Kazi Nazira Sharmin) Chairman of the Examination Committee Department of Applied Food Science and Nutrition Chattogram Veterinary and Veterinary Sciences University. Taslima Ahmed, Department of Applied Food Science and Nutrition, Chattogram Veterinary and Animal Sciences University (CVASU) for their scholastic guidance and supervision of the report work and drafting of the thesis. 17 Table-4.4: Percentage distribution of mothers based on the Infant and Young Child Feeding (IYCF) practices.
19 Table-4.6: Percentage distribution of stunting among 6-59 months children by gender 21 Table-4.7: Prevalence of acute malnutrition based on Middle Boar. Figure-4.6: Percentage distribution of stunting among 6-59 months children by age Figure 4.7: Distribution of children with Height-for-age Z-score.
Introduction
Rationale of the study
Our country has improved few indicators regarding health and nutrition, but there is still a large amount of people living without basic knowledge of health and nutrition, and the result is that we have not yet reached the safer percentage of malnutrition in Bangladesh. Very little available research has been conducted on the health and nutrition issues of the people living in the host community in Bangladesh, and among these people, children are the most vulnerable group. The objective of this study is to find out the real scenario of nutritional status of U-5 children living at Moheshkhali Upazilla and to involve the policy makers, Govt.
Aim
Specific objectives
Review of Literature
- Malnutrition
- Types of malnutrition
- Driving factors of malnutrition
- Breastfeeding
- Measurement parameters
- Assessment of Anthropometric measurement
- Assessment of Demographic measurement
- Z-Score
- Similar studies conducted elsewhere
Protein-energy malnutrition and nutritional deficiencies are known as the two major forms of malnutrition (Manoj and Ashutosh, 2011). Poverty and high food prices, unbalanced nutritional practices and lack of agricultural productivity are known to be major causes of malnutrition. Different levels of analysis must also be considered to identify the sociopolitical causes of malnutrition. For example, the population of a community under poor governments is also at risk if the world lacks healthcare-related services, but on a smaller scale. tied households or people are also at significantly greater risk due to variations in financial gain, access to land or education levels (Fotso and Kuate, 2006).
A z-score is also called a standard score and can be placed on a normal distribution curve. Previous birth interval, size at birth, mother's body mass index at birth and parents are considered to be the main factors contributing to malnutrition.
Materials and Methods
- Study area
- Study design
- Study Population
- Inclusion Criteria
- Exclusion Criteria
- Study parameter
- Ethical issue
- Data Collection Tool
- Data Collection
- Sample Size and Sampling Technique
- Study Variables
- Measurements
- Data Verification
- Analysis
The anthropometry, IYCF knowledge and practices of mothers, household food security and demographic information of the people living in Moheshkhali were studied. A structured questionnaire (Appendix I) was used to collect anthropometric, demographic, IYCF and household food security related data. After the pilot test, the questionnaire was validated with the actual situation to ensure the reliability of the study.
When there was more than one child under the age of five of a mother, lottery method was used to randomly select the child participating in the study. A low height-for-age, below -2SD of the reference population, indicates stunting while below -3SD indicates severe stunting. A low weight-for-height, below -2SD of the reference population, indicates wasting, while it is below -3SD.
A child with a weight-for-age z-score below -2SD of the reference population is underweight, while a child below or -3SD is seriously underweight. A well-structured questionnaire was used to collect data through personal interview with the children's mothers. The height of children >24 months was measured while the children stood upright with their feet flat on the height board, without shoes.
Maternal weight was measured using an electronic scale, and height (barefoot) was measured using a non-stretchable measuring tape and recorded to the nearest 0.5 cm. MUAC was measured on the left arm, midway between the elbow and the shoulder. After summarizing the collected data for each of the proposed indicators to answer the question about the objectives of the study, a planned analysis followed.
Results
Table 4.5: Prevalence of underweight measured by the Weight for Age Z-score (WAZ) and by gender of the children. 20 | P a g e Table 4.5 shows the percentage of children based on their weight for age Z-score and gender. Table 4.6 shows that 54.1% of the children had growth retardation, of which 26.5% had severe growth retardation and 27.6% had moderate growth retardation.
Table-4.7: Incidence of acute malnutrition based on Mid Upper Arm Circumference (MUAC) in the children. Table 4.8 shows the nutritional status of the examined children based on the IYCF's knowledge of their mother. This table shows no significant improvement in the children's nutritional status by various indicators based on the IYCF's knowledge of their mother.
Table 4.9 describes the nutritional status of the studied children according to their mother's IYCF practice. This study found no significant differences in children's nutritional status between mothers with poor and good IYCF practices. It also found that the mean WAZ (underweight) of children was -1.52 and -1.61 among the children's mothers who had poor and good knowledge, respectively.
No significant differences were found in the mean and standard deviation of the children's nutritional status on various indicators based on IYCF knowledge of their mother. It was found that the average WAZ (underweight) of the child was -1.54 among the child's mothers who practiced poor IYCF rules (correctly practiced 0 to 4 rules among 5 rules corresponding to the IYCF) and -1.60 among the child's mothers, who practiced good IYCF rules (practiced all 5 rules correctly in accordance with this IYCF). It also found that the mean WHZ (wasted) for the children was -0.53 and -0.56 WHZ (wasted) among the child's mothers who practiced poor and good IYCF rules, respectively.
It shows that MUAC of the studied children is significantly correlated with the maternal BMI (r = 0.205; p = 0.007). Weight for Height Z-score (WHZ), BMI for Age Z-score (BMIZ) and MUAC of the children were significantly correlated with maternal MUAC status.
Discussion
29 | P a g e Breastfeeding has been reported to play a key role in child nutrition, if children have not been breastfed on time and often, the risk of malnutrition increases because both are important in breastfeeding (CARE, 2010). The study showed that 44.7% of mothers gave colostrum within the first hour after giving birth. 82.9% of mothers continued breastfeeding until the baby was two years old (table 4.4).
The reason for the failure/lack of active IYCF and childcare practices may also simply be the lack of maternal health education or misunderstanding of the importance of IYCF. According to Olwedo et al., the children received complementary nutrition in a timely manner; However, 39% of children received complementary foods before 6 months of age and 13% after 6 months. The results of Kelati et al., 2011 show that 66.8% of women started breastfeeding immediately after birth.
This study shows that parity and family size are one of the root causes of malnutrition (Fotso and Kuate, 2006). On the other hand, as family size and parity increase, the Z-score decreases with increased levels of malnutrition (Fotso and Kuate, 2006). The result of this study showed that underweight (31.2%) was almost similar to that of 33.7% found in a study in a Burmese refugee camp and 33.7%.
30 | P a g e the negative skewness of the WAZ curve of these studied children compared to the WHO growth distribution curve shows that most of the children had a WAZ score <−2SD (Figure-4.6). The mean was lower than that of WHO standards, indicating a high prevalence of underweight among the children studied. The study described that sufficient regular basis foods present in the family with variety had a positive effect on the health and nutritional status of the children.
Conclusion
32 | P a g e points to the need to make a comprehensive, integrated and multi-sectoral plan to deal with the problem of malnutrition in the long term. Joint efforts by governmental and non-governmental organizations should be increased to reduce malnutrition rates among under-five children. To reduce child malnutrition effectively and efficiently and program should be designed and started.
The number of malnutrition in this area must be considered not only as a health problem, but as a serious protection and access to basic rights. This shows that it is very important to invest in the prevention of malnutrition instead of focusing only on the treatment.
Future Directions
Limitations
Recommendations
Future directions
The proportion of dietary salt intake and the percentage of salt in drinking water in the area can be investigated, which can maintain an impact on the nutritional status of people. Risk factors for severe acute malnutrition in under-five children: Joint Health Department of Ethiopia. Prevalence and factors associated with undernutrition among children aged 6 to 59 months in a pastoral community of Dollo Ado District, Somalia Region, Ethiopia.
Prevalence and factors associated with malnutrition in children aged 6-59 months in the pastoral community of Dollo Ado District, Somali Region, Ethiopia. Socioeconomic Inequalities in Early Childhood Malnutrition and Morbidity: Changing the Household-Level Effects of Community Health and Place. Prevalence and determinants of chronic malnutrition among preschool children: A cross-sectional study in Dhaka City, Bangladesh.
Prevalence of malnutrition and associated factors among children aged 6 to 59 months in Hidabu Abote District, North Shewa, Oromia Regional State. Prevalence of acute malnutrition and its associated factors among children aged 6 to 59 months in the Eritrean refugee camp Mai-Aini, northern Ethiopia. Muthayya, S.2009.Maternal nutrition and low birth weight – what really matters.Indian Journal of Medical Resources.
Nutritional knowledge of mothers/guardians and anthropometric incidence of children (2-5 years) in Obowo Local Government Area, Imo State, Nigeria. A study on prevalence of undernutrition and its determinants in anganwadi children of Malappuram district, Kerala. Summary report of WFP and UNHCR Joint Impact Assessments on the contribution of food aid to durable solutions in protracted refugee situations.
Questionnaire
Measurement of Length
Measurement of Height
Measurement of MUAC
Z-score
Variables View at SPSS
