A Study to Assess the Nutritional Status of Preschool Children (3-5 Years) In Selected Rural Anganawadis At Mysuru With A View To Develop Information Booklet

Lokesha S¹, Mrs. Ambika K², Prof. Sheela Williams³

¹M.S.c Nursing Student, Pediatric Nursing, JSS College of Nursing, Mysuru

²Assistant Professor & HOD of Pediatric Nursing, JSS College of Nursing, Mysuru

³Principal cum Professor and HOD, JSS College of Nursing, Mysuru

*Corresponding Author E-mail: ambikasath@gmail.com

ABSTRACT:

Background: In India, under-nutrition is a major public health problem. Almost 11 million children will die before they reach the age of five and 4 million of them in the first month of life. Malnutrition is the principal cause of child deaths. The consequences of malnutrition are; high level of morbidity, mortality and disability apart from poor physical growth and-development.

Aim: The aim of the present study was to assess the nutritional status of preschool children (3-5 years) in selected rural Anganawadis at Mysuru with a view to develop information booklet.

Methods: observational and descriptive survey design and convenience sampling was adapted to select 50 preschool children who are attending the Anganawadis at Suttur. The scale to assess the nutritional status and nutritional assessment checklist were used. The information booklet was given to all mothers.

Result: The collected data was analyzed by using descriptive and inferential statistics. Results reveals that, according to weight for age, 26 (52%) preschool children were having normal nutrition and 24 (48%) preschool children had first and second degree malnutrition, according to height for age, 23 (46%) preschool children were having normal height and 27(54%) preschool children were mildly and moderately impaired, according to their mid upper arm circumference, 20(40%) preschool children were nourished and 30(60%) preschool children were malnourished and according to their clinical signs, 33(66%) preschool children were having no deficiency and 17(34%) preschool children had mild malnutrition. Significant association was found between level of nutritional status and educational status of father of preschool children.

Conclusion: The findings of the present study concluded that majority of the preschool children in selected rural Anganawadis were malnourished. Hence the present study has given the evidence that health awareness should be created to improve the nutrition and information booklet is helpful to improve their nutrition status.

KEY WORDS: Preschool children; Information booklet.

INTRODUCTION:

Children under the age of 5 years constitute a priority group because of their large numbers. In India, they comprise about 13% of the total population. They are also regarded as vulnerable or high risk group because of the problems arising out during their growth, development & survival. 50% of the deaths are occurring among children during the first 5 years of life in developing countries including India. Malnutrition is regarded as the most widespread condition affecting the health status of under five children. Children under age of five years suffer from a host variety of diseases like diarrhoea, respiratory infections, measles, pertusis, polio, tuberculosis and diphtheria due to malnutrition.¹

In India, under-nutrition is a major public health problem.¹ Almost 11 million children will die before they reach the age of five and 4 million of them in the first month of life. Malnutrition is the principle cause of child deaths. Malnutrition in young children is attributed to inadequate feeding; faulty feeding practices, repeated infections like diarrheal diseases, acute respiratory infections and worm infestations. The consequences of malnutrition are; high level of morbidity, mortality and disability apart from poor physical growth and-development.²World health organization (WHO) estimated that approximately 150 to 200 million pre-school children (< 5 years) in developing countries are underweight and stunted, respectively. In India, weight for age has been the most widely used indicator for assessment of nutritional status, detection of undernutrition and monitoring the improvement following interventions in children. Anthropometric measurement is a practical and immediately applicable technique for assessing children's development patterns during the first five years of life. Assessing of growth patterns and also provides useful insights into the nutrition and health situation of entire population³.

NEED FOR STUDY:

Nutrition plays a key role in 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. Globally, more than one- third of child deaths are attributable to under nutrition. According to the Census of India (2001), the child population (0-6 years) was 15.9% of the total population. The prevalence of underweight children in India is among the highest in the world, and is nearly double that of Sub- Saharan Africa. The 3rd National Family Health Survey findings showed that 45% of less than 3 year old children were malnourished. To tackle the problem of malnutrition and the ill health of mothers and children, the Government of India has launched the Integrated Child Development Services (ICDS) program. It is the world’s largest early child development Program. It was initiated in India in 1975 with the objective of improving the nutritional status of pre-school children in addition to other services. Malnutrition is “the syndrome that results from the interaction between poor diets and disease and leads to most of the anthropometric deficits observed among children in the worlds less developed countries” (WHO 1995).⁴

Malnutrition affects physical growth, morbidity, mortality, cognitive development, reproduction, physical work capacity and it consequently impacts on human performance, health and survival. It is an underlying factor in many diseases for both children and adults, and is particularly prevalent in developing countries, where it affects one out of every 3 preschool-age children⁴.

Child malnutrition is a widespread public health problem. AS per UNICEF reports 167 million preschool children are underweight in the world of which half are from south Asia. Nationwide surveys are conducted in India indicate that more than half the children were underweight and stunted and one in six was exclusively wasted indicating acute under nutrition.⁵

OBJECTIVES:

1. To assess the level of nutritional status of preschool children through anthropometric measurements and clinical examination.

2. To find the association of level of nutritional status of preschool children with their selected personal variables.

3. To develop an information booklet on importance of nutrition among preschool children.

HYPOTHESIS:

H₁_:There will be significant association between level of nutritional status of preschool children and their selected personal variables.

METHODOLOGY:

RESEARCH APPROACH/DESIGN:

Observational and descriptive survey design was adopted for the study.

Study variables:

Nutritional status of preschool children.

Personal variables:

Age, sex, religion, type of family, family monthly income, education of parents, occupation of parents and birth order of the child.

SETTING OF THE STUDY

The study was conducted in Hosakote, Suttur, Biligere rural Anganawadis at Mysuru.

POPULATION

Population comprises of preschool children (3-5 years) in rural Anganawadis at Mysuru.

SAMPLE AND SAMPLING

The sample of present study comprises of 50 preschool children (3-5 years) in selected rural Anganawadis at Mysuru.

SAMPLING TECHNIQUE

Non probability convenience sampling was used for the samples for the study.

SAMPLING CRITERIA

Inclusion criteria:

Preschool children who are:

1. In the age group of (3-5) years attending selected rural Anganawadis.

2. Available at the time of data collection.

Exclusion criteria:

Preschool children who are sick at the time of data collection.

RESULTS:

Section I: Description of selected personal variables

Table-1 n=50

Sl. No.	Personal Variables	Frequency (f)	Percentage (%)
1	Age in years
	1.1 3yr 1 month-4yr	36	72%
	1.2 4yr 1 month-5yr	14	28%
2	Gender
	2.1 Male	25	50%
	2.2 Female	25	50%
3	Religion
	3.1 Hindu	50	100%
	3.2 Muslim	-	-
	3.3 Christian	-	-
	3.4 Others	-	-
4	Type of family
	4.1 Nuclear family	21	42%
	4.2 Joint family	29	58%
5	Education of mother
	5.1 No formal education	8	16%
	5.2 Primary school (1-4 Std)	15	30%
	5.3 Secondary school (5-10 Std)	25	50%
	5.4 PUC	2	4%
	5.5 Degree and above	-	-
6	Education of father
	6.1 No formal education	20	40%
	6.2 Primary school (1-4 Std)	7	14%
	6.3 Secondary school (5-10 Std)	15	30%
	6.4 PUC	5	10%
	6.5 Degree and above	3	6%
7	Occupation of the mother
	7.1 Home maker	50	100%
	7.2 Coolie	-	-
	7.3 Govt employee	-	-
	7.4 Private employee	-	-
8	Occupation of the father
	8.1 Coolie	42	84%
	8.2 Government employee	1	2%
	8.3 Private employee	7	14%
9	Family monthly income(in rupees)
	9.1 Below 3000	-	-
	9.2 3001-4000	4	8%
	9.3 4001-5000	18	36%
	9.4 Above 5000	28	56%
10	Birth order of the child
	10.1 First	22	44%
	10.2 Second	22	44%
	10.3 Third	6	12%

Section II: Description of anthropometric measurements of preschool children

Table 2. Frequency and percentage distribution of preschool children according to weight for age (Degree of malnutrition based on IAP classification) n=50

Degree of Malnutrition	Frequency (f)	Percentage (%)
Normal nutrition (>80%)	26	52%
1^st degree malnutrition (71-80%)	15	30%
2^nd degree malnutrition (61-70%)	9	18%
3^rd degree malnutrition (51-60%)	0	0
4^th degree malnutrition (<50%)	0	0

With regard to degree of malnutrition of preschool children 26(52%) preschool children were having normal nutrition and 24(48%) preschool children had first and second degree of malnutrition.

Table 3. Frequency and percentage distribution of preschool children according to height for age (grade of stunting based on Waterlows classification) n=50

Grade Of Stunting	Frequency (f)	Percentage (%)
Normal (>95%)	23	46%
Mildly impaired (87.5-95%)	22	44%
Moderately impaired (80-87.4%)	5	10%
Severely impaired (<80%)	0	0

With regard to grade of stunting of preschool children 23(46%) preschool children were having normal height and 27(54%) preschool children were mildly and moderately impaired.

Table-4. Frequency and percentage distribution of preschool children according to their mid upper arm circumference (Level of malnutrition) n=50

Level of malnutrition	Frequency (f)	Percentage (%)
Nourished (13.5cm)	20	40%
Malnourished (12.5cm)	19	38%
Moderate malnutrition (11-12.5cm)	11	22%
Severe acute malnutrition (<11cm)	0	0

With regard to level of malnutrition of preschool children, in the present data 20(40%) preschool children were nourished and 30(40%) preschool children were malnourished.

Section III. Description of level of nutritional status of preschool children

The level of nutritional status was assessed through examination of clinical signs of nutritional deficiency using nutritional assessment checklist.

Table-5. Frequency percentage distribution for level of nutrition status of preschool children n=50

Level Of Nutrition Status	Frequency (f)	Percent-age (%)
No deficiency (0-25%)	33	66%
Mild malnutrition (26-50%)	17	34%
Moderate malnutrition (51-75%)	0	0
Severe acute malnutrition (76-100%)	0	0

With regard to level of nutrition status of preschool children, in the present data 33(66%) preschool children were having no deficiency and 17(34%) preschool children had mild malnutrition.

Section IV-Association between level of nutrition status of preschool children and their selected personal variables

The results revealed that significant association was found between level of nutritional status of preschool children and education of the father and it is inferred that level of nutritional status of preschool children was influenced by education of the father. No significant association was not found with other personal variables like age, gender, religion, type of family, education of the mother, occupation of the mother, occupation of father, family monthly income and birth order of the child.

LIMITATIONS:

The limitations of the present study were:

1. The study was limited to preschool children (3-5 yrs) in selected rural Anganawadis at Mysuru.

2. The sample size of the study was limited to 50 preschool children (3-5 yrs).

3. The level of nutritional status was assessed through anthropometric measurements and nutritional assessment checklist to assess nutritional deficiency among preschool children.

4. Convenience sampling technique was used to select the sample.

RECOMMENDATIONS:

1. Similar study can be carried out on a larger scale for broader generalization.

2. A study can be conducted to determine effectiveness of structured teaching programme on balanced diet among mothers of preschool children.

3. A study can be conducted to assess knowledge of mothers regarding balanced diet for preschool children.

4. A comparative study can be conducted to improve the nutrition status of rural and urban preschool children in Anganawadis

CONCLUSION:

The findings of the present study concluded that 48% of preschool children had 1^st and 2^nd degree malnutrition based on weight for age, 54% of preschool children were stunted based on height for age, 60% of the preschool children were malnourished based on mid upper arm circumference, 34% of preschool children had mild malnutrition based on their clinical signs of nutritional deficiency. Hence it can be inferred that majority of the preschool children in selected rural Anganawadis were malnourished. Hence the present study has given the evidence that health awareness should be created to improve the nutrition and information booklet is helpful to improve their nutrition status.

REFERENCE:

1. Veena A, Yadavannavar MC, Shailaja S, Patil. Assessment of nutritional status of underfive children in urban field practice area. International Journal of Current Research and Review.2012;4(22):p.122-126.

2. Vijayashree M, Chandra M, Mallapur MD. Nutritional status of under five rural area of south India. 2011;65(4):p.151-156.

3. Amany Edward Seedhom MD, EmanSameh Mohamed MD, Eman Mohamed Mahfouz MD. Determinants of stunting among preschool children, Minia, Egypt. International Public Health Forum. June 2014; 1( 2): p.6-9.

4. FarzanaFarhat A. Assessment of nutritional status of rural Anganwadi children of Aligarh under the ICDS and rural health. 2012;6(2):p.95-98.

5. Jyothi LA, Khyurunnisabegum, Saraswathi G, Jamunaprakash. Nutritional status of rural preschool children -mediating factors. The journal of family welfare. Dec 2003; 49(2):p.45-56.