Thesis Paper

On

Comparative Study on Nutritional Status of Children (aged 6 to 24 months) and their Mothers between Selected Slum and Non-slum Areas of Dhaka City

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This cross sectional comparative study was conducted in purposively selected slum areas of Kamrangirchar and different non-slum areas of Dhaka city to assess and compare the nutritional status of children aged 6 to 24 months and their mothers. The purpose of the study was to compare the nutritional profile in terms of knowledge, Attitude and Practice (KAP) about pregnancy, delivery, lactation, child feeding practice and morbidity as well as socio-economic conditions to identify the significant influential factors, if any affecting the existing nutritional situation. A total of 190 child-mother pairs, 95 pairs from slum areas and another 95 pairs from non-slum areas, were randomly selected. Structured questionnaires were administered to mothers while anthropometric measurements and blood samples were collected by HemoCue method from the target children and their mothers. Collected blood specimens were tested in the laboratory of Institute of Nutrition and Food Science (INFS) the following day to identify the blood hemoglobin level. Statistical package for Social Scientists (SPSS) was used for data analysis. Indices of nutritional status that is weight-for-age z-score (WAZ), height-for-age z-score (HAZ) and weight-for height z-score (WHZ) for children and body mass index (BMI) for mothers were computed using the WHO Anthro program. Dietary analysis of the data collected from mothers by 24 hour recall method, was carried out by using Bangladeshi Food consumption table developed by INFS by using Fortran 77 software.

Significant associations between BMI of mothers and HAZ of children (P< 0.01, r=0.761) for slum areas, education level of mothers and WAZ of children (P< 0.01, r=0.141) for non-slum areas were found. A significant difference in energy, protein, fat, carbohydrate, calcium, iron, thiamin, riboflavin, niacin, vitamin C and Zinc intake (as for all nutrients P 9 month= 3

27. What was the birth weight?

Code:

2.5 Kg=2

Dont Know=3

28. Do you know what is Anemia?

Code:

Yes=1

No=229. Did you have Anemia during pregnancy?

Code:

Yes=1

No=2Dont Know=330. Did you take iron tablet during pregnancy?

Code:

Yes=1

No=2

31. If yes, then how many did you take?

Code:

1-150=1

15i-300=2Did not took=532. Did you take folic acid tablet during pregnancy?

Code:

Yes=1

No=2Dont Know=3II. Feeding Practices:

33. What did you first feed to your infant after birth? Code:

Colostrum=1

Honey=2

Swteened water=3Plain water=4

34. What was the method for postlacteal feeding? Code:

Tip of finger =1

Spoon =2

Plasti feeder bottle =3Need not to use ant method =9

35. When did you start breast feeding to the infant?

Code:

Never breast fed=1

Immediately after birth= 2

Within 24 hours=3Within 48 Hours=4> 48 hours =5

36. Did you give colostrum to your new born?

Code:

Yes=1

No=2Can not remember=3

37. If not; then what was the reason to reject colostrum?

Code:

Mothers illness=1

Ignorance=2Dont feel it necessary=3

Family discourage=4Bad for baby=5

Feed colostrum=9

38. Do you know the benefits of colostrum?

Code:

Yes=1

No=2

39. Did you exclusively breast feed your child upto 6 months?Code:

Yes=1

No=2Never breast fed=3

40. If no, then what did you offered for supplementation?

Code:

Formula Milk=1Cows milk=2

Cerelac=3Suji (Semolina)=4

41. Are you continuing breast feeding to your child ?Code:

Yes=1

No=242. If yes, how long will you continue breast feeding to your child?Code:

< 12 months=1

12-24 months=2

> 24 months=343. If no, how long did you follow breast feeding?

Code:

0- 1 month=10-4 month- =20-6 months=3

44. When did you start weaning food?

Code:

< 6 month=1

6-8 month=2

45. If before 6 months, why?

Code:

Breast milk is not enough to fulfill child requirement=1

Less breast milk production=2

Due to work load=3

Family pressure=4Others=5

Started after 6 months =9

46. What are the foods do you give your chid as complementary food now?

Code:

Formula Milk=1

Suji (Semolina)=2

Fruit/Fruit juice=3

Rice+Dahl/ Khichuri=4

Rice+Dahl/ Khichuri

with meat/fish/egg=5

47. When do you feed your child?

Code:

Childs wish=1

At fixed time=2Mother-in-laws wish=3

When the child cries=4

Other=5

48. Do you give your child fresh cooked food every time?

Code:

Yes=1

No=2NA= 9

49. If not, why?

Code:

Unaware =1

Can not afford=2 Not Applicable=9

50. Do you prepare separate food for your child?

Code:

Yes=1

No=2Not Applicable=9

III. Morbidity and Treatment Seeking Behavior: Did your Child suffer from any disease within last 3 months?

Code:

Yes=1

No=2

51. If yes, Name of the disease he/she suffered?Code:

Fever=1

Cold=2

Fever+Cold=3

Diarrhoea=4 Diarrhoea+ Fever =552. What do you do when your child gets sick?Code:

To physician =1

To Homeopath =2

To Traditional healer=3

To the nearer NGO centre=4

C. Anthropometric Assessment (mother and target children):

dentificationHeight /

Length (cm)Weight

(kg)

Mother of the child

Child Identification number (CIN)

D. Biochemical Assessment (mother and target children):

IdentificationOptical DensityHemoglobin

(gm/dl)

Mother of the child

Child Identification number (CIN)

E. Dietary Assessment :

Food Intake of mother by 24 hour recall method:

Age of the Mother: _________ YearHow was yesterday in respect of food intake?

Code: As usual normal day =1

Festival =2Sick =3Time of EatingMenuCooked / Raw FoodCode of the FoodTotal Weight

(gm)

Family measurementIngredientsCooked wt (gm)Cooking Method

Breakfast

Mid morning Snacks

Lunch

Mid Afternoon Snacks

Dinner

F. Clinical Assessment:Clinical Signs MotherCIN

12

Hair Discolored

Sparce

EyesNight Blindness

Bitots Spot

Conjunctival Xerosis

Corneal Xerosis

Keratomalacia

Pallor

LipsAngular Stomatitis

Angular Scars

Cheilosis

GumsBleeding gums

Swollen red Papillae

Fever

Tongue

Smooth

Raw and Red

NoseNasolabial Dyssebacea

GlandEnlarged Thyroid Gland

SkinFlakypaint dermatosis

Follicular hyperkeratosis

NailKoilonychia

SkeletalKnock Knee/ Bow leg

Edema

Others Enlarged abdomen

(Worm Infestation)

Location Map of Slum and Non-slum areas of Dhaka city

There exists influential factors affecting nutritional status and feeding behavior of urban slum and non-slum children (aged 6 months to 24 months) and their mothers of Dhaka city.

Figure 11: Percent Distribution of Non-slum Households according to adoption of Family Planning

Figure SEQ Figure \* ARABIC 10: Percent Distribution of Slum Households according to adoption of Family Planning

Class VI- VIII =5

Class VIII-SSC=6

SSC-HSC=7

Graduate=8

Class VI- VIII =5

Class VIII-SSC=6

SSC-HSC=7

Graduate=8

River/Pond=3

Deep Tube well =4

Others =5

301-500=3

Unlimited=4

Milk (Cow/Goat)=5

Milk (Formula)=6

Others=7

Fruit/Fruit juice=5

Confectionary/Snacks=6

Formula/Animal milk + Suji/ Cerelac= 7

Formula/ Animal milk + all above foods= 8

0-12 months=4

0-18 months=5

Not at all=6

Continuing bf=9

9-12 month=3

> 12 month=4

Not yet=5

Confectionary/Snacks=6

Rice+ Dahl/ Khichuri with meat, fish, egg &

vegetable=7

Rice+ Dahl/ Khichuri & vegetable=8

All Fooed=9

Cows milk= 10

Pox =10

Measles=11

Others=12

Not Applicable=99

Diarrhoea+ Fever+Cold =6

Typhoid=7

Pneumonia=8

Jaundice=9

Give medicine from nearer pharmacy=5

Follow traditional way=6

Nothing=7

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_1453621555.vsdEducation

Occupation

Income

Family Size

Expenditure on Food Item

Food Cunsumption

MaternalMalnutrition

Malnourished Neonate

Non-ExclusiveBreast Feeding

Faulty ComplementaryFeeding Practice

Prolonged BreastFeeding

MalnutritionOf the Child(6 24 Months)

KAP ofMother

Treatment SeekingBehaviour

Sanitation

Morbidity Pattern

Healthcare Facility

Water Environment& Living Condition