Nutritional Status And Common Morbidities Among Children Aged 1-5 Years In Rural Community Of Jammu Suri S, Sr Resident, LHMC & SSKH, New Delhi Kumar D, Head of Department, GMC & H, Jammu

Introduction Malnutrition, Acute Respiratory Infections (ARI) and Diarrhoeal diseases  Major public health concern in India  High morbidity and mortality in under-five children Prevalence of under- weight children in India is highest in the world  40% children under 3 years of age are under-weight and 45% are stunted in India (NFHS- 3) Malnutrition reduces children’s resistance to infection and increases the burden of diseases in the communities India ARI (15%); Diarrhoeas (11%) of mortality in under-five children (WHO 2012) Vitamin-A is an essential nutrient needed for the normal functioning of the visual system; maintenance of cell function for growth, epithelial integrity, red blood cell production, immunity and reproduction. Its deficiency leads to myriad manifestations ranging from night blindness to keratomalacia as a part of xerophthalmia syndrome. Even mild deficiency leads to increase in morbidity and mortality from respiratory and intestinal infections. Although the number of clinically affected children has declined in recent years with many interventional programs, the number of children with sub-clinical Vitamin-A Deficiency is still huge in the world. Sub-clinical Vitamin-A Deficiency increases children's susceptibility to infection, reduces physical growth, and decreases the possibility of survival from serious illness.

6/9/2018 Aims and Objectives To assess burden of Under-nutrition, ARI & Diarrhoeal diseases among children aged 1-5 years 1 To study their association with selected socio-demographic factors and dietary factors 2

Material and Methods Study design Community based, Cross-sectional study among children aged 1-5 years Study location Block RS Pura, Rural field practice area of GMCH, Jammu Study tool Caretakers interviewed for history of ARI and Diarrhoea among children in the last 2 weeks Nutritional status assessed by measurement of mid-upper arm circumference History of associated factors like breast-feeding, complementary feeding, Vitamin A prophylaxis received was also ascertained. The present cross-sectional study was carried out in Block R.S. Pura, a rural field practice area of Post Graduate Department of Community Medicine, Government Medical College, Jammu, located at a distance of twenty three kilometers from GMC Jammu. The population of the block was 1,80,560 as per Census 200196, spread over 198 villages. The health services in the block are administered through a network of institutions comprising of one Community Health Centre, five Primary Health Centres and twenty-six Sub-centres. The block is divided into eight zones for the purpose of administration. Only one village was selected from the last zone so as to complete desired number of 15 villages to be surveyed.

Material and Methods Sample size 35% prevalence of diarrhoea in children found in pilot survey n = 4pq/L2 (L=allowable error 10% of ‘p’) 750 children Sampling Multi-stage random sampling technique All villages listed zone-wise(8 zones). 2 villages selected randomly from each zone 50 households having 1-5 year child selected in each village 750 children surveyed across 15 villages The present cross-sectional study was carried out in Block R.S. Pura, a rural field practice area of Post Graduate Department of Community Medicine, Government Medical College, Jammu, located at a distance of twenty three kilometers from GMC Jammu. The population of the block was 1,80,560 as per Census 200196, spread over 198 villages. The health services in the block are administered through a network of institutions comprising of one Community Health Centre, five Primary Health Centres and twenty-six Sub-centres. The block is divided into eight zones for the purpose of administration. Only one village was selected from the last zone so as to complete desired number of 15 villages to be surveyed. 5

Results Age-wise distribution of study population 12-24 mo 25-36 mo 37-48 mo 49-60 mo 100% = 750 Overall distribution

Results Gender-wise distribution of study population Boys Girls 100% = 750 Overall distribution

Results Socio-economic distribution of study population Upper Upper Mid Middle Lower Mid Lower BPL 100% = 750 Overall distribution

Results Prevalence of under-nutrition among children Normal (>13.5) Mild (12.5-13.5) Severe (<12.5) 100% = 750 Overall distribution

Results Prevalence of morbidities among children (N=50 in each village) Episodes of diarrhea, measles, and ARI reported in surveyed population Number Total ARI Diarrhea Measles

Factors associated with Diarrhoea in children

Factors associated with Under-nutrition in children

Discussion Under- nutrition, ARI and Diarrhoeal diseases exist as a public health problem in the study area. Exclusive breast feeding for six months and age at which the child started complementary feeding were found to have significant association with the nutritional status of children. Diarrhoea was found to be significantly associated with age of the child, socio-economic status of the family, in the subjects who started weaning after the age of 12 months.

Discussion There was a significant association of prevalence of diarrhoea with Vitamin A supplementation and nutritional status. New preventive and treatment recommendations for under-nutrition, ARI and diarrhoea should continue for better understanding of the factors which lead to high child mortality and morbidity attributable to them.

Conclusion Multi-pronged approaches aimed at improving maternal and child health care including nutrition education, growth monitoring, exclusive breast feeding, complementary feeding, standard case management of diarrhoea and ARI would be beneficial to combat the problem of under-malnutrition.

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