INTRODUCTION:

“Health is Wealth” healthy children can make wealthy nation. Child health depends on consumption of food with adequate calories and all nutrients, which are essentials for the growth and development of the children.

The period from birth to two years of age is important for optimal growth, health and development. At this age children are particularly vulnerable to growth retardation, micronutrient deficiencies and common childhood illnesses such as diarrhoea and acute respiratory infections. Protein energy malnutrition weakens immune response and aggravates the effects of infection and so children who are malnourished tend to have more severe diarrheal episodes and are at a higher risk of pneumonia.

It is generally accepted that children who are underweight or stunted are at greater risk for childhood morbidity and mortality, poor physical and mental development, inferior school performance and reduced adult size capacity for work (NFHS- 3).

Malnutrition is the most wide spread condition affecting the health of children. Scarcity of suitable food, lack of purchasing power of the family as well as traditional beliefs and taboos about what the baby should eat often lead to insufficient balanced diet, resulting in deficiency disorders and malnutrition (Padmavathy 2011).

NEED FOR THE STUDY:

Recent UNICEF report is malnutrition kills 5 million children every year and one child kills every 6 seconds. Globally, PEM continues to be a major health burden in developing countries and the most important risk factor for illnesses and death especially among young children. The World Health Organization (WHO) estimates that about 60% of all deaths, occurring among children aged less than five years in developing countries, could be attributed to malnutrition. PEM is also associated with a number of co-morbidities such as lower respiratory tract infections including tuberculosis, diarrhoea diseases, malaria andanaemia (Ubesia et.al.2012).

The third National Family Health Survey estimated that 45.9% of Indian children and 33.2% of children in Tamil Nadu below 3 years of age are under weight. Mild to moderate malnutrition has been associated with an increased risk of childhood mortality (Singh et.al.2010).The National Family Health Survey data of 2008 show a similar trend: Almost one-third (31 per cent) of children under age five in Tamilnadu are stunted, or too short for their age, which indicates that they have been undernourished for some time; 22 % are wasted, or too thin for their height, which may result from inadequate recent food intake or recent illness and 30 per cent are underweight, which takes into account both chronic and acute under nutrition. The effects of such acute and chronic under nutrition are well established for increased mortality, poor cognitive and motor development and other impairments in function as fallout of under nutrition, show Dr Stuart Gillespie and Dr Lawrence J Haddad of IFPRI in their book The Double Burden of Malnutrition: Causes, Consequences and Solution. “Children who have been severely undernourished in early childhood suffer a later reduction in IQ by as many as 15 points (Martorell 1996), significantly affecting schooling achievement and increasing the risks of drop-out or repeat grades”.(Krithika Ramalingam21 June 2009).

From the above reports it was clearly understood that protein energy malnutrition is most prevalence among under-five children in India, which enhances the mortality and morbidity. So, the researcher is interested in identifying the malnourished children and treats the malnourished children with a nutritional intervention programme.

STATEMENT OF THE PROBLEM:

Assess the prevalence of malnutrition among hospitalized children in selected hospitals, Puducherry

OBJECTIVES:

· To assess the nutritional status of the children who are hospitalized

· To find out the association between the nutritional status and selected demographic variables

Assumption:

· Most of the children are suffering from malnutrition

Delimitation:

· Children who are available during the data collection period

· Children who are willing to participate in the study

· Children who are hospitalized during the data collection period

METHODOLOGY:

Research approach and design:

Quantitative approach with survey design

Setting of the study:

The study was conducted in selected hospitals in Puducherry

Population:

Children aged between 1 month and 18 years

Sample:

Children who are hospitalized during the data collection period

Sample size:

90 children

Sampling technique:

Convenient sampling technique

Methods of data collection:

Observation and interview method

Plan for data analysis:

Descriptive and inferential statistics used to analyse the collected data

DESCRIPTION OF THE RESEARCH TOOL:

Part-I: It includes the demographic variables of the children such as age, sex, income, birth order of the child, educational level of the mother and father, occupation of the father and mother , type of family, place of residency.

Part- II: Assessment of the children nutritional status

RESULTS AND DISCUSSION:

Majority of the samples were belongs to toddler age (37.8%), of them 54.4% belongs male gender. Highest percentage of samples’ father education was 64.4% at high school level, most of them were daily wages (36.7%) and their mothers’ education were 53.3% at high school level 87.8% of them were home makers. 46.7% of samples monthly income was <Rs.5000 were as only 11.1% were above >Rs.15, 000. Among the total samples 56.7% belongs to urban and the rest of them (43.3%) were from rural area which is comparable with Rajini et.al 2010, she was found that the prevalence of malnutrition in urban slums of Hyderabad was 69%. Highest birth orders were 47.8% belongs to first, and then 44.4% of them were second order and only 7.8% belongs to third order.

FIGURE 1: Distribution of Samples based on IAP classification on Malnutrition

From the above figure it was found that 54.4% of the samples were suffering from Grade I malnutrition, 23.3% of samples were in Grade II malnutrition, and only 10% of the samples were suffering Grade III malnutrition. Of the total samples 12.2% of them belong to normal. A similar prevalence was found by Sarin RO et al 2009, in which 16.3% and 30.0% of hospitalized children had moderate and severe malnutrition.

TABLE 1: Association between malnutrition and demographic variables

Sl:No	Variable	df	Table Value	X2 Value
1	Age	12	21.03	29.91*
2	Sex	3	7.81	5.48
3	Father Education	12	21.03	12.73
4	Mother Education	12	21.03	7.04
5	Father Occupation	9	16.92	16.15
6	Mother Occupation	9	16.92	5.56
7	Income	9	16.92	20.28*
8	Residency	3	7.81	3.11

The table 1 revealed that only two demographic variables such as age and income of the family had the association with malnutrition at the level of significance of 0.05. This study was par with Maheswari K, 2011 in her findings she found there was significant relationship with age and malnutrition of the children.

CONCLUSION:

From the results of this study it is obvious that still malnutrition prevails among hospitalized children as seen from the small sample groups. However malnutrition in children is an even more severe threat not only for immediate survival, but also for growth, long term development and health outcomes. Development and implementation of effective strategies for detection and treatment of malnutrition in paediatric patients is of utmost importance. It is recommended to establish nutrition support teams in paediatric hospitals by implementing screening test for nutritional risk, to identify patients who require nutritional support, to provide adequate nutritional management. The unacceptably high prevalence of malnutrition in paediatric patients documented in this study adds weight to the urgent need for implementation of those recommendations.

BIBLIOGRAPHY:

1. Padmavathy B. Nutritional status of pre-school children. Nightingale Nursing Times. 7 (1); Apr 2011: 59-62.

2. Maheswari K. Identifying Malnourished children. Nightingale Nursing Times. 6 (11); Feb 2011: 57-59.

3. Vibha. Malnutrition in children. Nightingale Nursing Times. 7(6); Sep 2011: 37-40.

4. Alsafooret al. PEM among preschool children in Oman: Results of a National Survey. La Revue de Sante de La Mediterraneeorientale. 13(5), 2013.

5. National Family Health Survey – 3 (NFHS-3), 2005-2006.

6. Annie John B. Nutritional Status among Children of Non-Working and Working Mothers. The Nurse. 4(2); Mar – Apr 2012: 22-26.

7. Ghosh S and Shah D. Nutritional problems in urban slum children. Indian Paediatrics. 41(7); July 2004:682-696.

8. Rajiniet al. A study of malnutrition among children aged 1-5 years in a selected urban slum in Hyderabad. Nightingale Nursing Times. 5(10); Jan 2010: 12-15.

9. Sarni RO et al. Anthropometric evaluation, risk factors for malnutrition, and nutritional therapy for children in teaching hospitals in Brazil. J Pediatr (Rio J). 859(3); May-Jun2009: 223-228.

10. Deaton and Dreze, Food and Nutrition in India: Facts and Interpretations. Economical and political weekly (2009) feb14; vol XLIV NO 7.

11. Singh A S et al. Locally made ready to use therapeutic food for treatment of malnutrition: A randomized controlled trial. Indian Paediatrics. 17; Aug 2010.

12. Ubesie A C et al. Under-five Protein Energy Malnutrition admitted at the university of in Nigeria teaching hospital, Enugu: a 10 year retrospective review. Nutrition journal. 11(43); 2012.

13. www.unicef.org

14. 2009 World Hunger Report

Received on 23.05.2014 Modified on 11.06.2014

Int. J. Nur. Edu. and Research 2(3): July- Sept. 2014; Page 189-191