RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF

DISSERTATION

TOPIC

STUDY OF NUTRITIONAL STATUS AMONG INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS) SCHEME CHILDREN AGED 1-5 YEARS IN SULLIA, D.K DISTRICT, KARNATAKA, INDIA.

Dr. R. NIVEDITHA,

POSTGRADUATE,

DEPARTMENT OF PAEDIATRICS,

K.V.G. MEDICAL COLLEGE,

SULLIA.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA

ANNEXURE- II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1 / NAME OF THE CANDIDATE AND ADDRESS
(IN BLOCK LETTERS) / Dr. R.NIVEDITHA.
D/o, RANGAPPA,
No. 51, ADICHUNCHANAGIRI ROAD, VIDYANAGAR,
HASSAN-573201,
KARNATAKA.
2 / NAME OF THE INSTITUTION / KVG MEDICAL COLLEGE,
KURUNJIBAG, SULLIA
DK-574327
KARNATAKA.
3 / COURSE OF STUDY AND SUBJECT / M.D. PAEDIATRICS.
4 / DATE OF ADMISSION TO COURSE / 25.5.2010
5 / TITLE OF THE TOPIC / STUDY OF NUTRITIONAL STATUS AMONG INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS) SCHEME CHILDREN AGED 1-5 YEARS IN SULLIA, D.K. DISTRICT, KARNATAKA, INDIA.
6 / BRIEF RESUME OF THE INTENDED WORK:
6.1 NEED FOR THE STUDY:
Nutrition is the cornerstone of socio-economic development. Nutrition plays a key role in physical, mental and emotional development of children. Much emphasis has been given to provide good nutrition, especially in the formative years of life as malnutrition is a silent emergency. Globally, more than one third of child deaths are attributable to under nutrition. The 3rd National Family Health Survey showed that 45% of < 3 year old children were malnourished. If this continues, India would be raising a generation which is debilitated and unable to contribute effectively to the productivity of the country.
The Integrated Child Development Services (ICDS) programme is the world's largest early child development programme. It was initiated in India in 1975 with the objective of improving the nutritional status of pre-school children in addition to other services.
There is a growing consensus that poor nutritional status during childhood can have long-lasting scarring consequences into adulthood, both in terms of health and mortality and in terms of other measures of human capital such as schooling and productivity 1, 2. Globally it is estimated that among preschool-age children in developing countries 183 million are underweight, 226 million are stunted and 67 million wasted 3. India has the highest occurrence of childhood malnutrition in the world 4.
Anthropometric indicators have been widely used in population-based studies to evaluate nutritional status particularly in the field of public health. Even though they represent indirect measures of under nutrition that do not take into account nutrient intake or biochemical examination, their wide use is justified due to the ease of the method and its high sensitivity to nutritional alterations in a population5.
Cohort studies, ideal for nutritional conditioning monitoring, suffer in developing countries, from the logistic difficulties usually associated with population studies of large magnitude. In such cases, cross-sectional studies can provide relevant elements for understanding the connection between health status and physical conditions of life. These studies have the advantage of relatively low costs, and they can also provide fundamental information for the implementation of health surveillance systems and the definition of long-term health intervention strategies 6.
As the nutritional status differs from one area to other due to change in environmental, social, economical and educational factors, this study will show nutritional status of Anganwadi children 1-5 year age group in Sullia. This study will also provide an evidence of the children who are under acute and chronic nutritional stress indicating the requirement of immediate and appropriate public health, nutritional programmes and the implications for public policy-makers, planners and organizations, seeking to meet national and international development targets.

6.2  REVIEW OF LITERATURE :
A study conducted by Syed Shafi Ahmed Muaz etal in four tea gardens of Sylhet division, Bangladesh, to assess the nutritional status of 1 to 5 years children of tea workers determined through anthropometric measurements reported, prevalence of wasting 42.3%, stunting and underweight 80.2% and 73% respectively7.
A survey conducted by National Nutrition Monitoring Bureau (NNMB) and the National Institute of Nutrition (NIN) on diet and nutrition in 12 states of the country indicated that the diets of the rural population are inadequate and deficient in most of the nutrients. About 60% of the preschool children were underweight, 62% were stunted and about 15% of these children had wasting8.
The results of the study conducted at Bauri preschool children of Nituria block, Purulia, West Bengal, indicated that nutritional status of the children was serious with very high rates of thinness of 61.5% and 70.8% in boys and girls respectively. A noteworthy point was that both sexes had similar rates of thinness9.
A study investigated age and sex variations in height and weight among 1-5 years old rural children of Integrated Child Development Services (ICDS) Centre’s of Chapra Block, Nadia District, West Bengal, India showed that the overall (age and sex combined) rates of stunting was 39.20 %. The rates of stunting was higher among boys (43.4%) compared with girls (35.4 %). Age specific prevalence rate of stunting was higher among 1 year children (52.05 %) compared with 2 years old children (31.69 %). On the other hand, boys aged 5 years had higher prevalence rate of stunting (61.90 %) compared to girls (28.87 %) at 4 years age. Height-for-age (HAZ) was used to evaluate stunting following the National Centre for Health Statistics (NCHS) Guidelines10.
A study conducted among 256 Anganwadi children of rural areas located at the outskirts of Bangalore city, Karnataka, showed that the prevalence of wasting, stunting and wasting-stunting was 31.2%, 9.4%, and 29.2% respectively. Wasting was more predominant among the younger age groups11.
A study conducted by Ashwini et al at anganwadis surrounding Manipal revealed that 32.3% children were malnourished, of whom 87.8% children were grade I malnourished and 12.2% children were grade II malnourished. Proportionally girls (46.2%) were more malnourished than boys (33.6%). The Assessment of nutritional status was done using ICDS growth chart12.
6.3 OBJECTIVES OF THE STUDY:
1. To assess the nutritional status of anganwadi children between 1-5 year of age in Sullia.
2. To compare the nutritional status of male and female children in 1-5 year age group.
3. To make suitable recommendations based on the present study.
7.1 SOURCE OF DATA
The present study is being conducted in children between 1-5 years of age enrolled in anganwadi under ICDS, at Sullia, D.K District, Karnataka.
7.2 METHOD OF COLLECTION OF DATA
This cross sectional study will be conducted at Sullia, D.K, District, Karnataka, India. This study will be carried out from June-2010 to May 2011.Information about age will be collected from anganwadi register. Study will be conducted on preschool children (1–5 years old) enrolled at anganwadi after obtaining permission from ICDS authorities. Height, weight and mid arm circumference measurements will be taken by the standard techniques13. They will be recorded with the subject wearing minimal clothing to the nearest 0.1cm and 0.5kg respectively14.Weighing machine, stadiometer, non stretchable measuring tape will be used.
INCLUSION CRITERIA :
Children between 1-5years of age attending anganwadi at Sullia, D.K.District, Karnataka, India, will be included.
EXCLUSION CRITERIA :
Children with chronic ill health, congenital anomalies, chromosomal anomalies and metabolic diseases will be excluded.
STUDY DESIGN:
Cross sectional study.
SAMPLE SIZE:
Sample size of 200 estimated with population prevalence 50% and absolute relative precision 10%.Hence sample size is 200 children between1-5 age group enrolled in anganwadi, Sullia.
FOLLOW UP :
Nil
FOLLOW UP PERIOD :
Nil
7.3 Does the study require any investigations or interventions to be conducted on
patients or other humans or animals? If so please describe briefly.
Yes
Anthropometric measurements will be taken and head, socio-economic profile and diet history will be collected from their parents or guardians after obtaining their informed consent.
7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Yes

8
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REFERENCES:
1. Maluccio JA, Hoddinott J, Behrman JR. The impact of an experimental nutritional intervention on education in to adult hood in rural Guatemala. Internet Journal of Biological Anthropology. 2009; 3: 2.
2. Behrman JR, Hoddinott, Maluccio J. What determines adult cognitive skills. Impacts of pre-schooling, schooling and post schooling experiences in Guatemala 2006. Internet Journal of Biological Anthropology. 2009; 3: 2.
3. Mitra M, Tiwari A. Malnutrition in pre-school children. A study of Brahmin Rawat and Teli preschool children of Raipur. J Life Sci 2009; 1(2): 85-89.
4. Bamji MS. Early nutrition and health. Indian perspective current Science 2003; 85:1137-42.
5. Post CL, Victoria CG. The low prevalence of weight-for-height deficits in Brazilian children is related to body proportions. J Nutri; 131: 1133-4.
6. Martorel R., Rivera J, Kaplowitz H.Consequences of stunting in early childhood for adult body size in Guatemala. Ann Nest; 48: 85-92.
7. Muaz SSA, Hasan MR, Shamim SA. Nutritional status of 1-5 years children of the tea workers in sylhet division. Bangladesh J child health 2010; 34 (1): 11.
8. Vijayaraghavan K, Rao DH. Diet & nutrition situation in rural India. Indian J Med Res1998; 108:243-53.
9. Das S and Bose K. Anthropometric characteristics and nutritional status of Bauri Pre-School children of Nituria Block,Purulia,West Bengal.The Internet journal of biological anthropology 2009;3:2.
10. Biswas S, Bose K, Mukhopadhyay A. High prevalence of stunting among integrated child development services (ICDS) scheme children aged 1-5 years of Chapra block, Nadia district,West Bengal, India. The Internet Journal of Biological Anthropology 2009; 3(2):13.
11. Joseph B,Rebello A,Kullu P. Prevalence of Malnutrition in Rural Karnataka, South India. J Health Popul Nutr 2002; 20(3):239-44.
12. Kumar A, Kamath V, Kamath A. Nutritional status assessment of under-five beneficiaries of Integrated Child Development Services program in rural Karnataka. AMJ 2010; 3(8): 495-8.
13. Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Chicago. Anthropologist 2009; 7(3): 217-19.
14. Ulijaszek SJ, Kerr DA. Anthropometric measurement error and the assessment of nutritional status.Br J Nutr 1999; 82:165-77.
9. / SIGNATURE OF CANDIDATE
10. / REMARKS OF THE GUIDE : Recommended
11. / NAME AND DESIGNATION OF THE
11.1 Guide Dr. JAGADEESH KUMAR.P.M,
Associate Professor,
Department of Paediatrics,
K.V.G. Medical college, Sullia.
11.2 Signature
11.3 Head of the Department Dr. EDWIN DIAS DCH, MD, DNB.
Professor and HOD
Department of Paediatrics,
K.V.G. Medical college, Sullia.
11.4 Signature
12. / 12.1 Remarks of the Principal
12.2 Signature
ETHICAL COMMITTEE CLEARANCE
1. TITLE OF DISSERTATION / STUDY OF NUTRITIONAL STATUS AMONG INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS) SCHEME CHILDREN AGED 1-5 YEARS IN SULLIA, D.K. DISTRICT, KARNATAKA, INDIA.
2. NAME OF THE CANDIDATE /
Dr. R.NIVEDITHA.
3. NAME OF THE GUIDE / Dr. JAGADEESH KUMAR. P.M.
4. APPROVED / NOT APPROVED
Sri KRISHNAMURTHY, Chairperson.
Dr. SUBBANNAYYA KOTIGADDE, Secretary.
Dr. S. GOPALRAO, Member
Dr. C.S.MOHANRAJ, Member
Dr. H.R.SHIVAKUMAR, Basic scientist
LAW EXPERT : Sri KRISHNAMURTHY, Advocate
PRINCIPAL
K.V.G. Medical College and Hospital, Sullia.