female

 

62

58

 

27(22.5)

23(19.1)

 

35(29.1)

35(29.1)

 

0.187

df=1

 

0.403NS

Birth order

1

2

3 or more

 

28

68

24

 

8(6.6)

29(24.1)

13(10.8)

 

20(16.6)

39(32.5)

11(9.1)

 

3.545

df=2

 

0.170NS

Birth weight of child (in kg)

<1

2-3

>3

 

 

 

11

70

39

 

 

 

0(0.0)

8(6.6)

42(35.0)

 

 

 

0(0.0)

18(15.0)

52(43.3)

 

 

 

1.622

df=1

 

 

 

0.147NS

Educational status of mother

Illiterate

Primary

Secondary

High Secondary

Graduate Or Above

 

 

 

105

13

2

0

 

0

 

 

 

44(36.6)

5(4.1)

1(0.8)

0(0.0)

 

0(0.0)

 

 

 

61(50.8)

8(6.6)

1(0.8)

0(0.0)

 

0(0.0)

 

 

 

0.115

df=2

 

 

 

0.944NS

Kuppuswamy socio-economic status

Upper Class

Upper Middle Class

Lower Middle

Upper Lower

Lower

 

 

 

 

1

0

3

16

100

 

 

 

 

1(0.8)

0(0.0)

1(0.8)

9(7.5)

39(32.5)

 

 

 

 

0(0.0)

0(0.0)

2(1.6)

7(5.8)

61(50.8)

 

 

 

 

3.178

df=3

        

 

 

 

0.365NS

Significance (p<0.05); NS= Non significant; *= significant

 

CONCLUSION:

In the present study, according to Gomez classification out of 120 children, 50(41.6%) of children are properly nourished, 45(37.5%) have a mild level of malnutrition followed by 24(20%) with moderate malnutrition and 1 (0.8%) with severe malnutrition.

 

There were no significant association with any selected demographic variables.

 

RECOMMENDATIONS:

·       This study can be comparative study to assess prevalence of malnutrition and its associated factors among under-five in rural and urban selected area.

·       The pre experimental study can be conducted to assess and evaluate health education program regarding malnutrition among under five in selected community area.

 

REFERENCES:

1.      Prasot, R.M., Verma, S.K., Kanaujiya, M.K. An epidemiological study of Protein Energy Malnutrition (PEM) among 1-6 years children in rural Lucknow, Uttar Pradesh, India. IOSR J Dental Med Sci. 2014; 13(3): 10-4.

2.      2 of 3 child death in India due to malnutrition: Report. Down to Earth. Latest news, opinion, analysis on environment and science issues. India, South Asia. https://www.downtoearth.org.in/news/health/2-of-3-child-deaths-in-india-due-to-malnutrition-repost-66792

3.      Priyanka R, Vincent V, Jini MP, Saju CR.  An assessment of the nutritional status of under five children in rural area of Thrissur district, KeralaIndia.Int J Community Med Public Health. 2016; 3: 3479-3486.

4.      Available from E.B.R. Nursing Research and Statistics. EMMESS Med Medical publIsher.Pg 126

 

 

 

Received on 27.09.2024         Revised on 23.10.2024

Accepted on 11.11.2024         Published on 28.11.2024

Available online on December 31, 2024

A and V Pub J. of Nursing and Medical Res. 2024;3(4):145-147.

DOI: 10.52711/jnmr.2024.33

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