"Seeing an Unseen": Nutritional status and Its determinants in Under-five children in Karachi,Pakistan.

Abstract

Optimal nutrition is an important determinant of child health, growth and development especially in the first five years of life. Under-nutrition continues to be a hidden but widespread problem for developing countries which is now one of the main public health concern. Pakistan has gone through devolution of its services related public sectors including health sector in its constitution. Sindh (Karachi is capital of Sindh province) is less well positioned than other provinces. There are very few local studies that carried out the prevalence of under nutrition in terms of three categories stunting, wasting and underweight.The main objective of the study was to determine the nutritional status and its determinants. Weight and height of children were recorded along with their mothers. Questionnaire was a research tool. Univariate, Bivariate (chi-square and fisher exact test) and multivariate (logistic regression) were used to analyze data. Almost 4% children were undernourished in which 5% were underweight, 3.5% were wasted and 12.8% were stunted children.Children who born with the weight of < 2500 gm [OR 7.64 (CI .932-62.64)] were 7.6 times more likely to be underweight. Those children who had runny nose [OR3.35 (CI 1.31-8.54)] and cough [OR 3.34 (CI 1.26-8.88)] in past 2 weeks were 3.35 and 3.34 times more expected to be underweight. Those children were 4.8 times more predictable to get wasted who were > 3rd born [OR 4.82 (CI 1.12-20.74)]. Insufficient number and smaller amount of meals increase the chance of wasting to 2.85 times [OR 2.85(CI 1.93-4.20)]. History of acute disease may modify the health status and children are the most vulnerable and most affected group because of the high requirement for growth and development. Birth interval, birth-order are potentially modifiable; so, these can be used for designing intervention programs.