DETERMINANTS OF PROTEIN ENERGY MALNUTRITION AMONG RURAL PRESCHOOL CHILDREN

CONTEXT: Protein energy malnutrition (PEM) is a widespread problem in developing countries and 60-70% of them suffer from mild to moderate type. AIMS, SETTING AND DESIGN: This was a cross-sectional study in Hoskote Rural Health Centre area of Vydehi Institute of Medical Sciences and Research Centre conducted a) to assess nutritional and health status of the anganwadi children and b) to determine factors contributing to protein energy malnutrition. METHODS AND MATERIAL: 268 children under five years of age formed the study group. Interview of the mothers, clinical and anthropometric measurements of the children was conducted. RESULTS: 63.8% of the children were undernourished according to IAP classification. Multivariate analysis revealed that birth weight and anemia were significant risk factors for development of protein energy malnutrition (Odds Ratio 1.4 and 2.5 respectively). Only 26.9% of these children had received colostrum. 13.8% had received exclusive breast feeding for six months. Complementary feeding was initiated either too early (< 4months) in 22.0% or too late (> 7months) in 39.9% of the children. 66.7% of the children were completely immunized. During the study 30.2% of the children suffered from illnesses, acute respiratory infections 57(21.3%), diarrhea 10(3.7%) and 14 (5.2%) had viral fever, fits or acute suppurative otitis media. CONCLUSIONS: a) antenatal nutrition to be improved to prevent low birth weight b) nutrition education for mothers to prevent anemia in children c) advocacy for breast feeding and appropriate complementary feeding practices by all health functionaries and anganwadi workers d) nutrition and health education should be given for mothers to enable them to prevent protein energy malnutrition in their children.