Download RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
SUBMITTED BY:
Mr.PRIJEESH S KUMAR
1st yr. M. Sc. (Nursing),
Child Health Nursing,
2011-2013 Batch.,
Oriental college of nursing,
Bangalore -10.
0
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. NAME OF THE CANDIDATE AND Mr.Prijeesh s kumar
1ST YEAR MSc NURSING,
ADDRESS
ORIENTAL COLLEGE OF
NURSING,#43/52,2ND MAIN.WEST
OF CHORD ROAD,RAJAJINAGAR,
BANGALORE-10.
2. NAME OF THE INSTITUTION
Oriental
College
of
Bangalore- 10.
3.
COURSE OF STUDY AND SUBJECT
1st Year M .Sc. Nursing,
Child Health Nursing
4. DATE OF ADMISSION OF THE 30 - 07 -2011
Nursing
COURSE
“A study to assess the
effectiveness of structured teaching
programme
on
knowledge
regarding
fat soluble vitamin
deficiency and its prevention in
children among mothers residing at
selected
community
area,
Bangalore.”
5. TITLE OF THE TOPIC
6. BRIEF RESUME OF THE WORK
6.0 INTRODUCTION
6.1 NEED FOR THE STUDY
6.2 REVIEW OF LITERATURE
6.2.1 STATEMENT OF THE STUDY
6.3 OBJECTIVES OF THE STUDY
6.3.1 OPERATIONAL DEFINITIONS
6.3.2 ASSUMPTION
6.3.3 HYPOTHESIS
6.3.4 SAMPLING CRITERIA
7. MATERIALS AND METHODS
7.1
7.2
7.3
7.4
Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
Enclosed
Sources of data: Data will be collected from mothers of children residing at
selected community area,Bangalore.
Method of data collection: Self administered questionnaire..
Does the study require any investigations of interventions to be conducted
on the patients or other human being or animals? Yes
Has ethical clearance been obtained from your institution?
YES. Ethical committee’s report is here with enclosed.
8 LIST OF REFERENCES
Enclosed
1
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1.
NAME OF THE CANDIDATE AND Mr.Prijeesh s kumar
1ST YEAR MSc NURSING,
ADDRESS
ORIENTAL COLLEGE OF NURSING,
#43/52,2ND MAIN,WEST OF CHORD
ROAD, RAJAJINAGAR,
BANGALORE.
2.
NAME OF THE INSTITUTION
3.
COURSE
OF
STUDY
SUBJECT
4.
Oriental College of Nursing,
Bangalore- 10.
AND 1st Year M .Sc. Nursing,
Child Health Nursing
DATE OF ADMISSION OF THE 30 - 07 -2011
COURSE
5.
“A study to assess the effectiveness
of structured teaching programme on
knowledge regarding
fat soluble
vitamin deficiency and its prevention in
children among mothers residing at
selected community area, Bangalore.”
TITLE OF THE STUDY
2
6. BRIEF RESUME OF THE INTENDED WORK:
6.0. INTRODUCTION
Children are future of society and mothers are guardian of that future. Hence to ensure
sound foundation and secure future of any society health and nutrition of their
children need protection. Children in preschool stage require most attention, as this is
the period of rapid growth and development, which makes them highly vulnerable to
malnutrition.
Proper nutrition in childhood can reinforce lifelong eating habits that contribute to
your children's overall well being and help them to grow up to their full potential and
a healthy life. Nutritional diseases are diseases in humans that are directly or
indirectly caused by a lack of essential nutrients in the diet. Nutritional diseases are
commonly associated with chronic malnutrition. Additionally, conditions such
as obesity from overeating can also cause, or contribute to, serious health problems.
Excessive intake of some nutrients can cause acute poisoning
Nutrition has major effects on health. Nutrition refers to the availability of energy and
nutrients to the body’s cells in relation to body requirements. Malnutrition refers to
any imbalance in satisfying nutrition requirements. Malnutrition among children is
often caused by the synergistic effects of inadequate or improper food intake, repeated
episodes of parasitic or other childhood diseases such as diarrhoea, and improper
er care during illness (Pelletier 1994; Ruzicka and Kane 1985). Malnutrition is often
cited as an important factor contributing to high morbidity and mortality among
children in developing countries1.
3
A number of factors affect child nutrition, either directly or indirectly. The most
commonly cited factors are food availability and dietary intake, breastfeeding,
prevalence of infectious and parasitic diseases, access to health care, immunization
against major childhood diseases, vitamin A supplementation, maternal care during
pregnancy, water supply and sanitation, socioeconomic status, and health-seeking
behavior. Demographic characteristics such as the child’s age and sex, birth intervals
and mother’s age at childbirth are also associated with child nutrition Several studies
indicate that inadequate or improper food intake and repeated episodes of infectious
diseases adversely affect children’s nutritional status found that proper treatment of
acute infectious diseases, especially diarrhoea, has beneficial effects for children’s
growth and nutritional status. Briend and colleagues (1988) found that breast-feeding
improves nutritional status and child survival. Esrey et al. (1988) and Mertens et al.
(1990) found that the presence of a clean water supply and sanitary facilities have
beneficial effects on child growth and nutrition. Vitamin A supplementation reduces
morbidity in children, it may also improve their nutritional3 status
4
6.1 NEED FOR THE STUDY
One in every 3 malnourished children in the world live in India.5
South Asia has the highest rates and largest number of malnourished children in the
world, with 47% of children in India aged under 5 categorized as moderately or
severely malnourished. This compares to rates of moderate or severe child
malnutrition of 38% in Ethiopia, 24% in Mozambique or 20% in Kenya or 8% in
China. 5
Malnutrition results not just from limited food intake – it is also caused by lack of
access to health services, poor feeding practices and infection. Furthermore,
malnutrition is perpetuated from one generation to the next. Poorly nourished mothers
give birth to babies weighing too little and lacking sufficient nutrition. 6
Roughly a third of adult women in India are underweight. Partly as a result of this and
inadequate nutrition during pregnancy, 26% of Indian infants are born at a
dangerously low birth weight (less than 2.5 kg). Low birth weight babies have 11-13
times higher risk of mortality in the neonatal period (the first 28 days of life) than
normal birth weight babies.8
The current probability of a child dying before his or her 5th birthday is 8.7%.i It is
estimated that at least half of these deaths are related to malnutrition, often associated
with infectious diseases.5
5
The relationship between nutritional status and child mortality is not conclusive,
however. Smedman and colleagues (1987) and the Kasongo Project Team (1983) do
not find a clear relationship between nutritional status and child survival. A
comprehensive review of studies of the relationship between malnutrition and child
mortality in developing countries can be found in Pelletier (1998). Malnutrition
during childhood can also affect growth potential and risk of morbidity and mortality
in later years of life. Malnourished children are more likely togrow into malnourished
adults who face heightened risks of disease and death. Poor nutritional status of
women has been associated with a higher age at menarche (Haq 1984; Roberts et al.
1986) and a lower age at secondary sterility (Karim et al. 1985)2.
Malnutrition can also have serious long term consequences as is impedes motor,
sensory, cognitive and social development. Thus, malnourished children will be less
likely to benefit from schooling, and will consequently have lower incomes as adults.6
Under-nutrition’s most damaging effects occur during pregnancy and the first 2 years
of a child’s life. The damages caused to health and development is irreversible,
making it crucial to address this problem between conception and 24 months of age. 7
Breastfeeding is essential for infants, providing them with a source of balanced
nutrition and antibodies against disease. An estimated 1.5 million babies worldwide
could be saved each year if every infant were breastfed exclusively for the first 4-6
months of its life. To do so, women must be adequately fed themselves and be taught
about breastfeeding’s health benefits. Currently, 37% of children in India under 6
months are exclusively breastfed.8
Vitamin and mineral deficiencies can also affect children’s survival and development.
Iodine deficiency can reduce learning capacity by up to 13%, and increase the risk of
6
death during childbirth, and in India this is widespread as less than 50% of all
households use iodized salt.9
On average, iron deficiency affects 44% of women in developing countries, but in
India the numbers who are iron deficient is estimated to be nearly 70%.
Vitamin A deficiency can cause blindness and increase morbidity and mortality
among pre-schoolers. Direct nutrition programmes can help alleviate this.10
Improving nutrition requires focused local and national action to provide health and
nutrition education and services, such as the promotion of exclusive breastfeeding, in
conjunction with prenatal care and basic maternal and child health services,
micronutrient supplements and fortified food.5
Under nutrition jeopardizes children’s survival, health, growth and development, and
slows national progress towards development goals. Under nutrition is often an
invisible problem.
Large-scale programmes – including the promotion, protection and support of
exclusive breastfeeding, providing vitamins and minerals through fortified foods and
supplements, and community-based treatment of severe acute malnutrition – have
been successful in many countries.11
Unsafe water, inadequate sanitation and poor hygiene increase the risk of diarrhea and
other illnesses that deplete children of vital nutrients and can lead to chronic
undernutrition and increase the risk of death.11
Improving child and maternal nutrition is not only feasible but also affordable and
cost-effective. Nutrition interventions are among the best investments in development
that countries can undertake.12
7
In India, 48 percent of children under 5 years old are moderately or severely stunted.ii
Stunting is an important predictor of child development; it is associated with reduced
school outcome. Compared to children who are not stunted, stunted children often
enroll later, complete fewer grades and perform less well in school. In turn, this
underperformance leads to reduced productivity and income-earning capacity in adult
life.13
Malnutrition in this stage has far reaching consequences on child’s future by severely
effecting child’s physical and mental development . Yet malnutrition among
preschool is widely prevalent in South East Asia region (Smith and Haddad 2000)
more so in India. As per available data about half of children in this age group suffer
from different grade of malnutrition. Malnutrition in turns weakens the immune
system of the child, thereby contributes to more than 50 % of deaths associated with
infectious diseases among this age group . 15
During preschool period child is mostly dependent on mother for all her nutritional
needs. Hence It is argued that the mother being the major care provider for the child
during preschool period, her status in the family may have bearing on nutritional
status of her child . Researchers have tried to relate malnutrition status of newborn
and preschool children with low intra household status of women. But women’s status
in itself a complex concept and includes various areas including her employment and
earning, economic autonomy, reproductive right, health and well being etc.
Researchers from all over the world have tried to study many of these factors related
with maternal status separately or in different combinations. However they have
reported varied effect on child nutrition status in different socio-cultural settings
(Sakisaka K et al 2006, Appoh LY et al 2005, Habib S et al 2005, Rathnayake IM et
8
al 2005, Mohamed AJ et al 2004, Hameida J et al 2002, Tada Yet al 2002, Toyama N
2001, MIshra VK 2000, Glick p 1998 et al etc.).16
6.2 REVIEW OF LITERATURE
Review of literature is a critical summary of research on a topic of interest
generally prepared to put a research problem in paper content to identify gaps
and weakness on previous studies to justify a new investigation.
The review of literature for the present study has been divided into the following
sections
A study was conducted to “ assess the impact of drought on childhood illnesses and
nutrition in children of rural population” using three stage sampling design. The study
has been carried out in 24 villages belonging to 6 tehsils of Jodhpur district which was
a drought affected desert district of Western Rajasthan in 2003. A total of 914 under
five children (0-5 years) could be examined for their childhood illnesses, malnutrition,
dietary intake and clinical signs of nutritional deficiency. Childhood illnesses
observed at the time of drought were respiratory (7.5 %), gastroenterological (7.5%),
and 5.6% fever (viral, malaria and jaundice), higher in males than females. Children
suffered from recent and long term malnutrition were 39% and 26% respectively as
per National Centre for Health Statistics (NCHS) standards. The extent of
malnutrition was significantly higher in females than in males (p<0.01). Vitamin A &
B complex deficiencies were 0.7% and 3/% respectively. The protein energy
9
malnutrition (PEM) was observed in 44.4%. Overall mean calorie and protein intake
deficit was observed to be very high (76.0 & 54.0 %). The comparison of present
drought results with earlier studies in normal and drought conditions showed higher
prevalence of PEM and deficiencies of calories & proteins in their diet17.
A study was conducted by Mukatay AW, Kalenga PM The first to assess
the nutritional status of children under five years-old living in a suburb of the city of
Lubumbashi, DR Congo, at the end of the 1998-2003 armed conflict. The second
objective aims to identify some predictors of malnutrition. A multivariate logistic
regression was applied to the results of a cross-sectional survey of 1963 children from
selected households. In addition to the anthropometric variables, living conditions
were also used. We observed 33.5% stunted growth and 3.8% emaciation. After
logistic regression, a low maternal educational level (less than 7 years), the absence of
a drinking water tap available in the house or yard, male gender, and age of children (
> 11 months) were all significantly associated with increased risk of stunted growth.
Moreover, decreased appetite, diarrhea and age of children ( < 12 months) were
significant predictors of emaciation. Compared to the classification of the World
Health Organization, our results indicate that the prevalence of stunting is high and
the prevalence of emaciation is low. Interventions against malnutrition should
consider the various predictors discussed in this study in order to reduce mortality and
morbidity in children and contribute to their well-being11.
A Cross sectional study was conducted by Njue MW and Makokha AO to determine
vitamin A supplementation awareness, attitudes and beliefs among mothers of
children underfive years old attending Mbagathi District Hospital. Both quantitative
and qualitative data using questionnaires, in-depth interviews and focus group
discussions.A systematic random sampling where every alternate client was recruited
10
and questionnaires administered to make 158 respondents. Key informants were
purposively chosen for in-depth interviews and focus group discussions. Results:
Ninety four percent of the respondents reported having heard about vitamin A, major
source of information being the health worker (82%). While 58% of the respondents
were aware that the recommended schedule for VAS for children is every 6 months,
almost half (49%) of respondents were aware vitamin A was given to mothers. Most
of the respondents were positive and supportive of VAS. There were no negative
beliefs or attitudes mentioned. However, majority (66%) had never discussed about
Vitamin A with other mothers/people. Only 18% of the respondents believed VAD
was associated with eye problems/blindness. Most mothers did not believe there was a
specific consequence of VAD. Majority (64%) of the respondents did not believe
there were any possible hindrances to taking their children for VAS12.
A cross-sectional study was conducted by Biswas S, Bose K, to assess prevalence of
under nutrition among children 3.0-5.9 years old in a rural area of West Bengal
covered by the Integrated Child Development Services Scheme (ICDS) using
Composite Index of Anthropometric Failure (CIAF). Randomly selected sixty six
ICDS centres of the Chapra Block Nadia District, West Bengal, India, were chosen. A
total of 2016 children, aged 3.0-5.9 years were studied. It was observed that boys
were heavier and taller than girls at all ages. Significant age differences existed in
mean height and weight in boys as well as in girls. Among the children, 48.20%,
10.60% and 48.30% were stunting, wasted and underweight, respectively. The CIAF
showed a higher prevalence of undernutrition, with 60.40% of the studied children
suffering from anthropometric failure, in comparison to the three other conventional
indicators. We conclude that the nutritional status of the subjects is unsatisfactory13.
11
A study was conducted to assess and quantify the magnitude of inequalities in underfive child malnutrition, particularly those ascribable to socio-economic status Data on
4187 under-five children were derived from the Nigeria 2003 Demographic and
Health Survey. Household asset index was used as the main indicator of socioeconomic status. Socio-economic inequality in chronic childhood malnutrition was
measured using the "extended" illness concentration and achievement indices. There
are considerable pro-rich inequalities in the distribution of stunting. South-east and
south-west regions had low average levels of childhood malnutrition, but the
inequalities between the poor and the better-off were very large. By contrast, Northeast and North-west had fairly small gaps between the poor and the better-off on
childhood malnutrition, but the average values of the childhood malnutrition was
extremely high14.
A community based, cross-sectional study was conducted in the Mollasimla village of
Hooghly district of West Bengal, to examine the differences in nutritional status of
under-five males and females and to determine the different bio-social factors
associated with such differences. It was found that 55.9%, 51.4% and 42.3% of the
girls were underweight, stunted and wasted respectively compared to 46.6%, 40.5%
and 35.3% of the boys and a significantly higher proportion of malnutrition was found
to be present among female children of higher birth order and those belonging to
families with lower per capita income compared to the males15.
A study was conducted by Khan NC, Ninh NX to assess the prevalence of sub clinical
vitamin A deficiency and anemia in children. A cross-sectional survey was conducted
in 40 villages of four ecological regions in Vietnam during Apr-May 2001. In total
1657 children were included by a cluster random sampling method. The prevalence of
12
sub clinical vitamin A deficiency (serum retinol <0.70 mumol/l) was 12.0% and the
prevalence of anemia (hemoglobin <110g/l) was 28.4 %. 35.1%. In the children under
6 months the prevalence of sub clinical vitamin A deficiency was 35.1 % whereas the
prevalence of anemia in this group was as high as 61.7%. The prevalence of children
with both sub clinical vitamin A deficiency and anemia was 6.1%. Sub clinical
vitamin A deficiency and anemia prevalence differed significantly across the regions,
with highest prevalence in the Northern Mountainous areas for vitamin A deficiency
and in the Northern Mountainous area and Mekong River Delta for anemia. It is
concluded that sub clinical vitamin A deficiency and anemia are still important public
health problems in Vietnam. Sustainable strategies for combating vitamin A
deficiency and nutritional anemia are needed and should concentrate on target groups,
especially infants and malnourished children in high risk regions16.
A study was conducted by Odunayo SI, Oyewole AO to determine the current
nutritional status and the influence of feeding practices and family characteristics on
the nutritional status of under-five rural Nigerian children. It was conducted using a
cross sectional, community based survey design. From 344 households, 420 children
were studied. Using the modified Wellcome Classification, the prevalence of PEM
was 20.5 percent whereas the prevalence of underweight, wasting and stunting using
the World Health Organization/ National Centre for Health Statistics (WHO/NCHS)
standards were 23.1 percent, 9 percent and 26.7 percent respectively. Young age was
significantly associated with a higher prevalence of underweight (P = 0.004).
Overcrowding, low maternal income and the use of infant formula feeds in children
who have attained the age of 6 months and above were associated with a higher
prevalence of wasting (P = 0.029, P = 0.031 and P = 0.005 respectively). Improved
living standard of families, empowerment of mothers with the aim of augmenting
13
family income and parental education on appropriate feeding practices may help in
reducing the incidence of under-five malnutrition in communities. The low prevalence
rate of malnutrition was probably due to activities of the NGO in this community17.
This retrospective study was conducted by Savadogo LG, Ouedraogo HZ, uses a
systematic sample derived from the year 1999 hospital register. In total data of 1573
children from 0 to 59 months were analyzed. The association between mortality and
dependent variables was measured by relative risks (RR) in univariate analysis. A
logistic regression was realized and attributable risk percent (etiologic fraction among
exposed) of death was calculated.The total intra-hospital lethality amounted to 15.3%.
Age, diagnosis, type of care recourse and malnutrition (low WA index) on admission
were associated to mortality. The logistic regression model confirmed the high risks
of deaths for young children (0-11m), children in malnutrition (low WA index) and
those with severe malaria. The attributable risk percent of death indicates that, 87% of
deaths are statically attributable to severe malnutrition (WA Z-score<=-3) and 64.3%
of deaths are statically attributable to moderate malnutrition (WA Z-score]-3, -2])10.
A case-control study was conducted to examine possible risk factors for diarrheal
deaths in under-age-five children in the developing countries. We analyzed data from
the surveillance system of our diarrhoea treatment centre/hospital for the period 199094 on 928 children less than 10 yersof age. In univariate analysis, 11 factors were
significantly associated with death: lack of breastfeeding, severe malnutrition,
complicated diarrhoea, pneumonia, xerophthalmia, duration of diarrhoea 7-14 days,
moderate or severe dehydration, recent history of measles, Shigella flexneri infection,
maternal illiteracy, and very low household income. Rotavirus diarrhoea was
negatively associated with fatal outcome. In the assessment of severe malnutrition,
14
weight-for-height measurement discriminated mortality risk better than weight-forage or height-for-age indices. Only two factors retained their significance, severe
malnutrition and non-breastfeeding in the multivariate analysis with adjusted odds
ratio (95% confidence interval) of 84.2 (9.1, 775.9) and 4.2 (1.3, 13.2) respectively16.
6.2.1. STATEMENT OF THE PROBLEM
“A study to assess the effectiveness of structured teaching programme on knowledge
regarding fat soluble vitamin deficiency and its prevention in children among mothers
residing at selected community area, Bangalore.”
6.3. OBJECTIVES OF THE STUDY
1. To assess the knowledge of mothers regarding fat soluble vitamin deficiency
and its prevention.
2. To assess the effectiveness of structured teaching programme on knowledge of
mother’s, prevention of fat soluble vitamin deficiency in children.
3. To identify the association between the knowledge with selected demographic
variables.
6.3.1 OPERATIONAL DEFINITIONS
1. Effectiveness: The degree in which the inappropriate knowledge of mothers to
prevent fat soluble vitamin deficiency is turned to be productive.
2. Structured Teaching programme: It refers to systematically developed
teaching with instructional aides designed for mothers regarding fat soluble
vitamin deficiency and its prevention in children.
15
3. Knowledge: Awareness of mothers of children regarding fat soluble vitamin
deficiency and its preventive measures.
4. fat soluble vitamin deficiency: health problems manifested in children as a
result of inadequate availability of fat soluble vitamin in diet.
5. Bleeding Diathesis: An unusual susceptibility to bleeding mostly due to hypo
-coagulability, in turn caused by deficiency of vitamin K
6. Rickets: Rickets is a softening of bones in children due to deficiency or
impaired metabolism of vitamin D.
7. Scoliosis - Sideways deviation of the backbone in children due to vit D
Deficiency.
8. Xerophthalmia - Dry and lusterless cornea and conjunctiva due to a vit
A deficiency
9. Osteomalacia - Softening of bones in adults due to vitamin D deficiency.
10. Osteoporosis - Loss of bony tissue in adults due to vitamin D deficiency
as a result bones become brittle.
11. Mothers- Women who are having children age group of below 12 years old.
6.3.2 ASSUMPTIONS:
1. Knowledge regarding fat soluble vitamin deficiency and its management may
be inadequate among mothers of children.
2. Structured teaching programme may enhance the knowledge and practices of
mothers regarding the fat soluble vitamin deficiency and its management.
6.3.3 HYPOTHESIS:
16
H1: There will be significant effective improvement in knowledge and of
mothers regarding fat soluble vitamin deficiency and its prevention.
H2: There will be significant association between knowledge of mothers and
selected demographic variables.
6.3.4. SAMPLING CRITERIA:
Inclusion Criteria
1. Mothers of children in selected community area
2. Who are available at the time of the study
3. Who are willing to participate in the study
Exclusion Criteria
1. Mothers who cannot read Kannada or English
2. Mothers who had exposure to similar studies
6.3.5 DELIMITATIONS:
1. Four weeks of data collection.
7. MATERIALS AND METHODS
7.1. SOURCE OF DATA:
Data will be collected from mothers of children residing at selected community area,
Bangalore.
7.2. METHODS OF COLLECTION OF DATA:
17
Research approach: Evaluative approach.
Research design
: Pre-experimental, one group pre-test post test design.
Setting
: Selected community area in, Bangalore.
Population
:All mothers of children residing at selected community
area, Bangalore.
Sample
:Mothers of children who meet the inclusion criteria.
Sample size
:60
Sampling technique
: Simple random sampling technique
Method Of Data collection
Tools for Data collection
:Self administered questionnaire.
: Structured knowledge questionnaire
Method of Data analysis and interpretation:
1. Frequency and percentage distribution to assess demographic variables.
2. Mean, Mean percentage and standard deviation to assess the Level of
knowledge
3. Paired ‘t’ test to find out effectiveness of S.T.P.
4. Chi-Square test to find the association between level of knowledge and
demographic variables.
Duration Of Study: 4 weeks.
18
VARIABLES
Independent variable:
Structured teaching programme
Dependent variable:
Knowledge regarding Fat soluble vitamin deficiency
Demographic variables:
Age, Marital status, Number of children, Religion ,Education. Occupation and
Socioeconomic status
Projected outcome- The study will be successful in improving the knowledge of
mothers regarding fat soluble vitamin deficiency and its prevention in children among
mothers residing at selected community area.
7.3. Does the study require any investigation or intervention to be conducted on
patients or other humans or animals? If so, please describe briefly.
Yes.
7. 4. Has ethical clearance been obtained from your institution in case of 7.3?
Yes, Ethical committee report is here with enclosed.
19
8. LIST OF REFERENCES:
1. India’s Undernourished Children: A Call For Reform and Action, World Bank
Report:http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPU
LATION/Resources/2816271095698140167/IndiaUndernourishedChildrenFinal.pdf; last accessed on
24/09/07
2. National Nutrition Monitoring Bureau (NNMB). 1979-2006. NNMB Reports.
National Institute of Nutrition, Hyderabad.
3. UNICEF Statistics, found at http://www.unicef.org/infobycountry/index.html
4. Health Education to Villages, Programmes for Mother and Child Nutrition at
http://hetv.org/programmes/nutrition.htm
5. UNICEF Statistics on India, at
http://www.unicef.org/infobycountry/india_statistics.html
6. WHO, Perinatal mortality – a listing of available information. Maternal Health
and Safe Motherhood Programme, Geneva, 1996. WHO/FRM/MSM/96.7
7. UNICEF Statistics on India, at
http://www.unicef.org/infobycountry/india_statistics.html
8. Black et al., Where and why are 10 million children dying every year? Lancet,
2003 (Child Survival Series)
20
9. Health Education to Villages, Programmes for Mother and Child Nutrition at
http://hetv.org/programmes/nutrition.htm
10. Malnutrition causes heavy economic losses, contributes to half of all child deaths,
but can be prevented – new World Bank report, March 2nd 2006, at
http://web.worldbank.org/WBSITE/EXTERNAL/NEWS/0,,contentMDK:208
39585~pagePK:64257043~piPK:437376~theSitePK:4607,00.html
11. Sustainable Development Department (SD), Food and Agriculture Organisation of
the United Nations (FAO), Gender and Nutrition July 2001 at
http://www.fao.org/sd/2001/PE0703a_en.htm
12. Sustainable Development Department (SD), Food and Agriculture Organisation of
the United Nations (FAO), Gender and Nutrition July 2001 at
http://www.fao.org/sd/2001/PE0703a_en.htm
13. UNICEF Statistics on India, at
http://www.unicef.org/infobycountry/india_statistics.html
14. Health Education to Villages, Programmes for Mother and Child Nutrition at
http://hetv.org/programmes/nutrition.htm
15. Habib S, Rishpon S, Rubin L. [Mother's education and ethnicity effect on health
measures for children in the Haifa subdistrict Harefuah. 2005
Jun;144(6):402-6, 455.
16. Hameida J, Billot L, Deschamps JP.Growth of preschool children in the Libyan
21
Arab Jamahiriya: regional and sociodemographic differences. East
Mediterr Health J. 2002 Jul-Sep;8(4-5):458-69.
17. Mukatay AW, Kalenga PM,Factors associated with malnutrition in children
aged under five years in Lubumbashi, University of Lubumbashi
22
9. Signature of the Candidate
10. Remarks of Guide
11.Name and Designation
11.1 Guide
:
11.2 Signature
:
11.3 Head of the Department
:
11.4 Signature
12.
12.1 Remarks of Chairman and Principal
:
12.2 Signature
:
23
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