Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

The Barriers and Factors Influencing the Overall Health Status And Treatment of Severe Acute Malnourished (Sam) Children


Affiliations
1 State Programme Officer, Swarna Jayanti Haryana Institute for Fiscal Management, Panchkula, Haryana, India
     

   Subscribe/Renew Journal


Severe acute malnutrition (SAM) is the deadliest form of malnutrition, affecting 19 million children worldwide. It is considered a medical disorder, specifically associated with losing body fat and wasting skeletal muscles. SAM was defined as weight-for-height Z-score and lt; -3 SD according to the (WHO, 2006) Growth Standards, MUAC <115 mm, or the presence of oedema. Infants and young children below the age of 5 years are the most vulnerable as their nutritional needs are higher for growth and development; keeping this in view, the present work was conducted on SAM children. One of the study's main objectives was to investigate and explore the barriers and factors affecting SAM children with complications admitted at various inpatient facilities known as Nutritional Rehabilitation centres (NRCs). This was a cross-sectional study. Purposive sampling was used and the subjects were the SAM children (age 0-59 months) qualifying the standard criteria for admission at various NRCs of Shivpuri district, Madhya Pradesh. Mothers of SAM children were also included in the study. The major findings were that there were many risks and barriers found which hinder the good nutritional status among children and mothers. The major risk factors were low socio-economic status (BPL), lack of knowledge of mothers regarding feeding practices (exclusive breastfeeding, colostrum, weaning), unsafe and poor drinking water, poor hygiene and sanitation, repeated infections in children, poor hand washing practices, illiteracy among mothers and addictive behaviour of father, etc. Seasonal month-wise variations were common in every block. Maximum children were admitted during the time of rainy season followed by summers.

Keywords

malnutrition, SAM, NRC, risk factors, barriers, nutritional status
Subscription Login to verify subscription
User
Notifications
Font Size


  • Agostoni, C., Braegger, C., Decsi, T., Kolacek, S., Koletzko, B., Michaelsen, K. F., & Szajewska, H. (2009). Breast-feeding: A commentary by the ESPGHAN committee on nutrition. Journal of Pediatric Gastroenterology and Nutrition, 49(1), 112-125.
  • Abuya, B. A., Onsomu, E. O., Kimani, J. K., & Moore, D. (2011). Influence of maternal education on child immunization and stunting in Kenya. Maternal and Child Health Journal, 15(8), 1389-1399.
  • Black, R. E., Cousens, S., Johnson, H. L., Lawn, J. E., Rudan, I., Bassani, D. G., & Eisele, T. (2010). Global, regional, and national causes of child mortality in 2008: A systematic analysis. The Lancet, 375(9730), 1969-1987.
  • Ben Slama, F., Ayari, I., Ouzini, F., Belhadj, O., & Achour, N. (2010). Exclusive breastfeeding and mixed feeding: knowledge, attitudes and practices of primiparous mothers. Eastern Mediterranean Health Journal, 16(6), 630–635.
  • Caulfield, L. E., Witter, F. R., & Stoltzfus, R. J. (1996). Determinants of gestational weight gain outside the recommended ranges among black and white women. Obstetrics and Gynecology, 87(5), 760-766.
  • Cunningham-Rundles, S., McNeeley, D. F., & Moon, A. (2005). Mechanisms of nutrient modulation of the immune response. Journal of Allergy and Clinical Immunology, 115(6), 1119-1128.
  • Chatterjee, S., & Saha, S. (2008). A study on knowledge and practice of mothers regarding infant feeding and nutritional status of under-five children attending immunization clinic of a medical college. Internet Journal of Nutrition and Wellness, 5(1), 1-9.
  • Dewey, K. G., Heinig, M. J., & Nommsen-Rivers, L. A. (1995). Differences in morbidity between breast-fed and formula-fed infants. The Journal of Pediatrics, 126(5), 696-702.
  • De Onis, M., Frongillo, E. A., & Blössner, M. (2000). Is malnutrition declining? An analysis of changes in levels of child malnutrition since 1980. Bulletin of the World Health Organization, 78, 1222-1233.
  • Frost, M. B., Forste, R., & Haas, D. W. (2005). Maternal education and child nutritional status in Bolivia: Finding the links. Social Science and Medicine, 60(2), 395-407.
  • Ghattas, H. (2014). Food security and nutrition in the context of the global nutrition transition. Food and Agriculture Organization: Rome, Italy.
  • Guerrant, R. L., Oriá, R. B., Moore, S. R., Oriá, M. O., & Lima, A. A. (2008). Malnutrition as an enteric infectious disease with long-term effects on child development. Nutrition Reviews, 66(9), 487-505.
  • Handa, S. (1999). Maternal education and child height. Economic Development and Cultural Change, 47(2), 421-439.
  • Henry, P., Berggren, W., Berggren, G., Dowell, D., Menager, H., Bottex, E., & Cayemittes, M. (2007). Long-term reductions in mortality among children under age 5 in rural Haiti: Effects of a comprehensive health system in an impoverished setting. American Journal of Public Health, 97(2), 240-246.
  • Hunter, P. R., MacDonald, A. M., & Carter, R. C. (2010). Water supply and health. PLoS Medicine, 7(11), e1000361. Jeyaseelan, L., & Lakshman, M. (1997). Risk factors for malnutrition in south Indian children. Journal of Biosocial Science, 29(1), 93-100.
  • Jefferies, J. M. C., Cooper, T., Yam, T., & Clarke, S. C. (2012). Pseudomonas aeruginosa outbreaks in the neonatal intensive care unit a systematic review of risk factors and environmental sources. Journal of Medical Microbiology, 61(8), 1052-1061.
  • Kavosi, E., Rostami, Z. H., Kavosi, Z., Nasihatkon, A., Moghadami, M., & Heidari, M. (2014). Prevalence and determinants of under-nutrition among children under six: A cross-sectional survey in Fars province, Iran. International Journal of Health Policy and Management, 3(2), 71.
  • Kumar, D., Agarwal, N., & Swami, H. (2006). Socio-demographic correlates of breastfeeding in urban slums of Chandigarh. Indian Journal of Medical Sciences, 60(11), 461.
  • Mariara, K.J., Ndenge, G. K., & Mwabu, D. K. (2008). Determinants of children's nutritional status in Kenya: Evidence from demographic and health surveys. Journal of African Economies, 18(3), 363-387.
  • Muller, F., Heckman, J. J., Lochner, L., & Masterov, D. V. (2005). Interpreting the evidence on life cycle skill formation. Handbook of the Economics of Education, 1, 697-812.
  • Mamabolo, R. L., Alberts, M., Steyn, N. P., Delemarre-van de Waal, H. A., & Levitt, N. S. (2004). Prevalence and determinants of stunting and overweight in 3-year-old black South African children residing in the central region of Limpopo province, South Africa. Public Health Nutrition, 8(5), 501-508.
  • Meyer, A., Van Der Spuy, D. A., & Du Plessis, L. M. (2007). The rationale for adopting current international breastfeeding guidelines in South Africa. Maternal and Child Nutrition, 3(4), 271-280.
  • Nguyen, N.H., & Kam, S. (2008). Nutritional status and the characteristics related to malnutrition in children under-five years of age in Nghean, Vietnam. Journal of Preventive Medicine and Public Health, 41(4), 232-240.
  • Oyekale, A. S. (2012). Factors explaining acute malnutrition among under-five children in Sub-Sahara Africa (SSA). Life Sciences Journal, 9, 2101-2107.
  • Park, K. (2012). Park's textbook of preventive and social medicine (21st ed.). M/S Banarsidas Bhanot publishers, Jabalpur: 50-118.
  • Rayhan, M. I., & Khan, M. S. H. (2006). Factors causing malnutrition among under five children in Bangladesh. Pakistan Journal of Nutrition, 5(6), 558-562.
  • Ruel, M. T., Levin, C. E., Armar-Klemesu, M., Maxwell, D., & Morris, S. S. (1999).Good care practices can mitigate the negative effects of poverty and low maternal schooling on children's nutritional status: Evidence from Accra. World Development, 27(11), 1993-2009.
  • Sarmistha, P. (1999). An analysis of childhood malnutrition in rural India: Role of gender, income and other household characteristics. World Development, 27, 1151- 1171.
  • Salah, E.O.M ., Nnyepi, M., Bandeke, T., & Mahgoub, S. E. O. (2006). Factors affecting prevalence of malnutrition among children under three years of age in Botswana. African Journal of Food Agriculture Nutrition and Development, 6(1), 1-11.
  • Scrimshaw, N. S., Taylor, C. E., Gordon, J. E., & World Health Organization (1968). Interactions of nutrition and infection. World Health Organization, 57, 3-329.
  • Sommerfelt, A. E., & Stewart, M. K. (1994). Childrens nutritional status. Calverton, Maryland, Macro International, 1994 Jun. vi, 47 p. (Demographic and Health Surveys Comparative Studies No. 12)
  • Sa´nchez-Carrillo, C., Padilla, B., Marin, M., Rivera, M., Cercenado, E., Vigil, D., Sa´nchez-Luna, M., & Bouza, E. (2009). Contaminated feeding bottles: The source of an outbreak of Pseudomonas aeruginosa infections in a neonatal intensive care unit. American Journal of Infection Control, 37, 150-154.
  • Syed Tariq, A., Naik, S.A., Wasim Rafiq, A., & Saleem, R. (2015). Demographic, clinical profile of severe acute malnutrition and our experience of nutrition rehabilitation centre at children hospital Srinagar Kashmir. International Journal Contemporary Pediatrics, 2, 233-237.
  • Tripathi, M. S., & Sharma, V. (2006). Assessment of nutritional status of pre-schoolers in slum areas of Udaipur city. Indian Journal of Public Health, 50(1), 33.
  • Yadav, R. J., & Singh, P. (2004). Knowledge attitude and practices of mothers about breast-feeding in Bihar. Indian Journal of Community Medicine, 29(3), 3.
  • UNICEF ( 2010). Causes and most vulnerable to under-nutrition-UNICEF conceptual framework. New York: UNICEF.
  • WHO (1999). Management of severe malnutrition: A manual for physicians and other senior health workers. World Health Organisation. World Health Organisation.
  • WHO (2009). Child growth standards and the identification of severe malnutrition in infants and children. A joint statement by the World Health Organization and the United Nations Children's Fund.
  • WHO (World Health Organization) (2015b) Immunization, vaccines and Biologicals. Retrieved 10.12.15 from http://www.who.int/immunization/programmes_ systems/supply_chain/resources/tools/en/.
  • WHO & UNICEF (2009). Child growth standards and the identification of severe malnutrition in infants and children. A joint statement by the World Health Organization and the United Nations Children's Fund.
  • WHO informal consultation (2004). Informal consultation to review the current literature on severe malnutrition. Geneva: WHO.

Abstract Views: 267

PDF Views: 0




  • The Barriers and Factors Influencing the Overall Health Status And Treatment of Severe Acute Malnourished (Sam) Children

Abstract Views: 267  |  PDF Views: 0

Authors

Neeru
State Programme Officer, Swarna Jayanti Haryana Institute for Fiscal Management, Panchkula, Haryana, India

Abstract


Severe acute malnutrition (SAM) is the deadliest form of malnutrition, affecting 19 million children worldwide. It is considered a medical disorder, specifically associated with losing body fat and wasting skeletal muscles. SAM was defined as weight-for-height Z-score and lt; -3 SD according to the (WHO, 2006) Growth Standards, MUAC <115 mm, or the presence of oedema. Infants and young children below the age of 5 years are the most vulnerable as their nutritional needs are higher for growth and development; keeping this in view, the present work was conducted on SAM children. One of the study's main objectives was to investigate and explore the barriers and factors affecting SAM children with complications admitted at various inpatient facilities known as Nutritional Rehabilitation centres (NRCs). This was a cross-sectional study. Purposive sampling was used and the subjects were the SAM children (age 0-59 months) qualifying the standard criteria for admission at various NRCs of Shivpuri district, Madhya Pradesh. Mothers of SAM children were also included in the study. The major findings were that there were many risks and barriers found which hinder the good nutritional status among children and mothers. The major risk factors were low socio-economic status (BPL), lack of knowledge of mothers regarding feeding practices (exclusive breastfeeding, colostrum, weaning), unsafe and poor drinking water, poor hygiene and sanitation, repeated infections in children, poor hand washing practices, illiteracy among mothers and addictive behaviour of father, etc. Seasonal month-wise variations were common in every block. Maximum children were admitted during the time of rainy season followed by summers.

Keywords


malnutrition, SAM, NRC, risk factors, barriers, nutritional status

References