Prevalence of under nutrition in under-five tribal children of Melghat: A community based cross sectional study in Central India

Abstract

UnderweightWasting SAM a b s t r a c t Objective: Under nutrition has chronically remained a major public health problem among tribal children population in India. The present study aimed to estimate the prevalence of various forms of under nutrition in 'under five' children in Melghat e a difficult to reach, hilly, forest area of Maharashtra in Central India using different standards.Methods: A community based cross-sectional study was conducted in Dharni & Chikhaldara blocks in tribal area of Melghat over a period of two months. A representative sample of 2926 under-five children from randomly chosen 33 villages in two blocks was selected with cluster sampling. Information on various demographic and anthropometric characteristics (e.g. age, sex, height, weight) of study subjects was collected in a pre-designed proforma by trained tribal female village health workers (VHWs). Under nutrition was assessed by using Standard WHO criteria like stunting, underweight, wasting, and IAP grades; alone and in combination. Crude and adjusted prevalence estimates accounting for clustering effect were obtained along with 95% Confidence Intervals.Results: Out of total 2926 U5 children, 1006 (34.4%) were severely stunted, 547 (18.7%) were SUW and 209 (7.1%) were SAM, and 199 (6.8%) were severely under nourished (grade IIIeIV) according to IAP standards. However, when various WHO criteria & IAP gradations were applied in combination, more number 2241 i.e. (76.59%) of the U5 children in Melghat were found to be severely or moderately under nourished. by one or more standards.Conclusion: Very high prevalence of severe stunting, severe underweight and severe acute malnutrition was found in tribal U5 children population in Melghat. A combination of more than one criteria may be useful in tracking more number of under nourished children in tribal communities, which otherwise would be missed by any single criterion alone. The study findings will be helpful in planning prevention and planning of programmes that would focus more on populations most affected.

Health of tribal populations in India: How long can we afford to neglect?

“…Child malnutrition rates are also significantly higher and poverty more common for tribal populations compared with other populations3. In a cross-sectional study conducted in 2015, three-fourths (76.6%) of the 2926 under-5 children surveyed among tribal district of Melghat in Maharashtra, India, were found to be severely or moderately undernourished11. The situation of undernutrition is extremely worrisome in most tribal areas12.…”

Community-based management of severe malnutrition: SAM and SUW in the tribal area of Melghat, Maharashtra, India

“…1,5 Acute malnutrition is attributable to 14.6% of all child deaths having 8 times more fatality rate among malnourished children than normal children. [6][7][8][9] The prevalence of chronic malnutrition in India is among the highest in the world, and is nearly double than that of Sub-Saharan Africa, with dire consequences of mortality, morbidity, educability, and productivity. [9][10][11] Prevalence of malnutrition is much higher in tribal India.…”

“…Our study revealed prevalence of severe malnutrition (SAM -7.1%, SUW -18.7%, and severe stunting -34.4%) in U5 children of Melghat. 8 Prevalence of moderate and severe malnutrition (À2SD WHO) in tribal Melghat is as wasting in 26%, underweight in 58.4%, and stunting in 66.1%. 8 These levels are considered very high, above the 'WHO Trigger Levels', indicating a need for public health interventions.…”

“…8 Prevalence of moderate and severe malnutrition (À2SD WHO) in tribal Melghat is as wasting in 26%, underweight in 58.4%, and stunting in 66.1%. 8 These levels are considered very high, above the 'WHO Trigger Levels', indicating a need for public health interventions. 7 Major contributing factors for severe malnutrition are faulty child feeding practices (like delayed initiation of breast feeding, colostrum not given, and late weaning at 9-12 months); infectious diseases like ARI, Diarrhea, and Malaria; poor hygiene and sanitation, etc.…”

“…9,[20][21][22] Co-existence of acute and acute-on-chronic malnutrition cannot be denied in the developing world. [6][7][8]12 In this study, we have evaluated the efficacy of community-based management by local therapeutic food (LTF) and micronutrients (LTF-MN), home-based treatment of infectious diseases, and behavior change communication (BCC) on SAM and SUW through village health workers (VHWs) in tribal community of Melghat.…”