MOTHERS’ KNOWLEDGE ON NUTRITIONAL DEFICIENCY DISORDERS IN
CHILDREN: A DESCRIPTIVE SURVEY
Angela Rajan1, Dr. Mamatha.S.Pai2, Binu Margaret E3MSc Nursing
1. MSc Nursing, Manipal College of Nursing, Manipal, Manipal University, Madhav
nagar, Udupi District, Karnataka
2. Professor, Department of Child Health Nursing,
Manipal College of Nursing, Manipal,
Manipal University, Madhav nagar,
Udupi District, Karnataka, India.
3. Assistant Professor, Department of Child Health Nursing,
Manipal College of Nursing, Manipal,
Manipal University, Madhav nagar,
Udupi District, Karnataka, India.
Corresponding Author:
Binu Margaret,
Assistant Professor, Department of Child Health Nursing,
Manipal College of Nursing, Manipal,
Manipal University, Madhav nagar,
Udupi District, Karnataka, India. Pin Code: 576104.
Email: binumarg@gmail.com
Phone No: +919844602532
MOTHERS’ KNOWLEDGE ON NUTRITIONAL DEFICIENCY DISORDERS IN
CHILDREN: A DESCRIPTIVE SURVEY
Angela Rajan1, Dr. Mamatha.S.Pai2, Binu Margaret E3
1
MSc Nursing, 2 Professor, 3Assistant Professor
Department of Child Health Nursing, Manipal College of Nursing, Manipal, Manipal
University, Manipal, Karnataka, India.
Corresponding Author: Binu Margaret E, Assistant Professor, Department of Child Health
Nursing, Manipal College of Nursing, Manipal, Manipal University, Karnataka, India. Pin
Code: 576104. Email: binumarg@gmail.com
ABSTRACT
A descriptive study was conducted to assess the knowledge on nutritional deficiency
disorders among 200 mothers in selected villages under Rural Maternity and Child Welfare
(RMCW) centres of KMC, Manipal.
Demographic proforma and structured knowledge
questionnaire were used to collect the data. Simple random sampling was used for the
selection of setting and purposive sampling was used for the selection of samples. The
findings of the study showed that, majority of the mothers 130 (65%) had average
knowledge, 60 (30%) possessed poor knowledge and remaining 10 (5%) had good
knowledge on nutritional deficiency disorders. The study also found that the knowledge of
mothers on selected nutritional deficiency disorders in children was associated with the
demographic variables like education, occupation and monthly income. Hence the findings of
the present study indicate the need for appropriate interventions to empower the mothers on
nutritional deficiency disorders in children.
Keywords: Knowledge, nutritional deficiency disorders, mothers, Iron deficiency anemia,
protein energy malnutrition, vitamin A deficiency disorder, iodine deficiency disorder.
BACKGROUND OF THE STUDY
India is considered to be one among the countries with largest child population in the
world. Under nutrition in young children is widely distributed and fairly concentrated in the
developing regions of the world. Over 150 million children suffer from under nutrition
globally1. The level of child under nutrition remains unacceptable throughout the world, with
90 per cent of the developing world’s chronically undernourished children living in Asia and
Africa2. The current UNICEF data shows that one in three malnourished children worldwide
are found in India, whilst 42 percent of the nation's children under five years of age are
underweight3. In the survey conducted by the Udupi Taluk Child Development Project from
January to April in the year 2012; it has been identified that 583 children aged below six
years were suffering from severe acute malnutrition in Udupi district. Out of the 213 children
suffering from severe acute malnutrition, 74 children belonged to Kundapur taluk, 69 to
Karkala taluk and 70 to Udupi taluk.4 Hence, it can be said that childhood under nutrition is a
prevalent public health issue throughout the developing world especially in India. Reviews
also suggest that there are ample causes that contribute to child’s malnutrition which include
poor composition of the diet, inappropriate caregiver-feeding behaviours and improper
maternal knowledge on child nutrition as the major factors.5 In view of the above facts, the
investigator observed that malnutrition is one of the ‘silent emergencies’ seen in children of
age 0-5 yrs. So the parents of the children, especially mothers being primary care givers
should possess adequate knowledge on child nutrition to reduce the incidence and prevalence
rate of malnutrition. In this context, it becomes a great need to conduct a research study
among mothers to assess the knowledge on nutritional deficiency disorders and to find the
factors associated with the knowledge level of mothers. This will inturn contribute to
empower mothers on the nutrition of the child and enhance the health and well being of their
children.
The objectives of the study were to: assess the knowledge of mothers on selected nutritional
deficiency disorders in children using a structured knowledge questionnaire and to find the
association between knowledge on selected nutritional deficiency disorders with selected
variables such as age, education, occupation, monthly income, type of family and source of
information
MATERIALS AND METHODS:
A descriptive survey was conducted among mothers having atleast one child in the age group
of 1-12 yrs residing in the Padu alevoor, Rampura and Moodu alevoor villages under Alevoor
RMCW centre of KMC, Manipal. A total of 200 mothers who fulfilled the sampling criteria
were taken as sample using purposive sampling. The setting was selected using simple
random sampling from among the list of six RMCW centres of KMC Manipal. The study was
undertaken after the approval from the Institutional Ethical Committee of Kasturba hospital
and obtaining consent from the study participants.
Data collection tools:
The data was collected using the tools: demographic proforma and structured knowledge
questionnaire on selected nutritional deficiency disorders in children. The demographic
proforma consists of 15 items which includes the variables like the age, education,
occupation, type of family, monthly income, age of children, type of school in which
children seek education, source of information of nutritional deficiency disorders etc. The
Structured knowledge questionnaire on nutritional deficiency disorders in children included
the content areas like meaning, etiological factors, clinical features, diagnostic measures,
medical and dietary management of protein energy malnutrition, vitamin A deficiency
disorders, Iron deficiency anemia, and iodine deficiency disorders. The tool had a total of 30
multiple choice questions with three distractors and one correct answer. Each correct answer
had a score of one and the maximum possible score was 30. The scores were arbitrarily
categorized as Good knowledge (21- 30), Average knowledge (11-20) and Poor knowledge
(0-10). The tools was validated, pretested and the reliability coefficient was found to be
r=0.831. All the tools were translated into the local language, Kannada and retranslated to
English to obtain the language validity.
Data collection procedure:
The data was collected by house to house survey. The researcher met the subjects at their
homes for collecting the data. After explaining the purpose of the study, ensuring the
confidentiality and obtaining the consent, the tools were administered to the subjects. The
mothers filled both the questionnaires on demographic proforma and structured knowledge
questionnaire on nutritional deficiency disorders. Since the knowledge of the mothers
regarding nutritional deficiency disorders in children was comparatively less and also to
make sure that the study subjects have been provided with some information, an information
booklet developed and validated by the researcher regarding the nutritional deficiency
disorders in children and the major nutritional programmes were distributed to all the mothers
who participated in the research study.
RESULTS:
The data was analysed based on the objectives of the study using descriptive and inferential
statistics. The findings of the present study are organised under the following headings:
Section 1: Description of Sample characteristics:
For describing the sample characteristics, frequency and percentage was computed and is
presented in table 1:
Table 1: Frequency and percentage distribution of sample characteristics
Frequency ( f)
n=200
Percentage (%)
18
149
33
9
74.5
16.5
3
57
89
41
4
6
1.5
28.5
44.5
20.5
2
3
170
20
6
4
85
10
3
2
99
64
32
5
49.5
32
16
2.5
Type of family
Extended
Joint
Nuclear
17
109
74
8.5
54.5
37
Type of school in
which children seek education
Government
Private
110
90
55
45
Source of information on
nutritional deficiency disorders
TV and Radio
Newspapers and magazines
Healthcare professionals
Relatives and friends
73
51
64
12
36.5
25.5
32
6
Sl.No
Sample characteristics
1.
Age
21-30
31-40
41-50
2.
3.
4.
5
6
7
Education
1st-5th std
6th- 9th std
SSLC
PUC
Diploma
Graduate
Occupation
House wife
Beedi worker
Govt employee
Staff nurse
Monthly income in Rupees
Upto 10000
10001-20000
20001-30000
30001-40000
The data presented in table 1 showed that majority 149 (74.5%) of mothers belonged to the
age group of 31-40 yrs and 170 (85%) were housewives. Most of them 109 (54.5%) belonged
to joint family and their major source of information was 73 (36.5%) media and 64 (32%)
health care professionals respectively.
Section B. Knowledge of mothers on nutritional deficiency disorders in children:
A. Description of knowledge scores of mothers on nutritional deficiency disorders in
children
The data among 200 mothers revealed that, only 10 (5%) had good knowledge, 60 (30%) had
poor knowledge and the remaining 130 (65% ) possessed average knowledge on nutritional
deficiency disorders in children. The mean and standard deviation of knowledge scores of the
mothers was 12.2 ± 4.120.
B. Description of area wise mean, standard deviation and mean percentage scores of
knowledge level
The data regarding area wise distribution of mean and standard deviation of
knowledge scores obtained by the mothers in the areas of protein energy malnutrition, iron
deficiency anemia, vitamin A deficiency disorders and iodine deficiency disorders is depicted
in table 2.
Table 2: Area wise distribution of mean and standard deviation of the knowledge scores
Sl No:
1
Areas of knowledge
Protein energy
Total
number of
items
13
Maximum
possible
scores
13
Mean
Standard
deviation
4.99
2.178
5
5
2.295
1.625
6
6
2.45
1.779
6
6
2.48
1.813
malnutrition
2
Vitamin A deficiency
disorders
3
Iron deficiency anemia
4
Iodine deficiency
disorders
The data presented in table 2 shows that the mean and standard deviation in the area of
protein energy malnutrition is 4.99 ± 2.178, vitamin A deficiency disorders is 2.295 ± 1.625,
iron deficiency anemia is 2.45 ± 1.779 and iodine deficiency disorders is 2.48 ± 1.813.
The mean percentage score of each area was computed from the obtained mean scores of
each area. Mean % score= Obtained mean score/ Maximum possible score ×100. The area
wise mean percentage score of knowledge level was maximum (45.90%) in the area related
to vitamin A deficiency disorders and minimum (38.39%) in the area related to protein
energy malnutrition. The mean percentage score in the area of Iron deficiency anemia was
40.83% and Iodine deficiency anemia was 41.33% respectively.
Section 3: Association between knowledge and selected variables:
There was a significant association between knowledge and selected demographic variables
like education (fisher’s exact value=58.414, p<0.01), occupation (fisher’s exact
value=65.705, p<0.01) and monthly income (fisher’s exact value= 25.589, p<0.01). Hence,
the knowledge on nutritional deficiency disorders is dependent on education, occupation and
monthly income of the mother.
DISCUSSION
The present study findings is supported by a descriptive study conducted by Sakir et al6 in
2008 to assess the knowledge of 105 mothers of under-five children towards Marasmus in
selected areas of Karachi, Pakistan in the year 2008. The results showed that majority of
mothers had inadequate knowledge about Marasmus (85%).
The present study also revealed that mean percentage score was maximum (45.90%) in the
area of vitamin A deficiency disorders and minimum (38.39%) in the area of protein energy
malnutrition. This study result is supported by another cross sectional study conducted by
Thomas et al7 in 2007 to assess the level of knowledge about Protein Energy Malnutrition
and other nutritional deficiency disorders among mothers of under five children. The results
indicated that 63.4% of mothers were not aware of protein energy malnutrition when
compared to Vitamin A deficiency (23.4%) and Anemia (7.2%).
The present study revealed that there was a significant association between knowledge of
mothers on selected nutritional deficiency disorders in children with selected demographic
variables like education, occupation and monthly income. The present study findings is
supported by a study conducted by Appoh and Kerkling8 in the year 2005, to find out the
importance of maternal nutritional knowledge on child nutritional status. These results imply
that mother's knowledge on child nutrition is an inevitable factor that determines the child’s
nutritional outcome and it contributes a lot to the proper growth and development of the
child.
CONCLUSION
The present study concludes that mothers had an average knowledge on nutritional deficiency
disorders in children and there is a need to empower the mothers on nutritional deficiency
disorders. Education programmes with effective teaching strategies will motivate the general
public to learn and improve the knowledge on child’s nutrition which in turn helps in
promoting the health of the family as well as the community.
REFERENCES
1. Child Welfare. Department of women and child development, [Online], Available:
http://wcd.in/cwnew.htm
2. Kail,R,E. (2006) Children and their development: Prentice Hall, [Online], Available:
http://en.wikipedia.org/wiki/Child-development
3. Child
nutritional
status
according
to
UNICEF,
[Online],
Available:
www.unicef.org/mozambique/child-survival-4895.html
4. Child Malnutrition Indicators, [Online], Available: http://en.ncbi.nic.in
5. Child care, [Online], Available: http;//en.wikipedia.org/wiki/Child nutrition-NNMBS2005-2006
6. Sakir, M., Hijaz, M., Mohammed, A., Hussain, W.(2010) ‘Assessment of maternal
knowledge
and
attitude
towards
Marasmus
in
Pakistan’,
International
Multidisciplinary Research Journal, Vol 92(5), pp.290-295.
7. Thomas, S., Vijaykumar, C., Rajeev, V., Ganesh, Y.( 2007) ‘Assessment of
knowledge of mothers on child nutritional status in urban slums in India’, Journal of
Pediatric Nursing, Vol. 33(5), Sept, pp. 421-426.
8. Appoy, L.Y., Kerkling, S,. (2008) ‘Impact of maternal nutritional knowledge on
child nutritional status in Volta region of Ghana’, Journal of American Academy of
Pediatrics,; Vol.121(1), Mar, pp. 100-105.