DIET INTERVENTION FOR REDUCING MALNUTRITION AMONG PRESCHOOL CHILDREN

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2 Indo-Am. J. Agric. & Vet. Sci., 2014 Maharshi ISSN Deepa and Suratani Sreedhar, 2014 Vol. 2, No. 3, September Meghana Publications. All Rights Reserved Research Paper DIET INTERVENTION FOR REDUCING MALNUTRITION AMONG PRESCHOOL CHILDREN Maharshi Deepa 1 * and Suratani Sreedhar 1 *Corresponding Author: Maharshi Deepa deepanarayana@rediffmail.com Malnutrition is a major problem among preschool children. It is a condition results from eating a diet in which certain nutrients are lacking. Malnutrition at an early age leads to reduced physical and mental development during childhood. Reducing malnutrition involves not only intake of qualitative food as well as adequate healthcare and healthy environment. The study was undertaken to explore the causes of malnutrition and to explore the effects of dietary intervention on body weights of children. The experimental study was carried out to study the dietary interventions. Pretested interview schedule was used for collecting the data from mothers of preschool children and anthropometric measurements were taken from the children. Sample were selected based on their anthropometric measurements. Diet was planned with locally available food groups. Results revealed that there is a significant change in the body weights of children. Mean scores on awareness levels on importance of balanced diet has shown that there is change in knowledge level of mothers after the training program. There is significant difference in the weights of children at.005 level. Few measures were high lightened to reduce the intensity of malnutrition, which were followed during the course of intervention. Keywords: Malnutrition, Diet intervention, Balanced diet INTRODUCTION Malnutrition is the condition that develops when the body is deprived of vitamins, minerals and other nutrients. Under nutrition occurs when enough essential nutrients are not consumed. Approximately 70% of the world s children live in Asia, resulting highest concentration of childhood malnutrition in the region. As per World bank estimates India occupied 2 nd rank with 17% malnutrition children. Besides Protein energy malnutrition, Asian children also suffer from micro nutrient deficiency. Iron deficiency anemia affects 40-50% of preschool children. The etiology of childhood malnutrition is complex involving interaction of multiple determinants that include biological, cultural and socioeconomic influences. Protein energy malnutrition and micro nutrient deficiency which leads to early growth failure often can be traced to poor maternal malnutrition and 1 Sri Venkateswara Veterinary University, Krishi Vigyan Kendra, Lam Guntur. 70

3 Indo-Am. J. Agric. & Vet. Sci., 2014 Maharshi Deepa and Suratani Sreedhar, 2014 healthcare. It also results in intra uterine growth retardation before and during pregnancy and low birth weight of children. Interventions that are cost effective and culturally appropriate for the elimination of childhood malnutrition deserve the support of all. About 30% of the infants were dying due to poor intake of food by mothers and malnutrition after birth. A sizable number of pregnant women were succumbing to anemia. Only a concerted effort by the field staff of Medical and Health and allied departments and awareness programs for the women could check the menace (Hindu, Guntur, Jan 2, 2013). Hence the present explorative study was taken up in Duggirala and Mangalagiri mandals of Guntur district of Andhra Pradesh, India, to study the underlying factors for malnutrition and to suggest suitable measures for combating malnutrition. THEORETICAL APPROACHES The concept of the Becker theory (1965) is based on two levels, affecting the child nutritional status. One is at house hold level and another is at child level. Household level factors includes the quality of child care such as age, experience, education of the mother or caregiver, own health status and environmental factors, such as place of residence and availability of minimum facilities are also enter the production function. Second factor at child level reflects combined effects of many factors, including nutrient intake, health, birth order, and behavioral factors governed by parental preferences John Rawls Theory of Justice proposes the universal access is called social Primary goods (like liberties, opportunities, self-respect, etc.) for all individuals in the Society equally. One of the primary good, though not explicit in his theory but implicit, that has to be ensured to every citizen of the society is health. Moreover, it assumes primary significance in the perspectives of human capital, human development and human rights, the health and nutritional deprivation of children can have severe negative implications. But the unfinished reality is that even today many children in the developing societies are deprived in health and nutrition. Genetic Potential Theory or Deprivation Theory and the Other by Heretic Views According to Genetic potential theory, each individual is endowed with a maximum potential of growth, especially in the case of children below 5 years of age. The failure to achieve the maximum genetic potential is believed to be affected by the socioeconomic factors like nutrition, socioeconomic condition, etc., thereby resulting in growth retardation. The exponents of the Heretic View, on the other hand argue that deviation from genetic potential does not entail any functional impairment. Instead, children or adults may be small but healthy. CONCEPTUAL FRAMEWORK OF THE DETERMINANTS OF CHILD NUTRITIONAL STATUS SOCIOECONOMIC VARIABLES Income levels Age Place of residence Educational status of mother PROXIMAL FACTORS (INDIVIDUAL VARIABLES) Weight at birth Birth order Sex of the child Health status of children CHILD NUTRITIONAL STATUS Low birth weight of children 71

4 Indo-Am. J. Agric. & Vet. Sci., 2014 Maharshi Deepa and Suratani Sreedhar, 2014 Malnourished Chronic nutritional disorders CULTURAL DETERMINANTS Low decision making of women on finance Gender discrimination Early girl child marriages Mother s knowledge on nutrition MATERIALS AND METHODS The present study was conducted in Duggirala mandal of Guntur district in Andhra Pradesh. A total of 60 children were selected from 12 villages, five children from each village using random sampling technique. Samples were selected based on their anthropometric measurements. Cognitive and Social skills were measured along with body weights at frequent intervals. Pretested interview schedule was used for collecting the data along with 24 Recall methods from mothers of preschool children. Pre and post testing were carried out for mothers using interview schedule on their knowledge level about importance of balanced diet and feeding practices of children. Body weights of the children, Social skills and Cognitive skills were recorded at fortnight intervals. The data was analyzed using standardized statistical procedures laid down by the Snedekor. RESULTS AND DISCUSSION Food consumption pattern: Most of families had food intake of cereals more than pulses and the proportion of pulses and cereal combination is very less. Intake of green leafy vegetables is almost negligible. Forty percent of the mothers of preschool children has low mean score on knowledge about balanced diet. Low socioeconomic status, less awareness about balanced diet are the important factors contributing to different consumption patterns which are less than Indian Council of Medical Research recommended dietary allowance. National Family Health Survey study revealed that maternal characteristics such as socioeconomic and behavioral factors are more influential in determining childhood nutritional status. Nutrient intake: The mean intake is less than recommended dietary allowances of ICMR. The nutrient values are below the average values. The intake of calcium and iron was very less among the pregnant and lactating mothers. Knowledge about intake of balanced diet and infant feeding and weaning practices are significant at 0.005% after the training program. The consumption of milk was very inadequate. Most of the protein and energy were derived from cereals and which indicated the deficiency of Iron and B complex are more common among preschool children. The present findings were in concurrence with the reports of Khader, (1996) which indicated that the deficiency of iron, ascorbic acid and beta carotene deficiency seem to be more predominant in rural population followed by riboflavin, thiamine and niacin deficiency in Guntur district. Nutritional status: The anthropometric measurements of children compared to standards of heights and weights shown that they are below the average levels of National Nutrition Monitoring Board, when compared with initial body weights. The study revealed that there is significant increase in body weights of children. Maternal characteristics such as socioeconomic and behavioral factors are more influential in determining childhood nutritional status found by Rajaram (2007). Children were given iron and calcium rich diet along with protein energy based food. Mothers were given training on preparation of nutritive recipes. The present findings were corroborating with observation of Grantham Mc Grego (1995) who found that children who suffered early childhood malnutrition had poor IQ levels, cognitive functions, school achievements and 72

5 Indo-Am. J. Agric. & Vet. Sci., 2014 Maharshi Deepa and Suratani Sreedhar, 2014 great behavior problems. Results revealed that children have shown significant improvement at level in cognitive and social aspects when compared with initial cognitive and social skills. Along with nutritional guidance, mothers were given orientation on developmental aspects of children. Supplementation trials and programs aimed at improving dietary diversity and quality in general are more likely to show effects on indicators of behavior development. Schurch (1995). It was found that individual factors showed evidence of state- and villagelevel clustering of malnutrition. Rajaram et al. (2007). Measures taken for combating malnutrition: The following measures were suggested in combating malnutrition among children Capacity building of mothers on till completion of the intervention on different aspects of causes of malnutrition and its prevention. Method demonstration on preparation of nutritive recipes Focused inputs distribution Regular follow up of the intervention Linkage with line departments in identification of clinical symptoms Training to grass root level workers/ Social workers / Health Workers involved in working with preschool children. CONCLUSION Malnutrition among preschool children is a major concern in developing countries like India. The major thrust area is identifying the causes of malnutrition and developing community based measures is necessary for reducing the malnutrition. Strategies play a vital role in addressing the issue, and planning local specific intervention. Measures were planned based on the intervention program and followed. Energy protein rich diets were planned with available food groups by making a change in mixing of proportions. Iron rich foods and nutritive protein based foods were planned. Mothers were given regular awareness on this intervention as they are the primary caretakers. Regular follow up is very much essential for recording the changes. An intervention program can address the issues when all the stakeholders participate in the planning process. REFERENCES 1. Grantham-Mcgregor, S. (1995), A Review of Studies of the Effect of Severe. Malnutrition on Mental Development, The Journal of Nutrition, Vol. 125, pp. 2233S- 2238S. 2. Khader V (1996), Food intake and nutrient adequacy of rural population of Guntur District (Andra Pradesh), Indian J Med Sci, Vol. 50, No. 2, pp Rajaram S, Zottarelli L K and Sunil T S (2007), Malnutrition in rural areas and its effects, Review in India, Vol. 3, No. 2, pp

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