ANTHROPOMETRIC ASSESSMENT OF NUTRITIONAL STATUS IN UNDER FIVE CHILDREN OF SLUM AREA OF SINAMANGAL

Submitted by:Anurag SedaiAsmita ThapaNirmala BistaSweta PathakTilak Mahatra

• Malnutrition essentially means “bad nourishment”. It concerns not enough as well as too much food, the wrong types of food, and the body's response to a wide range of infections that result in malabsorption of nutrients or the inability to use nutrients properly to maintain health.

• Clinically, malnutrition is characterized by inadequate or excess intake of protein, energy, and micronutrients such as vitamins, and the frequent infections and disorders that result.

• People are malnourished if they are unable to utilize fully the food they eat, for example due to diarrhoea or other illnesses (secondary malnutrition), if they consume too many calories (over nutrition), or if their diet does not provide adequate calories and protein for growth and maintenance (under nutrition or protein-energy malnutrition).

INTRODUCTION

Malnutrition in all its forms increases the risk of disease and early death. Protein-energy malnutrition, for example, plays a major role in half of all under-five deaths each year in developing countries (WHO 2000). Severe forms of malnutrition include:

• Marasmus (chronic wasting of fat, muscle and other tissues)• Cretinism • irreversible brain damage due to iodine deficiency• blindness and increased risk of infection • Even death from vitamin A deficiency. Nutritional Status• The state of the body with respect to each nutrient and to the overall state of the

body weight and condition is known as the nutritional status. Nutritional status is compromised where people are exposed to high levels of infection due to unsafe and insufficient water supply and inadequate sanitation.

Contd…

The cause• Individual nutritional status depends on the interaction between food that is

eaten, the overall state of health and the physical environment. Malnutrition is both a medical and a social disorder, often rooted in poverty.

Anthropometric Assessment• An assessment of nutritional status of community is one of the firs step in the

formulation of any public health strategy to combat malnutrition. • Anthropometric measurement is one of the common and well accepted

methods of the nutritional assessment. This technique is concerned with the measurements of the physical dimension and gross composition of the human body at different age levels and degree of nutrition.

• Anthropometric measurement can be done by; weight, height, Mid Upper Arm Circumference (MUAC), Body Mass Index (BMI), skin fold thickness, head and chest circumference and waist/hip ratio.

Contd…

• Chronic food deficits affect about 792 million people in the world (FAO 2000), including 20% of the population in developing countries. Worldwide, malnutrition affects one in three people and each of its major forms dwarfs most other diseases globally (WHO, 2000).

• Malnutrition affects all age groups, but it is especially common among the poor and those with inadequate access to health education and to clean water and good sanitation. More than 70% of children with protein-energy malnutrition live in Asia, 26% live in Africa, (WHO 2000).

• According to World Development Indicator Database (2001), Nepal’s malnutrition prevalence of weight for age of under five children is 48.3% and the report by National Health Plan states that nearly half of the country's 1.7 million under-fives are stunted or suffer from chronic malnutrition.

• According to Nepal Demographic and Health Survey (2011), nearly three in ten children (29 percent) are underweight and 8 percent are severely underweight.

STATEMENT OF PROBLEM

• General Objective:• To study the nutritional status of under five children in slum area of

Sinamangal, Kathmandu by anthropometric measures.• Specific Objectives:• To determine the nutritional status of under five children by weight for

age.• To determine the nutritional status of under five children by Mid upper

Arm Circumference.• To assess the distribution of nutritional status of under five children by age

group.• To assess the distribution of nutritional status of under five children by

caste.• To assess the distribution of nutritional status of under five children by sex.

OBJECTIVES

3.1. Study Design:

The study design was Descriptive cross-sectional type.

3.2. Study Area

The study area was Slum area of Sinamangal, Kathmandu

3.3. Study Population:

Under five year children of slum area of Sinamangal, kathmandu

3.4. Study duration

The study was conducted from November to December 2011.

 

METHODOLOGY

3.5. Sample Size The total sample size was 38 under five year children of slum area of

Sinamangal, Kathmandu3.6.Sampling Procedure Convenient sampling technique was used to choose the sample.3.7. Data collection techniques and tools Primary data was collected by interview technique with the help of semi

structured questionnaire. For measurement of weight, Salter scale, Bathroom scale was used whereas for measurement of MUAC,MUAC tape was used.

3.8. Data analysis SPSS 16.0 was used for data entry. The descriptive statistics (frequency, percentage) was used for data analysis in

MS-EXCEL 2007 and SPSS 16.0. The data were presented in tabular form in MS-WORD 2007. 

Contd…

Contd…• Nutritional status of children was classified according to Z

score classification given by WHO which is illustrated below:

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Cut-Off Points for Under Weight ( Weight for Age )

Description Of Nutritional Status Weight for Age Index Z Scores( SD)

Severe Underweight < -3 z score( less than minus 3)

Moderate Underweight < -2 z scores, but greater than or equal

to -3 z score

Normal ≥ -2 z score ,greater than or equal to -2

z scores

3.9. Limitation of the Study

Other variables couldn’t be taken due to lack of skills necessary for measurement of the variable.

3.10. Ethical Consideration

Ethical clearance was taken from institutional review board of faculty of Public Health of college. Verbal consent was taken from the guardian of the under five children before measurement.

Contd…

FINDINGS

Figure 1: Prevalence of malnutrition among under five children in slum area of Sinamangal by MUAC tape

CONTD…

Contd… Figure 2: Prevalence of malnutrition (under nutrition) among under

five children by weight for age

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Contd…Table 1: Distribution of nutritional status of under five children by age

group

Age of the child

Nutritional Status

Total

Severe

Malnutrition

Moderate

malnutrition

Normal

nutrition

0-11 months 0 1(16.7%) 13(44.8%) 14

12-23 months 0 1(16.7%) 3(10.3%) 4

24-35 months 0 0 3(10.3%) 3

36-47 months 1(33.4%) 2(33.3%) 4(13.7%) 7

48-59 months 2(66.6%) 2(33.3%) 6(20.6%) 10

Total 3(100%) 6(100%) 29(100%) 3814

Contd..

Sex of the child

Nutritional Status

Total

Severe

Malnutrition

Moderate

malnutrition

Normal

nutrition

Male 1(33.3%) 4(66.6%) 13(44.8%) 18

Female 2(66.6%) 2(33.3%) 16(55.1%) 20

Total3(100%) 6(100%) 29(100%) 38

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Table 2: Distribution of nutritional status of under five children by sex

CONTD..

Table 3: Distribution of nutritional status of under five children by Caste

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Caste of the children

Nutritional Status

Severe Malnutrition

Moderate malnutrition

Normal nutrition Total

Dalits0 4(13.7%) 4

Brahmin/Chhetri 0 1(16.6%) 2(6.8%) 3

Terai/Madhesi 3 (100%) 5(83.38%) 14(48.2%) 22

Janajati0 0 9(31.3%) 9

Total 3(100%) 6(100%) 29(100%) 38

CONCLUSION• Malnutrition is a major child health problem of Nepal. Better

nutrition of child is very important for their overall growth and development.

• Majority of the children in slum area of Sinamangal are well nourished.

• Only few were found to be severely and moderately malnourished.

• Hence, the overall nutritional status of under five children in slum area of Sinamangal area is satisfactory.

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RECOMMENDATIONS

• Mothers of under five children in slum area should be given regular counselling on nutrition

• Special nutrition related programs should be launched to adress the slum area through several NGOs/INGOs

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References:• National Demographic Health Survey. (2011)• Annual Reports, DoHS• www.who.int

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THANK YOU

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