ASSESSMENT OF

THE
NUTRITIONAL
STATUS OF
UNDER FIVE
CHILDREN IN
Research Question: What is the nutritional status of under
five children in a village in Nashik District, Maharashtra?

Abstract:(Background):- Children are considered to be the

backbone of any nation. Nutritional problems among children
cause major morbidity and mortality. Out of which, Malnutrition
among under-five children is an important concern for the health
authorities in global scenario. In developing countries,2.3 million
deaths occurred among 6-60 months aged children each year and
are associated with malnutrition which is almost about 41% of
total deaths in this age group. In case of India we can say, it is
home to the largest number of underweight and stunted children
in the world. The present study is aimed to assess the nutritional
status of under five children and to find out socio-demographic
determinant with it in rural community of Maharashtra and
strategies required to tackle malnutrition among them.
Keywords: Nutritional Status, Stunting, Underweight, Wasting

Aim & Objective: 1) To assess the nutritional status of under five

children in a village using anthropometric measurements.
2) To measure the prevalence of malnutrition with (underweight,
stunting and wasting) among under-five children.
Introduction: Malnutrition in India has been called ‘THE
SILENT EMERGENCY’. India is committed to having the
prevalence of underweight children by 2015 as one of the key
indicators of progress towards the Millennium Development Goal
(MGD). In spite of unprecedented economic growth,
improvements in childhood nutritional status in India over the last
decade have been slow still in India. It is observed that a large
share of the malnutrition burden is accounted by relatively small
number of states, districts, and villages. Only 5 states and 50% of
villages account for about 80% of the malnutrition burden. The
prevalence of stunting among under 5 is 48% and wasting is
19.8% and with an underweight prevalence of 42.5%.
Nutrition is a key determinant of good health, critical for
survival, good quality of life and well-being. Adequate nutrition is
essential in early childhood to ensure healthy growth, proper
organ formation and function, a strong immune system, and
neurological and cognitive function and contributes to poverty
through impeding individual’s ability to lead productive lives.
Maternal nutritional status has a direct relation to the child’s
nutritional status. An undernourished mother gives birth to a low-
birth weight baby who grows up with compromised feeding and
infections to a stunted child and adolescent and carries this
vicious life cycle approach by giving birth to an underweight child.
Undernutrition is more common in the lower income groups, and
even if malnutrition is present in the upper income group, it is
limited to the milder forms. Appropriate child feeding behaviour
goes a long way in preventing and overcoming malnutrition and
determining a child’s growth.

A recent study, among children aged between 3 months

and 3 years of age conducted in 130 districts through
Demographic and Health Surveys in 53 countries over a period
from 1986 to 2006 found that — variance in mild under-weight
has a larger and more robust correlation with child mortality than
the variance in severe under-weight. The study concluded that the
prevalence of mild under-weight deserves greater attention as a
useful signal of changing public health conditions among
preschool children in developing countries. Therefore, it is
important for the health system to detect malnutrition at an early
stage for planning and implementing timely interventions at the
community level.

Distribution of various types of risk factors and its

influence on nutrition status of children in a given setup should
be analysed for planning the control measures. Strengthening
public health interventions for mild malnutrition cases and
vulnerable groups, effective implementation and evaluation of
the strategies at regional level, research on overweight, obesity
and its etiological factors and steps for improving socioeconomic
development are the prerequisites for tackling malnutrition
among under-five children in India.

This study is specifically aim to reduce the Knowledge

Gap which exist in today’s times in rural community of Nashik
district which is mentioned further,
Knowledge Gap: 1. Despite efforts to improve child health,
malnutrition remains a significant public health concern in rural
India.
2) There is a lack of recent data on the nutritional status of under
five children in Nashik District, Maharashtra.

Method: It will be community based descriptive cross-sectional

study conducted on --- under five children (1-5yrs) in--------- village,
which is field practicing area of community medicine development of
Dr. Vasantrao Pawar Medical College, Hospital & Research Centre,
Nashik, Maharashtra. ---- under-five residing in this field practice area
and will be included in the study with the help of stratified random
sampling. And “RAPID ASSESSMENT METHODOLOGY” to inform
timely interventions.

Sample: The sample for present study will include all the under five
children who will be present at the time of data collection from --------
----------

Inclusion Criteria: A predesigned Questionnaire and pretested

schedule will be administered by asking for a history from the mother,
and children will be recorded who are living in the same area for past 1
year or more. Simple random sampling will be use to select an
individual for the study among eligible family members.

Exclusion Criteria: Children who are suffering from any systemic and
chronic illness.

Data collection: Institute Ethical Committee will be taken prior to the

study. Data will be collected using a semi structured and pre-designed
questionnaire schedule by personal interview method. Written
informed consent will be obtained prior to the study which will be
signed by the mother and interviewer. For identification and initial
contact, the help of medical social worker and Anganwadi workers
will be obtained to minimize the non-response.
 Children with length/Height-for-age below -2 standard
deviations (SD) of the WHO standards8,9 were labelled as
stunted and children with weight-for-age below -2 standard
deviations (SD) of the WHO standards were identified as
underweight.9,10 Weight-for-height of below -3 standard
deviations (SD) of the WHO standards was used to identify infants
and children as having sever acute malnutrition (SAM)11 and
weight-for-height between -2 and -3 standard deviations (SD) of
the WHO standards is used to identify infants and children as
having moderate acute malnutrition (MAM).

Study tools: A) Pre-designed questionnaire related to socio-

demographic factors, environmental conditions and birth history.
In addition, questionnaire also include questions on past and
present medical history, followed by general and systemic
examination and investigations.
b) The weight measurements will be recorded to the nearest 100 g
using standard weighing machine and IAP calculations.
c) The height of the children will be recorded to the nearest 0.1
cm using anthropometric height rod. For children below 24
d) Assessment of nutritional status of under five children by WHO
Z-Score.
e) Assessment of Nutritional Deficiencies by clinical Examination
by using checklist.
f) Rapid Assessment Methodology will be used, so that semi-
structured interviews and surveys would be helpful later for
analysing data of focused groups. It will help to complete the
research in short time frame with low cost.

Innovation: 1) This study will provide a comprehensive

assessment of nutritional status using anthropometric
measurements.
2) The analysed findings will be disseminated to local
stakeholders, ensuring that the research is translated into action.
Expected Outcome: 1. To provide evidence on the nutritional
status of under five children in the village, which will inform local
health initiatives and policies.
2. To contribute to the existing body of knowledge on childhood
malnutrition in rural India. And to the development of targeted
strategies to reduce malnutrition in rural India

Implications: Childhood nutrition is an integral component of

a multifocal relationship with health, economic, social
developments, and political system of the country. Child
malnutrition under the age of 5 years has a great influence on the
cultural, social, economic and community food practices. Unlike
adults, the nutritional status of children is directly influenced by
maternal health during pre-pregnancy, pregnancy and
breastfeeding. This may further help in screening, early
identification, appropriate referral and integrated management of
malnutrition in children under the age of 5 years and would help
to counter the situation. This study can also be impactful or
locally relevant in informing health initiatives and policies to
improve nutritional outcomes.

ICMR Alignment: 1. This study aligns with ICMR’s priority

area of “Child Health and Nutrition”.
2.The proposed research will contribute to the generation of new
knowledge and evidence-based practices in child health and
nutrition.

References:
1. ASSESSMENT OF THE NUTRITIONAL STATUS OF UNDER FIVE
CHILDREN IN KETHIREDDIPALLI VILLAGE, MOINABAD MANDAL,
TELANGANA. International Journal of Research and Analysis
Reviews (IJAR). www.ijar.org
2. Malnutrition in children under the age of 5 years in a primary
health care setting
Indiran Govender, 1 Selvandran Rangiah,2 Ramprakash
Kaswa,3 and Doudou Nzaumvila4
3. Malnutrition among under-five children in India and strategies
for control.
https://www.researchgate.net/publication/271713882_Malnutriti
on_among_under-
five_children_in_India_and_strategies_for_control

4. Trends of malnutrition from 1947-2021 among under-five

children in India
https://www.researchgate.net/publication/357454423_Trends_of
_malnutrition_from_1947-2021_among_under-
five_children_in_India

5. Prevalence and determinants of undernutrition among under-

five children residing in urban slums and rural area, Maharashtra,
India: a community-based cross-sectional study
https://doi.org/10.21203/rs.3.rs-15651/v7

6. Child growth standards-World Health Organization (WHO)

Standards (who.int)