Study of severe malnutrition in preschool children in Melghat

STUDY OF SEVERE MALNUTRITION IN

PRESCHOOL CHILDREN OF MELGHAT(A tribal block of Villages in Maharashtra, India)

By

Shirishkumar V. Naidu1 Dr. Shaila Gajbhiye2

Dr Meena Shriniwas Shelgaonkar3

1MSc Clinical Research, ICRI Mumbai 2Ex- Dean ICRI Mumbai

3(Clinical Pharmacologist Central India Institute of Medical Sciences, Bajaj Nagar Nagpur-10),

Director Phytabolites Neutraceuticals Pvt Ltd Nasik, Ex Associate Prof ICRI Mumbai,

Executive committee Member , Amhi Amchya Arogyasathi , Kurkheda Gadchiroli

+91 9527411453

Introduction 11/25/2014

Dr Meena S Shelgaonkar

2

Main concern:

Balancing of

sustainable community development and

Biodiversity conservation

Prime biodiversity

repository of the

state

Notified as a

sanctuary in 1985

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Rationale:

Melghat - tribal block of 61 villages (with

87.5% tribal population) in Maharashtra,

(India)

Unfortunately is

known for

malnutrition among

children, despite lots

of efforts taken by

Govt. and NGOs.Why?

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Objective:

Is health and nutritional education

beneficial to reduce malnutrition ?

To compare the status and causes of malnutrition

in children below age five

in Intervention and Control Villages in Melghat over

a period of 2 months.

? ? ?

iv)Materials and Methods

Intervention area (Five villages)

Intensive health and nutritional education awareness programs were conducted for mothers since last five years by MAHAN in addition to Govt. programs.

.

Control area

(five villages)

Government programs such

as 21 day care for severely

malnourished children,

Anganwadi,

were going on but no health

and nutritional education

programs.

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A questionnaire based survey was conducted

in 10/40 villages of Melghat

The study and Survey questionnaire was approved by Institutional

ethics committee of MAHAN – a NGO working in Melghat

Malnutrition

preventable ?

Inclusion criteria

Children of both sexes in the

age group of 0-5 years

Children residing in selected

villages only.

Exclusion criteria

Children of both sexes above 5

years of age

Children not residing in

selected area

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Intervention area

+

Control Area

Total no of children residing in villages under study = 600

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Questionnaire points

• General information about child and its

family members

• Educational & Economic status of parents

• Vaccination Status of child

• Physical Appearance & Nutritional Status of

child

• Environmental History

Result

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i) Table 1: Age sex distribution of children

Control area Intervention area

Total No of

Children (N=600)

Age wise distribution

0-1 years 79 71 150

1-3 yrs. 101 120 221

3-5 yrs. 120 109 229

Sex wise distribution

Boys 147 161 308

Girls 153 139 292

Table 2: Correlation of number of children and educational status of mothers

Number of children

(n=600)

Education Status of

Mother

346 Illiterate

152 Primary

102 Secondary

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Table 3: Prevalence of PEM vs. Normal Nutritional status

Preschool children from ten villages Normal % PEM %

Control Area (n=300) 27 73

Intervention Area (n=300) 34 66

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10Table 7: Prevalence of PEM in 0-5 yrs. as per Sex Wise distribution

Control Area

Intervention

Area Control Area

Intervention

Area

Boys (N=147) Boys (N=161) Girls (N=153) Girls (N=139)

Malnutrition

Grade

Normal 46(31.2%) 61 (37.8%) 35(22.8%) 41 (29.4%)

Grade I 59(40.1%) 66 (40.9%) 55(35.9%) 56 (40.2%)

Grade II 34(23.1%) 29 (18.0%) 56(36.6%) 39 (28.0%)

Grade III 6(4.0%) 3 (1.8%) 6(3.9%) 2 (1.4%)

Grade IV 2(1.3%) 2 (1.2%) 1(0.6%) 1 (0.7%)

Total 101(68.7%) 100 (61.4%) 118(77.1%) 98 (70.5%)

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0

10

20

30

40

50

60

70

0-1 yrs (n=79) 1-3 Yrs(n=101)

3-5 yrs(n=120)

0-1 yrs (n=71) 1-3 Yrs(n=120)

3-5 yrs(n=109)

Control Area (n=300) Intervention Area (n=300)

Prevalence of PEM in 0-5 yrs children

Normal

Grade I

Grade II

Grade III

Grade IV

Malnutrition Grade % 0-1 yrs (n=79) 1-3 Yrs (n=101) 3-5 yrs (n=120) 0-1 yrs (n=71) 1-3 Yrs (n=120) 3-5 yrs (n=109)

Normal 51.8 17.8 18.3 66.1 20.8 27.5

Grade I 32.3 38.6 43.3 26.7 45.8 44

Grade II 13.9 37.6 34.1 5.6 28.3 27.5

Grade III 2.5 4.9 4.1 0 3.3 0.9

Grade IV 2.5 0.9 0 1.4 1.6 0

Control Area (n=300) Intervention Area (n=300)

Prevalence of PEM amongst under 5 Year Old Children

Table 8: Age/Grade wise PEM Prevalence

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12Table 8: Prevalence of PEM in relation to education status of mother

No of

Children

Education

Status of

Mother

Normal

health % Grade I %

Grade II

%

Grade III

%

Grade IV

%

Malnutrition

overall %

346 Illiterate 28 34.9 32.3 4 2 71.9

152 Primary 40.1 26.9 28.2 2.6 1.9 59.8

102 Secondary 47 30.3 22.5 0 0 52

No of Children Normal healthy children%

children with PEM %

346

28

71.9

152

40.159.8

102

47 52

Education of mothers and PEM children

Illiterate Primary Secondary

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Discussion and conclusion:

Prevalence of malnutrition among the children under five years of age was

higher in Control villages (73.0 %) as compared to those in Intervention

villages (66.0 %).

The percentage of children under the normal Grade were higher in

Intervention villages (34.0 %) as compared to that of Control villages (27.0

%).

Children who are severely malnourished i.e. of Grade III the children under

Intervention villages showed less percentage (1.3 %) as compared to those

of children under Control villages (4.0 %).

This was basically due to lack of health and nutritional education practices in

control villages.

Malnutrition is preventable once it is known that it is due to lack of proper

diet.

More the education less is malnutrition.

Thank you very much

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Flip chart- education material 11/25/2014


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Trainer's side

Trainee’s side

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Healthcare

Study of severe malnutrition in preschool children in Melghat