Description
Background
India has administered several programs to manage under-five malnutrition till now, but there is a dearth of literature to address the nutritional scenario whether it has improved or not since the period of COVID-19, particularly in the tribal areas. Hence, the present study assesses the current prevalence of acute malnutrition in terms of Moderate Acute Malnutrition or MAM (WHZ>2SD & <3SD) and Severe Acute Malnutrition or SAM (WHZ<3SD) using Mid Upper Arm Circumference (MUAC <115mm for SAM) among children aged below five years in the Gadchiroli district of Maharashtra.
Methods
A community-based cross-sectional survey was conducted to identify the children (0-59 months) who had been registered to the 'Anganwadi program' in two selected blocks. Pre-tested structured questionnaires were used to collect data. The total sample considered for analysis was 1055 children. Standard anthropometric measurement was followed. Univariate and bivariate statistical analyses were performed.
Results
The prevalence of MAM and SAM is calculated among the study population at 1.4% and 9.8% respectively. A higher prevalence of MAM is found among male (38.5%) and female (27.1%) children in the age group below 6 months. Overall, a higher prevalence of MAM is found among girls (12.3%) than among boys (10.1%). The prevalence of SAM is 1.4 percent which is significantly higher among female children (1.7%) than among male (1.0%) children. Children in the age group 12 to 17 months are sixteen times more likely (Exp beta=16.885, p<0.001) to have MAM (MUAC<12.5cm) than the reference category children (i.e. children aged 6-11 months). Children from the Desaiganj block (Exp beta=0.423, p<0.001) are significantly less likely to have MAM than the children from the Bhamragad block. Children who are moderately wasted (WHZ<-2SD) are three times (Exp beta=3.510, p<0.001) more likely to have MUAC<12.5cm than the children who are not wasted. It is also found that about 3.9% of children are critically malnourished as having both MUAC<12.5cm and WHZ<2SD. The percentage of the children having both WHZ<-3SD and MUAC<11.5cm is 0.2 percent who are considered critically ill and need special treatment.
Conclusions
Block-level monitoring of MAM and SAM among children below 5 years is an urgent need and evaluation of ongoing nutrition programs, particularly to reduce the gap in the sex-specific prevalence of MAM and SAM in tribal areas is a prerequisite. In the absence of exact guidelines for the therapy of chronic malnutrition, training on the identification of any visible symptoms or ailments among children by the health workers and Anganwadi workers (AWW) in coordination with the Block Medical Officer (BMO) would be an important step to combat with child malnutrition.
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