INTRODUCTION:

Malnutrition is undoubtedly the most serious nutritional problem affecting several thousand young children in India. The problem of Malnutrition assumes much greater magnitude and significance in rural areas^1.

On September 20, 2013 UNICEF, WHO and the World Bank Globally, updated their joint database on child malnutrition and released new global and regional estimates for 2012. According to it,

• 162 million under-five year olds were stunted

• 99 million under-five year olds were underweight

• 51 million under-five year olds were wasted and 17 million are severely wasted.²

India has about 440 million children. About 27 million children are born every year in India but 2 million of them do not attend the age of 5. The world bank estimates that India is one of the highest ranking countries in the world for the number of children suffering from malnutrition³.

As per a study conducted in Western Maharashtra, India. On Apr 2013 by Patel. K. A and associates, Government Medical College, Miraj, among 146 under-5 children attending Anganwadis⁴;

• Among boys 63% children were malnourished, majority in Grade I malnutrition.

• Out of the total females, 72% were stunted and 43% were severely malnourished having mid arm circumference <12.5 cm⁴.

India has more malnourished children than sub-Saharan Africa and nearly one-in-every-5 malnourished children in the world is from India. The 2011 Global Hunger Index (GHI) Report ranked India 15th, amongst leading countries with hunger situation.⁵

The rural India is witnessing more malnutrition among Children < 5 years as higher than urban area. Female infants experience a higher mortality rate than male infants in all major states⁶.

According to the report by the Ministry of Statistics and Programme Implementation - Children in India 2012 - 48 per cent children under the age of five are stunted. It indicates that half of the country's children are chronically malnourished⁶.

According to a report prepared by NAANDI Foundation that covered 112 districts across India,42.5 per cent of children under five years of age are underweight (low weight for age), 58.8 per cent are stunted (low height for age), and 11.4 per cent are 'wasted' (low weight for height)⁷.

The World Bank report described malnutrition as India's silent emergency and stated that the rate of malnutrition cases among children in India is almost five times more than in China, and twice than in Sub-Saharan Africa³.

According to a news report on 26th July 2014 in ‘The new Indian express’; The government has identified as many as 34,594 children in Karnataka as severely malnourished. The highest number has been identified from Belgaum district which has 3,639 children suffering from malnutrition. The district recording second highest cases of malnutrition is Raichur with 3,558 affected children⁸.

In north Karnataka where people especially in rural areas have still not come out of the ritual superstitious practices, the malnutrition has rooted badly deep. In Bagalkot district 79,448 under five children are moderately malnourished and 2,629 are severely malnourished.

It is very essential to identify the factors that either initiate or force to sustain the condition of malnutrition among underfive children. This study attempted to identify the factors associated with malnutrition among under five children.

OBJECTIVES OF THE STUDY:

1. To identify the factors associated with malnutrition among under-five children residing in selected village of Bagalkot district.

2. To find the association between nutritional status and selected socio-demographic variables among under five children residing in selected village of Bagalkot district.

VARIABLES:

1. Study Variable 1: Factors associated with malnutrition among under five children residing in selected village of Bagalkot district.

2. Study variable 2: Nutritional status of under five children.

3. Socio demographic variables: It includes social and demographic characteristics of the subjects such as Age, gender, age of mother, age of father, Occupation of mother, occupation of father ,religion, educational status of mother, educational status of father, Type of Family, Family monthly income, total number of children for same parents, total number of member in the family.

MATERIALS AND METHODS:

The researcher’s objective was to determine the factors associated with malnutrition by collecting the data at a single point of time, so descriptive cross sectional design was found to be appropriate. Target population was under five children residing in villages of Bagalkot district. Accessible population was under five children residing in Bennur village.

At the time of data collection there were 112 under five children in Bennur village. Out of 112 under-five children 100 satisfied the criteria for sample section. The sample was selected by complete enumeration.

The data was collected using a structured interview schedule prepared by the researcher. The tool consisted three parts. Part – I: items to assess Socio-demographic information of the subjects. Part – II: data regarding factors associated with malnutrition: Which included Maternal factors, Factors related to under-five children, and Factors related to family. Part –III: It consists of anthropometric measurement.

The tool was validated by three experts: two from the department of paediatric Nursing and one from the department of community Health Nursing. The reliability of the tool was established by split half method (r = 0.78).

DATA ANALYSIS:

The description of socio-demographic factors was done using frequency and percentage distribution. The Health status of under five children was categorized using Gomez’s and Waterlow’s classification. chi square test and Fisher’s exact probability test were used to find the association between malnutrition and related factors and to find association between malnutrition and sociodemographic factors.

RESULTS: 14% of under-five children were less than one year, 24 % were 1-2 years old, 31% were 2-3 years old ,15% were 3-4 years old ,14% were 4-5 years old. 49% were male and 51% were female, 41% of mothers of under-five children were 20-24years, 45% were within the age group of 25 -29years. 45% of fathers of underfiv children were between the age group of 25-29 years, 36% were between 30-34 years. 75% subjects were Hindu, 24% were Muslim, 1% was Christian. 12% of fathers were with no formal education, 26 % of studied primary, 45% of fathers had education up to high school. 18% of mothers were with no formal education and 45% of mothers had education upto primary. 61% of mothers were housewife, 20% of mothers were labourer. 27% of father were, 18% of fathers were farmers,40% were doing business. 49% had family income less than-Rs 5000/- and 42% had family income between Rs. 5000/--10000/-. 76% of families had one to two children in the family, 21% families had three to four children and remaining 3% had five to six children in their family. 49% of families were nuclear family and 51% were joint family. 54% of families had three to five members, 26% of families had six to eight members, 17% of families had nine to eleven members and remaining 3% had twelve to fourteen members in their family. Section 2 assessment of Nutritional status of Under Five children based on Gomez’s Classification.

Nutritional status of children based on Gomez’s classification

Level of Nutritional Status	Nutritional status
Level of Nutritional Status	Frequency	Percentage
Normal	38	38%
Grade I (Mild)	24	24%
Grade II (Moderate)	25	25%
Grade III (Severe)	13	13%
Total malnutrition	62	62%

38% of underfive children were normal, 24% had grade I/Mild Malnutrition,25% had grade II/ Moderate Malnutrition and 13% had grade III/Severe Malnutrition. Overall 62% under-five children were malnourished.

Nutritional status of children based on waterlow’s classification

Nutritional status	Wasting (WFH)	Stunting (HFA)
Normal	7%	54%
Mild	28%	26%
Moderate	24%	11%
Severe	41%	9%

The nutritional status measured with reference to wasting (Weight for Height) 7% children were normal, 28% had mild wasting, 24% had moderate wasting and 41% had severe wasting and Nutritional status with reference to stunting ( Height for Age) 54% children were normal, 26% had mild stunting, 11% were had moderate stunting, 9%were had severe stunting.

Section 3: Association Between The Nutritional Status And Factors Associated With Malnutrition Among Under Five Children.

A Significant association was found between nutritional status of the child and factors : weight of mother ,Birth weight of child, Socio economic status of the family, immunization status of child, timing of weaning, abnormality’s at birth and type of diet.

A significant association was found between the nutritional status of children and socio-demographic variable: gender of the child, education of mother, family monthly income, and number of children in the family.

REFERENCES:

1. Deoki Nandan, Singh JV, Srivastava BC. Protein Energy Malnutrition in Children - A Case for the Need of a Planned Family. Health and Population, Perspectives & Issues. 1981; 4(2):106-112.

2. Joint UNICEF – WHO – The World Bank Child Malnutrition Database: Estimates for 2012.Data.Dashboards1.fromwww.who.int/nutgrowthdb/jme_2012_summary_note_v2.pdf‎.20-9-2013.

3. World Bank Report on Malnutrition in India" "World Bank Report". Source: The World Bank (2009). Retrieved 2009-03-13

4. Patel KA, Langare SD, Naik JD, Rajderkar SS. Department of Community Medicine (PSM), Government Medical College, Miraj, Maharashtra, India. J Res Med Sci. 2013 Apr;18(4):341-5

5. "2011 Global Hunger Index Report". International Food Policy Research Institute (IFPRI).12-05-2011.

6. Malnutrition problem to be tackled in "Mission Mode" Press Trust of India. New Delhi July 10, 2014.

7. Prachi Salve, India’s Malnutrition Problem Defies Higher Spends. India spend. July 16, 2014.

8. Shreya Sanghani. Practical solutions for child malnutrition info change children. The new Indian express. 26th July 2014.http://infochangeindia.org/201007138409/Children/Stories-of-change/Practical-solutions-for-child-malnutrition.html

Received on 06.04.2016 Modified on 15.04.2016

Int. J. Adv. Nur. Management. 2016; 4(3): 345-347.

DOI: 10.5958/2454-2660.2016.00060.0