DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20150991

Study of etiological determinants of undernutrition in undernourished children from Anganwadi

Mohan Anantrao Patil

Abstract


Background: Undernutrition is important childhood health problem especially in developing countries, closely related to childhood mortality and morbidity. It is multifactorial in origin. These determinants operate at different levels. Immediate causes operating at the individual level, underlying causes influencing households and communities and basic causes at society and policy makers level. In practice these determinants overlap considerably. Exact contribution of each determinant is difficult to assess. However knowledge of locally prevalent factors helps to fine tune interventional strategies.

Methods: A prospective observational study was conducted in 100 consecutive undernourished children in the age group of 0-6 years, referred from Anganwadi center to tertiary care center. They were assessed for determinants of undernutrition. Determinants of undernutrition were categorized as per UNICEF conceptual framework of undernutrition.

Results: Immediate determinants like Low birth weight, inadequate nutrition were significantly affected. Underlying determinants like quality and quantity of food, availability, access and utilization of health services, safe water supply and environmental sanitation, breastfeeding and complementary feeding, cultural taboos regarding food and health had remarkable association with undernutrition. Basic determinants like Women empowerment, maternal malnutrition and familial educational level were adversely affected. However determinants like food availability, access to food and socioeconomic status were satisfactory.

Conclusions: Determinants of undernutrition in all three categories were differentially affected. Search for locally relevant determinants of undernutrition will be helpful to target intervention measures.


Keywords


Undernutrition, Determinants, Anganwadi

Full Text:

PDF

References


Gupte S, Ghosh S, Gomez EM. Protein-energy malnutrition: overview. In: Suraj Gupte, eds. Pediatric Nutrition. 2nd ed. New Delhi: Peepee Publisher & Distributers; 2012: 214-226.

Elizabeth KE. Triple burden of malnutrition. In: Elizabeth KE, eds. Nutrition and Child Development. 4th ed. India: Paras Medical Publisher; 2010: 163-217.

National Family Health Survey, India. NFHS-3 fact sheets for key indicators based on final data, 2015. Available at: http://www.rchiips.org/nfhs/factsheet.shtml. Accessed 25 August 2015.

Arnold F, Parasuraman S, Arokiasamy P, Kothari M. Nutrition in India. National Family Health Survey (NFHS-3), India, 2005-06. Mumbai: International Institute for Population Sciences; Calverton, Maryland, USA: ICF Macro; August 2009: 14.

The World Bank. Repositioning nutrition as central to development. A Strategy for Large Scale Action. Overview. US: The World Bank; 2006: 11.

Harold Alderman, Meera Shekar. Nutrition, food security and health. In: Kligeman, Stanton, St. Geme, Schor, Behrman eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Elsevier Saunders; 2011: 170-179.

UNICEF. Conceptual framework. Available at: http://www.unicef.org/nutrition/training/2.5/4.html. Accessed 6 September 2015.

International Institute for Population Sciences (IIPS) and Macro International. National Family Health Survey (NFHS-3), India, 2005-06. Maharashtra, Mumbai: IIPS: June 2008: 17-18.

Paul VK, Lodha R, Agarwala A. Nutrition. In: Vinod K. Paul, Arvind Bagga, eds. Ghai Essential Pediatrics. 8th ed. New Delhi: CBS Publishers & Distributers; 2013: 88-109.

Mehta M. Malnutrition. In: A. Parthasarathy, eds. IAP Textbook of Pediatrics. 5th ed. New Delhi: JAYPEE; 2013: 129-144.

Gupte S, Chowdhary J, Gomez EM. Low birth weight Infants: overview. In: Suraj Gupte, eds. Pediatric Nutrition. 2nd ed. New Delhi: Peepee Publisher & Distributers; 2012: 104-107.

Gupte S, Gopalan CA. Prevention and control of malnutrition. In: Suraj Gupte, eds. Pediatric Nutrition 2nd ed. New Delhi: Peepee Publisher & Distributers; 2012: 141-143.

Subramanyam MA, Kawachi I, Berkman LF, Subramanian SV. Is economic growth associated with reduction in child undernutrition in India? PLoS Med. 2011;8(3):e1000424.

Dharmalingam A, Navaneetham K, Krishnakumar CS. Nutritional status of mothers and low birth weight in India. Matern Child Health J. 2010;14(2):290-8.

Talapalliwar MR, Garg BS. Nutritional status and its correlates among tribal children of Melghat, central India. Indian J Pediatr. 2014;81(11):1151-7.

Sahu SK, Ganesh Kumar S, Vishnu Bhat B, Premarajan KC, Sarkar S, Roy G, et al. Malnutrition among under-five children in India and strategies for control. J Nat Sci Biol Med. 2015;6(1):18-23.

Prema Ramachandran. Food & nutrition security: challenges in the new millennium. Indian J Med Res. 2013;138(3):373-82.

Ahmed AM, Ahmed T, Roy SK, Alam N, Hossain MI. Determinants of undernutrition in children under 2 years of age from rural Bangladesh. Indian Pediatr. 2012;49(10):821-4.

Malhotra N. Inadequate feeding of infant and young children in India: lack of nutritional information or food affordability? Public Health Nutr. 2013;16(10):1723-31.

Bharati S, Pal M, Bharati P. Determinants of nutritional status of pre-school children in India. J Biosoc Sci. 2008 Nov;40(6):801-14.

Frost MB, Forste R, Haas DW. Maternal education and child nutritional status in Bolivia: finding the links. Soc Sci Med. 2005;60(2):395-407.

Devashish Dass, Sumoya Ghosh. Malnutrition in Mumbai slums. In: Devashish Dass, Sumoya Ghosh, eds. White Paper Health. Mumbai: Idobro Impact Solutions; 11 December 2013: 5-14.