1. Associate Professor Mr. Basanta Kumar Rai
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA By
Milan Dhakal
Supervisor
Associate Professor Mr. Basanta Kumar Rai
External Examiner
Assoc. Prof. Birendra Kumar Yadav

2. Results and discussion Conclusion Recommendation Acknowledgement
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Presentation Outline
Introduction
Research question
Significance of study
Limitations of study
Results and discussion
Conclusion
Recommendation
Acknowledgement

3. FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Introduction
Nutrition is defined as the science of food and its relationship to health (Park ,2011)
Malnutrition can be described as the state of silent emergency (Bansal & Mehra, 1991).
Malnutrition is the most recognizable and perhaps most untoward consequence of poverty in children (Goel et al, 2007).
According to 2013 UNICEF report, globally 16% of under-five children were underweight. But majority of them resides in two regions of the world; the highest percentage is in South Asia (33%) and Sub-Saharan Africa (21%) (African Union, 2012). In addition, 52 million under five children were wasted and the highest is in South Asia where 16% were wasted (UNICEF, 2013).

4. Introduction contd… (source: MoHP,2011)
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Introduction contd…
Nutritional status of children in Nepal
(source: MoHP,2011)

5. FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Introduction contd…
The nutritional status of children in Nepal has improved over the last 10 years. The proportion of stunted children declined from 57 percent in 2001 to 41 percent in 2011 and that of underweight children from 43 to 29 percent in the same period. The proportion of wasted children declined from 13 percent in 2006 to 11 percent in 2011 (MoHP, 2011).
Low birth weight, PEM and micronutrient deficiencies are most common form of nutritional problems among under five year children in plain districts of Nepal.
Low birth weight, mother’s education, knowledge about the micronutrient, management of diarrhea, feeding practice and complementary practice, marriage, age, economic status are the factor affecting the nutritional status (Dhungana, 2013).
Several initiatives such as Growth monitoring, vitamin A distribution, deworming programs have been taken to reduce the impact of nutritional deficiency and promotion of health of under five years children in Nepal.

6. FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Introduction contd…
Panchgachhi VDC lies in Terai region and is located about 9Km south of Mahendra Highway
There are 2278 households, 12,301 total population and 959 children below five year of age (Panchgachhi VDC office,2015).

7. Objectives General objective
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Objectives
General objective
To assess the factors associated with nutritional status of 6 – 59 months children in Panchgachhi VDC
Specific objectives
To determine the nutritional status of months children in Panchgachhi VDC.
To identify associated factors of malnutrition among children aged 6 – 59 months in Panchgachhi VDC.

8. FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Research Questions
What is the existing nutritional status of 6 – 59 months children in Panchgachhi VDC?
What are the factors associated with the nutritional status of 6 – 59 months children in Panchgachhi VDC?

9. Significance of the study
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Significance of the study
Encourage local people to improve current nutritional status
Serve as helpful guide to plan suitable nutritional and health programs for this community based on facts and figures discovered from this study.
Provide information to government and voluntary institution about nutritional status as well as different demographic factors.
Encourage government and stakeholders for the development of programs and policies related to nutrition.
Discover the problems related to nutrition, care practices and feeding behavior of this community.

10. Limitations of the study
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Limitations of the study
Small sample size due to time and economic constraints
Seasonal variation is not considered
Findings cannot be generalized
24 – hour dietary recall was not included
Every information given by respondent might not be correct.

11. Materials and methodology
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Materials and methodology
Research Instruments
Weighing Machine
Stadiometer
MUAC Tape
Questionnaire
Research Method
Community based Cross – sectional descriptive study
Conducted from 1st to 9th June, 2015
Study Area
Panchgachhi VDC, Jhapa
Target Population
Children aged 6 – 59 months

12. Materials and methodology contd…
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Materials and methodology contd…
Inclusion Criteria
6 – 59 months children of Panchgachhi VDC
Exclusion Criteria
Disabled and seriously ill children
Children who were not available at household during survey
Study Variables
Dependent: Stunting, Wasting and Underweight
Independent:
Socio-economic and demographic
Child characteristics
Child care practices
Maternal characteristics
Environmental characteristics

13. Materials and methodology contd…
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Materials and methodology contd…
Sampling Techniques
2 wards (8 & 9) were selected by lottery method
simple random sampling used for selecting household with at least one 6 – 59 months children
Sample Size 97
Formula = Z2 * p(1-p)/d2
Adjusted for finite population
95% level of confidence
10% margin of error
Prevalance of malnutrition = 50%
10% non – response rate

14. Materials and methodology contd…
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Materials and methodology contd…
Data Collection Techniques
Interview with parent/caretaker of child to obtain data related to factors associated with nutritional status
Anthropometric measurements of children
a) Date of birth
b) Length/ height
c) Weight
d) MUAC
Data Analysis
WHO Anthro version used to determine nutritional status
SPSS version 20.0 for statistical analysis
Chi – square test applied to test association between nutritional status and its associated factors

15. Results and discussion
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Results and discussion
Out of 97 children, 51 were female and 46 male.
Prevalence of malnutrition
Moderately stunted 19.6% Severely stunted 10.3%
Moderately Wasted 14.4% Severely wasted 6.2%
Moderately underweight 12.4% Severely underweight 10.3%

16. Results and discussion contd… Gender distribution of malnutrition
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Results and discussion contd…
Gender distribution of malnutrition
Characteristics
Male(%)
Female(%)
All(%)
Severely wasted(<-3)
2.3
9.4
6.2
WHZ
Moderately wasted (>-3 and <-2)
11.3 17
14.4
Normal
86.4
73.6
79.4
Severely Stunted(<-3)
13.6
7.5
10.3
HAZ
Moderately Stunted(>-3 and <-2) 25
15.1
19.6
61.5
77.4
70.1
Severely Underweight(<-3)
11.4
WAZ
Moderately Underweight (>-3 and <-2)
13.2
12.4
77.3

17. Results and discussion contd… Age wise distribution of malnutrition
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Results and discussion contd…
Age wise distribution of malnutrition

18. Results and discussion contd… Distribution of wasting based on MUAC
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Results and discussion contd…
Distribution of wasting based on MUAC

19. Results and discussion contd…
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Results and discussion contd…
Distribution of stunting among 6 – 59 months children based on WHO standard

20. Results and discussion contd…
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Results and discussion contd…
Distribution of wasting among 6 – 59 months children based on WHO standard

21. Results and discussion contd…
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Results and discussion contd…
Distribution of underweight among 6 – 59 months children based on WHO standard

22. Results and discussion contd…
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Results and discussion contd…
Distribution of wasting based on MUAC among 6 – 59 months children based on WHO standard

23. Results and discussion contd…
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Results and discussion contd…
2. Factors Associated with under nutrition
Factors Associated with Stunting
* Statistically significant P < 0.05
HFA
Stunted
Normal ℵ2
P value
Value
Yearly Income
Less than 1 lakh
9(27%)
24(73%)
1 lakh to 3 lakh
15(31%)
34(69%)
0.205
0.903
More than 3 lakh
5(33.3%)
10(66.7%)
Mother educational status
Illiterate
11(35.4%)
20(64.6%)
0.679
0.41
Literate
18(27%)
48(73%)
Child Age Group
Less than 24 months
12(25.5%)
35(72.5%)
0.829
0.363
More than 24 months
17(34%)
33(66%)
Birth Order
First Child
18(33.3%)
36(66.7%)
0.686
0.407
Other than first child
11(25.5%)
32(74.5%)
Gender
Female
11(21.5%)
40(78.5%)
3.559
0.059
Male
18(39%)
28(61%)
Breast feeding Status
Yes
16(24.2%)
50(74.8%)
1.859
0.173 No
11(38%)
18(62%)
Family Size
Less than or = 4
19(41.3%)
27(58.7%)
5.432
0.02*
More than 4
10(19.6%)
41(80.4%)

24. Results and discussion contd…
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Results and discussion contd…
Factors Associated with wasting
* Statistically significant P < 0.05

25. Results and discussion contd…
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Results and discussion contd…
Factors Associated with Underweight
* Statistically significant P < 0.05
WFA ℵ2
P Value
Underweight
Normal
Value
Annual Income
Less than 1 lakh
6(18%)
27(82%)
1 lakh to 3 lakh
14(28.6%)
35(71.4%)
2.09
0.35
More than 3 lakh
2(13.3%)
13(86.7%)
Breast feeding status
Yes
14(21.2%)
52(78.8%)
0.1
0.752 No
7(24%)
22(76%)
Gender
Female
12(23.5%)
39(76.5%)
0.04
Male
10(21.7%)
36(78.3%)
Family Size
Less than or equal to 4
11(24%)
35(76%)
0.07
0.783
more than and equal to 5
11(21.5%)
40(78.5%)
Child age
Less than 24 months
10(21.3%)
37(78.5%)
0.749
More than 24 months
12(24%)
38(76%)
Birth Order
First Child
17(31.5%)
37(68.5%)
5.38
0.02*
Other than first child
5(11.6%)
38(88.4%)
Mother educational status
Illiterate
10(32.2%)
21(67.8%)
2.38
0.123
Literate
12(18.2%)
54(81.8%)

26. FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Conclusion
This is the first study conducted in Panchgachhi VDC to determine the nutritional status of 6 – 59 months children and their determinants.
Under nutrition is still an important problem among under five children in Panchgachhi VDC.
Family size, birth order, current status of breast feeding and child’s age were the risk factors associated with malnutrition in children in study area.
Cultural belives, associated with hygiene and child feeding, might be responsible for the cause of malnutrition which is in need of change for improvement of nutritional status.
Findings of this study are of great importance as they identify potential actions that can be taken for the imporvement the nutritional status of children.
Comprehensive, integrated and multi-sectoral plan should be made for addressing the problem of malnutrition in long term.

27. FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Recommendations
There is need for intervening nutritional and health education program
Urgent need for more attention on feeding and hygienic practices
Results and findings could be used by stakeholders to formulate nutritional plans and policies
Survey of this nature can be carried out at regular intervals for monitoring and improvement of nutritional status of the community
Public awareness programs could be launched to improve anit- natal and post natal care of mother
Cross-sectional or longitudinal survey can be conducted to determine the magnitude, distribution and other probable causes of malnutrition.

28. Acknowledgements Associate Professor Mr. Basanta Kumar Rai
FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
Acknowledgements
Associate Professor Mr. Basanta Kumar Rai
Supervisor, Central Campus of Technology
Mr. Dambar B Khadka, HOD, Nutrition & Dietetics
Central Campus of Technology
All faculty members of Nutrition & Dietetics
All the respondents.
Juniors and Friends.

29. FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
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30. FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF 6 – 59 MONTHS CHILDREN IN PANCHGACHHI VDC, JHAPA
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