Nutritional Status and its associated factors among under five years Muslim children of Kapilvastu district, Nepal.

Research Report.

ABSTRACT:

Background: Malnutrition is a major public health problem throughout the developing world predominantly in Southern part of Asia. Muslim populations in Nepal have poor health outcomes and highest mortality rate. Most of the studies are concerned with the nutritional status of under-five children and mother in general population, but very limited research has been conducted to investigate the causes/reason of having malnutrition among Muslim children in Nepal. Hence this study aim to find out nutritional status and its associated factors among under 5 Muslim children of Kapilvastu district Nepal.

Methodology: Community based descriptive cross-sectional study was conducted among 336 Muslim children under 5 years (6 months to 59 months) in Kapilvastu district of Nepal. Multistage probability random sampling was used for the study. Among 10 units 3 units were selected randomly to generalize the Muslim community of district. Then from selected 3 units, 2 wards from each local unit which covers large proportion of Muslim population were selected purposively. After, entering the selected wards listing of the household (HH) having children 6 months to 59 months of Muslim community was done from each ward with the help of Female Community Health Volunteers (FCHV)/community leader than in order to select the respondents, 56 mothers and their children of 6 months to 59 months for anthropometric measurement from each wards were selected by using simple random sampling technique. Data were collected from mothers and anthropometric measurement of their children was done by door to door visit. Bivariate analysis was carried out to find the association between independent variables and dependent variables by using chi square test. Those variables which were significantly associated with dependent variable at 0.05 and less level of significance from bivariate analysis were further analyzed using logistic regression model in multivariate analysis.


Results: About half (50.3%) Muslim children were underweight where very few (0.9%) were overweight and 17.3% percent were wasted. The mean Z- score for weight for age (underweight) was -3.23 (95 percent CI: -3.369, -3.084), for weight for age (overweight) was 2.22 (95 percent CI: 1.940, 2.494), and for weight for height (wasting) was -0.28 (95 percent CI: -0.505, -0.052). Children who were living in family having more than 4 members (AOR= 2.82, CI: 1.25-6.38), children living in joint or extended family (AOR= 0.33, CI: 0.16-0.68), children who were living with other than both parents (AOR=2.68, CI: 1.38-5.21), children whose mother have primary level education (AOR =2.59, CI: 1.09-6.10) have underweight, fathers who had completed SLC and above education (AOR=0.41, CI: 0.19-0.89), school going children (AOR=0.27, CI: 0.15-0.48) children of the respondents who do not have their own agriculture land (AOR=2.68, CI: 1.55-4.65), children who have the history of chronic disease (AOR= 3.01, CI= 1.06-08.54) were significantly associated with underweight. Similarly, children whose mother have secondary level education (AOR =0.30, CI: 0.10-0.88), fathers who had primary level education (AOR=3.50, CI: 1.26-9.74), school going children (AOR=0.16, CI: 0.06-0.41), children of the respondents who do not have their own land (AOR=4.73, CI: 2.13-10.48), children of the respondents who have family monthly income more than NRs. 20000 (AOR=0.21, CI: 0.08-0.57), children who have the history of chronic disease (AOR= 3.55, CI= 1.38-9.12) were significantly associated with wasting.

Conclusion: The key nutritional indicators such as underweight, stunting and wasting in under-five Muslim children were above the cutoff point from the significant level of public health given by WHO, as well as higher than the national level data. Children having greater than four members in the family, nuclear family, who are living with other than their parents, mother’s having primary education, illiterate fathers, children who were not going school, who do not have their own agricultural land and history of child’s and parents chronic disease were found to be independent predictors of increased risks for underweight. Illiterate mothers, father’s having primary education, children who were not going school, who do not have their own agricultural land, family monthly income of lesser than 10000 Nepalese rupees were found to be independent predictors of increased risks for wasting. As the malnutrition is high in under five Muslim children, this study suggests a collaborative and immediate attention should be taken from the responsible governmental and nongovernmental organizations working in nutrition and health. Efforts should be done to promote the women and men education by providing informal learning opportunity, intervention regarding parental support to child, children school enrolment at appropriate age, prevention and treatment of children and parent’s chronic diseases, intervention for income generating activities and intervention addressing the problems of household food insecurity should be emphasized among the Muslim communities. Similarly, large-scale research should be recommended among underprivileged and unserved Muslim communities.