Prevalence of under nutrition and associated factors among female higher secondary students in the schools of costal block panchayat in Kerala

Prevalence of under nutrition and associated factors among female higher secondary students in the schools of costal block panchayat in Kerala Raj Eliza S.1*, Nisha R S.2, Philip S.3 DOI: https://doi.org/10.17511/ijphr.2019.i2.02 1* Sharon Raj Eliza, Senior Resident, Department of Community Medicine, Government Medical College, Kottayam, Kerala, India. 2 Nisha R S, Professor and Head, Department of Community Medicine, Government Medical College, Idukki, Kerala, India. 3 Sairu Philip, Professor and Head, Department of Community Medicine, Government TD Medical College, Alappuzha, Kerala, India.

There are 9 higher secondary schools in Ambalapuzha block divided into 3 strata -5 govt, 2 govt-aided and 2 private. Total number of female higher secondary students in the 5 govt school is 450 (90 in each school), 2 govt aided schools is 900 (450 in each school) and in the 2 private school is 50 (25 in each school).
Total number of female higher secondary students in Ambalappuzha block=1400. Sample size required is 557. To get a proportionate sample from govt , govt aided and private school, number of students to be taken from govt school=450/1400*557= 179,from govt aided school=900/1400*557= 359 and from private school=50/1400*557=20.
To get the required sample size, all female higher secondary students from 2 govt schools, 1govt aided school and 1 private school was chosen.
Schools were taken as clusters. The schools were chosen randomly by lottery method. All the female higher secondary students in the selected school was enrolled into the study Study Procedure: Information was collected from the adolescents using the semi structured questionnaire. Weights were determined using a platform weighing scale in kilograms. Height was measured using a no stretchable measuring tape in metres.
The body mass index was be calculated. Data was  Students T test was also used to compare mean BMI in different groups.
The independent general characteristics that were analyzed are When Chi square test was applied the following factors were found to be significantly associated    In 2012 a study was conducted by Dr. Ashok Kumar on adolescents in rural Tamil Nadu found that prevalence of undernutrition were common among the girls in Hindu community [12], which is similar to our study which shows association between Hindu religion and under nutrition. In our study majority of the study participants belonged to nuclear families 76.5 % which is similar to NFHS 3 data which shows that majority of people in Kerala (54.8%) belonged to nuclear families [11].
Our study also found significant association between occupation of the father (manual laborer or Fisherman) and undernutrition among adolescents.

K Venkaiah et al conducted a study on rural adolescents in Varanasi in 2002 and found that
families of laborers were significantly associated with underweight [14].
Ambalappuzha block, where the study was done mainly consists of poor families where majority of the men were semiskilled laborers (35.5%) and women were housewives (78.7%). A study by M.Z.
Goldani in Brazil in 2013 showed that individuals whose fathers at the time of their birth were engaged in unskilled jobs or were unemployed were on average 1.18 kg/m2 heavier than those whose fathers had non manual occupations when reach adolescence [15].
Our study also found significant difference in BMI between study participants whose fathers were manual laborer as compared to study participants whose fathers were involved in other occupation or of the study subjects Last one year was taken into account.

Influence of media:
In the present study significant association was found between absence of media influence on dietary intake and undernutrition. Among the study participants 22.4% were influenced by media in taking decision regarding their nutrition.
In a study from Chennai done in the age group 11 to 17 years it was reported that, 82% buy food products and snacks based on advertisement, 42% follows diet and 42% exercise to get the body like their favorite media personality [19].  [22] which is similar to our study which also showed significant difference in BMI among those who were influenced by media in taking decision regarding their diet and nutrition and those who were not.

Consumption of egg:
Our study also showed significant difference in BMI among subjects who consume egg once a week and and those who consume less than that. In a study on 'The relationship between body mass index and lifestyle in a Brazilian adult population: a cross-sectional survey ' by Maria Rosárion in 2007 showed correlation between consumption of egg and mean BMI in women [23].
On multivariate analysis occupation of father of the study subjects (manual laborer or fisherman) was found be the only independent predictor of undernutrition among female higher secondary students in Ambalappuzha Block Panchayat. This is similar to the study by Amitava pal et al in 2015 which showed fathers occupation as an independent predictor of under nutrition [13].

Conclusion
Prevalence of under nutrition was found to be high among female higher secondary students in Ambalappuzha Block. Father being a manual laborer or fisherman was found to be an independent predictor of undernutrition.  Available from [Article] [Crossref]