Determinants of Malnutrition Under 5 Years Children - A Cross Sectional Study in the Palpa District of Nepal

Abstract

Malnutrition is a pathological state resulting from a relative or absolute deficiency or excess of one or more essential nutrients. Malnutrition continues to be a primary cause of ill health and mortality among children in developing countries. It is a major public health problem and accounts for abouthalf of all child deaths worldwide. Since deficient physical growth is naturally reflected in their suboptimal mental achievement. As per the findings of Nepal Demographic and Health Survey (NDHS, 2011) stunting is 41 per cent, while underweight and wasting, 29 per cent and 11 per cent respectively. The main objective of study is to assess the factors responsible for malnutrition of children under 5 years in Palpa district, Nepal.A cross sectional community based study was conducted whereas multistage sampling was adopted. A total of 390 respondents age between 6-59 months were selected for present study. It was observed that one fifth (20.51%) of children were mild malnourished followed by 5.13 per cent were moderate malnourished on the basis of weight for age. On the basis of height for age, around one quarter (22.31%) were mildly impaired, followed by 3.84 per cent were moderately and 1.03 per cent severely impaired. On the basis of weight for height, mild impaired children were 4.62 per cent, moderate impaired 1.79 per cent and severe impaired were 0.51 per cent. Huge numbers of children (60.60%) were malnourished whose mothers were illiterate. More than three quarter of respondents (78.71%) had received four ANC visit according to schedule. Majority of respondents (80.76%) had taken full course of iron tablet during pregnancy and after delivery of the 42 days, who had not taken full course of iron tablet their children were more likely to be malnourished (OR=5.40, p<0.005). Similarly, 76.15 per cent respondents had introduced breastfeeding within 1 hour and large number of respondents (91.79%) had introduced exclusive breastfeeding up to 6 months. The respondents who were not fed colostrum to their children were more likely to be malnourished (OR=9.06, p<0.005). Almost half (47.83%) children were malnourished who had not completed full immunizationwhereas only 23.26 per cent were malnourished among completion of immunization. Likewise, 63.64 per cent children were sick whose mothers were illiterate, 67.45 per cent children had taken normal amount of calorie as recommended level. More than half (59.43%) of the children were stunted and almost similar number (56.53%) of children were underweight among those who consumed low calories. Maternal education, immunization status, history of disease, colostrum feeding, exclusive breastfeeding, receiving of iron tablet, consumption of calorie all are important determinants for malnutrition.