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Determinants of Nutritional Status among Mothers and their Children of Age 6–59 Months
BPH, K. C. Amita2MPH, Sharad Chand3Ph.D., Ramesh Datta Pant4PHARM. D, Manoj S. Dikkatwar3PHARM. D, Bishnu Dev Pant1HA
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Received: ,
Accepted: ,
How to cite this article: Dahal D, Amita KC, Chand S, Pant RD, Dikkatwar MS, Pant BV. Determinants of nutritional status among mothers and their children of age 6–59 months. Glob J Med Pharm Biomed Update 2023;18:7.
Abstract
Objectives:
The main aim is to study the determinants of nutritional status among mothers and their children aged 6–59 months in Nepal’s Panauti municipality.
Material and Methods:
A descriptive and cross-sectional study was conducted among 226 mothers and their children 6–59 months residing in ward no. 1, 2, and 4 of Panauti Municipality. A combination of a semi-structured questionnaire and anthropometric measurements was used to assess various determinants of nutritional status. A Chi-square test was used to check the association between variables.
Results:
The study found that the prevalence of maternal underweight was low (2.7%) whereas the prevalence of overweight and obesity was 36.7% and 13.7%, respectively. Around 27.9% of the children were severely stunted, 3.6% underweight, and 3.5% wasted, whereas 22.1% of the children were overweight. About 54% of the mothers and 57.52% of the children were malnourished. Ethnicity was significantly associated with mothers’ nutritional status and factors such as ethnicity, pre-lacteal feeding, and cultural practices of the mother were significantly associated with the nutritional status of children.
Conclusion:
The study concluded that more than half of the mothers and children were malnourished. Demographic factors-like ethnicity were significantly associated with the nutritional status of mothers and children, whereas factors like pre-lacteal feeding and cultural practices of the mother were significantly associated with the nutritional status of the children.
Keywords
Balanced diet
Child health
Maternal health
Malnutrition
Overweight
INTRODUCTION
Proper nutrition indicates a good quality of life and makes people more productive in their dayto-day lives. Better food leads to good health characterized by a more robust immune system and low occurrence of illness.[1] Poor nutrition may reduce immunity, increase susceptibility to disease, impair physical and mental development, and reduce productivity. Nutrition is one of the significant determinants of health and it is influenced by certain demographic, social, and cultural factors, food habits, food security, and so on.[2] Dietary intake/food habit is one of the immediate determinants, whereas age, sex, occupation, ethnicity, and religion are some of the variables that influence nutritional status in the long run. The availability of adequate, safe, and nutritious food to maintain active life is known as food security (even during crisis and seasonal shortages). Food security is crucial in determining nutritional status.[3] Poor access to food, particularly during pregnancy and lactation, leads to undernutrition and increase the risk of low birth weight, childhood stunting, and anemia in mothers.
On the other hand, the overconsumption of food/calories is linked to overweight and obesity, as seen in middle and high-income countries.[4,5] It is also evident that food insecurity can contribute to overweight and obesity because nutritious food tends to be expensive; thus, people choose less expensive food, often high in calories and low in the required nutrients. Different psychosocial factors link obesity with food insecurity because it causes feelings of anxiety, stress, and depression, leading to behaviors that increase the risk of cardiovascular disease.[3,5]
Maternal and child undernutrition contributes 10% to the total global burden of disease and is also responsible for more than one-third of child deaths. Poor nutritional status of children and mothers has long-term health consequences, and the ramifications extend to inter-generational low productivity and perpetuation of poverty.[6] Malnourished children are highly susceptible to disease, and global literature has revealed that 45% of under-five deaths are due to undernutrition. Therefore, reducing underweight can be an essential step toward reducing childhood morbidity and mortality.[1,2] As documented in scientific literature, Nepal has a very high rate of child malnutrition. About 36% and 27% of children aged below 5 years are stunted and underweight, respectively, and about 17% of women of reproductive age have chronic energy deficiency (body mass index [BMI] <18.5) and 41% are anemic.[7] In contrast, overweight and obesity are rising problems in Nepal. About 22% of women of reproductive age and 1% of children below 5 years are overweight in Nepal, as documented by the national demographic health survey 2016.[8] Since improper nutrition is evidenced through various statistical references cited above, the current research aims to study the determinants of nutritional status among mothers and their children aged 6–59 months in Nepal.
MATERIAL AND METHODS
Ethical consideration
Administrative approval was sought from the concerned authorities of HOPE International College and Panauti Municipality (Ward number 1, 2, and 4) and written informed consent was obtained before starting the data collection. All the participants were informed of the purpose and procedure of the study. Privacy, confidentiality, and anonymity of participants and data were maintained throughout the study.
Design, duration, site, and required sample size for the study
This was a cross-sectional descriptive study conducted among women with children 6–59 months during data collection. The study was conducted for 13 months from November 2018 to November 2019 in the selected ward numbers: 1, 2, and 4 of Panauti Municipality, Kavreplanchowk, Nepal. The required sample size of the study was reached based on the prevalence of undernutrition in Nepal and determined by:
Where,
n = Desired sample size
Z0.05 = Z at α (0.05) = 1.96
P = Prevalence of undernutrition in women of reproductive age in Nepal was 17% (In Nepal Demographic and Health Survey (NDHS) 2016)
q = 1-P = 1–0.17 = 0.83
e = level of error 5% = 0.05
Hence, desired sample size, n = {(1.96)2 × 0.17 × 0.83}/ (0.05)2 = 216
Keeping a 5% non-response error, the minimum required sample size was = 226
Inclusion and exclusion criteria
The mothers of children aged 6–59 months, who understood the Nepali language and were willing to participate in the study were enrolled after obtaining their written consent. The mothers with psychiatric issues, terminal illness, insufficient time for completion of the study, and emergency health conditions of their children were excluded from the study.
Development and validation of research tools
A translated version of the investigator-prepared validated questionnaire and household food insecurity assessment scale (HFIAS) in the Nepali language were used to collect the relevant information. A semi-structured questionnaire comprising 71 questions divided into seven different sections was developed. Different types of primary, secondary, and tertiary sources of information were used for preparing the questionnaire. The different sections in the questionnaire were: Part I (Sociodemographic details, ten questions), Part II (Information on mother, 12 questions), Part III (Information on children, 16 questions), Part IV (Food habits of the mother, 15 questions), Part V (Food habits of children, four questions), Part VI (Household food insecurity, ten questions), and Part VII (Cultural practices, four questions). The content of the questionnaire was validated by the research supervisor, research advisors, public health teachers, and public health experts. The suggestions made by the experts were incorporated and the final version of the questionnaire was prepared in English. The final English version of the questionnaire was translated into the Nepali language by a professional English-Nepali language translator. The translated Nepali version of the questionnaire was translated back to English by two English teachers to confirm the accuracy. The Nepali version of the questionnaire was pre-tested by conducting face-to-face interviews among the respondents residing in ward number 3 of the Panauti municipality. The HFIAS comprised nine questions reflecting three different domains of food insecurity and the standard scale was used as referenced in the scientific literature.
Data collection tools and techniques
Two separate tools were prepared to gather relevant information from the study respondents. A semi-structured questionnaire was used to collect the details pertinent to the various factors associated with the nutritional status of the mother and their children by performing face-to-face interviews. Another form was developed to record anthropometric measurements, including the height and weight of the mother and their children.
Measurement of variables
Height/Length
The length of each child aged 6–12 months was taken using a baby scale device. The length was read to the nearest 0.1 cm. The height of the children aged above 12 months and mothers was measured in standing positions by following all the standard procedures.
Weight
The weight was measured using a weighing scale and was read to the nearest 0.1 kg after removing footwear and heavy jewelry, ensuring minimum clothing was worn. For children who were unable to stand, weight was obtained from the difference between the mother’s values of weight with and without their child.
Data management, statistical analysis, and interpretation
The collected data were reviewed, checked, coded, and organized to reduce errors and entered in Epidata and later transported to the social sciences statistical package (SPSS Version 22.0). The data were analyzed using the descriptive statistics method and the results were expressed in terms of frequencies and percentages. The association/relation between different variables and expected outcomes were analyzed using the Chi-square test.
The nutritional status of mothers was identified by calculating BMI and categorized as:
Underweight: <18.5 kg/m2
Normal: 18.5–24.9 kg/m2
Overweight: 25–30 kg/m2
Obese: 30–40 kg/m2
Extremely obese: >40 kg/m2.
The nutritional statuses of children were identified using Z-scores and categorized as
<(−3) = Severe
(−3)–(−2) = moderate
−2–2 = Normal
>2 = Overweight (in case of underweight and wasting).
RESULTS
Distribution of study respondents based on sociodemographic details
Out of 226 respondents, the majority (48.7%) belonged to the 24–29 age group, followed by 32.3% in the 19–24 age group. About 79.6% belonged to the nuclear family while 3.1% belonged to the extended family. Among the respondents, 78.3% were Hindu and only 2.2% were Christian. The highest number of respondents was Brahmins (41.6%), whereas only 4.9% belonged to other categories like Dalits. Most respondents (91.2%) and their husbands were literate and had completed education up to the secondary level (38.9%). Most of the mothers were housewives (57%) and their husbands were engaged in agriculture (27.4%) and had an annual family income of less than NRs. Most of the mothers were housewives (57%) and their husbands were engaged in agriculture (27.4%). Majority (86.7%) of family had an annual family income of less than NRs 50,000. About 62.8% got married between the ages of 19 and 24 and had only one child. The details on sociodemographic parameters are shown in [Tables 1a and 1b].
| Variable characteristics (n= 226) | Frequency (n) | Percentage |
|---|---|---|
| Age-group of respondents | ||
| 19–24 | 73 | 32.3 |
| 24–29 | 110 | 48.7 |
| 29–34 | 32 | 14.2 |
| 34–39 | 4 | 1.8 |
| 39–44 | 2 | 0.9 |
| Number of family members | ||
| 3–7 | 180 | 79.6 |
| 7–11 | 39 | 17.3 |
| 11–15 | 7 | 3.1 |
| Religion of respondent | ||
| Hindu | 177 | 78.3 |
| Buddhist | 44 | 19.5 |
| Christianity | 5 | 2.2 |
| Ethnicity of respondents | ||
| Chhetri | 42 | 18.6 |
| Brahmin | 94 | 41.6 |
| Tamang | 54 | 23.9 |
| Newar | 25 | 11.1 |
| Others | 11 | 4.9 |
| Literacy status of respondents | ||
| Yes | 206 | 91.2 |
| No | 20 | 8.8 |
| Education level of respondent | ||
| Primary level | 34 | 15.0 |
| Lower secondary level | 56 | 24.8 |
| Secondary level | 88 | 38.9 |
| Bachelor’s degree and above | 28 | 12.4 |
| Education level of spouse | ||
| Primary level | 27 | 11.9 |
| Lower secondary level | 61 | 27.0 |
| Secondary level | 85 | 37.6 |
| Bachelor’s degree and above | 40 | 17.7 |
| Variable characteristics (n= 226) | Frequency (n) | Percentage |
|---|---|---|
| Occupation of respondent | ||
| Housewife | 129 | 57.1 |
| Agriculture | 62 | 27.4 |
| Business | 14 | 6.2 |
| Service | 17 | 7.5 |
| Others | 4 | 1.7 |
| Occupation of Spouse | ||
| Agriculture | 62 | 27.4 |
| Business | 37 | 16.4 |
| Labor | 52 | 23.0 |
| Service | 48 | 21.2 |
| Foreign employee | 27 | 11.9 |
| Household monthly income | ||
| 1000–50000 | 196 | 86.7 |
| 50000–100000 | 27 | 11.9 |
| 100000–150000 | 2 | 0.9 |
| 150000–200000 | 1 | 0.4 |
| Age during marriage | ||
| 14–19 | 68 | 30.1 |
| 19–24 | 142 | 62.8 |
| 24–29 | 16 | 7.1 |
| Number of children given birth to | ||
| One | 140 | 61.9 |
| Two | 68 | 30.1 |
| Three | 14 | 6.2 |
| Four | 4 | 1.8 |
Distribution of respondents based on their information during pregnancy
The majority of the respondents had consumed adequate food (95.1%) during pregnancy and had good health status (94.2%). Most of the respondents 97.8% had antenatal checkup visits, 64.25% completed it as per the protocol and 92.9% delivered their children at a health facility while 6.6% of them delivered their child at home. About 73.9% of mothers completed their postnatal checkups after delivery. The details are shown in [Table 2].
| Variable (n= 226) | Frequency | Percentage |
|---|---|---|
| Adequate food during pregnancy | ||
| Yes | 215 | 95.1 |
| No | 11 | 4.9 |
| Health during pregnancy | ||
| Good | 213 | 94.2 |
| Sick | 13 | 5.8 |
| Antenatal checkup visit | ||
| Yes | 221 | 97.8 |
| No | 5 | 2.2 |
| Number of visits (n= 221) | ||
| Three times | 16 | 7.23 |
| Four times | 142 | 64.25 |
| More than 4 times | 60 | 27.14 |
| Others | 4 | 1.81 |
| Place of delivery | ||
| Health Centre | 210 | 92.9 |
| Home | 15 | 6.6 |
| Others | 1 | 0.4 |
| Presence during delivery at home (n= 16) | ||
| SBAs | 9 | 56.25 |
| Family members | 7 | 43.75 |
| PNC visits | ||
| Yes | 167 | 73.9 |
| No | 59 | 26.1 |
| Number of visits (n = 167) | ||
| One time | 134 | 80.23 |
| Two times | 20 | 11.98 |
| Three times | 7 | 4.19 |
| More than 3 times | 4 | 2.3 |
SBAs: Skilled birth attendants, PNC: Post natal care
Distribution of respondents based on their children’s information
The majority of the children were males (50.9%) and belonged to the 6–24 (59.3%) months group. About 61.9% of the mothers had two or more children with an average spacing of 10–26 months. The majority of the children were above 2.5kg when delivered and were fed with colostrum; 95.1% and 92% of them were breastfed immediately after birth. Children were breastfed for more than 4 times (69.9%) in most of the cases after proper handwashing (97.2%). Half of the children were fed with food other than breast milk during their prelacteal period, whereas most of them had complementary food after 6 months of birth. Two-thirds of the children completed the immunization on the schedule and 98.7% of the children were free from the disease.
Distribution of respondents based on their food habits
The majority of mothers (91.6%) consumed 3–4 meals/day throughout the week. 97.8% had Rice (Bhat), pulses (dal), and curry and vegetables (Tarkari) as their main meal. About 90.7% had vegetables and fruits 1–2 times/day. Around 90% of respondents were found to have skipped their breakfast. Slightly above the half (50.9%) of the mothers were unaware of the food pyramid, whereas 11.1% had complete knowledge. Three quaters of respondents had the habit of drinking tea, and 98.2% of them were non-alcoholic. About 20.8% of the respondents always considered the nutritional value of food. Nepali food was the most liked type of food by 92.5% of them. More than half (58.4%) of the respondents preferred to eat junk food, of which the majority 87.88% preferred noodles and biscuits. The details are shown in [Table 3].
| Characteristics (n= 226) | Frequency | Percentage |
|---|---|---|
| Frequency of meals per day | ||
| 3–4 meals/day | 207 | 91.6 |
| 1–2 meals/day | 16 | 7.1 |
| 5–6 meals/day | 3 | 1.3 |
| Food usually skipped | ||
| Breakfast | 203 | 89.8 |
| Snacks | 14 | 6.2 |
| Lunch | 8 | 3.5 |
| Dinner | 1 | 0.4 |
| Frequency of dairy products consumption per day | ||
| 1–2 times a day | 166 | 73.5 |
| Never | 52 | 23.0 |
| 3–4 times a day | 8 | 3.5 |
| Knowledge about food pyramid | ||
| No idea | 115 | 50.9 |
| Not much | 46 | 20.4 |
| Well | 40 | 17.7 |
| Very well | 25 | 11.1 |
| Care of nutrition in food | ||
| Sometimes | 70 | 31 |
| Rarely | 61 | 27 |
| Never | 48 | 21.2 |
| Usually | 47 | 20.8 |
| Consumption of junk food | ||
| Yes | 132 | 58.4 |
| No | 94 | 41.6 |
| Types of junk food consumed (n = 132) | ||
| Noodles and Biscuits | 116 | 87.88 |
| Momo and Chowmein | 11 | 8.33 |
| Chatpate and Panipuri | 5 | 3.8 |
Distribution of respondents based on their children’s food habits
The majority of children (69.9%) were fed daily with dal, bhat, and tarkari as the main meal while 70.4% were fed fruits and vegetables 1–2 times a day. About 87.6% were fed with bread/ cereals or potato 1–2 times a day. Most of the children were fed dairy products. The details are depicted in [Table 4].
| Characteristics (n= 226) | Frequency | Percentage |
|---|---|---|
| Main meal of child | ||
| Dal, bhat, and tarkari | 158 | 69.9 |
| Lito | 62 | 27.4 |
| Others | 6 | 2.7 |
| Feeding the child with fruits and vegetables in a day | ||
| Never | 13 | 5.8 |
| Sometimes | 27 | 11.9 |
| 1–2 times a day | 159 | 70.4 |
| 3–4 times a day | 27 | 11.9 |
| Feeding child with bread/cereals/potato in a day | ||
| Never | 24 | 10.6 |
| 1–2 times a day | 198 | 87.6 |
| 3–4 times a day | 4 | 1.8 |
| Feeding the child with dairy products per day | ||
| Never | 37 | 16.4 |
| 1–2 times a day | 174 | 77 |
| 3–-4 times a day | 15 | 6.6 |
Household food security
[Table 5] shows the details of food security. About 92% of the subjects responded that they had good food security. About 94.7% of households were not found to have the inability to eat, 92.5% did not experience limited types/supply of food, 94.2% did not eat less than required food, and 94.7% did not experience scarcity of food in the house in the past 4 weeks. The details are shown in [Table 5].
| Characteristics (n= 226) | Frequency | Percentage |
|---|---|---|
| Inability to eat during the last 4 weeks | ||
| No | 214 | 94.7 |
| Yes | 12 | 5.3 |
| Number of times that happened (n= 12) | ||
| Rarely | 5 | 38.5 |
| Sometimes | 8 | 61.5 |
| limited types of food during the past 4 weeks | ||
| No | 209 | 92.5 |
| Yes | 17 | 7.5 |
| Number of times that happened (n= 17) | ||
| Rarely | 6 | 33.3 |
| Sometimes | 11 | 61.1 |
| Often | 1 | 5.6 |
| Ate less food during the past 4 weeks | ||
| No | 213 | 94.2 |
| Yes | 13 | 5.8 |
| Number of times that happened (n= 13) | ||
| Rarely | 4 | 30.8 |
| Sometimes | 9 | 69.2 |
| Lack of food in the house in the past 4 weeks due | ||
| No | 214 | 94.7 |
| Yes | 12 | 5.3 |
| Number of times that happened (12) | ||
| Rarely | 3 | 25 |
| Sometimes | 8 | 66.7 |
| Often | 1 | 8.3 |
| Have you ever past a day and night without eating food | ||
| No | 225 | 99.56 |
| Yes | 1 | 0.04 |
| Household food security | ||
| Food secure | 208 | 92 |
| Mildly food insecure | 9 | 4 |
| Moderately food insecure | 9 | 4 |
Distribution of respondents based on cultural practices
The majority of respondents (96.9%) celebrated Dashain and Tihar as main festivals, followed by (79.2%) that celebrated Janai Purnima, and only 2.2% celebrated Christmas. About 99.1% had a change in their diet during these festivities. The most consumed food items during these times were sweets (93.8%), meat (93.4%), and a mixture of pulses (82.3%). The majority of the responders (35.4%) did not prefer to eat buff, followed by pork (32.7%), chicken and mutton (18.6%), and garlic and onion (13.7%) due to their cultural practices. The details are shown in [Table 6].
| Characteristics (n= 226) | Frequency | Percentage |
|---|---|---|
| Festivals celebrated | ||
| Dashain | 219 | 96.9 |
| Tihar | 219 | 96.9 |
| Janai Purnima | 179 | 79.2 |
| Teej | 175 | 77.4 |
| Buddha Jayanti | 51 | 22.6 |
| Christmas | 5 | 2.2 |
| Change in eating patterns during festivals | ||
| Yes | 224 | 99.1 |
| No | 2 | 0.9 |
| Foods eaten during festivals | ||
| Sweets | 212 | 93.8 |
| Meat | 211 | 93.4 |
| Kwati | 186 | 82.3 |
| Foods prohibited by their culture | ||
| Buff | 80 | 35.4 |
| Pork | 74 | 32.7 |
| Chicken and mutton | 42 | 18.6 |
| Garlic and Onion | 31 | 13.7 |
Nutritional status of mothers and their children
The majority of the mothers 46.5% who participated in the survey had a normal BMI, 36.7% were found overweight, 13.7% were obese, 2.7% were underweight, and 0.4% were extremely obese. Most of the children (84.1%) had normal weight according to their age, 12.4% were moderately underweight, 2.7% were overweight and 0.9% were severely underweight. The details of the nutritional status of children are shown in [Table 7].
| Characteristics (n= 226) | Frequency | Percentage |
|---|---|---|
| Weight for age | ||
| Severely underweight | 2 | 0.9 |
| Moderately underweight | 28 | 12.4 |
| Normal | 190 | 84.1 |
| Overweight | 6 | 2.7 |
| Height for age | ||
| Severely stunted | 63 | 27.9 |
| Moderately stunted | 40 | 17.7 |
| Normal | 123 | 54.4 |
| BMI for age | ||
| Severely wasted | 3 | 1.3 |
| Moderately wasted | 5 | 2.2 |
| Normal | 168 | 74.3 |
| Overweight | 50 | 22.1 |
Association of various factors with the nutritional status of mothers and their children
In the case of mothers, among several variables, only ethnicity (P = 0.031) was a significant factor, whereas other factors such as age-group (P = 0.161), religion (P = 0.13), literacy (P = 0.42), education (P = 0.46), education of husband (P = 0.05), occupation (P = 0.17), occupation of husbands (P = 0.42), monthly family income (P = 0.08), food habit (P = 0.60), household food security (0.38), and cultural practices (P = 0.24) were not associated with the nutritional status of mother.
In the case of children, ethnicity (0.016), prelacteal feeding (P = 0.005) and cultural practices of mother (P = 0.009) were found significantly associated, whereas maternal factors such as age-group (P = 0.47), religion (P = 0.15), extra food during pregnancy (P = 0.396), health during pregnancy (P = 0.38), ANC visits (P = 0.30), place of delivery (P = 0.52), PNC visits (P = 0.43), maternal nutritional status (P = 0.71) and children’s characteristics like age (P = 0.52), sex (P = 0.16), birth spacing (P = 0.83), birth weight (P = 0.81), colostrum feeding (P = 0.82), time for breastfeeding (P = 0.91), frequency of breastfeeding (P = 0.95), and diseases in the past month (P = 0.84) were found to have no statistical significant association with nutritional status of children. The complete details on the associated factors with mothers and their children’s nutritional status are shown in [Table 8] (only statistically significant parameters are shown).
| Characteristics | Nutritional Status | χ2 Significance | |
|---|---|---|---|
| Demographic Variable (n= 226) | Normal | Malnourished | (P-Value) |
| Association of variables with nutritional of mothers | |||
| Ethnicity | 0.031* | ||
| Brahmin | 40 | 54 | |
| Chhetri | 13 | 29 | |
| Tamang | 31 | 23 | |
| Newar | 13 | 12 | |
| Others | 8 | 3 | |
| Association of variables with nutritional of children | |||
| Ethnicity | 0.016* | ||
| Brahmin | 36 | 15 | |
| Chhetri | 27 | 58 | |
| Tamang | 20 | 34 | |
| Newar | 10 | 14 | |
| Others | 2 | 9 | |
| Prelacteal feeding | 0.005* | ||
| Yes | 31 | 67 | |
| No | 64 | 63 | |
| Cultural Practices of mothers | 0.009* | ||
| Poor cultural practices | 21 | 50 | |
| Good cultural practices | 74 | 80 | |
DISCUSSION
The prevalence of women who are underweight and having children aged 6–59 months shown in the study is 2.7%, which is <17% that of the value of the national prevalence of undernutrition among women aged 15–45 years as per NDHS 2016.[8] Similarly, the prevalence of overweight women in Panauti Municipality was found slightly higher than the national prevalence of 22%.[8,9] The prevalence of undernutrition in women concluded by this study is much lower 26.7% in comparison with the study carried out in Madagascar by Ravaoarisoa et al.[10] The prevalence of overweight and obesity is lower than that of overweight (45.6%) and obesity (18%) in a study conducted in Khartoum.[11] The prevalence of underweight, stunting and wasting in children aged 6–59 months was 13.3%, 45.6%, and 3.5%, respectively, in Panauti municipality, which is comparatively less than the prevalence of underweight at 20.8%, stunting at 53.9%, and wasting 10.6% mentioned in a study conducted by Dhungana.[12] In the context of countries other than Nepal, the prevalence of stunting is similar to the study conducted in Haryana, India. However, the prevalence of underweight and wasting found in the present study is lower than that of the results of a survey carried out in Ethiopia, which were 19.5% and 17.5%, respectively.[13,14]
The present findings showed a high prevalence of overweight children (22.1%) aged 6–59 months, in comparison to the national data (1% of NDHS 2016).[8] The present value is found nearly similar to the value of prevalence in a study carried out in Ethiopia (23.36%). Using the chi-square test, the mother’s ethnicity was found to have a statistically significant association with the mother’s and children’s nutritional status. The present study presented no considerable variation in children’s nutritional status according to their gender; similar findings were presented in a survey conducted in Padampur VDC, Chitwan.[15] Similarly, the study showed no association between age and nutritional status in both cases of mothers and children, and this contrasts with the research conducted in Khartoum as well as in Nepal.[11,12]
The study showed that mothers’ nutritional status had a significant association with ethnicity, while children’s nutritional status had a significant association with different characteristics such as; ethnicity, pre-lacteal feeding, and cultural practices. This result is also supported by many other studies, such as the study conducted in Madagascar, Gorkha, Haryana, Ethiopia, and Kenya.
CONCLUSION
The study concluded that nearly half of the mothers involved in the study had normal BMI; more than one-fourth of mothers were overweight and slightly less than one-fourth of mothers were obese. More than one-fourth of the children were severely stunted, 3.6% were underweight, and 3.5% were wasted. Nearly one-fourth of children were overweight. More than half of the mothers and children aged 6–59 months were malnourished. The study also showed a significant association of ethnicity with the nutritional status of mothers. Similarly, factors including ethnicity, pre-lacteal feeding, and cultural practices of the mother were significantly associated with the nutritional status of children aged 6–59 months. This study showed the nutritional status of mothers and children and the more significant fraction of mothers and children being malnourished.
Acknowledgment
We, the authors of this paper, would like to thank the entire Bachelor of Public Health (BPH) office employee, instructors of Hope International College, administration management, the information technology branch, the Municipal Corporation, and the respondents for their support and guidance during the study. We also want to thank Mrs. Satya Humagain for providing logistical support during the field visits.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent.
Conflicts of interest
There are no conflicts of interest.
Financial support and sponsorship
Nil.
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