Malnutrition among under-five children in India and strategies for control

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Abstract

Malnutrition among under-five children is an important concern for the health authorities in India. The aim of the present review was to assess the burden of under-nutrition and over-nutrition, its determinants and strategies required to tackle malnutrition among under-five children in India. Recent data were collected from Google search, Medline, and others. The information retrieved was reviewed and analyzed for discrepancies. Existing evidence shows that the prevalence of under-nutrition among under-five children was high and varied widely (under-weight: 39-75%, stunting: 15.4-74%, wasting: 10.6-42.3%) depending on the assessment methodology adopted. Studies on assessment of over-nutrition status among under-five children were limited. Distribution of various types of risk factors and its influence on nutrition status of children in a given set up should be analyzed for planning the control measures. Strengthening public health interventions for mild malnutrition cases and vulnerable groups, effective implementation and evaluation of the strategies at regional level, research on overweight, obesity and its etiological factors and steps for improving socioeconomic development are the prerequisites for tackling malnutrition among under-five children in India.

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Infant and young child feeding indicators and determinants of poor feeding practices in India: secondary data analysis of National Family Health Survey 2005-06.

, Sandhya Khadse, Upul Senarath … (2010)

In India, poor feeding practices in early childhood contribute to the burden of malnutrition and infant and child mortality. To estimate infant and young child feeding indicators and determinants of selected feeding practices in India. The sample consisted of 20,108 children aged 0 to 23 months from the National Family Health Survey India 2005-06. Selected indicators were examined against a set of variables using univariate and multivariate analyses. Only 23.5% of mothers initiated breastfeeding within the first hour after birth, 99.2% had ever breastfed their infant, 89.8% were currently breastfeeding, and 14.8% were currently bottle-feeding. Among infants under 6 months of age, 46.4% were exclusively breastfed, and 56.7% of those aged 6 to 9 months received complementary foods. The risk factors for not exclusively breastfeeding were higher household wealth index quintiles (OR for richest = 2.03), delivery in a health facility (OR = 1.35), and living in the Northern region. Higher numbers of antenatal care visits were associated with increased rates of exclusive breastfeeding (OR for 2 7 antenatal visits = 0.58). The rates of timely initiation of breastfeeding were higher among women who were better educated (OR for secondary education or above = 0.79), were working (OR = 0.79), made more antenatal clinic visits (OR for 2 7 antenatal visits = 0.48), and were exposed to the radio (OR = 0.76). The rates were lower in women who were delivered by cesarean section (OR = 2.52). The risk factors for bottle-feeding included cesarean delivery (OR = 1.44), higher household wealth index quintiles (OR = 3.06), working by the mother (OR = 1.29), higher maternal education level (OR = 1.32), urban residence (OR = 1.46), and absence of postnatal examination (OR = 1.24). The rates of timely complementary feeding were higher for mothers who had more antenatal visits (OR = 0.57), and for those who watched television (OR = 0.75). Revitalization of the Baby Friendly Hospital Initiative in health facilities is recommended. Targeted interventions may be necessary to improve infant feeding practices in mothers who reside in urban areas, are more educated, and are from wealthier households.

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Is obesity becoming a public health problem in India? Examine the shift from under- to overnutrition problems over time.

Jiann-Chu Chen, Premendu Mathur, Ying Wang … (2009)

This study aimed to examine the prevalence and trends of overweight, obesity and undernutrition in recent decades in India. Based on a systematic literature search on PubMed and other data sources, most published studies were regional or local surveys in urban areas, while good representative data from the India National Family Health Surveys (NFHS, 1992-1993, 1998-1999 and 2005-2006) allowed for examining the trends at the national level. Overall, the available data showed that in India, prevalence of overweight was low while that of undernutrition remained high. Overweight was more prevalent among female, urban and high-socioeconomic-status (SES) groups. NFHS data showed that the prevalence of overweight in women and pre-school children did not increase much in the last decade: 10.6% and 1.6% in 1998-1999 to 12.6% and 1.5% in 2005-2006 respectively. As for underweight, NFHS 2005-2006 showed high prevalence among ever-married women (about 35%) and pre-school children (about 42%). The prevalence of overweight and obesity had increased slightly over the past decade in India, but in some urban and high-SES groups it reached a relatively high level. Factors associated with undernutrition need closer examination, and prevention of obesity should be targeted at the high-risk groups simultaneously.

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Nutritional status as a predictor of child survival: summarizing the association and quantifying its global impact.

David K Brown, Joyce Schroeder (1993)

By pooling the results from five previously published prospective studies, we have obtained estimates of the relative risks of mortality among young children 6-24 months after they had been identified as having mild-to-moderate or severe malnutrition. These risk estimates, along with global malnutrition prevalence data, were then used to calculate the total number of young-childhood deaths "attributable" to malnutrition in developing countries. Young children (6-60 months of age) with mild-to-moderate malnutrition (60-80% of the median weight-for-age of the reference population) had 2.2 times the risk of dying during the follow-up period than their better nourished counterparts (> 80% of the median reference weight-for-age). Severely malnourished young children (< 60% of the reference median weight-for-age) had 6.8 times the risk of dying during the follow-up period than better nourished children. Each year approximately 2.3 million deaths of young children in developing countries (41% of the total for this age group) are associated with malnutrition. The comparability of studies, methods used to derive pooled values, potentially confounding factors that may influence risk estimates, and the validity of the results are discussed. Child survival programmes should assign greater priority to the control of childhood malnutrition.

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Journal

Journal ID (nlm-ta): J Nat Sci Biol Med

Journal ID (iso-abbrev): J Nat Sci Biol Med

Journal ID (publisher-id): JNSBM

Title: Journal of Natural Science, Biology, and Medicine

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 0976-9668

ISSN (Electronic): 2229-7707

Publication date (Print): Jan-Jun 2015

Volume: 6

Issue: 1

Pages: 18-23

Affiliations

[1] Department of Preventive and Social Medicine, JIPMER, Puducherry, India

[1 ] Department of Pediatrics, JIPMER, Puducherry, India

[2 ] Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India

Author notes

Address for correspondence: Dr. Swaroop Kumar Sahu, JIPMER, Puducherry - 605 006, India. E-mail: swaroop.sahu@ 123456gmail.com

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Publisher ID: JNSBM-6-18

DOI: 10.4103/0976-9668.149072

PMC ID: 4367032

PubMed ID: 25810629

SO-VID: 5917b1fb-6077-4747-89f9-0e6e0ef47ed5

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This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Malnutrition among under-five children in India and strategies for control

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Most cited references 46

Infant and young child feeding indicators and determinants of poor feeding practices in India: secondary data analysis of National Family Health Survey 2005-06.

Is obesity becoming a public health problem in India? Examine the shift from under- to overnutrition problems over time.

Nutritional status as a predictor of child survival: summarizing the association and quantifying its global impact.

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