Morbidity profile and nutritional status of tribal under five children attending the phulwaris in rural Chhattisgarh

Madonne Rufina Dishani, Radhika Kannan, Reni Philip, Naveen Ramesh, Yogesh Jain, Anjali Mohite


Background: According to UNICEF report, 19.8% children under-five years in India are wasted, 48% are stunted and 42.8% are underweight. Multisectoral initiatives by the national and state governments are yet to reduce the burden of malnutrition. Jan Swasthya Sahyog (JSS) Health Centre in Chhattisgarh, plays a vital role in improving nutritional status of tribal under- three children attending the phulwaris (or creches). Objectives of this study were to assess the nutritional status of under-five children attending the phulwaris located under Bamhni sub center and to identify the common morbidities among these children.

Methods: The researchers conducted health check-up for 357 children in the 19 phulwaris of Bamhni sub center spread over 16 villages.

Results: Mean age of children attending the phulwaris was found to be 29±12.5 months. Among the 357 children, 128 (35.9%) were underweight; 53 (14.8%) were severely underweight; 35 (9.8%) were wasted; 18 (5%) were severely wasted; 58 (16.2%) stunted and 16 (4.5%) severely stunted according to WHO growth charts for weight for age, weight for height and height for age respectively. Point prevalence of morbidity was 142 (39.7%), which included respiratory tract infection (24.6%); scabies (8.4%); otitis media (3.1%); pyoderma (2.2%); developmental delay (2.2%); worm infestation (2.2%); sickle cell anemia (0.6%) and (0.3%) had epilepsy.

Conclusions: Under nutrition was still prevalent among the children attending the phulwaris and upper respiratory tract infection was the most common morbidity.


Tribal, Under-five, Anganwadis, Malnutrition, Respiratory tract infection

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WHO. Child malnutrition. World Health Organization; 2017. Available at: Accessed on 25 June 2019.

Population of India, 2015. Available at: Accessed on 25 June 2019.

Manjunath R, Kumar KJ, Kulkarni P, Begum K, Gangadhar MR. Malnutrition among under-five children of Kadukuruba tribe: Need to reach the unreached. J Clin Diagnostic Res. 2014;8:2-5.

Birdi TJ, Joshi S, Kotian S, Shah S. Possible Causes of Malnutrition in Melghat, a Tribal Region of Maharashtra, India. Glob J Health Sci. 2014;6:164-73.

Khan Y, Bhutta ZA. Nutritional deficiencies in the developing world: Current status and opportunities for intervention. Pediatr Clin North Am. 2010;57:1409-41.

Statistics, India. UNICEF. Available at: Accessed on 25 June 2019.

Kapil U. Integrated Child Development Services (ICDS) scheme: a program for holistic development of children in India. Indian J Pediatr. 2002;69:597-601.

Kanjilal B, Mazumdar PG, Mukherjee M, Rahman MH. Nutritional status of children in India: household socio-economic condition as the contextual determinant. Int J Equity Health. 2010;9:19.

Kumar S, Majumdar A, Kumar V, Naik B, Selvaraj K, Balajee K. Prevalence of acute respiratory infection among under-five children in urban and rural areas of puducherry, India. J Nat Sci Biol Med. 2015;6:3.

National Family Health Survey-4. Available at: Accessed on 25 June 2019.

National Family Health Survey-4. Available at: Accessed on 25 June 2019.

Phulwari (creches) - Jan Swasthya Sahyog (JSS) Available at: Accessed on 25 June 2019.

Olack B, Burke H, Cosmas L, Bamrah S, Dooling K, Feikin DR, et al. Nutritional status of under-five children living in an informal urban settlement in Nairobi, Kenya. J Heal Popul Nutr. 2011;29:357-63.

Awasthi S, Pande VK. Seasonal pattern of morbidities in preschool slum children in Lucknow, north India. Indian Pediatr. 1997;34:987-93.

Sambo M, Ejembi C, Adamu Y, Aliyu A. Out-of-pocket health expenditure for under-five illnesses in a semi-urban community in Northern Nigeria. J Community Med Prim Heal Care. 2005;16:29-32.

Ishore K, Bhattacherjee S, Das DK. Morbidity among tribal under-five children of tea garden areas in a block of Darjeeling district, West Bengal: A cross-sectional study. J Clin Diagnostic Res. 2015;9:LC01-3.

Nair D, Kar SS, Selvaraj K, Ramalingam A. Morbidity profile and out of pocket health care expenditure among under five children of an urban area of Puducherry. J Nat Sci Biol Med. 2015;6:139-42.

Sardana K, Mahajan S, Sarkar R, Mendiratta V, Bhushan P, Koranne RV, et al. The spectrum of Skin Disease Among Indian Children. Pediatr Dermatol. 2009;26:6-13.

Colah RB, Mukherjee MB, Martin S, Ghosh K. Sickle cell disease in tribal populations in India. Indian J Med Res. 2015;141:509-15.