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“EFFECTIVENESS OF THE EDUCATIONAL
INTERVENTION TO IMPROVE KNOWLEDGE ON
ESSENTIAL NUTRIENTS AMONG PARENTS OF
PRIMARY SCHOOL CHILDREN: A DESCRIPTIVE
STUDY”




                              Submitted By:
         Supervisor:
         Mrs. Vijayalakshmi   Subendu Mukherjee
                              s044168
                              M.Sc. 2009 - 2010
INTRODUCTION & RATIONALE OF THE
STUDY
• Both protein-energy malnutrition and micronutrient deficiencies retards
  physical and cognitive growth; increases susceptibility to infections.

• 820 million undernourished in developing countries: 524 million in Asia,
  India has the largest number in the world; 250 million children below 10
  years of age accounting for more 1/3rd of the Globe.

• Many previous studies have proved that one of the major factors of high child
  malnutrition is maternal illiteracy or poor knowledge among mothers.

•  Numbers of government programs implemented have been futile. 47%
  Karnataka’s Child Population is malnourished.
• Growing children like primary school children are at maximum risk to be
  affected from poor nutrition


• 22 % poverty rate but 47% Malnutrition rate. WHY?
AIMS AND OBJECTIVES
               AIM:
• To assess the effect of educational intervention in developing knowledge on
  essential nutrients among parents of primary school children.
        OBJECTIVES:
    Primary:
•   To find out the effectiveness of the educational intervention in developing
    knowledge on essential micro-nutrients among the parents of primary school
    children.
    Secondary:
•   To determine the various factors influencing the nutritional status of primary
    school children.
•   To assess the nutritional status of the children and to determine the
    prevalence of various types of malnutrition.
•   To determine the prevalence of malnutrition in terms of child’s age and
    gender.
•
MATERIALS & METHODS:
   STUDY
  SETTINGS        Indiranagar & Koramangala ; BANGALORE

STUDY DESIGN    Interventional, Non - randomized, Questionnaire
                      based, Descriptive case series study.
SAMPLE SIZE &       120; Frequency percent analysis, Descriptive
 STATISTICAL    Statistics – Cross Tabulation, Chi – square Analysis,
    TOOLS                           Student t test
                •Parents or Caregivers having atleast one children
                aged between 3 to 10 years in the family.
 INCLUSION      •Child should be, a primary school going student, i.e. ,
                studying within class nursery to standard five
                •Parents or the caregivers could be able to read and
                write in English.


 EXCLUSION        Subjects unwilling to give informed consent.
STUDY PROCEDURE


         DESK                  ADMINISTRATIVE            FIELD RESEARCH
       RESEARCH                 FORMALITIES

                                 Review of study
   Extensive Web Search                                  ANM was approached
                                  documents by
                                    ICRI SC.
   Development of Study                                 Door to Door evaluation of
       Instruments                   STUDY                  Inclusion Criteria
                                    APPROVAL
       Preparation of
                                                             Informed Consent
     Literature Review
           section
                                                            Height & Weight of
                                                                the children
Post Score Noted
                                                         Part A of the questionnaire
                          Part B of the questionnaire            Answered
                                  Answered.
Study Intervention
      - PPT                     Pre Score Noted              Invited for Study
                                                               Intervention
RESULTS
• EFFECTIVENESS OF THE STUDY INTERVENTION:

         Comparison            t                   df              p value
         Pre - Post       12.919             119            .000

      As per t- distribution table the value of t0.001 for df (119) is 3.37.
      Therefore as |t| > t0.001 for df =119, H0 (null hypothesis) is rejected at
      0.1% level of significance.

      FACTORS v/s Nutritional Status.
        SIGNIFICANT                                      NON-SIGNIFICANT
  FACTORS         TOOLS            p value              FACTORS               p value
  Number of       Chi- Square      0.38 [p<0.05 ]       Family Income         0.652
  Children                                              Working Members       0.222
  Outside Food    Chi- Square      0.012 [p<0.05 ]      Maternal Occupation 0.412
  Intake
                                                        Maternal Education    0.512
  Sanitary        Chi- Square      0.042 [p<0.05 ]
  Condition                                             Drinking Water        0.932
PREVALENCE
                                      Prevalence As per Age [NCHS]
    19.17%                 Healthy
                  45.83    Stunted
 18.33%                    Wasted
         16.67%            Both



Prevalence As per Gender

30.00%
25.00%
20.00%
                           Healthy
15.00%
10.00%                     Malnutri
5.00%                      tion

0.00%
           BOY      GIRL
Limitations:
• Social Desirability.
• Inadequate Timelines.
• Homogeneity.
Conclusion
• Study Intervention was found to be effective in developing
  Knowledge among parents.

• 3 Factors; Number of Children in the Family, Frequency of Outside
  Food intake, Sanitary condition of the residing area were found to be
  negatively associated to nutritional status.

•    As per NCHS scale majority of the study children suffered from
    either form of malnutrition which were stunting, wasting or both.

• No difference in prevalence based on Gender. Micro-nutrient
  deficiency in terms of Anthropometric measurements were found to
  be much more higher in children aged 3 – 5 years compared to older
  children.
Future Work
• Study on larger population for larger period with an inclusion of a
  follow up period.

• Randomized design with an inclusion of a control arm could be used
  within the study population to evaluate the effectiveness of the study
  intervention between interventional arm and control arm in a more
  robust way.

• Study findings can be used as basis by government in developing
  stronger strategic plan to tackle these health problems such as
  sanitation problem etc.
REFERENCES
• http://192.91.247.105/aboutwfp/facts/hunger_facts.asp?section=1&su
  b_section=5.

• http://www.azadindia.org/social-issues/child-labour-in-india.html

• http://whqlibdoc.who.int/hq/1997/WHO_NUT_97.4.pdf.

• http://www.ibfanasia.org/Article/IYC-Undernutrition.pdf

• http://www.sikhspectrum.com/112006/images/map.jpg
Interventional study on Malnutrition

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Interventional study on Malnutrition

  • 1. “EFFECTIVENESS OF THE EDUCATIONAL INTERVENTION TO IMPROVE KNOWLEDGE ON ESSENTIAL NUTRIENTS AMONG PARENTS OF PRIMARY SCHOOL CHILDREN: A DESCRIPTIVE STUDY” Submitted By: Supervisor: Mrs. Vijayalakshmi Subendu Mukherjee s044168 M.Sc. 2009 - 2010
  • 2. INTRODUCTION & RATIONALE OF THE STUDY • Both protein-energy malnutrition and micronutrient deficiencies retards physical and cognitive growth; increases susceptibility to infections. • 820 million undernourished in developing countries: 524 million in Asia, India has the largest number in the world; 250 million children below 10 years of age accounting for more 1/3rd of the Globe. • Many previous studies have proved that one of the major factors of high child malnutrition is maternal illiteracy or poor knowledge among mothers. • Numbers of government programs implemented have been futile. 47% Karnataka’s Child Population is malnourished. • Growing children like primary school children are at maximum risk to be affected from poor nutrition • 22 % poverty rate but 47% Malnutrition rate. WHY?
  • 3. AIMS AND OBJECTIVES AIM: • To assess the effect of educational intervention in developing knowledge on essential nutrients among parents of primary school children. OBJECTIVES: Primary: • To find out the effectiveness of the educational intervention in developing knowledge on essential micro-nutrients among the parents of primary school children. Secondary: • To determine the various factors influencing the nutritional status of primary school children. • To assess the nutritional status of the children and to determine the prevalence of various types of malnutrition. • To determine the prevalence of malnutrition in terms of child’s age and gender. •
  • 4. MATERIALS & METHODS: STUDY SETTINGS Indiranagar & Koramangala ; BANGALORE STUDY DESIGN Interventional, Non - randomized, Questionnaire based, Descriptive case series study. SAMPLE SIZE & 120; Frequency percent analysis, Descriptive STATISTICAL Statistics – Cross Tabulation, Chi – square Analysis, TOOLS Student t test •Parents or Caregivers having atleast one children aged between 3 to 10 years in the family. INCLUSION •Child should be, a primary school going student, i.e. , studying within class nursery to standard five •Parents or the caregivers could be able to read and write in English. EXCLUSION Subjects unwilling to give informed consent.
  • 5. STUDY PROCEDURE DESK ADMINISTRATIVE FIELD RESEARCH RESEARCH FORMALITIES Review of study Extensive Web Search ANM was approached documents by ICRI SC. Development of Study Door to Door evaluation of Instruments STUDY Inclusion Criteria APPROVAL Preparation of Informed Consent Literature Review section Height & Weight of the children Post Score Noted Part A of the questionnaire Part B of the questionnaire Answered Answered. Study Intervention - PPT Pre Score Noted Invited for Study Intervention
  • 6. RESULTS • EFFECTIVENESS OF THE STUDY INTERVENTION: Comparison t df p value Pre - Post 12.919 119 .000 As per t- distribution table the value of t0.001 for df (119) is 3.37. Therefore as |t| > t0.001 for df =119, H0 (null hypothesis) is rejected at 0.1% level of significance. FACTORS v/s Nutritional Status. SIGNIFICANT NON-SIGNIFICANT FACTORS TOOLS p value FACTORS p value Number of Chi- Square 0.38 [p<0.05 ] Family Income 0.652 Children Working Members 0.222 Outside Food Chi- Square 0.012 [p<0.05 ] Maternal Occupation 0.412 Intake Maternal Education 0.512 Sanitary Chi- Square 0.042 [p<0.05 ] Condition Drinking Water 0.932
  • 7. PREVALENCE Prevalence As per Age [NCHS] 19.17% Healthy 45.83 Stunted 18.33% Wasted 16.67% Both Prevalence As per Gender 30.00% 25.00% 20.00% Healthy 15.00% 10.00% Malnutri 5.00% tion 0.00% BOY GIRL
  • 8. Limitations: • Social Desirability. • Inadequate Timelines. • Homogeneity.
  • 9. Conclusion • Study Intervention was found to be effective in developing Knowledge among parents. • 3 Factors; Number of Children in the Family, Frequency of Outside Food intake, Sanitary condition of the residing area were found to be negatively associated to nutritional status. • As per NCHS scale majority of the study children suffered from either form of malnutrition which were stunting, wasting or both. • No difference in prevalence based on Gender. Micro-nutrient deficiency in terms of Anthropometric measurements were found to be much more higher in children aged 3 – 5 years compared to older children.
  • 10. Future Work • Study on larger population for larger period with an inclusion of a follow up period. • Randomized design with an inclusion of a control arm could be used within the study population to evaluate the effectiveness of the study intervention between interventional arm and control arm in a more robust way. • Study findings can be used as basis by government in developing stronger strategic plan to tackle these health problems such as sanitation problem etc.
  • 11. REFERENCES • http://192.91.247.105/aboutwfp/facts/hunger_facts.asp?section=1&su b_section=5. • http://www.azadindia.org/social-issues/child-labour-in-india.html • http://whqlibdoc.who.int/hq/1997/WHO_NUT_97.4.pdf. • http://www.ibfanasia.org/Article/IYC-Undernutrition.pdf • http://www.sikhspectrum.com/112006/images/map.jpg