Malnutrition among school-going children in the perspective of regional and socio-economic disparity in Punjab

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Date
2017
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Punjab Agricultural University, Ludhiana
Abstract
The present study was conducted on one thousand and fifty school children (11-17y) selected from urban and rural government schools of three regions of Punjab, namely, Majha (n=210), Doaba (n=210) and Malwa (n=630) using thirty-cluster multistage sampling technique. The undernutrition in terms of thinness and stunting among children was studied in the perspective of regional and socio-economic disparity in Punjab. For the assessment of overnutrition as well as undernutrition in the form of thinness and stunting, children were classified according to WHO (2007) BMI-for-age (BAZ) and Height-for-age z-scores (HAZ). The results showed that the children’s diets were inadequate in energy, protein, fat, thiamine, riboflavin, niacin, vitamin B12, folic acid, vitamin C, calcium, iron and zinc. Mean food variety scores (FVS) of the children from Malwa region were significantly (p≤0.01) higher in comparison to that of Majha and Doaba region. The overall mean Household Dietary Diversity Score (HDDS) and FVS of the children from Punjab were 5.8 out of 12 and 19.3 out of 44, respectively, which indicated that their diets had poor diversity. Blood hemoglobin level of 20% of the subjects showed the highest prevalence of anemia among children from Doaba region (100%) followed by Malwa (98%) and Majha (91%) region, whereas, children from Majha region (30%) had the highest prevalence rates of stunting as compared to those from Malwa (17%) and Doaba (9%) regions. Almost equal proportion of the children from Majha and Malwa region (24 and 23%, respectively) were found to be thin, whereas, Doaba region had the highest prevalence (27%) of thinness. Overnutrition among Punjabi school children was found to be scarce, the prevalence being 11, 7 and 4% in Majha, Doaba and Malwa regions, respectively. Overall, from Punjab, the prevalence of undernutrition in terms of thinness and stunting (24 and 18%, respectively) was far lesser than the prevalence of anemia (97%) among school going children. A substantial disparity (p≤0.05) in anemia was noted with respect to caste of the children, while on the basis of BAZ scores, only religion had a significant (p≤0.05) relationship with thinness, among various socio-economic factors studied. HAZ scores for the assessment of stunting showed a significant (p≤0.01) relationship with family income and parent’s education. In conclusion, most of the socioeconomic factors appeared to influence long term chronic rather than short term acute undernutrition among Punjabi school children. Hence, the policy-makers should give utmost priority to poverty alleviation, improvement in education; more privileges to marginalized communities and better implementation of prevailing health and nutrition programs in the framework of development programs of the state in order to achieve optimum physical, nutritional and health parameters of school-going children.
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