Adolescent nutrition survey in Nepal, 2014.

Research Report.

SUMMARY: The World Health Organization (WHO) defines adolescence as a period of life spanning the ages between 10-19 years where both physical as well as psychological changes occur. The major nutritional problems of adolescent population include stunting and thinness, micro nutrient deficiency and obesity. Generally, most health programs overlook these nutritional problems of adolescents because the adolescent population is often considered healthy. The study was thus executed to determine the nutritional status of adolescents in Nepal. A descriptive cross sectional study was conducted in the fiscal year 2070/71 (2013/14). The study included male and female adolescents (10-19 years) from 13 districts representing the three ecological (Mountain, Hill and the Tarai) regions of Nepal. A multistage cluster sampling was used to select study district and the study participants. The study used data arising from the anthropometric measurement to determine adolescents' nutritional status. Similarly, hemoglobin and serum ferritin level was assessed to determine the anemia prevalence. The study findings reveal that 71% (95% CI: 61.2-79.1) of male (95% CI: 61.2-79.1) adolescents and 59% (95% CI: 48.2-68.5) of female (95% CI: 48.2-68.5) adolescents were undernourished. More than two-fifth 43% (95% CI: 28.2-58.4) married adolescent and 65% (95% CI: 55.574.2) of unmarried adolescents were undernourished. The likelihood of Uunder nutrition was high among adolescent residing in the Tarai 72% (95% CI: 62.1-79.8) followed by Hill 59% (95% CI: 47.8-68.7) and Mountain 54% (95% CI:43.0-64.2). The prevalence was almost similar among adolescents living in urban areas 63% (95%CI: 51.8-73.4) and rural areas 65% (95%CI:55.1-73.9). By religion, the highest prevalence of under nutrition was observed among Muslim 81% (95% CI: 63.2-91.1), followed by Hindu 66% (95%CI:55.7-74.4), Christian 65% (95% CI :48.2-78.3) and Buddhist 55% (95% CI:40.2-68.7). A higher prevalence was observed among disadvantaged non Dalit Tarai caste 80% (95% CI:71.3-86.9) followed by religious minorities 76% (95% CI:57.5-88.1). Adolescents without household latrine had prevalence of under nutrition 76% (95%CI:67.1-83.1) 61% (95%CI: 50.1-70.1) with household having latrine). Adolescents who refuse to wear shoes had higher prevalence of under nutrition 76% (95% CI:61.7-85.5) adolescents who prefer to wear shoes 64% (95% CI:54.3-73.2). Fruits and vegetables appeared to have protective effects against under nutrition. For example, the prevalence of under nutrition was higher among adolescents who ate less than one serving of fruits and vegetables per day compared to those eating 5 or more servings per day. Overall, 35% of adolescents were anemic at the time of study. The figure is slightly higher among early adolescents 33% (95%CI:30.5-35.6) and 27% (95%CI:33.8-40.3) among late adolescent. The prevalence of anemia was 27% (95% CI:24.5-30.1) among male whereas almost double 42% (95%CI:38.9-45.0) among female. By religion, the highest prevalence was observed among Muslims 45% (95%CI:33.0-58.2) followed by Christian 41% (95%CI:27.656.5) and Hindu 35%(95%CI:32.9-36.9). The least prevalence was observed among Buddhist 18% (95%CI:12.1-27.1). The highest prevalence was observed among religious minorities 44% (95%CI:29.6-58.5), followed by disadvantaged non Dalit Tarai adolescents 40% (95%CI:34.946.2) and the lowest among relatively advantaged Janajatis 21% (95% CI:14.8-29.3). The study suggests sanitation and hygiene could be an important determinant of anemia. Anemia prevalence was, for instance, lower 33% (95% CI:30.9-35.2) among adolescents having household latrine and among adolescents without latrine 38% (95%CI:34.0-43.1). Similarly, the prevalence was lower 34% (95%CI:31.8-35.6) among adolescents wearing shoes while going out than those 52% (95%CI:41.7-61.8) travelling barefooted. Anemia prevalence was 31% (95%CI:15.4-52.2) among adolescents consuming iron and folic acid while 35% (95% CI:32.7-36.5) among those not consuming the iron and folic acid. The study concludes that adolescents from the disadvantaged group, residing in remote areas, having limited access to sanitation facilities and consuming little amount of fruits and vegetables are at risk of under nutrition as well as the anemia. The study, therefore, suggest targeted interventions to promote healthy eating and sanitation practices of the most vulnerable adolescents.