Assessment of Nutritional Status of under Five year Rural children in ...

Assessment of Nutritional Status of
under-five year rural children in the Districts of
Madhya Pradesh State
District: BHOPAL
Morena
Bhind
Sheopur
Gwalior
Datia
Shivpuri
Neemuch
Mandsaur
Ratlam Ujjain
Jhabua
Indore
Dhar
Alirajpur
Rajgarh
Shajapur
Dewas
Sehore
Guna
Harda
Bhopal
Ashok
Nagar
Vidisha
Raisen
Hoshangabad
Tikamgarh
Sagar
Narsimhapur
Chhindwara
Chhatarpur
Panna
Damoh
Seoni
Jabalpur
Katni
Mandla
Satna
Umaria
Dindori
Rewa
Shahdol
Sidhi
Anuppur
Singrauli
Barwani
Khargone
Khandwa
Betul
Balaghat
Burhanpur
NATIONAL INSTITUTE OF NUTRITION
Indian Council of Medical Research
Hyderabad – 500 007
2011

Assessment of Nutritional Status of under
Five year Rural children in the Districts of
Madhya Pradesh State
- Bhopal District
G.N.V.Brahmam
K.Venkaiah
A.Laxmaiah
I.I.Meshram
K.Mallikharjuna Rao
Ch.Gal Reddy
Sharad Kumar
M.Ravindranath
K.Sreerama Krishna
National Institute of Nutrition
Indian Council of Medical Research
Hyderabad – 500 007
2011

CONTENTS
Page No.
ACKNOWLEDGEMENTS
PROJECT STAFF
RESULTS AT GLANCE
EXECUTIVE SUMMARY
i – iii
1. INTRODUCTION 1 – 4
1.1 Profile of Bhopal District 3
2. OBJECTIVES 4
2.1 General Objective 4
2.2 Specific objectives 4
3. METHODOLOGY 4 – 7
3.1 Sampling Design 4
3.1.1 Sample size 4
3.1.2 Selection of Villages 4
3.1.3 Selection of Households 5
3.2 Investigations 5
3.2.1 Household demographic and socioeconomic Particulars 5
3.2.2 Anthropometry 5
3.2.3 Clinical examination 5
3.2.4 History of Morbidity 6
3.2.5 Maternal Particulars 6
3.2.6 Infant and Young child feeding practices 6
3.2.7 Coverage of children under various health & nutrition
intervention Programmes 6
3.2.8 Spot testing of household cooking salt for Iodine 6
3.3 Recruitment, training, standardization of field Investigators and
data collection
3.4 Quality Control 7
3.5 Data Analysis 7
4. RESULTS 7 – 19
4.1 Coverage 7
4.2 Household Socio-economic and Demographic particulars 7
4.2.1 Community 7
4.2.2 Type of family 8
4.2.3 Family size 8
4.2.4 Literacy status of father 8
4.2.5 Literacy status of mother 8
6
Nutritional Status of

4.2.6 Household landholding 8
4.2.7 Major occupation of father 8
4.2.8 Major occupation of Mother 8
4.2.9 Per capita monthly income 8
4.3 Household Physical facilities 9
4.3.1 Type of house 9
4.3.2 Household amenities 9
4.4 Iodine content of Cooking salt 9
4.5 Maternal characteristics 9
4.5.1 Age and parity of mother 9
4.5.2 Particulars of last Pregnancy (mothers of

ACKNOWLEDGEMENTS
We express our sincere thanks to Mr. B.R. Naidu, I.A.S, Principal Secretary,
and Smt. Tinoo Joshi, I.A.S, and Dr. Loveleen Kacker, I.A.S, past Principal
Secretaries, Women and Child Development & Social Justice Department,
Government of Madhya Pradesh for providing us an opportunity to carry out this
study.
Our thanks are due to Ms. Kamini Chauhan I.A.S, Deputy Secretary, Dr.
Anupam Rajan, Director and Shri. Akshaya Srivatsav, Joint Director, Women and
Child Development Department, Government of Madhya Pradesh for their support
during the study.
We are also thanksful to Shri. Gulshan Bamra, former Director, and Sri Praveen
Kumar Gangrade, former Jt. Director, Women and Child Development Department,
Government of Madhya Pradesh, and their colleagues for extending their cooperation and
help in the execution of this study.
The infrastructural & logistic support extended by Prof. S.K. Trivedi,
Executive Director, Mr. Gokul pal, Research Officer and their colleagues at Indian
Institute of Development Management (IIDM), Bhopal is gratefully acknowledged.
Our thanks are also due to UNICEF-Madhya Pradesh and UNICEF-New Delhi
for their support by providing anthropometric equipment for use in this study.
The help and support provided by the Districts Project Officers, Child
Development Project Officers, Supervisors, Anganwadi Workers (AWWs) and
ASHA worker (Health functionaries) of the concerned districts in the execution of
the survey, is gratefully acknowledged.
Our sincere thanks to the entire field staff for their commitment and
sincere efforts in the collection of data.
We grateful to Dr. B. Sesikeran, Director, N.I.N and Dr. Vishwa Mohan
Katoch, Director-general, I.C.M.R, and Secretary, Department of Health Research,
Ministry of Health and Family Welfare, GoI, for their constant support and
encouragement.
We also thank Mr. G.Manohar Reddy, Research Officer, Mr. R. Raghunath
Babu, Technical Assistant, Mrs. G.Madhavi, Technician, Ms. D.Sarala & G.Madhavi
Tabulators, NNMB-CRL, and Ms. D. Balamani, Ms. D. Saritha & Ms. M. Venkata
Ramanamma, Punch Operators, and Mrs. L. Rajeswari & Mr. M. Shashi Kumar Reddy,
Data Entry Operators for their technical help.
We are also thankful to Mr. G. Hanumantha Rao, and Mrs. G. Prashanthi,
Personal Assistants for their secretarial assistance.
Last but not least, we are extremely grateful to the community for their
unstinting cooperation, without which the study would not have been completed
successfully.
Authors

PROJECT STAFF
RESEARCH ASSISTANTS
Sl.No.
1.
2.
3.
4.
5.
6.
7.
Name
Mr. ARUN KUMAR SHARMA
Mr. MUKESH KUMAR REKHWAL
Mr. AVINASH RAI
Mr. KUNDAN MISHRA
Mr.SACHIN PAREY
Mr. NIMESH KUMAR
Mr. SEVAKRAM GORE
FIELD INVESTIGATORS
Sl.No.
1.
2.
3.
Name
Mr. DONGAR KUMAR VERMA
Ms. ASHMA JAHAN
Mr.OMPRAKASH NATH
Nutritional Status of

RESULTS AT GLANCE

RESULTS AT A GLANCE
DISTRICT PROFILE
Total population (2001 Census) 18,36,784
Sex Ratio 896
Population density (per sq km) 663
Percent of Schedule caste 14.0
Percent of Schedule Tribes 3.3
Literacy status (%) 75.1
Female literacy (%) 66.7
SAMPLE CHARACTERISTICS
HHs surveyed (n) 396
Average Family size (n) 5.9
Average per capita monthly income (Rs) 1176
COMMUNITY (%)
Scheduled Caste 25.5
Scheduled Tribe 9.3
TYPE OF FAMILY (%)
Nuclear 52.0
Extended Nuclear 19.2
Joint 28.8
LITERACY STATUS (%)
Father 79.3
Mother 59.3
LAND HOLDING (% HHs)
Land less Families 51.8
Marginal Farmers 9.8
Small Farmers 12.6
Large Farmers 25.8
(Contd… 2)
.
Nutritional Status of < 5 year Children Bhopal Dt. - Madhya Pradesh

RESULTS AT A GLANCE (Contd…2)
MAJOR OCCUPATION OF HOUSEHOLD
Percent
Labourers 57.1
Cultivators 25.7
Land Lords -
Artisans -
Service 9.6
Business 6.1
TYPE OF HOUSE
Kutcha 22.0
Semi-Pucca 68.4
Pucca 9.6
SOURCE OF DRINKING WATER
Open well 2.5
Tube well 90.4
Tap 2.3
HOUSEHOLD ELECTRICITY 91.4
PRESENT AND USING SANITARY LATRINE 21.2
IODINE CONTENT OF COOKING SALT
0 ppm 7.6

DELIVERY CONDUCTED BY
RESULTS AT A GLANCE (Contd…3)
BREAST FEEDING AND COMPLEMENTARY FEEDING
Percent
M.O. PHC 53.2
TBA/ANM/LHV 18.0
Pvt. Doctor 10.8
Untrained Dai/Others 17.1
Low birth weight (% infants) 4.8
Initiate of Breast feeding (hours)

EXECUTIVE SUMMARY

Executive Summary
Undernutrition continues to be a major public health problem in the developing
countries, including India, the most vulnerable groups are women and young
children. Proper nutrition helps in adequate growth and development in children,
which is basic requirement for human development. The undernutrition has multifactorial
in aetiology and its determinants include both food and non-food factors.
According to the recent reports of NFHS-3 (2005-06), the prevalence of
underweight, stunning and wasting (

had done their ANC registration early i.e., < 16 weeks of gestation. About 76% of the
pregnant women received IFA tablets during pregnancy, of which 39% received ≥90
tablets and about 24% reported that they consumed ≥90 tablets. About 79% of
deliveries were institutional took place either in govt (69.4%) or private (9.9%)
hospitals. About 64% of deliveries were conducted either by a Medical officer, PHC
(53.2%) or doctors at private hospitals (10.8%). Birth weight was recorded in about
71% of infants, while records were available for about 38% of infants. As per the
records, about 5% of new born babies had birth weight of

to 3.6%) among 24-59 months children, while the prevalence of ARI was higher
among children aged 12-23 months. The prevalence of fever was lower (9.5%) among
children aged 36-47 months. About 72% of the mothers in general, reported that they
consult private practitioner, while 28% went to PHC, when their children fall sick.
The overall prevalence of undernutrition (

1. INTRODUCTION
India, in the past few decades, has witnessed rapid progress in terms of
industrialization and agricultural production. Yet malnutrition, especially
undernutrition continues to be a major problem of public health significance in the
country. It is a major contributor to high rates of childhood mortality, maternal
mortality and morbidities in the community 1 . Though, poverty is a major underlying
cause, scores of other factors such as socio-demographic, socio-cultural and lifestyle
practices contribute significantly to the problem of malnutrition.
Prevalence of low birth weight, mainly due to intrauterine growth retardation
continues to be high, which is attributable to maternal undernutrition. This is further
aggravated by inappropriate infant and young child feeding practices, such as
discarding of colostrum, delayed initiation of breast feeding, early or delayed
initiation of complementary feeding and sub-optimal complementary feeding
practices in terms of type of feed, quantity and frequency.
It has been found that non-exclusive breast feeding in the first six months of
life results in 1.4 million deaths and 10% of the disease burden among infants and
young children every year in the developing countries 2 . It is also estimated that about
10-15% of under five year deaths in resource poor countries could be prevented by
achieving 90% of exclusive breast feeding alone 3 and 22% of neonatal deaths could
be prevented if breast feeding is initiated within the first hour of birth 4 .
About 21% of global deaths and DALYs (Disability Adjusted Life Years) in
children younger than 5 years are attributed to stunting, severe wasting and
intrauterine growth retardation. Long term consequences of undernutrition during the
early stages of child growth and development include likelihood of short stature in
adult life, low educational achievements, giving birth to smaller children, lower
economic status and reduced physical work capacity and productivity in adulthood 5 .
Further, the country is passing through a phase of rapid socio-economic
transition leading to over nutrition in certain segments of the population, especially in
the urban communities. Changing lifestyles and dietary habits are contributing to
increase in the prevalence of overweight/obesity among children and young adults
exposing them to the risk of chronic degenerative disorders such as hypertension,
Type 2 diabetes, coronary artery disease, stroke, cancers etc in the later part of life.
More over undernutrition during early childhood can lead to overweight/obesity in
adulthood, a risk factor for diet related chronic diseases 6 .
The major nutritional problems of public health significance in the country are,
protein energy malnutrition (PEM), vitamin A deficiency (VAD), iron deficiency
Nutritional Status of

anaemia (IDA) and iodine deficiency disorders (IDD). Preschool children, adolescent
girls, women of reproductive age group, elderly, those belonging to socioeconomically
backward groups such as scheduled caste and schedule tribe
communities, communities residing in chronically drought affected rural areas are
nutritionally the most vulnerable segments of the populations.
Several nutrition programmes have been designed and are being
implemented in India, through respective State Governments, during the past few
decades for the prevention and control of both macro and micronutrient malnutrition
in the population. They include supplementary feeding through ICDS, distribution of
iron and folic acid tablets, massive dose vitamin A supplementation, Mid-day meal
programme etc. Also, several poverty alleviation and developmental programmes
are being implemented by central and State governments, for the overall
socioeconomic development of the communities. In addition, Public Distribution
System and TPDS are striving to provide essential commodities at affordable price,
especially to those below poverty line throughout the year, all over the country, to
ensure household food security.
Children, who are subjected to socio-economic and dietary constraints during
their critical years of growth and development, end up as adults with small body size.
Such adults may be apparently healthy, but there is evidence to suggest that their
productivity and earning capacity are impaired (Satyanarayana and Naidu, 1977 7 ).
Repeat surveys by National Nutrition Monitoring Bureau (1999 8 ) in eight States
revealed that, despite very little or no change in the dietary intakes of rural population
over a period of time, there was a decrease in the prevalence of severe forms of
undernutrition among young children with concomitant increase in normal grades.
However, the proportion of children with mild to moderate undernutrition remained
similar. Recent survey carried out by NNMB (2006 9 ) in the rural areas of nine States
revealed that about 40% under 5 year children were underweight, 45% were stunted
and 20% were wasted. The corresponding figures for the State of Madhya Pradesh
were, 46%, 59% and 24% respectively.
According to NFHS-3 10 , in the State of Madhya Pradesh, 60% of

ecommended several action programmes in its National Plan of Action on Nutrition
(1995) 12 . Though, the Government of India and the respective State Governments
have been implementing several health, nutrition intervention and developmental
programmes through its National Nutrition Policy and National Plan of Action on
Nutrition for overall improvement of health and nutrition status of the community, the
prevalence of undernutrition continues to be significantly high.
The type and magnitude of undernutrition may vary from district to district,
depending on geographical and agro-climatic conditions and therefore, warrant
region-specific interventions. In order to devise and implement area specific
intervention strategies and to monitor their impact over a period, it is necessary to
generate data base at district level.
In this context, the Government of Madhya Pradesh is contemplating to
develop State Nutrition Policy and develop plan of action for implementation, in order
to improve the nutritional status of the communities. Therefore, at the request of the
Department of Women & Child Development, Government of Madhya Pradesh, the
National Institute of Nutrition carried out survey in all the following 50 districts of the
State, to assess the nutritional status of under 5 year children and infant and young child
feeding practices.
Sl. No. District
Sl.
Sl.
Sl.
Sl.
District
District
District
No
No.
No
No
District
1 Alirajpur 11 Chindwara 21 Indore 31 Neemuch 41 Shadol
2 Anuppur 12 Damoh 22 Jabalpur 32 Panna 42 Shajapur
3 Ashokngar 13 Datia 23 Jhabua 33 Raisen 43 Sheopur
4 Balaghat 14 Dewas 24 Katni 34 Rajgarh 44 Sidhi
5 Barwani 15 Dhar 25 Khandwa 35 Ratlam 45 Singrauli
6 Betul 16 Dindori 26 Khargone 36 Rewa 46 Shivpuri
7 Bhind 17 Guna 27 Mandla 37 Sagar 47 Tikamgarh
8 Bhopal 18 Gwalior 28 Mandsaur 38 Sathna 48 Ujjain
9 Burhanpur 19 Harda 29 Morena 39 Sehore 49 Umaria
10 Chhatarpur 20 Hoshangabad 30 Narsimhapur 40 Seoni 50 Vidisha
The results of the study carried out in Bhopal district of Madhya Pradesh
State during February-August 2010, is presented in this report.
1.1 Profile of Bhopal District
Bhopal district is a district of Madhya Pradesh state in central India. The city
of Bhopal serves as its administrative headquarters. Bhopal district is bounded by
the district of Guna to the north, Vidisha to the northeast, Raisen to the east and
southeast, Sehore to the southwest and west and Rajgarh to the northwest. As of
the census taken in 2001, the district has a total population of 18, 36,784 people.
The Total area of District is 2772 Sq.km, with a population density of 663/sq.km. The
Nutritional Status of

district has a Sex Ratio of 896. Bhopal has an average literacy rate of 75.1%, higher
than the national average of 59.5%; with 82.6% of the males and 66.7% of females
were literate.
2. OBJECTIVES
2.1 General Objective
The general objective of the study was to assess the health and nutritional
status of

3.1.3 Selection of Households
In each of the selected villages, a total of 20 households (HHs) having at
least one index child of

3.2.4 History of Morbidity
Information on history of morbidity among the children such as fever,
respiratory infection, diarrhoea etc., if any, during the preceding 15 days of visit was
collected.
3.2.5 Maternal Particulars
Maternal particulars such as parity, antenatal care, TT immunization, receipt
of IFA tablets, particulars of delivery and recording of birth weight were collected on
mothers of

and pre-tested before being used in the survey. Data was collected in each district
by two teams.
3.4 Quality Control
Random checks were carried out by scientists from NIN, periodically by
revisiting the households surveyed by the field staff, to ensure quality of data
collection.
3.5 Data Analysis
The data was scrutinized and entered into the computers as soon as it was
received at NIN. The data cleaning was done by carrying out range and consistency
checks. Descriptive and analytical statistics of the data were carried out using SPSS
Windows version 15.0. Appropriate statistical tools were used wherever needed.
4. RESULTS
4.1 Coverage
A total of 396 households from 20 villages were covered for the present study
(Table 1). A total of 463 children (Boys:249; Girls:214)

4.2.2 Type of family
Fifty two percent of the households were nuclear families, while joint and
extended nuclear families accounted for 29% and 19% respectively.
4.2.3 Family size
The average family size was 5.9. About 36% of the HHs had family size of 1-4
members, 55% of HHs had 5-9 members and 9% of HHs had ≥10 members in the
family.
4.2.4 Literacy status of father
About 79% of the fathers of the index children were literates. About 19% had
an education level of 1-5 th class, 5% had schooling of 6 th -7 th class, 43% studied up
to 8 th -10 th class, 7% studied up to intermediate, while 5% had graduation or above.
4.2.5 Literacy status of mother
About 59% of the mothers of the index children were literates. About 29% of
them had an education level of 1-5 th class, 4% studied up to 6 th -7 th class, 22% had
schooling of 8 th -10 th class, 3% studied upto intermediate, while 2% were educated
upto graduation or above.
4.2.6 Household landholding
About 52% of households did not posses any agricultural land. About 10%
were marginal farmers (

4.3 Household Physical facilities
4.3.1 Type of house
About 68% of the houses were semi-pucca in nature, while 22% were kutcha
and 10% were pucca in nature (Table 3).
4.3.2 Household amenities
The major source of drinking water was from tube well (90.4%), followed by
open well (2.5%) and tap (2.3%). Majority (93.9%) of HHs were using firewood, while
6% were using LPG for cooking. About 91% of the houses were electrified. About
one fifth (21.2%) of the HHs were using sanitary latrine. About 59% of the HHs had
separate kitchen facility.
4.4 Iodine content of Cooking salt
The distribution of HHs according to iodine content of cooking salt as estimated
by spot testing kit is presented in Table 4. It was observed that almost all the HHs
(92.2%) were using free flowing salt. About 91% of HHs were using adequately
iodized (≥15 ppm) salt, 1% samples had

for not availing ANCs were ‘not aware of the need’ (18.2%), ‘loss of wage’s’ (6.1%), and
‘ANCs not held in the village’, ‘place is not accessible’, ‘no faith’ and ‘timings are
inconvenient’ (3% each).
About 76% of pregnant women received IFA tablets, mostly from AWW (45.4%) or
ANM (15.2%). About 39% received ≥90 tablets, while 24% consumed ≥ 90 tablets
during the pregnancy. Nearly 91% of the mothers reportedly received TT immunization.
About 79% received two doses of TT, while 12% received one dose only. The main
reason for not availing TT was ‘not aware of the need’ (9.1%) and ‘No faith’ / fear of
getting pain (3% each).
4.5.3 Particulars of last Delivery (Mothers having

(Fig.1). About 95% percent of the mothers interviewed reportedly fed colostrum to
the newborn.
0-5 month infants
About 52% of the infants, below 6 months were solely breastfed, while about
39% received water in addition to breast milk and 9% received complementary foods
in addition to breast milk before 6 months of age (Table 11).
6-11 months infants
None of the infants aged 6-11 months were solely breast fed. About 14%
received water in addition to breast milk, while 86% received complementary foods
in addition to breast milk. (Table 11). Of those who were currently receiving water or
complementary foods in addition to breast milk (100.0%), about 8% were solely
breast fed even without water up to six months. Of those who were currently
receiving complementary foods (85.9%), the complementary feeding was initiated at
6 months of age in about 74% of infants, while 8% received after 6 months of age
(Fig. 2). The commonly used complementary foods included home made semisolids
(78.2%), followed by cow/buffalo milk (73.1%) and home made solids (67.9%),
(Table 11).
The foods generally included in the complementary feeds were cereals &
millets (85.9%), pulses (79.5%), fats & oils (74.4%), milk & milk products (70.5%),
fruits (57.7%), other vegetables & Green leafy Vegetables (44.9% each) and roots &
tubers (50%). About 63% of the children received at least 3 complementary feeds per
day, while 23% received 2 feeds a day. About 77% of mothers fed the infants with
their hand, while 4% mothers used spoon to feed the child. In about 4% of cases, the
infants consumed foods themselves with their hands. The feeding was supervised
mostly by the mother (85.9%) (Table 12).
4.6.2.2 12-35 month children
About 60% of the children were currently receiving complementary foods in addition
to breast milk, while 40% were completely weaned. The type of food being currently
given included home made semi solids (97.5%), home made solids (93.7%) and
cow/buffalo milk (85.8%). The most commonly used food groups included, cereals &
millets (99.5%), pulses (98.5%), fats & oils (97.1%), fruits (88.7%), other vegetables
(87.7%), milk & milk products (85.8%), GLV and roots & tubers (83.3% each), eggs
(26.5%) and flesh foods (18.1%). About 35% of the children were fed ≥ 4 times a
day, 56% were fed 3 times a day, while 9% were fed ≤ 2 times a day. About 59% of
the children consumed food themselves with their hands, while 40% were fed by
their mothers by hand. In most of the cases, feeding was supervised by their
Nutritional Status of

%
70
60
50
Fig.1 Distribution (%) of 0-11 months Children according to
Time of Initiation of Breastfeeding (BF)
61.3
40
30
20
10
0
17.1
11.7
9
0.9
=24 Hrs
70
60
Fig.2 Distribution (%) of 6-11 months Children according to Age of
Initiation of Complementary Feeding
%
74.3
50
40
30
20
10
3.9
7.7
14.1
0

mothers (91.7%), followed by elder siblings (3.4%) and ground parents (0.5%)
(Table 13).
4.6.3 Care of the Child
About 10% of the mothers carried their children to the work-spot. While 14%
stated that they were cared either by their older siblings (7.3%) or by their in-laws
(6.3%) (Table 14).
4.6.4 Personal Hygiene
About 11% of mothers washed their hands with soap before feeding the child.
The soap was used by 55% of mothers to wash their /child’s hand after defecation
(Table 14).
4.6.5 History of Morbidity
The particulars of morbidity during preceding fortnight among

4.6.7 Coverage for Immunization under UIP
The particulars of coverage of 12-24 months children for immunization under
Universal Immunization Programme (UIP) during the first year of life are provided in
Table 18 and Fig. 3. Majority (97.4%) of the children were fully immunized and only
about 3% were partially immunized. About 98-100% received polio, DPT & BCG
vaccines, while 98% received measles vaccination. Major source of this information
was from parents (89.7%), followed by AWW record (7.7%) and mother & child
protection card (1.7%) The major reasons for not immunized or partially immunized
are ‘not offered’ (1.7%) and ‘time/place not known/inconvenient’ (0.9%).
4.6.8 Coverage for Massive dose of Vitamin A Supplementation
The National programme on Prevention and control of blindness due to Vitamin
A deficiency envisages that all the children between 9 to 60 months should receive
biannual massive dose of vitamin A. The particulars of coverage of children for
massive dose vitamin A during the previous one year are provided in Table 19. In
general, about 92% of 9-59 months children reportedly received at least one dose of
vitamin A, while the coverage was about 80% among 9-17 months and 95% among
18-59 months children. About 39% of 18-59 months children received the stipulated 2
doses during preceding one year, while about 56% received a single dose of vitamin
A. In a majority of cases, the massive dose vitamin A was administered at AWC
(89.9%), mostly either by ANM (63.1%) or AWW (28.6%). The major reasons for nonreceipt
of massive dose of Vitamin A were, ‘not offered’ (46.3%), ‘mother was busy’
(2.1%) and ‘time and place not convenient’ (0.5%).
4.6.9 Coverage for Iron and Folic acid tablets Supplementation
About 14% children of 12-59 months reportedly received IFA tablets during
the preceding year, either from AWW (9.4%) or ANM (4.5%). Only 2.3% received ≥
90 IFA tablets, while 2% consumed ≥ 90 tablets (Table 20).
4.7 Nutritional status of children (

Fig. 3 Coverage (%) of 12-24 months Children for Immunization under
Universal Immunization Program (UIP)
%
100
90
98.3 98.3 98.3
98.3 100 100 100 98.3
97.4
80
70
60
50
40
30
20
10
0
BCG DPT1 DPT2 DPT3 OPV1 OPV2 OPV3 Measles Full Imm. Partial
Imm.
2.6
Nutritional Status of

4.7.2 Nutritional anthropometry
4.7.2.1 Mean Weight and Height
The mean weight and heights of

20
16
Fig.4 Distance charts for Weights - Boys
Median Wt - WHO Standards
Mean Wt - Current Study
Wt (Kgs)
12
8
4
0
0
1
2
3
4
5
6
7
8
9
10
11
12-17
18-23
24-29
30-35
36-41
42-47
48-53
54-59
Age (Months)
20
16
Fig.5 Distance charts for Weights - Girls
Median Wt - WHO Standards
Mean Wt - Current Study
12
Wt (Kgs)
8
4
0
1
2
3
4
5
6
7
8
9
10
11
Age (Months)
12-17
18-23
24-29
30-35
36-41
42-47
48-53
54-59
Nutritional Status of

120
100
Fig.6 Distance charts for Heights - Boys
Meadian Ht-WHO standards
Mean Ht -Current Study
80
Ht (Cms)
60
40
20
0
0
1
2
3
4
5
6
7
8
9
10
11
Age (Months)
12-17
18-23
24-29
30-35
36-41
42-47
48-53
54-59
120
100
Fig.7 Distance charts for Heights - Girls
Meadian Ht-WHO standards
Mean Ht -Current Study
80
Ht (Cms)
60
40
20
0
1
2
3
4
5
6
7
8
9
10
Age (Months)
11
12-17
18-23
24-29
30-35
36-41
42-47
Nutritional Status of

Fig.8 Prevalence (%) of Undernutrition among

Wasting
The overall prevalence of wasting (

Fig.10 Prevalence (%) of Undernutrition among

differences observed in the prevalence of underweight, stunting and wasting were
not statistically significant.
Literacy status of father
The literacy statue of the father was found to be significantly associated with
underweight and stunting status of their children. The prevalence of underweight and
stunting was significantly (p

Fig.11 Prevalence (%) of Undernutrition among

Fig.13 Prevalence (%) of Undernutrition among

higher (71.4% and 64.3% respectively) than those who were cultivators (50% each)
or housewife’s (51.5% and 43.2% respectively) The prevalence of wasting was
significantly (P

Fig.15 Prevalence (%) of Undernutrition ` among

among children from HHs using firewood (56.4%)as compared to those HHs using
other fuel for cooking (46.7%)
Electrification
The prevalence of underweight and stunting was relatively higher among
children from HHs having electricity (56.4% and 48.1% respectively), compared to
those HHs not having electricity (48.7% and 43.6% respectively), while on the other
hand the prevalence of wasting was higher among children from HHs do not have
electricity (30.8%) than HHs with electricity 24.1%) However, the differences
observed in the prevalence of underweight, stunting and wasting were not
statistically significant.
Presence/use of Sanitary Latrine
Though not statistically significant, the prevalence of underweight, stunting
and wasting was lower among those households using sanitary latrines (48%, 39.4%
and 22% respectively), compared to those not using or not having sanitary latrines
(57.9% , 50.1% and 25.3% respectively), however, the differences observed in the
prevalence of wasting was marginal when compared to underweight and stunting.
Separate Kitchen
The prevalence of underweight, stunting and wasting, though not statistically
significant, was relatively lower among children from HHs having separate kitchen
(53.2%; 44.3% and 23.4% respectively), compared to those who do not have
separate kitchen (59.7%, 53.0% and 26.5% respectively).
History of Morbidity during preceding fortnight
The prevalence of stunting and wasting was marginally higher (49.4% and
27.6% respectively) among children with history of morbidity (such as fever, diarrhoea,
respiratory infections etc) in the preceding fortnight , compared to those children with
no history of morbidity (46.8% and 22.9% respectively), while the prevalence of
underweight was comparable between groups (56% each).
Nutritional Status of

5. DISCUSSION AND CONCLUSIONS
According to NFHS-3 survey, about 80% of the pregnant women had
undergone ANC in the state of Madhya Pradesh. The present study revealed that
about 82% of pregnant women had undergone antenatal check-up and 91%
received TT immunization in the Bhopal district of Madhya Pradesh 10 . National
population policy 2000 envisaged that about 80% of deliveries should be Institutional
and 100% should be conducted by trained personnel 16 . In Bhopal district, about 79%
deliveries took place either in PHC/ Government (69.4%) or Private hospitals
(9.9%).Sixty four percent of deliveries were conducted by medical doctors, while
18% were conducted by trained personnel, like TBA / ANM / LHV. This finding is
encouraging and such practices to be strengthened further.
Even though birth weights were recorded in about 71% of the newborns, but the
records were available for 38% of them only. As per the records, about 5% of the
new born babies had birth weight of

Epidemiological research showed that mother’s milk and breastfeeding of
infants provides advantages with regard to general health, growth and development
while significantly decreasing risk for a large number of acute and chronic diseases.
In the present study, breastfeeding was the common practice among the mothers.
However, only about 17% of the mothers reportedly initiated breastfeeding within an
hour of delivery. Though, this figure is comparable to that reported by the NFHS-3 for
the State (16%), indicates the need for educating, the mothers for initiation of
breastfeeding within an hour of delivery. Pre-lacteals were given in about 14% of the
newborns only. Practiced of giving pre-lacteals to new born to be discouraged,
because pre-lacteal feeds might harm the immature gut of the child, especially if they
are contaminated. The delayed initiation of breasted feeding observed in the district
is a matter of concern and requires due attention because, early initiation of breast
feeding is the primary determinant of maternal milk production and secretion.
Avoidance of other fluids or foods is essential to optimize breast milk intake by the
newborn. Most of the other fluids or foods are less nutritious than breast milk and
therefore, if displacement occurs, the infant may be at a nutritional disadvantage
even if prepared hygienically 19 . In many communities, it is traditionally believed that
colostrum is unhealthy and therefore is harmful to the baby. However in the present
study, colostrum was given by 95% of mothers which is good for the child’s health
and nutrition and such desirable practices should be encouraged further in the
district.
Breast milk can contribute significantly as a source of energy, fat, high quality
protein and micronutrients, especially when the quality of available complementary
food is low (Academy of Educational Development, 1999 19 ). WHO 20 and UNICEF
(1993a 21 ) recommends that complementary feeding should be initiated immediately
after 6 months of the infant’s age and breastfeeding should be continued well into
the second year of life and for longer duration, if possible. In the present study, about
74% of the infants aged 6-11 months received complementary foods at 6 months of
age. This type of desirable feeding practices should be encouraged.
In the present study, about 14% of infants did not receive any complementary
foods up to 1 year of age, while about 8% have receiving the same anywhere
between 7 to 12 months of age. The mothers to be educated to introduce
complementary feeds from 6 th months of age, as breastmilk alone is not sufficient to
meet the growing nutritional needs of infant. The complementary foods being given
mostly included, home made semi solids, cow/buffalo milk and home made solids.
The frequency of feeding was at least 3 times in 63% of the infants. Effective
immunization programme against the common communicable diseases are required
Nutritional Status of

for the majority of the susceptible populations particularly in the developing
countries, wherein the risk of disability or death from preventable infectious diseases
is a matter of concern. Therefore, coverage under universal immunization
programme should be 100%. It has been observed in this study, most of the children
(97.4%) were fully immunized.
The programme for prevention of blindness due to vitamin A deficiency
envisages distribution of massive dose vitamin A to all the children aged between
9-59 months, every 6 months. It was observed that about 80% of children between
9-17 months 95% children between 18-59 months received at least one dose vitamin
A during previous one year. Only about 39% of 18-59 months children received the
suggested two doses during the preceding one year, indicates the poor coverage
which has to be strengthened further. The coverage of children for iron-folic acid
supplementation was only about 14% while negligible proportion of children (2.3%)
received ≥ 90 tablets and 2% consumed ≥ 90 tablets, which indicates weak
education component. There is a need to strengthen the service delivery and
monitoring mechanisms for these programmes.
The common morbidities such as ARI, fever and diarrhoea were reported by the
mothers. The prevalence of diarrhoea was lower (2.3% to 3.6%)among children
between 24 to 59 months group, while the ARI was higher (17.1)% in 12-23 months
group. The prevalence of fever was lower (10%) among children of 36-47 months
old. The plausible reasons for this could be due to the prevailing undesirable infant
and young child feeding practices coupled with non-receipt of appropriate health
care management.
Consumption of adequately (≥15 ppm) Iodised salt is very high in the district
91.4%, compared to National figure (51%) and for the State (36%) (NFHS-3).
Nutritional status of infants and young children is not only a vital health issue, but it is
also central to sustainable growth and development of the child 22 .In the present
study, the prevalence of underweight, stunting and wasting was 56%, 48% and 25%
respectively. It was observed that the underweight status of children deteriorated as
age advances especially from six months onwards. The prevalence of stunting was
lower 33.4% and 23.1% among children in 6-11 and36-47 months groups
respectively, when compared to other age groups (50% to 60%), while the
prevalence of wasting were lower in 0-5 (18.2%) and 36-47(13.1%) months groups
respectively, while this was ranged between 25% to 29% respectively. The current
prevalence of undernutrition, in all its three forms in the district was either lower or
comparable, when compared to the figure reported for the State of Madhya Pradesh
by NFHS-3 (2007). The prevalence of underweight was higher, while the stunting
was lower, when compared to the figure reported by NNMB (2006). While the
Nutritional Status of

prevalence of wasting was comparable. Probably, Attention has to be given towards
factors such as, early initiation of breast feeding, initiation of complementary foods at
an appropriate age, energy and nutrient density of the complementary foods given,
the frequency and variety of foods offered, hygiene aspects of food preparation,
personal hygiene, the amount of breast milk consumed at different stages of
complementary feeding, the frequency of breastfeeding and inappropriate
complementary feeding during and after illness, to bring down the prevalence of
undernutrition further in the district.
The 21% of global deaths and DALYs (disability adjusted life years) in children
younger than 5 years old are attributed to stunting, severe wasting and intrauterine
growth retardation. Long term consequences of undernutrition during the early
stages of child growth and development include, likelihood of short stature in adult
life, low educational achievements, giving birth to smaller children, lower economic
status and reduced physical work capacity and productivity in adulthood 17 .
The study revealed significant association between nutritional status and
different socio-economic and demographic variables, which indicate significantly
higher rates of underweight among, children in SC & ST communities, from nuclear
& extended nuclear families, of illiterate parents and mothers being involved in
labour. Similarly, higher prevalence of stunting was observed among children of ST
& SC communities, from nuclear &extended nuclear families, of illiterate parents,
HHs do not possess any agriculture land, parents involved in labour, HHs with PCI
of Rs 600-900 and living in kutcha houses, while significantly higher proportion of
wasted children was found in families, where mother was involved in cultivation.
Promotion of better infant and young child feeding and health care practices is
needed for improving the health and nutritional status of young children.
Strengthening of existing National Nutrition Programmes viz ICDS supplementation,
distribution of IFA tablets/syrup to preschool children is essential.
Last but not the least, there is a need to augment the programmes for income
generation to enhance household food and nutrition security.
- o0o -
Nutritional Status of

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1. de Onis M, Blossner M, Borghi E, Frongillo EA, Morris R. Estimates of global
prevalence of childhood underweight in 1990 and 2015. JAMA 2004;
291:2600-6.
2. Black,RE, Allen LH, Bhutta ZA etal. Meternal and child undernutrition: global
and regional exposures and health consequencies. Lancet 2008; 371: 243-260
3. Jones G, Steketee RW, Black RE etal. How many child deaths can we prevent
this year Lancet 2003; 362: 65-71.
4. Edmond KM, Zandoh C, Quigley MA etal. Delayed breast feeding initiation
increases risk of neonatal mortality. Pediatrics 2006; 117: e380-e386.
5. Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Ritcher L and Sachdev HS.
Maternal and child undernutrition: Consequences for adult health and human
capital. The Lancet 2008; 371:340-57.
6. Barker DJP, Osmond C, Forsen TJ, Kajantie E, Eriksson JG. Trajectories of
growth among childrenwho have coronary Events as Adults. N Eng J Med
2005; 353:1802-9
7. Satyanarayana K., Naidu AN., Chatterjee B., Rao BSN. Body size and work
output. Am. J. Clin. Nutr. 1977; 30:322-325.
8. National Nutrition Monitoring Bureau: Report of Second Repeat Survey –
Rural. NNMB Tech. Rep. No. 18, 1999.
9. National Nutrition Monitoring Bureau. Diet and nutritional status of rural
population. NNMB Tech. Rep. No.24, National Institute of Nutrition (ICMR),
Hyderabad, 2006
10. National Family Health Survey 2005-06.
11. Ministry of Human Resource Development, Government of India, National
Nutrition Policy, New Delhi: Department of Women and Child Development,
1993.National Plan of action
12. Ministry of Human Resource Development, Government of India, National Plan
of Action on Nutrition, New Delhi: Food and Nutrition Board, Department of
Women and Child Development, 1995.
13. Jelliffee D.B. Assessment of nutritional status of community. WHO Monograph
series No.53, 1966.
14. World Health Organization. Measuring change in nutritional status, WHO,
Geneva, 1983.
15. WHO Multicentre Growth Reference Study Group. WHO Child Growth
Standards based on length/height, weight and age. Acta Paediatr Suppl 2006;
450:76-85.
16. www.whoindia.org/EIP/policy/population...
Nutritional Status of

17. Black RE, Lindsay HA, Bhutta ZA, Caulfield LE, Mercedes de Onis, Majid
Ezzati, Colin Mathers, Juan Rivera. Meternal and child under nutrition: Global
and regional exposures and health consequences. Maternal and child under
nutrition study group. The Lancet, 2008; 371:340-357.
18. American Academy of Paediatrics. Breast-feeding and the use of Human milk
American Academy of Paediatrics, Work Group on Breastfeeding. Pediatr
1997; 100:1035-1039.
19. Academy of educational development. Recommended feeding and dietary
practices to improve infant and maternal nutrition. Linkages – Improving
nutrition and reproductive health. 1999.
20. The optimal duration of exclusive breast-feeding. Report of an Expert
Consultation, WHO, Geneva, 2001.
21. UNICEF. Breast feeding facts of life. UNICEF (1993a).
22. Dewey KG, Heinig MJ, Nommsen LA, Lonnerdal B. Adequacy of energy intake
among breast-fed infants in the DARLING study: relationship to growth
velocity, morbidity and activity levels. Davis Area Research on Lactation, Infant
Nutrition and Growth. J Pediatr.1991; 119:538-47.
Nutritional Status of

TABLES

Table - 1
Particulars of Coverage
Particulars
Coverage (n)
Socio-economic particulars (HHs) 396
Under 5 year children for anthropometry
463
(Boys 249, Girls 214)
Children below 12 months 111
Children 12-35 months 204
Children 36-59 months 148
Spot testing of HHs salt for iodine 396
Infant & young child Feeding Practices
Mothers with

Table - 2
Socio-economic Profile of the Households of Index children
Community
Type of Family
Family Size
Particulars
Percent
n 396
Scheduled Tribe 9.3
Scheduled Caste 25.5
Backward Community 54.8
Others 10.4
Nuclear 52.0
Extended Nuclear 19.2
Joint 28.8
1 -4 36.4
5 – 9 54.5
10 9.1
Average Family Size 5.9
Literacy status of Father
Literacy status of Mother
Illiterate 18.7
Read & write 1.5
1 – 5 Class 19.2
6 – 7 Class 4.8
8 – 10 Class 43.2
Intermediate 7.3
Graduate & above 4.8
NA 0.5
Illiterate 40.4
Read & write 0.3
1 – 5 Class 29.3
6 – 7 Class 4.0
8 – 10 Class 21.7
Intermediate 2.5
Graduate & above 1.8
(Contd….)
Nutritional Status of

Table – 2 (Contd…)
Socio-economic Profile of the Households of Index children
Particulars
Extent of HH landholding (Acres)
Major Occupation of Father
Major Occupation of Mother
Per capita monthly income (Rs)
Percent
n 396
Nil 51.8
Marginal farmers

Table - 3
Physical facilities of the Households
Type of house
Particulars
Source of Drinking Water
Type of Cooking Fuel
Percent
n 396
Kutcha 22.0
Semi Pucca 68.4
Pucca 9.6
Open Well 2.5
Tube Well 90.4
Tap 2.3
Others 4.8
Firewood 93.9
Kerosene 0.5
Bio- Gas -
LPG 5.6
Household electricity present 91.4
Sanitary Latrine
Present and in use 21.2
Present and not in use 0.8
Absent 78.0
Separate Kitchen Present 58.6
Nutritional Status of

Table – 4
Distribution (%) of HHs according to use of Iodized salt and iodine content
Type of salt used
Iodine Content
Particulars
Percent
n 396
Powdered salt 0.5
Rock Salt 7.3
Free-flowing 92.2
0 ppm 7.6

Table - 6
Particulars of last pregnancy of mothers of < 6 months children
Particulars
Percent
n 33
Undergone Antenatal check-up (ANC)
Total number of ANCs
Yes 81.8
No 18.2
One 6.1
Two 9.1
Three 33.3
Four 21.2
≥ five 12.1
NA 18.2
Undergone First ANC at (Weeks of gestation)
Place of ANC
ANC conducted by
< 8 weeks 18.2
9- 12 weeks 15.2
13- 16 weeks 36.3
17-20 weeks 6.1
21-24 weeks 3.0
≥24 weeks 3.0
NA 18.2
Home -
AWC 24.2
PHC/CHC 18.2
Taluk/Dist.hospital 15.2
Private Clinic 24.2
NA 18.2
ANM 33.4
Medical Officer 24.2
Pvt. Doctor 24.2
NA 18.2
( Contd..)
Nutritional Status of

Table – 6 (Contd…)
Particulars of last pregnancy of mothers of < 6 months children
Particulars
Components of ANC*
Percent
n 33
Physical Examination 78.8
Weight Recording 78.8
Urine Test 60.6
Haemoglobin Estimation 63.6
Blood pressure measurement 63.6
Health & Nutrition advise given during ANC
If yes, what advise*
Yes 78.8
No 3.0
Not availed ANC 18.2
To attend for regular checkups 78.8
To consume more GLVs 75.8
To consume more Vegetables & fruits 75.8
To take IFA tablets for 100 days 75.8
Reasons for not availing ANCs*
Others 33.3
Not aware of the need 18.2
No faith 3.0
No ANC held in the village 3.0
Timings are inconvenient 3.0
Place is not accesssible 3.0
Loss of wages 6.1
Nutritional Status of

Table – 6 (Contd…)
Particulars of last pregnancy of mothers of < 6 months children
Particulars
TT Immunization received
If yes, No. of doses
Reasons for not receiving TT
Percent
n 33
Yes 90.9
No 9.1
One dose 12.1
Two doses 78.8
Not received 9.1
Not aware of the need 9.1
No faith 3.0
Fear of getting pain 3.0
* Multiple responses
Nutritional Status of

Table – 6 (Contd…)
Particulars of last pregnancy of mothers of < 6 months children
Particulars
Received IFA tablets
IFA tablets received from
No. of IFA tablets received
No. of IFA tablets consumed
Percent
n 33
Yes 75.8
No 24.2
ANM 15.2
AWW 45.4
MO-PHC 9.1
Private Doctor 6.1
Not received 24.2
30-60 9.1
60-90 6.1
≥90 39.4
Do not Know 21.2
NA 24.2

Table –7
Particulars of last Delivery of mothers of

Table - 8
Distribution (%) of < 60 months children according of Birth order
Birth order
Percent
n 463
First 31.3
Second 34.6
Third 16.4
Fourth 9.9
Fifth and above 7.8
Table - 9
Distribution (%) of < 60 months children having siblings according to
interval between last two births
Interval between last two births(months)
Percent
n 318

Table – 10
Distribution (%) of

Table - 11
Distribution (%) of infants (

Table - 12
Distribution (%) of 6-11 months Children according to Feeding Practices
Feeding Practices
Percent
n 78
Foods generally included in home made complementary foods*
Cereals & Millets 85.9
Pulses 79.5
Green Leafy Vegetables 44.9
Other Vegetables 44.9
Roots & Tubers 50.0
Fruits 57.7
Milk & milk products 70.5
Eggs 7.7
Meat & Chicken 3.8
Fats & Oils 74.4
Number of complementary feeds per day
Mode of complementary feeding
2 23.1
3 51.2
4 10.3
5 1.3
Not yet started 14.1
Mother with spoon 3.8
Mother with hand 77.0
Self with spoon -
Self by hand 3.8
Feeding bottle 1.3
Not yet started 14.1
Supervision of complementary feeding by
* Multiple responses
Mother 85.9
Grand parents -
Not yet started 14.1
Nutritional Status of

Table - 13
Distribution (%) of 12-35 months Children according to Feeding Practices
Feeding Practices
Percent
n 204
Children solely breast fed -
Children currently Breast fed + complementary feeding 59.8
Weaned 40.2
Type of food currently being given*
Cow/buffalo milk 85.8
Formula milk -
Commercial baby food -
Home made semi-solids 97.5
Home made solids 93.1
Not yet started -
Foods generally included in home made foods*
Cereals & Millets 99.5
Pulses & legumes 98.5
Green Leafy Vegetables 83.3
Other Vegetables 87.7
Roots & Tubers 83.3
Fruits 88.7
Milk & milk products 85.8
Eggs 26.5
Flesh foods 18.1
Fats & Oils 97.1
Not yet started CF -
* Multiple responses ( Contd….)
Nutritional Status of

Table – 13 (Contd…)
Distribution (%) of 12-35 months Children
According to Feeding (CF) Practices
Feeding Practices
Number of complementary feeds per day
Mode of feeding complementary food
Supervision of complementary feeding by
Percent
n 204
≤2 8.8
3 55.9
≥4 35.3
Not yet started CF -
Mother with spoon 1.0
Mother with hand 40.2
Self with spoon -
Self by hand 58.8
Not yet started CF -
Mother 91.7
Father -
Elder Sibling 3.4
Grand parents 0.5
Others 4.4
Not yet started CF -
Nutritional Status of

Table – 14
Distribution (%) of mothers of 0- 59 months Children according to
Care of the child and personal Hygiene
Particulars
Care of the child when mother goes out for work
Age group (months)

Table – 15
Prevalence (%) of the Morbidity among 0- 59 months children during
previous fortnight by age groups
Age Group
(months)
n Fever Diarrhoea ARI
At least one
morbidity
0-5 33 21.2 9.1 9.1 27.3
6-11 78 29.5 11.5 12.8 44.9
12-23 117 29.9 14.5 17.1 48.7
24-35 87 24.1 2.3 11.5 35.6
36-47 84 9.5 3.6 14.3 21.4
48-59 64 18.8 3.1 10.9 31.3
Pooled 463 22.9 7.8 13.4 36.7
Nutritional Status of

Table – 16
Distribution (%) of mothers of 0- 59 months Children according to
Care of the child during Sickness
Particulars
Personnel generally consulted during illness of the child
Morbidity during previous fortnight
Age group (months)

Table - 17
Participation (%) in ICDS supplementation programme
(6- 59 months children)
Particulars
Age group (months)
6-35 36-59 6-59
n 282 148 430
Participating 86.1 98.0 90.2
Regular 28.7 80.4 46.5
Irregular 57.4 17.6 43.7
Not participating 13.8 2.0 9.8
Nutritional Status of

Table -18
Distribution (%) of 12- 24 months children according to Coverage for
Immunization under UIP
Immunization Particulars
Percent
n 117
Received all vaccines ( Fully Immunized) 97.4
Partially immunized 2.6
Not immunized -
Reasons for no / incomplete immunization
BCG 98.3
DPT1 98.3
DPT2 98.3
DPT3 98.3
OPV1 100.0
OPV2 100.0
OPV3 100.0
Measles 98.3
Unaware of need -
Time & place not known/ inconvenient 0.9
Source of information
Not offered 1.7
Fully immunized 97.4
Mother & child protection card 1.7
Immunization card 0.9
Parents 89.7
AWW record 7.7
Nutritional Status of

Table - 19
Distribution (%) of 9- 59 months Children According to receipt of massive
dose vitamin A during previous one year
Particulars
Receipt of massive dose vitamin A
No. of doses of vitamin A
Place of administration
Age group (months)
9-17 18-35 36-59 9-59
N 81 156 148 385
Yes 80.2 91.7 98.6 91.9
No 17.3 4.5 1.4 6.0
Do not remember 2.5 3.8 0.0 2.1
One 80.2 53.2 58.1 60.8
Two 0.0 38.5 40.5 31.2
Not received 17.3 4.5 1.4 6.0
Do not remember 2.5 3.8 0.0 2.1
Home 1.2 0.6 0.0 0.5
AWC 77.8 89.8 96.6 89.9
SC 1.2 1.3 2.0 1.6
Not received/do not remember 19.8 8.3 1.4 8.1
Massive dose vitamin A administered by
AWW 26.0 30.1 28.4 28.6
ANM 54.2 61.6 69.5 63.1
LHV 0.0 0.0 0.7 0.3
Not received/do not remember 19.8 8.3 1.4 8.1
Reasons for not receiving/incomplete massive dose vitamin A
Unaware of need 1.2 0.0 0.0 0.3
Not offered 9.9 52.6 59.5 46.3
Time or place not convenient 1.2 0.6 0.0 0.5
Mothers was busy 3.7 3.2 0.0 2.1
Others 1.2 1.3 0.0 0.8
Nutritional Status of

Table - 20
Distribution (%) of 12-59 months Children according
to receipt of Iron & folic acid tablets
Particulars
Received IFA tablets
IFA tablets received from
No. of IFA tablets received
No. of IFA tablets consumed
Age group (months)
12-35 36-59 12-59
n 204 148 352
Yes 13.7 14.2 13.9
No 86.3 85.8 86.1
ANM 4.9 4.1 4.5
AWW 8.8 10.1 9.4
MO-PHC - - -
Not received 86.3 85.8 86.1

Table - 21
Prevalence (%) of nutritional deficiency signs among 0 - 59 months
children
Clinical signs
Age groups (Months)
0-11 12-35 36-59 0-59
No of children examined 111 204 148 463
NAD 100 98.0 95.3 97.6
Hair. discoloured - 0.5 - 0.2
Emaciation - 0.5 - 0.2
Night Blindness(XN) - - 0.7 0.2
Knock Knees or Bow legs - - 0.7 0.2
Dental caries - 1.0 3.4 1.5
NAD: No Abnormality Detected
Nutritional Status of

n
Table -22
Mean Height and weight of 0-59 months Children by age group and gender
BOYS
GIRLS
Age
Height (cm) Weight (kg) n Height (cm) Weight (kg)
(Months)
Mean ± SD Mean ± SD Mean ± SD Mean ± SD
1 50.8 0.0 3.5 0.0

Table - 23
Distribution (%) of 0-59 months Children according to nutritional status by
SD Classification: By Age group
Underweight (Weight for Age)
Age
Group
(months)
n
Severe
(

Table -24
Distribution (%) of 0- 59 months Children according to nutritional status by
SD Classification*: By Gender
Nutritional Status
Gender
n

Table -25
Distribution (%) of 0- 59 months Children by Nutritional status according to
SD Classification: By Socio-demographic variables
Particulars
1. Community
n
Weight for age Height for age Weight for height

Table -25 (Contd...)
Distribution (%) of 0- 59 months Children by Nutritional status according to
SD Classification: By Socio-demographic variables
Particulars
n
Weight for age Height for age Weight for height

Table – 25 (Contd…)
Distribution (%) of 0- 59 months Children by Nutritional status according to
SD Classification: By Socio-demographic variables
Weight for age Height for age Weight for height
Particulars n