Nutritional Status among Under Five Children and Their Mothers with Gender Perspective
Date
2012
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Central Department of Statistics
Abstract
Survey results since 1975 in Nepal do not ascertain favorable situation of nutrition
among children under five years of age as indicated by the percent of children with
stunting, wasting and underweight. National Family Health Survey (NFHS), 1996
revealed that 54.8% were stunted, 12.7% were wasted and 54.2% were underweight.
Nepal Micronutrient Status Survey, 1998 displayed that 54% of children in Nepal
were stunted and 47% underweight. The first national nutritional survey in 1975 also
exhibited similar findings of 48.1% stunted, 2.8% wasted and 50% underweight. The
data suggest that there is no enhancement in the nutritional status in the country
during this time span. Nepal Demographic and Health Survey 2001 revealed the
percent prevalence for underweight and wasted children of under five years of age as
48.3% and 9.6% and about 50% of these children showed stunting. Similarly, NDHS
2006 reveals that the percent prevalence for underweight and wasted children of
under five years of age are 39% and 13%. Forty nine percent of the children under
five years of age are stunted. To overcome the problem of malnutrition, the factors
associated with nutrition needs to be studied. Many studies show that wealth status
of household, size of the child at the birth, educational status of mothers and
mother’s autonomy are related with her own and her child’s nutrition.
This study was intended to determine percent prevalence of nutritional status as
indicated by percent of normal children and percent of underweight, stunted and
wasted children as well as percent of mothers with normal and low body mass index.
This study also tried to explore the factors associated with nutrition among children
under five years of age and the mothers. There are many indicators of gender status
and while analyzing the data, some of the variables related to status of women such
as woman’s educational status, employment status, working hour per day, decision
making ability, contraceptive use and media exposure etc. were tried to link with
nutrition of children and women themselves.
This was an observational study carried out in Kathmandu district. This study also
used the secondary data of Nepal Demographic and Health Survey, 2006 for the
enrichment of the scope of the study to whole Nepal. The primary data were
collected from Kathmandu district. The proportional allocation of households from
different VDCs and municipalities was insured. The households were selected by
spinning a bottle at different junctions in survey area. The sample size calculated
was 454 children. The primary data was collected by interviewing the mothers. The
anthropometry for under-5 years and their mothers were collected by using weighing
machine, Sakir’s tape and measuring tape. STATA 9, PHSTAT2, Growth analyzer
3.5, Epi Info 2000, Microsoft Excel 2007, SPSS 13 and SPSS 17 were used for
analysis. Necessary tables, chi square test (exact test where applicable),z test for
proportion, Kruskal Wallis test, ANOVA, ordinal regression, MANCOVA, LMS
method for smoothing growth centile curve and chi square test of goodness of fit
were used in the process of data analysis.
The percent of children with stunting, underweight and wasting was found as 58.8%,
34.4% and 14.6% respectively as per present study. Ordinal regression came out as
suitable method for nutrition data. Wherever required assumption for ordinal
regression failed, partial proportional odds model was a good substitute. Alternative
gamma parameterization results were observed in line to partial proportional odds
model. MANOVA analysis could not hold required assumption in this data set.
Household wealth, area of residence, size at birth, education of mothers was found to
impact the nutrition of children. Moreover, employment status of the mothers
showed effects on child’s height. Furthermore, mothers’ exposure to mass media
emerged as significant predictor for underweight. Female children showed
substantial risk of being underweight. Likewise, exclusive breastfeeding resulted into
better MUAC facet. Media exposure showed positive blow on nutrition of women
and higher number of children to the woman indicated negative agreement with her
BMI. The growth charts did not resemble marked gender differences in its mold. The
fiftieth centile comparison with CDC 2000 charts indicated lower height for age
assessment for NDHS and Kathmandu data. Overlapping fiftieth centiles of
Kathmandu with CDC 2000 charts which were elevated than NDHS were observed
for weight for age.
Looking at these insights, it could be concluded that at one hand wealth status of the
household was important in defining the nutrition of the children and at the other
hand size of the child at birth and education of the mothers, employment status of the
mothers played effective role. Here the important notion is that size at birth is linked
with mother’s nutrition during pregnancy. Employment and education may
contribute to gain autonomy among the mothers which would be reflecting in
household resource allocation resulting into more allocation in nutritious food.
Key words: BMI, Nutrition, Height for Age, Weight for Age, Weight for Height
Description
Keywords
Nutritional status, Gender Perspective, Children