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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 16  |  Issue : 1  |  Page : 11-14

Anthropometry measurements and nutritional status of children attending anganwadis in rural areas


Preventive and Social Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (M), Wardha, Maharashtra, India

Date of Submission11-Jan-2019
Date of Decision30-Dec-2020
Date of Acceptance31-Jan-2021
Date of Web Publication29-Jul-2021

Correspondence Address:
Dr. Ansi Patel
Nehru ward, Hanuman chowk, Civil Lines, Gondia - 441601, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_6_19

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  Abstract 


Background: The study is regarding the effectiveness of ICDS scheme in India which is for the benefits of children's nutrition and health. Aims: The aim of this study is to determine the assessment of the nutritional status of children attending Anganwadi in Seloo and Deoli. Objective: The objective is to assess the nutritional status of children according to American Association for Health Education in Anganwadi at the village Seloo and Deoli of Wardha district. Materials and Methods: All the students of Seloo and Deoli taken as subject for anthropometric measurements to asses nutritional status. Study type is cross sectional study. Results: In Seloo, almost 56.6% of children are underweight. In Deoli, almost 50% of children are underweight. Conclusion: The overall prevalence of undernutrition in the study population was assessed, and severe undernutrition was found to be present.

Keywords: Nutritional status, Anganwadis, PEM, Anthropometry, ICDS, Malnourished, Undernutrition


How to cite this article:
Patel A, Gada H, Menon M, Panicker A, Patil N, Bora S. Anthropometry measurements and nutritional status of children attending anganwadis in rural areas. J Datta Meghe Inst Med Sci Univ 2021;16:11-4

How to cite this URL:
Patel A, Gada H, Menon M, Panicker A, Patil N, Bora S. Anthropometry measurements and nutritional status of children attending anganwadis in rural areas. J Datta Meghe Inst Med Sci Univ [serial online] 2021 [cited 2021 Sep 16];16:11-4. Available from: http://www.journaldmims.com/text.asp?2021/16/1/11/322641




  Introduction Top


Nutrition may be defined as the science of food and its relationship to health. It is concerned primarily with the part played by nutrients in body growth, development, and maintenance. Good nutrition means “maintaining a nutritional status that enables us to grow well and enjoy good health.”

Over the past 50 years, many advances have been made in the knowledge of nutrition and in the practical application of that knowledge. Specific nutritional disease has been identified such as protein–energy malnutrition (PEM), endemic goiter, nutritional anemia, nutritional blindness, and diarrheal diseases. The associations of nutrition with infection, immunity, fertility, maternal and child health, and family health have engaged scientific attention.

During recent years, the science of nutrition has moved out of the laboratory and linked itself to epidemiology. This association has given birth to newer concepts which are broadly known as health for all – It is the basis for the WHO's primary health care strategy to promote health, human dignity, and enhanced quality of life. The promotion of proper nutrition is one of the eight elements of primary health care.

”Health for All” has therefore been WHO's guiding visions for more than seven decades and also the inspiration behind the current organization-wide drive to support countries in moving towards.


  Universal Health Coverage: Everyone and Everywhere (WHO Theme 2018) Top


Significance of anthropometry

  • Primary measures of past or current nutritional status in children
  • Distinguish between stunting and wasting
  • Identify PEM and obesity
  • Monitor changes after nutrition intervention
  • Clinical settings identify and hospital patients with Camurati-Engelmann Disease (CED) or over nutrition
  • Public health screening.


Anthropometric measurements

The age-dependent factors include weight, height, head circumference, and chest circumference. The age-independent factors include mid-arm circumference (1–5 years), weight for height, and skinfold thickness.

The most important scheme in the field of child welfare is Integrated Child Development Services (ICDS). The population norms for setting up of Anganwadi Centers (AWC) and mini-AWC have been revised to cover all habitations by SC/ST/minorities.

India has unacceptably high levels of child undernutrition with 38.4% of children stunted and 21% of children wasted (National Family Health Survey 4), despite strong constitutional, legislative policy, plan and program commitments evident by the creation of ICDS in 1975 and National Coverage of the Mid-Day Meal Scheme in 1995. In fact, a child under 5 years is almost twice as likely to be chronically underweight in India as in sub-Saharan Africa.

We are still far from a world without malnutrition. While the 2018 edition of the joint malnutrition estimates shows that stunting prevalence has been declining for 18 years, nearly one in 4–151 million children under 5 years were stunted in 2017 and 52 million suffered from wasting. Meanwhile, the number of overweight children worldwide has remained stagnant for more than a decade.

Aim

The aim of this study is to determine the assessment of the nutritional status of children attending Anganwadi in Seloo and Deoli.

Objectives

The objective is to assess the nutritional status of children according to American Association for Health Education in Anganwadi at the village Seloo and Deoli of Wardha district.

Methodology

  • Study duration – 4 months
  • Study type – Cross-sectional study
  • Sample size – All students of Deoli and Seloo
  • Inclusion criteria – All students present
  • Exclusion criteria – Those who are absent and not willing to give consent
  • Data collection tool – Anthropometric measurements
  • Data collection method


    • Weight: Weighing scale
    • Height: Measuring scale
    • Chest circumference, head circumference, middle-upper arm circumference: Measuring tape.


  • Data analysis – Done using MS Excel.


Ethical clearance

The Institutional Ethics Committee of DMIMSDU has approved the Research work proposed to be carried out at Jawaharlal Nehru Medical College, Sawangi(M), Wardha. Date: 11th Jan 2017 with Reference no DMIMS(DU)/IEC/2017-18/140.


  Results and Observation Top


Seloo profile

[Table 1] depicts the age-wise distribution of children attending anganwadi in Seloo, with a maximum percentage of students is from the age group of 4 years with 33.3% and the least is from the age group of 2 year old of age with 3.3% in a total of 30 students.
Table 1: Age-wise distribution of children in Anganwadi at Seloo

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[Table 2] depicts the sex-wise distribution of children attending Anganwadi in Seloo, and there is an equal distribution among male and female children attending this Anganwadi.
Table 2: Sex-wise distribution of children in Anganwadi at Seloo

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[Table 3] depicts a high prevalence of malnourished children are underweight (56.6%), followed by Moderately acute malnourished (13.3%) and lastly, Severely acute malnourished (3.3%) in seloo anganwadi. The percentage of children coming under normal PEM grade consists only about 26.6%.
Table 3: Nutritional status of children in Seloo according to weight for age (WHO classification 0-5 years)

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Deoli profile

[Table 4] depicts the age-wise distribution of children attending Deoli Anganwadi. As per this analysis, the maximum number of children attending Anganwadi belongs to the age group of 3 years, and the least belongs to the age group of 6 years.
Table 4: Age-wise distribution of children in Anganwadi at Deoli

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[Table 5] depicts the sex-wise distribution of children attending Anganwadi in Deoli; this table shows a male predomination (53.3%).
Table 5: Sex-wise distribution of children in Anganwadi at Deoli

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[Table 6] shows a high prevalence of underweight children attending Deoli anganwadi; almost 50% of children are underweight and about 16.6% of children are moderately acute malnourished. The percentage of children coming under normal PEM grade consists only about 33.4%.
Table 6: Nutritional status of children in Seloo according to weight for age (WHO Classification: 0-5 years)

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  Discussion Top


India stands at a very vulnerable position, with one of the highest prevalence of undernutrition in the world in spite of the improvement in food availability and poverty alleviation. In addition to it, numerous determinants play a role in its causation. The interplay of these determinants and their complementary effect makes it difficult to isolate one key factor in causing undernutrition.

The ICDS scheme has an empirical role in combating undernutrition whose services include supplementary nutrition, health checkups, and growth monitoring. However, even after 43 years of its initiation, the problem of undernutrition still persists (As shown in [Figure 1]) and the decrease in the prevalence is relatively low. It has given more attention to coverage rather than the quality of care. It has neglected aspect of educating parents on improving nutrition through proper childcare and feeding behavior within the family budget but focused more on food distribution. Even when the ICDS coverage is as high as 90%, the utilization is limited to 28% among under 6 children. In addition to this, inadequate skills of the staff, lack of logistics, and poor supervision have added to the problem.
Figure 1: >30% of children in India who are under 5 are stunted

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Dealing with this requires a holistic approach due to the complex interrelation of factors in causation of PEM, which has continued to haunt India as a silent crisis.[1],[2],[3],[4],[5],[6]


  Conclusion Top


After conducting a survey of the children attending the Anganwadi at Deoli and Seloo center, we thereby come to a conclusion:

  • The maximum number of children attending anganwadis is between the age group of 3 and 5 years.


    • At Seloo – between 4 and 5 years
    • At Deoli – between 3 and 4 years.


  • There is maximum ~57% prevalence of underweight children in Seloo followed by 50% in Deoli, according to the WHO classification of PEM.


The overall prevalence of undernutrition in the study population was assessed, and severe undernutrition was found to be present. Malnutrition continues to be a major problem in children below 6 years of age. Although the ICDS scheme is taking measures to combat this problem, India's progression reducing child malnutrition has been slow. However, continuous monitoring of anganwadis could identify underlying factors of malnutrition, thus helping in the planning of preventive strategies.

Summary

Nutrition may be defined as the science of food and its relationship to health. It is concerned primarily with the part played by nutrients in body growth, development, and maintenance. Good nutrition means “maintaining a nutritional status that enables us to grow well and enjoy good health. India stands at a very vulnerable position, with one of the highest prevalence of undernutrition in the world in spite of improvement in food availability and poverty alleviation. In addition to it, numerous determinants play a role in its causation. The interplay of these determinants and their complementary effect makes it difficult to isolate one key factor in causing undernutrition. We have analyzed the data from different Anganwadis in Seloo and Deoli of children between the age of 0–5 years and have come to a conclusion that according to the WHO criteria of PEM almost 57% children are undernourished in Seloo and almost 50% in Deoli. Although the ICDS scheme is taking measures to combat this problem, India's progression reducing child malnutrition has been slow. However, continuous monitoring of Anganwadis could identify the underlying factors of malnutrition, thus helping in the planning of preventive strategies.

Acknowledgment

We would like to thank the department of community medicine for providing us with the golden opportunity to conduct the project on the topic anthropometry measurements and nutritional status of children attending anganwadis in rural areas and also helping us to conduct the survey in the anganwadis.

We also want to thank our guide Dr. Nikhil Dhande for his support, help, and guidance without which our project would have been incomplete. We also would like to thanks our colleagues for their help and support.

Finally, we thank our Jawaharlal Nehru Medical College, Sawangi (m), for always encouraging us to do extracurricular activities that enhance our learning process during the period of internship.



 
  References Top

1.
Nagrale N, Patond S, Jain K. Estimation of Cephalic Index of Chhattisgarhi Population: An Anthropometric Study from Central India. Journal of Forensic Medicine and Toxicology 2019;36:9-12. Available from: https://doi.org/10.5958/0974-4568.2019.00003.6. [Last accessed on 2018 Dec 21].  Back to cited text no. 1
    
2.
Meshram K, Mourya A, Hinge M, James L, Mankar P. Effectiveness of Planned Teaching on Knowledge and Practice Regarding Growth Monitoring of Under-Five Children among Anganwadi Workers in the Rural Area of Wardha District. Int J Curr Res Rev 2020;12:20-4. Available from: https://doi.org/10.31782/IJCRR.2020.122310. [Last accessed on 2018 Dec 21].  Back to cited text no. 2
    
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Kurhadkar M, Rathi R, Damke S, Belsare A. Comparative Study in the Effectiveness of Pathadi Churn and Protein Powder in Karshya with Special Reference to under Nutrition among Pre-School Children. International Journal of Pharmaceutical Research 2019;11:2026-9. Available from: https://doi.org/10.31838/ijpr/2019.11.04.505. [Last accessed on 2018 Dec 21].  Back to cited text no. 3
    
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Kinyoki DK, Ross JM, Lazzar-Atwood A, Munro SB, Schaeffer LE, Abbasalizad-Farhangi M, et al. Mapping Local Patterns of Childhood Overweight and Wasting in Low- and Middle-Income Countries between 2000 and 2017. Nature Medicine 2020;26:750-9. Available from: https://doi.org/10.1038/s41591-020-0807-6. [Last accessed on 2018 Dec 21].  Back to cited text no. 4
    
5.
Patel AB, Bann CM, Garces AL, Krebs NF, Lokangaka A, Tshefu A, et al. Development of the Global Network for Women's and Children's Health Research's Socioeconomic Status Index for Use in the Network's Sites in Low and Lower Middle-Income Countries. Reprod Health 2020;17:1-10. Available from: https://doi.org/10.1186/s12978-020-01034-2.[Last accessed on 2018 Dec 21].  Back to cited text no. 5
    
6.
Gaidhane A, Holding P, Shah M, Patil M, Telrandhe S, Jadhav N, et al. “Photostory—A 'Stepping Stone' Approach to Community Engagement in Early Child Development.” Frontiers in Public Health 2020;8:1-11. Available from: https://doi.org/10.3389/fpubh.2020.578814. [Last accessed on 2018 Dec 21].  Back to cited text no. 6
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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