Key findings:

Key findings from this study on mothers' knowledge about malnutrition in Dhanot, District Kangra, include: 71.75% of mothers were aged 26-30 years, 45.25% had secondary education, 92.25% were Hindu, 79.75% were homemakers, and 73.25% delivered in government hospitals. The study found that 76.5% of mothers had good to very good knowledge about malnutrition.

What is known and what is new?

The known aspect in this abstract is the critical role of mothers in shielding children from malnutrition through proper feeding practices. The new contribution is the specific evaluation of mothers' knowledge about malnutrition in the context of Primary Health Center, Dhanot, District Kangra, providing insights into the current level of awareness and the need for targeted interventions in this region.

What is the implication, and what should change now?

The implication of this study is the need for targeted educational interventions to further improve mothers' knowledge about malnutrition and promote optimal feeding practices for children under five. Changes needed include emphasizing the importance of early breastfeeding initiation, appropriate complementary feeding, and dietary diversity in health education programs to enhance the nutritional status of young children.

INTRODUCTION

Inadequate food nutrient intake leads to malnutrition, a condition that affects the body's ability to sustain healthy tissues and organ functions. These nutrients include minerals, vitamins, proteins, fats, and carbohydrates. Underlying causes of death and morbidity in children under the age of five include malnutrition. [1-3]

Given that mothers are the ones in charge of raising their children, it is crucial for them to be well-informed about their nutrition. Mothers who are better knowledgeable about nutrition can raise their kids in a healthy way and shield them from this illness. [4,5]

A number of studies have assessed knowledge about malnutrition in different parts of India; such studies are limited among mothers in rural areas of District Kangra. Thus the present study was developed to examine the knowledge towards malnutrition among mothers having under 5 children attending Primary Health Center, Dhanot of District Kangra. 

Objectives of the Study

To evaluate the knowledge towards malnutrition among mothers having under 5 children attending Primary Health Center, Dhanot of District Kangra

• Research Approach -Descriptive

• Research Design-Hospital based cross-sectional survey design

• Setting of the study- OPD at Primary Health Center, Dhanot of District Kangra

• Study duration- between January 2022- March 2022 

• Study population- Mothers came to OPD and having children aged less than 5 years 

• Sample size- 400 Mothers assuming 50% mothers have adequate knowledge regarding Malnutrition, 5% absolute error, 95% confidence level, and 5% non-response rate.

• Sampling Technique- convenience Sampling technique

• Sampling criteria- first five mothers who came to OPD and having children aged less than 5 years were selected everyday till the completion of sample size after explaining the purpose of the study. Informed consent was taken from them and confidentiality of the selected participants was also maintained 

• Inclusive Criteria- Mothers who were willing to participate in the study.

   

1. Exclusion Criteria: Mothers who were not willing to participate in the study

2. Description of Tool- 

   1. Demographic data survey instrument: The demographic form elicited information on participants’ background: age, marital status, religion , employment, education, family’s monthly income, delivery pattern , ANC Check up and many more.

   2. Questionnaire: The questionnaire contains 20 structured knowledge related questions having three options (yes, no, don’t know).  The participants have to choose the right one. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as >80%(16-20)=very good,60-79%(12-15) =Good,41-59% ( 8-11)=Fair,<40% (< 8)=poor

3. Validity of tool - by the experts in this field

4. Data collection by  under the guidance of supervisors and mothers were given 30 minutes time to complete that questionnaire and collected at the end of the prescribed time

5. Data analysis with Epi Info V7 Software with appropriate statistical test in terms of frequencies, percentage.

The present study in table 1and 2 was developed to evaluate the knowledge towards malnutrition among mothers having under 5 children attending Primary Health Center, Dhanot of District Kangra.  A total of 400 Mothers came to OPD and having children aged less than 5 year were selected after explaining the purpose of the study. Among the total mothers, maximum 287(71.75%) were having age between 26-30 years, educated up to Matric & Senior Secondary 181(45.25%) Hindu 369(92.25%), Housewife 319(79.75%), Multigravida 299(74.75%) and delivered in government hospitals 293(73.25%).

Table 1. Socio demographic characteristics of the participants

Table 2. Responses of the participants to various statements

Table 3: Knowledge towards malnutrition among mothers’

      Maximum =20 Minimum=6

In the present study in table 3, 8.5%(34) mothers’ had very good knowledge (16-20 marks) towards malnutrition , 68.0%(272) having good knowledge  (12-15 marks), 16.75%(67) having fair knowledge  (8-11 marks) and 6.75% (27) having poor knowledge  (<8 marks).

In India, child malnutrition is a significant underlying factor in child mortality. As a higher percentage of stunted, wasted, and underweight children were reported from rural areas, malnutrition among children under the age of five is becoming increasingly prevalent in rural India. The most frequent causes of malnutrition included improper baby feeding techniques, reduced nutrient utilization caused by parasites and infections, inadequate food security, poor environmental conditions, and a lack of appropriate child care practises. [4,5]

NFHS 5 data on Malnutrition in  District  kangra showed that there was an increase in  percentage of stunting (height-for-age), severely wasted (weight-for-height),  underweight (weight-for-age) and overweight (weight-for-height) as compared to NFHS-4. [6] (Table-4)

Table-4: NFHS-5 data on malnutrition in District Sirmaur

The improvement of children's nutritional status is a crucial part of primary healthcare. Planning and analysis must be thorough and systematic if malnutrition is to be prevented. Education among mothers can have a variety of intra-household impacts, lowering the incidence of nutritional deficit. Consider malnutrition. Improvements in health and nutrition knowledge in favor of better nutrition, including breastfeeding, weaning practices, and child feeding, as well as successful dietary behavior on the part of mothers who manage food resources in the household, were the effects that mothers' education would bring. [7,8]

An important global health objective continues to be the reduction of child malnutrition through breastfeeding and proper supplemental feeding. To lower infant morbidity and death, nutritional education that targets behavioral change, especially among rural moms, is crucial. [9]

Limitations of the study 

The present study has certain limitations such as cross sectional in nature, and small sample size that made it difficult to generalize the findings. Future research should be focused on larger sample and qualitative studies such as focus group interviews to identify barriers to promote appropriate knowledge and practices about malnutrition among mothers.

However, despite these limitations, the present study findings may be helpful to the health professionals and policy makers in designing the interventions to promote age-appropriate feeding and dietary practices related to nutrition.

The current study comes to the conclusion that mothers are well-informed about malnutrition. Even yet, there was still a big gap in our understanding of malnutrition because it wasn't up to speed with the WHO's recommendations.

To lower child mortality, morbidity, and malnutrition, education that focuses on behaviour change is crucial. To increase awareness and habits addressing malnutrition, adequate education programmes stressing prompt initiation, appropriates, fortification, iron supplements, and meal diversity are required.

Funding: No funding sources.

Conflict of interest: None declared.

Ethical approval: The study was approved by the Institutional Ethics Committee of Himachal Pradesh.

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9. Kwoh, Yik San, et al. "A Robot with Improved Absolute Positioning Accuracy for CT Guided Stereotactic Brain Surgery." IEEE Transactions on Biomedical Engineering, vol. 35, no. 2, 1988, pp. 153-160. https://doi.org/10.1109/10.1354.