Child Malnutrition in Darbhanga District North East India
India has the highest prevalence of underweight and malnourished children in the world and is almost double of the Sub-Saharan Africa. One in every three malnourished children in the world lives in India (World Health Organisation, 2008). Indian National Family Healthy Survey reports that, 48% of children under the age of three are malnourished and 19.8% suffered from acute malnutrition (IIPS, 2006). There are many inequalities across castes and gender in particular regions of India, with rural and remote populations suffering the most vulnerability (Mishra, RN 2006). Bihar is a state located in north east of India and is the third most populated state with the highest precent of people living below the poverty line. It is characterized by an enormous stretch of cultivate and fertile flat land with major rivers running through. However Bihar is frequently touched by floods throughout monsoon months (Espie et al 2011). In 2007 Bihar flooding, the international non-governmental organisations delivered an emergency response to address the health and nutrition needs of population being affected. To assist the emergency response, an initial assessment of the nutrition situation based on standardised procedures was conducted (World Health organisation 2004). The outcome of this assessment showed that, a high level of malnutrition is present especially children under the age of 5 years throughout the whole state and particularly in the district of Darbhanga, the poorest region of Bihar. The association between flood and acute malnutrition in children under the age of 5 is still vague and a question remained about the prevalence of acute malnutrition during the rest of the year (Espie et al 2011). Darbhanga district is the poorest area with the highest landless population in Bihar. According to the Census of India 2001, its population was 3 018639 of whom 91.6% are in rural and 20.1% are children under the age of 6 years. Scheduled castes, the low castes and poorest population represent 15.5% of the population. In this district about 38 per cent of the households in urban and 27% of rural regions had a separate room as kitchen. Around 14 per cent had electricity and fresh water supply was only available to 4% of the households. Availability of flushed toilet is only 5% of households in the state (Yadav, RJ & Singh P 1999). The economy in general of this district is entirely depends on land and agricultural activities. A few other industries such as animal farming and fishery are also carried out largely as a household-level trivial production source to supplement agricultural income and rarely treated as an independent occupation. Therefore, not owning an adequate amount of land is the primary reason for poverty and malnutrition in Darbhanga (Espie et al 2011). The prevalence of acute malnutrition in Darbhanga district children under the age of 5 years was 19.4%. The proportion of children with optimum growth rate and level of protein and calorie intake was significantly lower among scheduled caste as compared to others. The malnutrition among children depends on both sanitary conditions and dietary intake. A severe and moderate level of malnutrition was present among those children living in poor housing and sanitary conditions than those children in better sanitary conditions despite the amount of dietary intake is equal in both groups. Therefore, to reduce malnutrition it is essential to have a focus on dietary intake along with providing safe drinking water, better sanitation and housing conditions to improve their general standard of living (Yadav, RJ & Singh, P 1999). The prevalence of micronutrient deficiencies among children in India is also consistently among the highest in the world. The prevalence of iron deficiency anemia (IDA) among preschool children in 75% and Vitamin A deficiency is 60%. About one in four school children have...
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