The study was carried in permission with Institutional Ethics Committee of Govt. Medical College, Jagdalpur, and Chhattisgarh. A community based cross-sectional study was conducted in village Dimrapal, Biringpal and Pandripani catchment area of Rural Health Training Center (RHTC) Tokapal. Door to door survey conducted during the months of July-September 2017. Data was collected using predesigned semi structured questionnaire. All mothers who have children under 5 years of age were interviewed.
A semi-structured pretested interview schedule was used to collect information from the mother. In some cases (if mother was not available), information was collected from the caregiver. Weight and height were measured for all the selected children. Anthropometric measurements were carried out following standard methods. The data included weight, recumbent length (for children less than 24 months of age) and height (for children more than 24 months of age). Weight was measured using analog weighing machine Height was measured against a non-stretchable tape fixed to a vertical wall, with the participant standing on affirm/level surface and it was measured to the nearest 0.5 cm. Recumbent length (for children less than 24 months of age) was measured by using a measuring tape. All measurements were taken twice and the average of two readings was used for analysis. 0-5 year’s children were taken for underweight and stunting in this study. Socioeconomic Status (SES) - was determined by using Modified Prasad’s scale .
Based on the age, body weight and height, several indices such as height-for-age, weight-forage and weight-for-height have been suggested . The children are classified using three categories:
- Underweight (low weight-for-age)
- Stunting (low height-for-age)
- Wasting (low weight-for-height)
Low anthropometric values are those more than 2 SD away from the Centers for Disease Control and Prevention (CDC) standards, 2000 [19,20].
- Underweight is defined as low weight-for-age and it reflects past (chronic) and present (acute) under nutrition. Children with z-scores < -2.00 are said to be underweight
- Stunting is defined as a low height-for-age for children, and it measures the past (chronic) child under nutrition. Children with z-scores < -2.00 are said to be stunted
- Wasting is defined as low weight-for-height for children, and it is a measure of current or acute under nutrition. Children with z-scores < - 2.00 are said to be wasted
Inclusion criteria & Exclusion criteria
All children under 5 years living in study field area (village Dimrapal, Biringpal and Pandripani) of RHTC Tokapal District Bastar were included in study. Children who were too unwell, agitated & unwilling for anthropometric measurements were excluded from the study. Only 10 children were excluded because of above mentioned reasons. Children who were too unwell, agitated & unwilling for anthropometric measurements were excluded from the study. Only 10 children were excluded because of above mentioned reasons (Table 1-4).
Toilet and handwashing
Only 4 families reported to have open defecation while none of the family reported to NOT to wash hands after defecation and feeding child. It’s good to see this response as state is doing very fine in terms of Swachh Bharat Mission Swachh Bharat Abhiyan (SBA) or Swachh Bharat Mission (SBM) is a nation-wide campaign in India for the period 2014 to 2019 that aims to clean up the streets, roads and infrastructure of India’s cities, towns, urban and rural areas. The campaign's official name is in Hindi and translates to “Neat and tidy India Mission” in English. The objectives of Swachh Bharat include eliminating open defecation through the construction of household-owned and community-owned toilets and establishing an accountable mechanism of monitoring toilet use. Run by the Government of India, the mission aims to achieve an “Open-Defecation Free” (ODF) India by 2 October 2019) .
Age at Marriage and pregnancy
Average age was 20.4 years with 19 (13.6%) were having age 18 or less at time of marriage.24 (17%) mothers were having age of less than 21 when they had this pregnancy (child for which anthropometric measures were taken) and 10% were having age more than 30.
Care around birth
113 (80 %) mothers reported receiving complete Antenatal care while no mother reported of not receiving Antenatal Care (ANC). 86% mothers received both Tetanus Toxoid (TT1 and TT2). Iron and Folic Acid (IFA) tablets were received by 86% mothers. 85% deliveries were reported to be institutional deliveries. Post-natal care is an issue as 74% mothers reported that they have not received any post-natal care.
Nutritional and dietary practices
Breastfeeding to newborn and colostrum administration was reported by 100% mothers which is a good practice. 93% mothers initiated breastfeeding immediately after birth or within one hour of birth. 90% mothers started supplementary feeding after age of 6 months. 82% families reported to have Non-vegetarian diet. 94% families reported that females of family including girl child have food along with family rather than having left over food. All families wash vegetables before cooking them. 80% of mothers were having Non-vegetarian diets.
Birth details and immunizations
80% of children were having birth order 1 or 2. Birth weight of less than 2.5 kg is reported by 29% children. Every Child was having Immunization card irrespective of the place of delivery. 72% children having all 3 birth vaccinations: BCG, Hep B and OPV 0 dose with 100% BCG coverage. All appropriate vaccinations at age of 6 weeks, 10 weeks, and 14 weeks were received by 41%, 37% and 38% children respectively. 86% of children have received Measles and Vitamin A at age of 9 months.
Other relevant history
At time of data collection, 10.7% children were having history of past illness, 7% were having history of worm infestation. 40% were having history of suffering from cough/wheeze/increase Respiratory rate in last 15 days while 26% children were suffering from fever in last 15 days. 50% of children approached healthcare provider from Govt. for all these issues (Table 5).