RIGHT TO LIFE – A STUDY OF NUTRITION PRACTICES AND FOOD SECURITY OF

CHILDREN

Prof. M.Lakshmipathi RajuFormer Professor in Social Work, S.P. Mahila University, Tirupathi and Acharya Nagarjuna University, Guntur. Presently Co-ordinator, Dept. of Social Work & H.R.M, M.R.P.G.College, Vizianagaram- 535 002.

K.ViswabhushanAsst.Professor and HOD, Dept.of Social Work, MRPG College, Vizianagaram

K.SrinivasuAsst.Professor, Dept.of Social Work, MRPG College, Vizianagaram

1. The convention on the Rights of Child adopted on 20th Nov, 1989 by UNO

2. Children constitute 50 percent of World Population.

3. The Child has inherent Right to life( Article b)

4. Child is vulnerable and deprived of minimum necessities.

5. To ensure the survival and development of child.

NUTRITION SITUATION IN INDIA

1. It al of children in India undernourished

2. 30% are born underweight (<2.5 Kg)

Under nutrition acute in Madhya Pradesh : 55%

Bihar : 54%

Orissa : 54%

Uttar Pradesh : 52%

Severe under weight for : 18%

Children with stunted growth : 46%

NUTRITION SITUATION IN ANDHRA PRADESH

Nutrition Status

Underweight - 45%

Stunted Growth - 39%

ANEMIA IN CHILDREN

National Average : 74%

Rajasthan : 82%

Bihar : 81%

West Bengal : 78%

CHILD HEALTHChild Health: Physical, mental, emotional, spiritual and social well–being of children

Govt. Programmes for Child Health

1. Immunization

2. Prophylaxis schemes

3. I.C.D.S Programmes

Objectives of Child Health

1. Reduction of infant mortality.

2. Improving nourishment.

3. Mortality, Morbidity, Nutritional status indication of Child Health.

CAUSES IMMEDIATE AND UNDERLYING

1. Mortality linked with disease.

2. Undernutrition leads to stunted growth.

3. It lowers immunity.

4. Lack of food only reason for undernutrition.

5. Children malnourished between 6 months and 2 years.

6. Nutritional needs increase over two years of age.

MAIN CAUSES OF CHILD NUTRITION

1. Maternal poor nutrition.

2. Low milk quality.

3. Declining Breast feeding practices.

4. Inadequate complementary feeding.

5. Poor sanitation.

6. Recurrent illness.

7. Undesirable eating habits.

8. Inadequate access to quality nutrition.

9. Inadequate skills of mother for feeding and caring.

10.Inadequate time available for Mother due to work load.

11.Traditional practices.

12.Gender inequality.

MEASURES TO COMBAT UNDER NUTRITION IN CHILDEN

1. Nutrition education to pregnant women.

2. Behaviour change communication approaches.

a) Early breast feeding.

b) Exclusive breast feeding for about 6 months.

c) Timely initiation of complementary feeding.

d) Continued breast feeding till 2nd year.

e) Household and personal hygiene.

f) Use of health services.

ABOUT I.C.D.S

1. ICDS launched on October 2nd, 1975.

2. It covers health, nutrition and pre-school education.

3. Primary focus on children under 6 years.

4. It also covers pregnant and nursing mothers, adolescent girls.

5. Services provided through Anganwadi in the village or slum area.

6. One ICDS project in every Block with 120 AWCs.

AGE –APPROPRIATE COMPLEMENTARY FEEDING

1. Every child 7 – 24 months to be fed age –appropriate, energy and nutrients.

2. Children given prophylactic iron and folic and supplements to prevent anemia.

3. Hygiene practices followed when feeding children.

ELEMENTS OF STUDY

The elements of study include ;

(1)Quantity

(2)Separate bowl

(3)Frequency

(4)Maintain Hygiene

(5)Know quantity as per age

(6)Spoon feeding

(7)Adding oil/ghee

STUDY ABOUT

1. To study appropriate feeding practices of 7 months to 2 years.

2. To study introduction of complimentary feeding at appropriate age of child.

3. To study adequacy of complementary feeding( - frequency, quantity, density, quality.)

4. To assess knowledge, behaviour and practice on appropriate feeding practices among children of 7 months to 2 years.

Goal: To study malnutrition among children from 7 months to 2 years, the child feeding practices.

OBJECTIVES

METHODOLOGY OF STUDY

1) Study confined to Vizianagaram District only.

2) Purposive sampling method adopted to find out Anganwadi Centres.

3) The sample size included 50 Anganwadi Centres.

4) 17 each from rural, urban and tribal projects i.e. Nellimarla, Vizianagaram/Bobbili and Parvathipuram

5) An interview schedule developed to collect information (Household Survey of Mothers of 7 months to 24 months aged children.

STUDY AREA

Total Population : 22,49,254 - 2001 census

Males : 11,19,541

Females : 11, 29, 713

1009 females per 1000 males

Population Density - 344 persons per sq K.M

ICDS FACILITES

17 PROJECTS - 02 Tribal Projects

- 03 Urban Projects

- 12 Rural Projects

TABLE - 1  Table: 1 Rural Tribal Urban

Weighing scale is working: 76.47 82.35 68.75

Using of near by centers weighing scale 11.76 17.65 18.75

Using weighing scale of ANM 23.53 5.88  

Growth status of the children      

Zero to 6 month      

Normal 57.81 49.66 46.67

Grade-1 30.73 37.93 24.44

Grade-2 11.46 14.48 18.89

Grade-3 0 0 1.11

Grade-4 0 0 0

7 month to 3 years 0   0

Normal 64.71 38.85 46.36

Grade-1 44.29 36.93 29.74

Grade-2 21.63 23.26 14.87

Grade-3 0.52 1.2 0

Grade-4 0 0 0

3 years to 5 Years      

Normal 46.67 39.58 43.75

Grade-1 35.43 34.03 29.60526

Grade-2 17.14 24.54 13.48684

Grade-3 0.76 1.16 0

Grade-4 0 0 0

GROWTH MONITORING AND NUTRITION STATUS

TABLE - 1

Table I shows that :1

(1) Weighing Scale working ( 82.35%) in Tribal areas.

Weighing Scale not working - 68.75% Urban areas

76.44% Rural areas

(2) In all age groups the normal status in the growth of children is found in the rural areas when compared with Urban and Tribal areas.

 Table 2 7 to 12 M 13 to 18M 19 to 23M 7 to 12 M 13 to 18M19 to 23M 7 to 12 M 13 to 18M

19 to 23M

  Rural Rural Rural Tribal Tribal Tribal Urban Urban Urban

AWW Advised how often to feed semisolids like rice, dal, roti 89.29 97.62 97.92 76.81 89.02 91.67 98.97 100 100

If yes how often each day did she /they say you must feed the child

1 Time 8.93 2.38 0 1.45 2.44 1.19 8.25 0 0

2 time 16.96 14.29 10.42 24.64 15.85 9.52 11.34 17.19 8.2

3 times 50 52.38 52.08 50.72 65.85 71.43 47.42 48.44 47.54

More 24.11 30.95 37.5 13.04 15.85 13.1 32.99 34.38 44.26

Did she/they tell you how many Katoris ( Bowls) of semi-solids foods to feed every day? 85.71 89.29 89.58 85.51 96.34 89.29 93.81 96.88 95.08

If Yes how Many Katoris do you feed your child?

Half-Katories 16.07 3.57 4.17 4.35 8.54 7.14 15.46 0 0

1-Katoris 28.57 15.48 10.42 11.59 13.41 15.48 31.96 31.25 0

2-Katoris 28.57 36.9 35.42 21.74 17.07 32.14 25.77 31.25 24.59

3-Katories 12.5 20.24 37.5 43.48 31.71 27.38 20.62 14.06 21.31

4-Katories 14.29 26.19 10.42 18.84 29.27 17.86 14.43 23.44 54.1

Table 2 shows

1) The table indicates that the use of Katoris by respondents is very positive.

Use of 2 Katoris in rural and urban areas.

Use of 3 Katoris in tribal areas.

2) Feeding of semi-solicits like rice, dal, roti given by Anganwadi Worker is positive.

95% in rural and urban areas.

85% in tribal areas.

3) Frequency of feeding of Semi-solids of 3 times is 50% in all the areas.

it is more times in need.

4) Use of Katoris ( or) Bowls while feeding semi – solids is very positive in 90% in all age groups and in all areas.

 Table-37 to 12 M 13 to 18M

19 to 23M

7 to 12 M 13 to 18M 19 to 23M 7 to 12 M

13 to 18M

19 to 23M

  Rural Rural Rural Tribal Tribal Tribal Urban Urban Urban

Did AWW/ANM/ASHA tell you whether to feed the child from your plate or from a separate plate

No advise 13.39 0 2.08 13.04 4.88 11.9 0 0 0

Feed from mother/Fathers plate 0 1.19 2.08 2.9 15.85 7.14 4.12 0 8.2

Feed in Separate bowls/ Plate 86.61 96.43 95.83 84.06 79.27 75 93.81 100 100

Advised to add some oil/Ghee ( in addition to that used at the time of cooking) from top to the food of the child before feeding him/her 89.29 94.05 89.58 75.36 79.27 78.57 93.81 100 96.72

Advise you and others in the family to wash hands before feeding the child or before preparing the food? 92.86 96.43 100 94.2 97.56 91.67 97.94 95.31 100

Advised anything about feeding solid/ semi -solid foods to the child. 91.96 97.62 95.83 92.75 89.02 89.29 97.94 98.44 96.72

TABLE 3 – HYGIENE AND FEEDING PRACTICES

Table 3 shows

(1) Use of separate Bowl or Plate while feeding is very positive – 85% in all age groups and in all areas.

Mothers are following health hygiene care practices.

(2) Use of oil or ghee while feeding by Mothers is very positive 90% in all age groups and in all areas.

All mothers are aware about using ghee while feeding the child.

(3) Knowledge of Washing hands before feeding the child is very positive(96%).

(4) Feeding solid and semi-solid food to the child is very positive (90%) in all age groups and in all areas.

MAJOR FINDINGS

1) Majority of Mothers and separate Bowl in rural areas when compared with Tribal and Urban areas.

2) Supplementary nutrition to 9 – 12 and 19 – 24 months – 100%.

3) Supplement in the form of wheat, doll, oil – very positive in all age groups, in all areas.

4) Use of Bowls very positive in all age groups in all areas.

5) Majority of Mothers are washing hands before feeding.

6) Majority of mothers are feeding the child with egg.

7) The highest percentage of respondents use fish and meat at the age of 19-24 months.

8) Majority of mothers are using oil/ghee while feeding.

9) Majority of mothers aware of importance of breast feeding.

SUGGESTIONS AND RECOMMENDATIONS

1. To conduct training programme to create awareness on quantity of food, health, hygienic practices.

2. To create awareness on Health services by Govt. and NGOs.

3. To Organize nutrition education programs for pregnant women and mothers of young children.

4. Feeding of solid and semi-solid food should start at right time of 6 months instead of 8th or 9th month.

5. To create breast feeding along with boiled food till the age of 2 years.

6. To educate the mothers and fathers in bringing up the child and in participating in all related programs.

7. Meeting of mothers, home contact and educating mothers will improve positive healthy behaviour.

8. Tribal areas to be given prior importance in future course of planning different strategies to be adoppted to reinforce behaviour change.