synopsis of prevalence of malnutrition among under five years children in Rukmini Nagar, Belgaum Reaserche:- Mr. Sawan Kumar Yadav Guide:- Dr. Mubashir Angolkar, Coordinator and Assistant Professor Department of Public Health, J.N. Medical college, Belgaum, Karnataka, India

1. KLE UNIVERSITY, BELGAUM.
ANNEXURE- II
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1.
NAME OF THE
CANDIDATE AND ADDRESS
MR. SAWAN KUMAR YADAV
POST GRADUATE STUDENT,
MASTER OF PUBLIC HEALTH,
J. N . MEDICAL COLLEGE
KLE UNIVERSITY,
BELGAUM – 590010.
Kumarsawan42@yahoo.com
2. NAME OF THE INSTITUTE
DEPARTMENT OF PUBLIC HEALTH,
J N MEDICAL COLLEGE,
KLE UNIVERSITY ,
BELGAUM – 590010.
3. COURSE OF STUDY AND SUBJECT MASTER OF PUBLIC HEALTH
4.
DATE OF ADMISSION TO COURSE 28-07-2013
5.
TITLE OF THE TOPIC
“PREVALENCE OF MALNUTRITION
AMONG UNDER FIVE YEARS
CHILDREN IN RUKAMININAGAR”
- A CROSS SECTIONAL STUDY.

2. 6. BRIEF RESUME OF THE INTENDED WORK:
6.1. NEED FOR THE STUDY:
Adequate nutrition is essential in early childhood to ensure healthy growth, proper
organ formation and function, a strong immune system and neurological and cognitive
development. Economic growth and human development require well-nourished
populations who can learn new skills, think critically and contribute to their communities.
Child malnutrition impacts cognitive function and contributes to poverty through
impeding individuals’ ability to lead productive lives. In addition, it is estimated that more
than one-third of under-five deaths are attributable to under nutrition.1
Malnutrition is responsible, directly or indirectly, for 54% of the 10.8 million deaths
per year in children under five and contributes to every second death (53%) associated
with infectious diseases among children under five years of age in developing
countries. Malnutrition is of particular concern in developing countries. A report by
UNICEF published in 2006 states that around 146 million children in developing
countries are underweight - that is one out of every fourth child. Out of these, over half
of the world's underweight children live in just three countries: Bangladesh, India and
Pakistan.2
Overall half of the young children in India are underweight 47%,
stunted 46%, one in six children are wasted 16%, the levels of under nutrition are much
higher in rural areas than urban areas, but even in urban areas more than one third of
young children are stunted. Underweight under nutrition is most prominent in the states
of Bihar, Madhya Pradesh and Rajasthan. About half of the children are underweight in
Orissa, Maharashtra and west Bengal. In rural areas, 20.3% of the children were
severely malnourished, 30.2% were moderately malnourished, 50.5% were
malnourished (moderate and severe). In urban areas 12% of the children were severely
malnourished, 27% of the moderately malnourished and 39% were malnourished
(moderate and severe). Malnutrition levels were much higher among tribal children in
rural areas in Maharashtra the incidence is as high as 73.6% .3
The present problem has high prevalence rate in India, so many under five
children are suffering from malnutrition, and some factors influence and cause the
prevalence of malnutrition in Karnataka hence the researcher found that it is necessary
to find the prevalence and find its association with health influencing factors among
under five children in selected areas of Belgaum.

3. 6.2 OBJECTIVES:
1. To find the prevalence of malnutrition among under five children.
2. To know the health influencing factors among under five year children.
6.3 REVIEW OF LITERATURE:
A study was conducted on prevalence of malnutrition and socioeconomic
determinants among children in Sikasso (Mali) with a sample of 491 families. The
determinants of wasting and stunting were analysed using logistic regression.
The results revealed that the prevalence of stunting was about 25%. Prevalence
of wasting was about 12%, which is very high, and had been increasing in the
past years. No strong associations with socio-economic factors were observed
for wasting. Stunting was strongly associated with the education level of both
parents, and with the family assets.4
A multi centered case control study was conducted on evaluating risk factor
for malnutrition in children under the age of six years in Iran. The sample was 76
children with malnutrition and 76 children without malnutrition were randomly
recruited for case and control groups. The prevalence of risk factors in the two
groups was compared. Data were gathered from a health center database and
interviews with mothers and health workers. The Wilcox on signed-rank test and
logistic regression were used for data analysis. The result revealed that the
Female gender, poverty, short maternal height, and use of unhygienic latrines in
the home were significantly associated with childhood malnutrition (P < 0.05).
The conclusion was the results of this study indicate four main factors (poverty,
small maternal height, female gender, and absence of hygienic latrines in the
home) as underlying factors in malnutrition of children under the age of 6 years.5
A cross-sectional survey was conducted on the nutritional status of
preschool-age children in a development area in the southern Indian state of
Tamil Nadu. Sample size was 1223. The result revealed that 45% of the children
were underweight (low weight-for-age), 51% were stunted (low height-for-age),
and 21% were wasted (low weight-for-height). The rates of severe malnutrition
using any of these criteria were low, and only 9.6% of the children were both
wasted and stunted. The nature of the malnutrition strongly depended on age
group. Rates of stunting increased with age, reaching 63% in the fifth year of life,
whereas rates of wasting peaked at 36% in the second year of life and declined
to 14% in the fifth year. Surveys that are designed to produce information on
stunting and wasting are important in the planning and evaluation of nutrition
intervention programmes.6

4. A cross sectional study was conducted on prevalence and determinants of
chronic malnutrition in Dhaka city Bangladesh. The sample comprised 380
randomly selected children. Results of analysis of this study data revealed that
the prevalence of stunting among preschool children in Dhaka city was 39.5%,
with 25% severely stunted and 14% moderately stunted (p<0.001). Results of
bivariate analysis revealed that socioeconomic and demographic factors were
most significantly associated with the stunting of children. Children were found to
be well-nourished if their parents had a tertiary-level education or higher and if
the mother held a job and had good knowledge of nutrition. Well-nourishment of
the children were also associated with the height of mothers (above 148 cm),
good family educational background, normal birth weight, greater frequency of
food intake (more than six times/day), and fewer fever episodes in the last six
months. Results of multivariate linear regression models showed that height of
mothers, birth weight of children, education of fathers, knowledge of mothers on
nutrition, and frequency of feeding were the most significant factors that had an
independent and direct influence on the stunting of children. To achieve the
Millennium Development Goal target of 34% malnutrition prevalence by 2015, it
is important to have specific government intervention to focus on the causes that
directly influence the stunting of children.8
A study was done in Nepal to assess the prevalence of energy malnutrition in
children under five years and survives delivery responses in Nepal. NDHA 2006
reports that 49% of children in Nepal under five are stunted, 13 % are wasted,
and 39% % are underweight. It also reports that the distribution of the problem is
not uniform. Rural populations are the most affected with stunting, wasting, and
underweight and that while stunting is a major problem in the mountainous areas,
wasting is more significant in the terai. The study also shows that western areas
are most affected by stunting.10
A cross sectional study was conducted to assess nutritional status of under five children
in ubran slums of Bareilly during December 2010 to April 2011 at 3 purposively selected
slums (Faltuganj, Kurramgotia and kalibadi) of Bareilley district, Uttar Pradesh. The
cross sectional study was carried out in selected urban slums of Barilley district, Uttar
Pradesh. Mothers of under five children were interviewed regarding socio demographic
characteristics. Anthropometric measurements were done to assess the nutritional
status of under five children by structured questionnaire. Out of the 166 under five
children surveyed, 110(66.3%) were malnourished. Nearly 32.5%, 16.9%, 8.4% and
8.4% were suffering from grade I, II, III&IV malnutrition respectively. Malnutrition
increased significantly with the increase in age and was slightly more prevalent among
the boys. Malnutrition was slightly higher amongst those having mixed diet, belonging to
nuclear families, living in semipucca houses, using water from well and hand pump, and
using public latrines. 11

5. 6.4 RESEARCH QUESTION:
What is the prevalence of malnutrition among under five years children of
Rukmininagar?
7. MATERIALS AND METHODS:
7.1 SOURCE OF DATA:
The data will be collected from under five children and their mothers residing in selected
areas of Rukmini Nagar.
7.2. METHOD OF COLLECTION OF DATA:
7.2.1 DATA COLLECTION
The data will be collected by pre tested and pre designed questionnaire. The
questionnaire will contain detailed information of age, sex, educational status, past
history of illness, present history of illness, and followed by anthropometric
measurement and systemic examination.
7.2.2 DATA COLLECTION INSTRUMENTS:
The instrument require for find out the prevalence of malnutrition by using
the parameters of malnutrition measured by using the standard tools like weighing
machine and inch tape etc.
7.3. STUDY DESIGN:
A Cross Sectional Study.
7.4. STUDY PERIOD:
February 2014 – October 2014
7.5 STUDY POPULATION:
In this study, the population includes the children below the five years of age and
residing in Rukmini Nagar.
7.6 SAMPLING TECHNIQUE:
Simple Random sampling.

6. 7.7. SAMPLE SIZE:
The prevalence of malnutrition under five has been estimated 46% as a whole in the
country. 20
So,
Prevalence (p) = 46%
Q(100-p) =54%
Error taken (d) =5%
Confidence level =95%
Now,
n = (zα
2 pq)/d2
= (1.962 ×46×54)/52
= 381.2 =381.2~385
A total 385 under five children will be selected for the present
study.
7.8 INCLUSION CRITERIA:
Those children who have not turned 5 years of age as on 1st January 2014.
7.9 EXCLUSION CRITERIA:
1. Those parents who will not give consent.
2. Those who are sick at the time of data collection.
7.10 DATA ANALYSIS:
1. Data will be compiled and coded in MS-EXCEL
2. Data analysis will be done using statistical software i.e. SPSS,
3. Percentage and Chi-square test will be used as a statistical test.
7.11 Has Ethical clearance been obtained from your institution?
Awaited.

7. 8. LIST OF REFERENCE
1. Onis M, Brown D, Blössner M and E. orghi B;.Levels and trends in child malnutrition,
World Health Organization and UNICEF. Accessed on 13thSeptember,2013
2. Joseph B., Rebello A, Kullu P, and V.D. Raj;Prevalence of Malnutrition in Rural
Karnataka, South India, A Comparison of Anthropometric Indicators, Journal of health
population nutrition 2002 Sep;20(3):239-244.
3. Malnutrition in India, http/www.nutrition.org/misc/terms.shtml..Accessed on
13thSeptember,2013
4. SS Yamamoto, Malik AA, Haque MA , Prevalence and determinants of chronic
malnutrition among preschool children, Journal of Health Population and
Nutrition. 2011 Oct;29(5):494-9.
5. Girish B, A study of nutritional status of anganwadi children of nagamangala taluk,
mandya district, Karnataka state http://hdl.handle.net/123456789/5404.
6. Gugsa Yimer, original article Malnutrition among children in Southern Ethiopia:
Levels and risk factors, the Ethiopian Journal of Health Development, 2000;14(3):283-
292.
7. Steinhoff MC, Hilder AS, Srilatha VL, Mukarji D,Prevalence of malnutrition in Indian
preschool-age children: a survey of wasting and stunting in rural Tamil Nadu, 1983, Bull
World Health Organ. 1986;64(3):457-63.
8.Sharghi A, Kamran A, Faridan M,”Evaluating risk factors for protein
energy malnutrition in children under the age of six years in Iran”, Int Journal Gen
Med. 2011;4:607-11. E pub 2011 Aug 17.
9. Bouvier P, Papart JP, Wanner P, Picquet M, Rougemont, A Malnutrition
of children in Sikasso (Mali): prevalence and socio-economic determinants Soz
Praventivmed. 1995;40(1):27-34.
10. A.bastola; Prevalence of energy malnutrition in children under five years and
service delivery responses in Nepal; International journal of health sciences and
research ISSN;2249-9571,vol.2; issue:7;October 2012
11. Srivastava A, Bhushan Kr, Mahmood S E, Shrotriya v, Mishra S, Payal and Shaifali
I.Nutritional status of under five children slums of Bareilly. Indian Journal of Maternal
and child health.vol.14 (1), 2012.

8. BUDGET PLAN: (Approximate)
1.Expenditure in printing materials:
A) Consent forms 2000/-
B) Questionnaire forms 3000/-
2. Instrumental charge:
4000/-
(Weighing machine and measuring tape)
3. Preparation of dissertation
9,000/-
4. Expenditure in travel 3,000/-
5. Miscellaneous: 4,000/-
TOTAL ESTIMATED BUDJET 25,000/-
TIME PLAN
Phases
Time period
Outline of plan
Phase I
August-December 2013
i. Selection of Topic
ii. Preparation of questionnaire
iii. Informed Consent
iv. Submission of Synopsis
Phase II
Phase III
Phase IV
DEC-2013
FEB 2014-OCT 2014
NOV 2014-MAR 2015
i. synopsis registration
ii. Ethical clearance
i. Enrollment of study subject
ii. Data Collection
i. Analysis of collected data
ii. Discussion & writing up work
iii. Submission of dissertation to KLE university

9. 9. SIGNATURE OF THE
CANDIDATE
10. REMARKS OF THE GUIDE
11. NAME AND DESIGNATION
11.1 GUIDE DR.(MRS.) MUBASHIR ANGOLKAR,
CO-ORDINATOR OF PUBLIC HEALTH,
DEPARTMENT OF PUBLIC HEALTH
J.N.MEDICAL COLLEGE,
(KLE UNIVERSITY)BELGAUM-590010.
11.2 SIGNATURE
11.3 CO-GUIDE DR (MRS.) ASHWINI NARASANNAVAR
DEPARTMENT OF PUBLIC HEALTH,
J.N.MEDICAL COLLEGE, KLEU.
BELGAUM-590010
11.4 SIGNATURE
11.5 HEAD OF THE DEPT.
DR (Mrs.) VIJAYA A NAIK
PROF.AND HEAD,
DEPT.OF PUBLIC HEALTH,
J.N. MEDICAL COLLEGE,
KLE, UNIVERSITY, BELGAUM. KARNATAKA
11.6 SIGNATURE
12. PRINCIPAL DR. A.S. GODHI
PRINCIPAL, J.N . MEDICAL COLLEGE,
BELGAUM.
13. REMARKS/SIGNATURE

10. APPENDEX- I
INFORMED CONSENT FORM
“Prevalence of malnutrition among under five years children of RukminiNagar,
Belgaum” – A Cross sectional study
INVESTIGATOR – SAWAN KUMAR YADAV
P.G STUDENT, JNMC, KLE
BELGAUM-590010
GUDIDE – DR. MUBASHIR ANGOLKAR
CO-ORDINTAOR OF PUBLIC HEALTH,
DEPARTMENT OF PUBLIC HEALTH
Introduction:
This study is going to be carried out to assess the prevalence of malnutrition so, You
are invited to participate in this study which intends to obtain information on nutritional
status of your children and your socio-economic factors that directly influence it.
Objective:
To find the prevalence of malnutrition among under five children and to know the health
influencing factors among under five year children residing in the selected area of
Rukmini Nagar.
Explanation of procedures:
In this study, you will have to answer a few questions about your socio demographic
details and anthropometric details of children like Height, weight and mid-arm
circumference will be taken. The entire procedure may take about 15-20 minutes.
Possible Benefits:
This study will help to understand the pattern of physical growth of children. It will help
to know the underlying causes of malnutrition.
Risks:
There is no risk Involved in participating in this study.
Confidentiality:
Your identity will not be revealed. All information collected will be coded and kept
confidential.
Withdrawal:
Participation in this study is voluntary. If you do not wish to participate in this study, you
will not lose benefits to which you are entitled.
Costs of participation:

11. The cost of the study will be borne by the researcher. There will be no additional cost to
you for participating in this study.
Payment for participation:
No incentives will be provided to you for participating in this study.
Authorization to Publish Results:
The results of the study will be used for publication, However the Participant’s Identity
will be kept Confidential.
Questions:
You have the right to ask & have answered, to any questions or doubt you have about
this study. If you have queries or concerns, you can contact MR. SAWAN KUMAR
YADAV , POST GRADUATE STUDENT, MASTER OF PUBLIC HEALTH, DEPT. OF
PUBLIC HEALTH, KLE UNIVERSITY, BELGAUM – 590010, Mobile No. 8867712573
or GUIDE, Dr. MUBASHIR ANGOLKAR, Co-RDINATOR OF DEPARTMENT OF
PUBLIC HEALTH, J.N.M.C, KLEU, mobile no.9886983624.
If you have any questions about rights as a study participant. You may contact
Dr.GANGA.S.PILLI, Chairperson of Institutional Ethics Committee, JNMC, KLE
University, and Belgaum. Phone no. - 0831- 2473777(Extn-4052).
Legal rights
By signing this consent form, we are not waiving any of your legal rights.

12. CONSENT STATEMENT
I have permitted the investigator to conduct the study. My signature below indicates my
permission and I have read the information provided above (or the information provided
above has been read to me) and I was given the opportunity to ask questions and that
they have been answered to my satisfaction.
_______________________________
Name of Participant Signature or Left hand thumb
impression.
_______________________________
Name of Witness Signature of Witness
_______________________________
Name of Researcher Signature of Researcher
DATE………………………….
PLACE………………………...
ASSENT STATEMENT
I volunteer and give assent to participate in this study. I have read (or have been read to
me) the information sheet. Full opportunity was given to me to ask for clarification of
doubts. I am fully satisfied with the answers to the questions/queries/doubts I wished to
clarify. I hereby voluntarily agree to participate in this study. Furthermore , I recognize
that I have the complete right to withdraw this consent at any point during the study. I
understand that the information given by me will be confidential and is being used for
research purpose only.
Futher, I am aware that the results of this research will be published without disclosing
any identification of the participants.
______________________________________ _______________
Name &signature / left hand thumb impression Date & Place
______________________________________ _______________
Name & signature of person obtaining consent Date & Place

13. QUESTIONNAIRE
“PREVALENCE OF MALNUTRITION AMONG UNDER FIVE YEARS CHILDREN IN
RUKAMININAGAR” -A CROSS SECTIONAL STUDY .
The information will be obtained by the investigator.
PART-I (GENERAL INFORMATION)
01. Name of the interviewee ……………………………………………………………………
02.Address ………………………………………………………………………………….........
03. Age: ………………………….. sex: ………………………………………
04. Name of the head of the family………………………………………………………….
05. Type of the family: - 1.Nuclear 2. Joint 3. Others
06. Religion: Hindu / Muslim / Christian / others ( specify………………… )
Cast: sc / ST / OBC / general
07. Relation of the respondents to the children…………………………………………......
08. Family description.
SN. NAME OF THE FAMILY MEMBERS AGE SEX EDUCATION
01.
02.
03.
04.
05.
06.
07.
08.
09.
09. Number of children in the family………………..
10. Number of children under one year……………..
11. Number of children under five year……………..
12. Housing condition.
Roof Wall Floor
Type of material use for
Type of material use for
construction of the roof
construction of the wall
Type of material use for
construction of the floor
a. Iron sheets
b. Tiles
c. Asbestos
d. Concrete
e. Tins
f. Grass/rapyrus
g. Others(specify)
a. Burnt/stabilized
bricks with cement
b. Burnt/ stabilized
bricks with mud
c. Cement blocks
d. concrete
e. Stone with cement
f. Unburnt bricks with
cement
g. Unburnt bricks with
mud
h. Mud and poles
i. Other(specify)
a. Concrete/stone
b. Bricks
c. Cement screed
d. Rammed earth
e. Wood
f. Others(specify)

14. 13. If yes, how much is the distance of shed to the residency?
a). 10m. b. less than 20m. c. more than 20m
14. Toilet room status.
a).yes b) no
PART – II
SOCIO- ECONOMIC STATUS
15. Occupation of the head of the family……………………………………...................
16. Monthly income ……………………………………………………………………..
17. No. of dependent person in the family……………………………………………….
18. Expenditure detail in monthly:
S.N. Expenditure in Amount in Rs.
01. health
02. Education
03. Food
04. Saving
05. others
19. What is the source of drinking water for members of your household?
a) piped-in dwelling
b) Public tap
c) Tube well or borehole
d) Protected dug well or protected
e) spring
f) Unprotected dug well or spring,
g) rainwater
h) Pond, river or stream
i) Tanker-truck, vendoW
j) Other
20. How far is this source from your dwelling?
a. one premises
b. Less than 100 m
c. 100m to less than 500m
d. 500m-1KM
e. Don’t know
PART- III
ANTHROPOMETRIC MEASUREMENT
21. Name of the child……………………………………………………………………
22. Date of birth ………………………………………………………………………..
23. Age……………………
24. Sex a). Male b). female
25. PHYSICAL EXAMINATION

15. Body Mass Index ( BMI ): wt (kg)/ ht(m2)
a. height (cm): ………………………weight (kg):
………………………….…...……………….….cm
b. mid- arm circumference: ……………….…….cm
c. head circumference: ……….….…...…….......cm
d. chest circumference:………….………...........cm
e. waist ..circumference:………. ………..….......cm
f. hip circumference: ……………......................cm
g. body mass index: …………………….….........cm
26. Illness history of the children;
a. past history of illness:
…………………………………………………………………………………………
…………………………………………………………………………………………
………………………………………………………………………………………
b. present history of illness:
………………………………………………………………………………………………
………………………………………………………………………………………………
………………………………………………………………………………………………
27. Immunization status
BENEFICIARY AGE VACCINE
STATUS
A= continue, B=
finished, C= drop, D=
haphazardly
Infants Birth BCG* and OPV**
6 weeks DPT&OPV
10weeks DPT&OPV
14 weeks DPT&OPV
9 months Measles vaccine
18 months DPT&OPV(Booster
dose)
Children 5 years DT vaccine

16. 28. Mother and Child Listing Form
Line
no.:
1. Name: 2. Is
male or
female?
1=male
2=female
3. Date of birth?
(dd/mm/yy)
4.
Age
in
years
5. Age 5
or
over?
1 2
1 2
1 2
1 2
1 2
1 2
29. Age of weaning to the baby?
………………………….
30. Are you sending your baby to the care of Anganwadi?
a. Yes b. no
31. If yes then does the anganwadi worker informed about any health complication of
the baby?
a. Yes b. no
32. Does the anganwadi worker help you to solve the health problem of your baby?
A. Yes b. no
33. If yes, how does they help you?
a. By supplying nutrition food
b. Health counseling
c. Rupees
d. Others.(specify)………………………………………………………………………
…***THE END***