Predictors of anthropometric failure among under five slum children of Jammu, India

Authors

  • Deepika Dewan Department of Community Medicine, Government Medical College Jammu, J&K
  • Dinesh Kumar Department of Community Medicine, Government Medical College Jammu, J&K
  • Rajat Gupta Department of Pathology, J&K Health Services, Jammu, J&K

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20151593

Keywords:

CIAF, Diarrhea, Feeding practices, Under nutrition, Z-score

Abstract

Background: Under nutrition continues to be a major public health problem in India despite years of efforts and huge resources invested to tackle the situation. Accurate assessment of the magnitude is important for allocation of resources and monitoring of trends. Of the various measures recommended, Composite index of anthropometric failure (CIAF) provides the burden of under nutrition in a single measure and helps in detection of children with multiple anthropometric failures in community. Research with simultaneous use of Z scores and CIAF in under nutrition is limited.

Methods:This cross-sectional community based study was done in urban slums to determine the prevalence of under-nutrition and its determinants using Z Scores and CIAF. 250 under five children registered with eight randomly selected anganwadis from urban slums Jammu, J&K, India were studied.  

Results: Of 250 children studied, 183 (73.2%) were suffering from under-nutrition (one or the other form of anthropometric failure)according to CIAF. 38.8%, 20.4% and 42.8%  under-fives were classified as underweight, wasted and stunted respectively by conventional indices. Morbidity, age at weaning and children with more than three siblings were found independent predictors of anthropometric failure on multivariate logistic regression.

Conclusions:CIAF seems to provide an accurate reflection of under-nutrition than the currently used weight-for-age Z score. The study underscores the importance of appropriate physical environment and proper infant and child feeding practices in prevention of under nutrition.

References

Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006;367(9524):1747–57.

Gragnolati M, Shekar M, Das GM, Bredenkamp C, Lee YK. India's Undernourished Children: A Call for Reform and Action. Washington, DC: Health, Nutrition, and Population Division, World Bank; 2005. Accessed online from Dec 2015.

PAHO/WHO. Guiding principles for complementary feeding of the breastfed child. Division of Health Promotion and Protection Food and Nutrition Program 2001. Accessed online Dec 2015.

World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee Technical Report Series ; 854.WHO, Geneva.1995.Accessed online from Dec 2015.

Svedberg P. Poverty and under nutrition: theory, measurement and policy. New Delhi: Oxford India Paperbacks. 2000.

Nandy S, Irving M, Gordon D, Subramanian, Smith DG .Poverty, child under nutrition and morbidity: New evidence from India. Bulletin of the World Health Organization. 2005;83:210-6

World Health Organization. WHO recommended surveillance standards. Geneva: WHO. 1999.

World Health Organization. Nutritional anaemias. Report of a WHO scientific group. WHO Technical Report Series; 405Geneva, WHO, 1968. Accessed from Dec 2015.

WHO Anthro (Version 3.2.2 January 2011) and macros.

WHO Child Growth Standards Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age Methods and development. WHO Multicentre Growth Reference Study .Department of Nutrition for Health and Development; 2006. Accessed online from December 2015.

Dang SN, Yan H .Optimistic factors affecting nutritional status among children during early childhood in rural areas of Western China. ZhonghuaYuFang Yi XueZaZhi. 2007;41:108-14.

Berger MR, Fields-Gardner C, Wagle A, Hollenbeck CB. Prevalence of malnutrition in human immunodeficiency virus/acquired immunodeficiency syndrome orphans in the Nyanza province of Kenya: a comparison of conventional indexes with a composite index of anthropometric failure. J Am Diet Assoc. 2008;108(6):1014-7.

Government of India. National Family health Survey 3(2005-6) IIPS. Ministry of Health and family Welfare, Mumbai 2007. Accessed online from 2015.

UNICEF. The State of the World’s Children 2015: Executive summary. Reimagine the future: Innovation for every child. UNICEF; 2015. Accessed online from 2015.

HUNGaMA: Fighting hunger and malnutrition: The HUNGaMA Survey Report – 2011. Accessed online from Dec 2015.

Seetharaman N, Chacko TV, Shankar SLR, Mathew AC. Measuring malnutrition- The role of Z scores and the composite index of anthropometric failure (CIAF). Indian J community medicine. 2007;32(1):35-9.

Nandy S, Miranda J. Overlooking undernutrition? Using a composite index of anthropometric failure to assess how underweight misses and misleads the assessment of undernutrition in young children. Soc Sci Med . 2008;66:1963-6.

Mandal GC, Bose K. Assessment of overall prevalence of under nutrition using Composite Index of Anthropometric Failure (CIAF) among preschool children of West Bengal, India. Iranian J. Pediatr. 2009;19(3):237-43.

Dasgupta A, Parthasarathi R, Prabhakar VR, Biswas R, Geethanjali A. Assessment of Under Nutrition with Composite Index of Anthropometric Failure (CIAF) Among Under-Five Children in a Rural Area of West Bengal. Indian J Community Health. 2014;26(2):132-8.

Anjum F, Pandit M I, Mir AA, Bhat I A. Z score and CIAF – A comprehensive measure of magnitude of under nutrition in a rural school going population of Kashmir, India. Global Journal of Medicine and Public Health. 2012;1(5):46-9.

Shit S, Taraphdar P, Mukhopadhyay DK, Sinhababu A, Biswas AB. Assessment of nutritional status by composite index for anthropometric failure: a study among slum children in Bankura, West Bengal. Indian J Public Health. 2012;56(4):305-7.

Solanki R, Patel T, Shah H, Singh US. Measuring undernutrition through z-scores and Composite Index of Anthropometric Failure (CIAF): a study among slum children in Ahmedabad city, Gujarat. National Journal of Community Medicine. 2014;5(4):434-9.

Barrett H, Brown A. Health, hygiene, and maternal education: Evidence from Gambia. Soc Sci Med. 1996;43:1579-90.

Sengupta P, Philip N, Benjamin AI. Epidemiological Correlates of Under-nutrition in under-5 years children in an urban slum of Ludhiana Health and Population: Perspectives and Issues. 2010;33(1):1-9.

Goel MK, Mishra R, Gaur D, Das A. Nutritional surveillance in 1-6 year old children in urban slums of a city in Northern India. The internet Journal of Epidemiology. 2007;5(1):6-8.

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Published

2017-01-31

How to Cite

Dewan, D., Kumar, D., & Gupta, R. (2017). Predictors of anthropometric failure among under five slum children of Jammu, India. International Journal Of Community Medicine And Public Health, 3(1), 367–372. https://doi.org/10.18203/2394-6040.ijcmph20151593

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Original Research Articles