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Association Between Mothers Nutritional Knowledge in Childcare Practices and Nutrition Status of 6-59 Months Batar Community Children of Jhorahat Vdc, Morang

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Association Between Mothers Nutritional Knowledge in Childcare Practices and Nutrition Status of 6-59 Months Batar Community Children of Jhorahat Vdc, Morang ASSOCIATION BETWEEN MOTHERS NUTRITIONAL KNOWLEDGE IN CHILDCARE PRACTICES AND NUTRITION STATUS OF 6-59 MONTHS BATAR COMMUNITY CHILDREN OF JHORAHAT VDC, MORANG by Bhisma Rai Department of Nutrition and Dietetics Central Campus of Technology Institute of Science and Technology Tribhuvan University, Nepal 2017 Association between Mothers Nutritional Knowledge in Childcare Practices and Nutrition Status of 6-59 Months Batar Community Children of Jhorahat VDC, Morang A dissertation submitted to the Department of Nutrition and Dietetics, Central Campus of Technology, Tribhuvan University, in partial fulfillment of the requirements for the degree of B.Sc. Nutrition and Dietetics. by Bhisma Rai Department of Nutrition and Dietetics Central Campus of Technology, Dharan Institute of Science and Technology Tribhuvan University, Nepal March, 2017 Tribhuvan University Institute of Science and Technology Nutrition and Dietetics Department Central Campus of Technology, Dharan Approval Letter This dissertation entitled Association between Mothers Nutritional Knowledge in Childcare Practices and Nutrition Status of 6-59 Months Batar Community Children of Jhorahat, Morang presented by Bhisma Rai has been accepted as the partial fulfillment of the requirements for the Bachelor of Science in Nutrition and Dietetics. Dissertation committee 1. Head of the Department ……………………………………………. (Mr. Dambar B. Khadka, Teaching Assistant) 2. External Examiner ……………………………………………….. (Mr. Birendra Kumar Yadav, Assoc. Prof.) 3. Supervisor ……………………………………………….. (Mr. Basanta Kumar Rai, Assoc. Prof.) 4. Internal Examiner …………………………………………………. (Mr. Dambar B. Khadka, Teaching Assistant) 5. Co-Supervisor ………………………………………………. (Ms. Roma Ghimire, Teaching Assistant) March 18, 2017 iii Acknowledgements First and foremost, I offer my sincerest gratitude to my supervisor, Assoc. Prof. Mr. Basanta Kumar Rai, who has supported me throughout my dissertation with his patience and knowledge. His inspiration, guidance and keen observation throughout my research were really a great essence for the completion of my dissertation work. Also, I would like to thank Prof. Dr. Dhan Bahadur Karki, Campus Chief, Central Campus of Technology, for enormous support. I am also grateful to Mr. Dambar Bahadur Khadka, Department Head of Nutrition and Dietetics, for providing me necessary facilities whenever required and I am thankful to all the faculty members of Central Campus of Technology. I am thankful to chairperson of Jhorahat VDC and all the (Female Community Health Volunteers) FCHVs who helped me during my survey for dissertation work. I am also grateful to all the respondents and people of study area who cooperated with me during this study. I would also like to thank my seniors who directly or indirectly supported me to complete my thesis in particular I would like to thank Mr. Roshan Dangol and Mr. Sandeep Kumar Chaudhari for their valuable suggestions. My sincere thanks also go to my friend Ms. Sukrity Koirala and Mr. Sampurna Rai for their sincere efforts in data collection. I am thankful to my friends Anuska, Kusma and Prabina for their support in my thesis writing. I am also grateful to my friend Mr. Sujan Limbu who supported me throughout this course of study. Last but not the least, I would like to thank and dedicate this work to my dear parents for their support, unconditional love, blessings and sacrifices which gave me strength to keep going on. I also place on record my sense of gratitude to all whom directly or indirectly, have lent their hand in this venture. Date of submission: March 18, 2017 ______________ Bhisma Rai iv Abstract The aim of the present work was to find out the mothers‟ nutritional knowledge in childcare practices and nutritional status of 6- 59 months children of Batar community in the rural area of Morang district of Nepal, a community based cross sectional descriptive study was conducted. The data were collected from mothers of 144 children. Census sampling technique was used for data collection. A structured questionnaire was administered to the mothers. Anthropometric measurements and basic associated factors were collected. SPSS version 20 and WHO Anthro 3.2.2 version were used for data analysis. Chi-square technique was used to assess factors associated to nutritional status of children. Prevalence of underweight, stunting and wasting were 27.8%, 23.6% and 19.4%, respectively. Majority of mothers (63.2%) had average knowledge score, 28.5% had poor knowledge score and only 8.3% of mothers had good knowledge score. There was no significant difference in the prevalence among male and female children. Calorie intake by the children was significantly (P < 0.05) associated with stunting, wasting and underweight. Similarly, study indicated that having kitchen garden at home was significantly (P < 0.05) associated with stunting. Current breastfeeding status, reason of malnutrition and foods during diarrhea were significantly (P < 0.05) associated with wasting. The use of iron-folate tablets during pregnancy by mothers and nutritional knowledge score was significantly (P < 0.05) associated with underweight. v Contents Approval Letter .................................................................................................................. iii Acknowledgements ............................................................................................................. iv Abstract ................................................................................................................................ v Contents ............................................................................................................................... vi List of Tables ....................................................................................................................... ix List of Figures ...................................................................................................................... x List of Abbreviations .......................................................................................................... xi 1. Introduction ............................................................................................................ 1 - 5 1.1 Background of the study ....................................................................................... 1 1.2 Statement of problem and justification................................................................. 3 1.3 Objectives of the study ......................................................................................... 4 1.3.1 General objective ..................................................................................... 4 1.3.2 Specific objectives ................................................................................... 4 1.4 Research questions ............................................................................................... 4 1.5 Significance of the study ...................................................................................... 4 1.6 Limitations of the study ........................................................................................ 5 1.7 Assumption ........................................................................................................... 5 2. Literature review .................................................................................................. 6 - 24 2.1 Mother nutrition knowledge ................................................................................. 6 2.2 Education status of Nepalese mother .................................................................. 7 2.3 Exclusive breastfeeding (EBF) ............................................................................. 7 2.4 Weaning practice in Nepal ................................................................................... 8 2.5 Diarrhea in children .............................................................................................. 9 2.6 Malnutrition in children ...................................................................................... 10 2.7 Types of malnutrition ......................................................................................... 11 2.7.1 Protein energy malnutrition (PEM) ....................................................... 11 2.7.2 Micronutrient malnutrition ..................................................................... 12 2.8 Cause of malnutrition in under-five children ..................................................... 14 2.9 Nutritional status ................................................................................................ 15 2.9.1 Trends in children‟s nutritional status .................................................... 16 2.9.2 Factors affecting nutritional status ......................................................... 18 vi 2.10 Nutritional requirements ................................................................................... 19 2.11 Methods of assessing nutritional status ............................................................ 20 2.11.1 Direct method ....................................................................................... 20 2.12 Indirect methods ............................................................................................... 23 2.12..1 Vital health statistics ........................................................................... 23 2.12.2. Ecological variable .............................................................................. 23 2.12.3 Socio-economic
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