Prevalence of Undernutrition in Telangana
Discuss About The Malnutrition Among Under Children In India.
The children belonging to the rural areas of the Telangana, India are exhibiting and suffering from the high burden of recent and acute nutritional deficit. Thus this can also be inferred that the children of this state are more underweight as well which reflects both the condition of acute and chronic malnutrition. The remarkable increase in the number of children with the malnutrition in the state of Telangana demands an urgent attention. It is an established fact that one in every third child is affected by the hunger and is lamentable. Stunting in this children is a major phenomenon and it occurs due to the malnutrition during the periods of growth and also during the early life. It is also important to mention that the children that reside in the rural areas of Andhra Pradesh and in the urban areas of Telangana are suffering from the higher burden of stunting (Challa & Challa, 2015). The vital reasons for such an issue need to be explored, however, it can also have mentioned that the rapid changes due to the urbanization can be denoted as the social determinant of the health of the child’s health. The data collected from the National Family Health Survey 3 reveals that the 48 percent of the children below the age of 6 and 43 percent of children below the age of six in the state of Andhra Pradesh were found to be stunted (National Family Health Survey, 2018). The reduction in the trend reflects that the chronic undernutrition is falling. The latest data collected from the DLHS 2012-13 reveals an occurrence of stunting of 27.7 percent and 23.7 percent in the states of an Andhra Pradesh and Telangana respectively (Health Management Information System, 2018). The reasons for stunting in the state of Telangana can be designated as malnutrition and thus it needs further exploration. Underweight is also a form of undernutrition which includes the wasting and stunting. The present levels of underweight in the state of Telangana show the similar trends of data in the state of Andhra Pradesh (Challa & Challa, 2015).
Malnutrition is a general or abroad which is sometimes used as an alternative term for undernutrition and it is technically sometimes also referred to as over-nutrition. Children are said to malnourished if the diet is incapable of providing the sufficient amount of protein and calories for maintenance and growth. The children are unable to utilize the food they eat if the children are suffering from an illness (undernutrition). The children are can also be said to be malnourished if they consume more calories (over-nutrition) (Unicef, 2018).
Factors Contributing to Malnutrition
High severity of malnutrition has been prevalent in the sister states of Telangana and Andhra Pradesh. A Rapid Survey on Children (RSOC) within the year 2013 to 2014 by UNICEF before the bifurcation of the state took place. According to the survey, 35.4 percent of the children below the age of 6 years were found to be having stunted growth. The height was less in comparisons to the 2 standard deviations of the expected height. Also, 12 percent of the children that belong from the same age group are stunted severely (Chaurasia, 2016). This data revealed the high levels of malnutrition in states like Telangana. Also, according to the World Health Organization, the database on the child malnutrition and growth says that 30 percent to 39 percent of the occurrence of stunting is a perfect indicator of the severity in the malnutrition in children. The survey data also mention that the rural areas have more percentage of the stunted children (37.5) in comparison to the urban areas which has 31.1 percentage of stunted children. It has also been found that the Dalit children (37.9) and the Adivasi children (34.5). The severity of stunting has been found to be 12.1 percent in the rural areas in comparison to the 11.7 percent in the urban areas (The Hindu 2018).
The state of Telangana is also found to have fared badly in terms of the indicators like underweight, wasting and malnutrition. The survey did reveal that the 6 percent of the children under the 6 years of age also have less weight in comparison to the weight. Also, it has been found that the 6.8 percent of the children that belong from the rural region is found to be wasted, while it is 5.6 percent in the urban areas. The Dalit children below the age of 6 years are malnourished and 7.3 percent of the children are suffering from wasting. Also, according to the WHO child database, 5 to 9 percentage of the wasting also indicates that the there exists a malnutrition of medium severity (The Hindu, 2018).
A cross-sectional study conducted for a period of 2 years and the age group involved age group of under 60 months. The study focused on the population of the Ranga Reddy district of Telangana which had a total population of 52,96,396 and had 5,95,352 children within the age group of 0 to 6 years. The village to be studied had a population of 25,869 and it was approximated that there were 2600 children under the age of 5 years. The total number of children that participated in the study is 400 and it is found that out of the 400 children, 170 children were underweight (42.5 percent). 92 (23 percent) of the underweight children belonged to the severe underweight category and the remaining 78 (19.5 percent) belonged to the underweight category (Varma, 2017). The data from the NNMB report says that the prevalence of underweight among the children that belonged to this age group is 41.8 percent (National Nutrition Monitoring Bureau, 2018). The data furnished by the National family health survey (2006) also mentions that the prevalence of underweight in children is 43 percent. Thus the data found from the conducted study is in accordance with the national surveys and findings (Worldbank, 2018).
Negative Impact of Malnutrition on Children
In several settings, the prevalence of malnutrition begins at the age of 3 months, the process then slows down at the age of 3 years. The children within the age group of 2 to 3 years that have low height for age reflects a continuous process of stunting and low growth. For the older children, the failure to grow is a reflection of stunted growth. From the study, it has been found that out of the 179 children, 81 children were found to be having severe stunting and the remaining 98 children have moderate stunting. The overall percentage of stunting is found to be 44.75 percent. Thinness or wasting in the majority of the cases indicates the severe process of weight loss and it is associated with the severe disease and acute starvation (Varma, 2017).
Severe malnutrition in children is seen in the state of Telangana and the report published by the National Nutrition Monitoring Board Survey revealed that the 36.6 percent of the children are underweight, 44.7 percent of the children are either retarded or stunted. According to the report of World Health Organization, stunting has a direct relationship with the antenatal and post-delivery malnutrition (The Hans India, 2018).
It is important to note that the negative impacts of malnutrition have a harmful impact on the health and mind of the children. In other words, it can be said that the more a child is malnourished, the more nutrient a particular child is missing. This increases the tendency of the occurrence of problems (Debnath & Bhattacharjee, 2016). The symptoms and signs of malnutrition vary greatly depending on the type of nutritional deficiency. There are several other aspects of the ill effects of malnutrition are as follows:
- Low energy or fatigue
- Dizziness
- Poor immunity functions
- Scaly and dry skin
- Bleeding and swollen gums
- Decaying gums
- Reduced reaction time and trouble paying attention
- Underweight
- Poor growth
- Muscle weakness
- Bloated stomach
- Fragile bones or osteoporosis that breaks easily
- Issues with the organ functioning
- Problem is learning (Sahu et al., 2015)
Macro-environmental and micro-environmental drivers- the macro environmental drivers that contributes to the malnutrition among the children are the age, sex, birth order, mother’s education, education of the head of the household, mother’s occupation, occupation of the household, below poverty line status, socio-economic status, religion and type of family (Matariya, Lodhiya & Mahajan, 2016).
The microenvironmental drivers that contribute to the malnutrition to the children are source of drinking water (ring well or tube well), storage of water for use, storage is clean or unclean, storage stays covered or open, defaecation is in open or in latrine, hand washing by the mother before serving the food or before cooking food, appearance of the mother’s clothes (clean or unclean), overcrowding in house of residence (Matariya, Lodhiya & Mahajan, 2016).
Relationship between Poverty and Undernutrition
Extrinsic and Intrinsic drivers- the extrinsic drivers of malnutrition in the children is the improper policy of the Indian government, improper implementation of the food security policies, improper administrative system, insufficient and improper funding required for the food security, public distribution system no operating and targeting the people that are living below the poverty line.
The intrinsic drivers of malnutrition in children are the poverty, geographical location of residence from the main government infrastructure, inability to access food which is of high nutritional value.
Malnutrition is closely related to disease and poverty and each of the factors contribute positively to the permanence of the others. The low socio-economic status is bound to adversely affect the parent’s ability to afford the nutrient-rich food, and this, in turn, results into undernutrition. Evidence also suggests that there exists a positive relationship between the poverty and food insecurity. Poverty is also one of the major factors which contribute to the malnutrition, undernourishment in children. The parent’s inability to purchase food of high nutritional content renders the children undernourished (WHO, 2018).
Health inequity is mainly due to the socioeconomic determinants which play a vital role in the health of children. it has been found that the major inequities in health are due to the lack of proper sanitation facilities and it has a major contributory role in the child mortality. Another vital part is the lack of breastfeeding to the children immediately their birth. It is vital to note that the children are fed with glucose water, honey or other milk instead of feeding breastmilk after the 3 days of delivery. This severely reduces the build-up of the child immunity and hampers the growth in the initial phases of infancy (Pappachan & Choonara, 2017).
Half of the all the death among children under the age of 6 can be attributed to the undernutrition. Undernutrition or malnutrition annually takes 3 million lives a year. improving the nutrition at the global level requires the management of the political economy challenges and this exists in the sub-national, national and global levels. A greater mind shift is required to be build which will assist in shaping the global nutritional landscape. This will require the systematic incorporation of the political and economic reforms so that the nutritional policies can be reformed (Balarajan & Reich, 2016).
India ranks 114 out of the 132 countries in the Global nutrition report and has 38.7 percent of children affected (Globalnutritionreport.org, 2018).
Positives- the national nutritional policy emphasizes the protein and calorie intake. According to the minimum levels of intake of the protein intake, the income groups have shown to be taking in much more than the recommended level. Thus marking a minimal limit can help in demarcating the least amount of protein and calorie that a child must intake to sustain the good health (Niti.gov.in, 2018).
There is also an explicit mention of the micro-nutrient intake which has resulted into the mentioning the minimum levels of iron that a person or a child must consume (Niti.gov.in, 2018).
Negatives- one of the major drawbacks of the policy is that the policy failed to deal to deal with the poverty and the people are unable to have the minimum levels of calorie, protein and micronutrients. The policy thus failed to take into the poor people that lack jobs and are unable to sustain their life on a regular basis.
- Nutrition specific intervention- Nutrition specific intervention is the best way to intervene and provide the minimal calorie, protein and the micro-nutrient that can act as a guide. This will help the parents to frame the minimum amount of nutrient and the calorie that needs to be consumed so as to sustain and maintain a healthy life. The basic or the optimal level of micronutrients, proteins and calories that are necessary for the child’s development can be made along with a dietary plan so that the undernourishment or malnourishment can be reduced or prevented (Ruel, Alderman & Maternal and Child Nutrition Study Group, 2013).
- Maternal nutrition- maternal nutrition is the basis and is the most vital for the good nourishment of the child. Right from conceiving a child to the delivery of the same, the mother needs to maintain a well-balanced diet so that it can be ensured that the child born will be safe and healthy. Proper nourishment is required for the initial development of the baby and is vital for the child’s health as well. Children after their birth are breastfed so as to increase the immunity of the child which helps in the building a strong body in the later part of the life (Bhutta et al., 2013).
- infant and young child feeding- infants are the most vulnerable and thus must only be fed breast because mother’s milk at the initial stage of infancy has all the dietary requirement that a baby will require. Thus, it is important to outside food away from the infants. Whereas, the young child must be fed with a proper diet which will have the sufficient amount of calorie, micronutrient and protein so that the child can properly and so that the brain can develop in a proper way (Onis et al., 2013).
- water, sanitation and hygiene and access to health services- hygiene is the most important along with the sanitation facilities, maintaining hygiene plays a major role in warding off the major and minor diseases that occur due to the lack of hygiene. Sanitation is also one of the major aspects of the maintaining proper health. Proper facilitation of the sanitation will lead to a proper environment for the growth of a child. Water is the basic necessity and thus water services must be inadequate quantities so that the normal day to day life is not hampered. Access to the health services is also necessary and children must have the access to the proper health facilities so that the diseases and other disruptions can be treated effectively (Onis et al., 2013).
- Nutrition-sensitive approaches- A child will be rendered malnourished and undernourished whenever the basic and the minimal requirement of the nutrient is not provided to a child. Thus, food must be provided to a child which suffice the dietary requirements of a child. Healthy and unadulterated food can substances can be provided to the children so that they can develop a healthy mind and body (Sahu et al., 2015).
- Education and Literacy- Poverty is the main reason due to which people are unable to access job and the other social benefits. Poverty is also the sole reason due to which the children are unable to have the sufficient amount of food. Thus, to ward off poverty and malnutrition, it is essential to promote education and literacy in a country which can act as an active catalyst to remove poverty (Makoka & Masibo, 2015).
- Improvement of the status of women- empowered women is the soul of any enlightened society. Thus, it is necessary countries must improve the status of women and give them the rights of equality to stand with their head held high in the male-dominated society. Improved status of women will lead to a better integration of women into the society and will help in removing the ills that are existing within a society (Debnath & Bhattacharjee, 2016).
Conclusion
Thus, from the above study, it can be concluded that there is a challenging condition for the Telangana state with respect to the high incidence of a malnourished and undernourished child in the state. Several reports reveal that there is a large proportion of children that are undernourished and due to which they are having stunted growth, retarded brain development and wasting. Poverty and the other socio-economic factors play a major role in increasing the number of a number of children affected by malnourishment. The other major reason that can be cited is the lack of proper policy for handling the issue properly.
Reference
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