INTRODUCTION:

Hunger is the main obstacle for better learning in developing countries like India. Out of 119 countries India ranks 100^th with the prevalence of 21% wasting and 38.4% stunting on Global Hunger Index 2017. The status of Indian children can be explained as a standing humanitarian crisis and demands stronger commitment and greater investments. According to National Family Health Survey 2015-16 (NFHS-4) prevalence of underweight (weight for age) is 35.7%, stunted (height for age) is 38.4% and wasted (weight for height) is 21% among under five children which was 42.5%, 48% and 19.8% respectively in NFHS-3. Hunger leads to under nutrition and inadequate nutrition may lead to malnutrition, growth retardation, reduced work capacity and poor mental and social development.¹Children belonging to the low socio economic group have poor nutritional status² and the basic cause of under nutrition in women and children is inadequate access to resources due to poverty.³About 40% undernourished children in the world are from India and is due to dietary inadequacy in relation to their needs.^4,5Children of educated mother suffer less from malnutrition.⁶Formal education of mother’s directly transfers health knowledge to future mothers and ensures optimal nutritional status for the child.⁷To overcome class room hunger and to raise better education, Mid-Day Meal (MDM)was initiated in 1925 is the largest useful school lunch programme for underprivileged lower income group school children.⁸Although MDM programme dispenses a definitive influence on enrolment and attendance in school, question arises about the effectiveness of one time MDM in twenty four hours alone in nutritional status improvement.⁹The criteria of MillenniumDevelopment Goal 1 and 2 and 4 was to halve the ratio of children suffering from hunger all over the world to confirm all children are capable of completion of primary school education to reduce by two-third child mortality ratewithin 2015. However in present situation, improvement on reducing hunger and child mortality in India is likely to miss the goal.¹⁰Food Nutrition Bulletin 2010 depicts that malnutrition of school age children is up to 22% inIndia.¹¹for physical growth and mental development primary school age (5-10 years) is a progressive period. Hence low school enrolment, early drop outs, high absenteeism and poor educational performance are the results of malnutrition of primary school going children.¹²There is diversity in agro-climatic regions, socio- cultural practices, ethnic multiplicities, food habits and life styles not only in states but also in districts of Indiawhich needed various regional studies to identify the problems and solutions regarding nutritional status. Socio-economic status might influence the health conditions and mother’s education can play a pivotal role in the nutritional status of primary school going children. Therefore the present study aims to determine therelation between socio-economic factors and nutritional status of school children of Sankrail Block, Howrah district of West Bengal.

MATERIALS AND METHODS:

Present cross sectional study was conducted in five Government primary schools: New Andul H.C. Primary School, Kamrangu Prathomik Vidyalaya, Jhorehat Raj Rajeswari Prathomik Vidyalaya, Jhorehat G.S.F.P School, MashilaIslamia Prathomik Vidyalaya under rural area of Sankrail Block of Howrah District of West Bengal in month of August 2017. A total 151 students of both sexes (97 boys and 54 girls) were examined.

Data was collected by using pre-tested and pre-structured questionnaire to elicit information on family characteristics like age, sex, familytype, and number of family member, religion, and education of parents especially mother, monthly family income to understand the nutritional status of 6–11 years old children. A written consent from the school authorities was obtained for the purpose of present study. School records were used to confirm the age of children. To assess the height of each children stadiometer (accuracy of 0.1cm) was used. A portable balance (accuracy 0.1kilograms) was used to record the weight of subjects. Clinical signs like angular stomatitis, glositis, gum bleeding, pot belly, wrinkled or dry skin, hair color and texture, appearance of conjunctiva, presence of triangular patches, spoon nail, goiter, muscle wasting, limbs appears as skin to bone etc. were also recorded.

Nutritional status of the selected subject was compared with World Health Organization (WHO) 2007 classification, based on BMI for age (z score).With the help of Anthro Plus software developed by WHO 2007 malnutrition was calculated as Severe thinness (< -3SD), Thinness (≥ -3SD and < - 2SD), Normal (> -2SD and < 1SD), Over weight (> +1SD and ≤ +2SD) and Obesity (> +2SD) for BMI- for-age. The collected data were entered in MS Excel 2010 and analyzed for descriptive and inferential statistics. Chi square was done to test associations. P < 0.05 was considered significant.

RESULTS:

Table 1: General and Socio Economic Status of Primary school Children

Profile		Total (n =151)	Percentage (%)
Age (years)	6.1 – 7	04	2.64
	7.1 – 8	18	11.92
	8.1 – 9	30	19.86
	9.1 – 10	54	35.76
	10.1 – 11	45	29.8
Sex	Male	97	64.23
Sex	Female	54	35.76
Religious	Hindu	117	77.48
Religious	Muslim	34	22.51
Per capita monthly income (Rs.)	<811	12	7.94
	812 – 1569	57	37.74
	1570 - 2651	82	54.30
Educational Status (Mother)	Illiterate	42	27.81
	Up to Primary level	39	25.82
	Secondary level and above	70	46.35
Dietary Habits	Vegetarian	0	0
	Ova - Vegetarian	1	0.66
	Non - Vegetarian	150	99.33
No. of Family Members	≤4	103	68.21
No. of Family Members	5 and above	48	31.78

Table 1 shows the general socio-economic status of the sample respondents. In this present study 35.76% arein the age group of 9.1- 10 years followed by 29.8% of age 10.1- 11 years. 77.48% students belong to Hindu community and rest is the Muslim. All the respondents are non-vegetarian (151). According to B.G Prasad socio-economic classification, the sample participants are belonging to lower class (7.94%), lower middle class (37.74%) and middle class (54.35%). 68.21 % students belongs to small family type (≤ 4 family members). 46.35% parents (mother) had attained secondary and above education and 27.81 % mothers are illiterate.

Table 2: Nutritional status of school children as per BMI-for-age

BMI-for-age	Boys	Girls	Total
BMI-for-age	N (%)	N (%)	N (%)
Sever Thinness < - 3SD	13 (13.4)	9(16.66)	22 (14.56)
Thinness ≥- 3Sd and< - 2SD	12 (12.37)	11(20.3)	23 (15.23)
Normal >-2SD and< +1SD	54 (55.67)	33(61.11)	87 (57.61)
Overweight >+1SD and ≤ +2SD	4 (4.12)	1(1.85)	5 (3.31)
Obesity >+ 2SD	14(14.43)	0	14(9.27)
Total	97	54	151

Table 2 shows that 55.67 % boy and 61.11 % girls are in normal nutritional status. However, the prevalence of thinness and severe thinness is higher among the girls’ students than the boys. Obesity is found only in boys (14.43%). Only 3.31 % students are found as overweight.

Table: 3 Distribution of nutritional status according to BMI-for-age and their significance with family economic status

Nutritional Status	Economic Status			Chi Square and p value
Nutritional Status	Middle class	Lower middle class	Lower class	Chi Square and p value
Under Nutrition	22	21	2	Χ² = 2.8394 P =0.585
Normal	50	29	8
Over Nutrition	10	7	2

Table: 4 Distribution of nutritional status and their significance with mother’s educational status

Nutritional Status	Mother’s Education			Chi square and p value
	Secondary level and above	Primary level	Illiterate
Under Nutrition	18	10	17	Χ² = 8.817 P = 0.065
Normal	38	26	23
Over Nutrition	14	3	2

The prevalence of normal nutritional status was found to be apparently high among middle class students. Therefore chi square test of significance was applied to see if there was any statistically significant association, as depicted in Table: 3. the association between economic status and prevalence of nutritional status was not found to be statistically significant (Chi square = 2.839, p = 0.585). Similarly, the association between mother’s education and prevalence of malnutrition was not found to be statistically significant (Chi square = 8.817, p = 0.065) as shown in Table 4.

DISCUSSION:

In our study it is found that a large proportion of boys/girls belong to the normal nutritional status. Besides, the association between economic status and nutritional status is not significant. Also the association between mothers’ education and prevalence of malnutrition is not statistically significant. From the above results it may be said that the formal education of mothers is not sufficient for maintaining standard nutritional status among the children. It requires the awareness about nutrition and diet planning according to the requirement of the child, especially among the mothers. Investigations indicate that food items generally given under the mid- day meal scheme do not suffice for nutritional needs of the children, therefore highly nutritive or food fortified by essential nutrients like Iron, Calcium and Carbohydrates should be distributed in schools or should be made readily available at subsidized rates (13). Such information should also be disseminated to guardians. On the other hand the better economic status is also not a necessary factor influencing the better nutritional status among children. The social awareness relating to knowledge, attitude and practice of nutritional education is a necessary prerequisite for maintaining standard nutritional status among the vulnerable section of our community.

CONCLUSION:

It can be recommended that the government should follow-up the running nutritional programme and take necessary steps for informal nutritional education related awareness among parents, particularly mothers who are the primary caregivers to the children.This will help them to achieve positive attitude towards the importance of healthy and hygienic food habit, balanced diet and do practice for healthy and disease free country. Besides this, regular weight and height measurement at school should be taken so that school intervention programms should be developed and implemented which keep the children free from diseases and provide them a healthy environment.

ACKNOWLEDGEMENT:

The headmasters and headmistresses, teachers of schools are thankfully acknowledged for their help during data collection. Thanks are also due to the school children for their co-operation and active participation in the study.

REFERENCES:

1. Mehrotra M, Arora S and Nagar V. Nutritional health status of primary school children A study in Bareilly district. Indian Educational Review. 2011; 48(1): 18-29.

2. Awasthi N and Kumar AR. Nutritional status of hill primary school children. The Indian Journal of Nutrition and Dietetics. 1999; 36: 453-60.

3. UNICEF. The state of the world’s children 1998. New York: UNICEF, 1998.

4. MannaPK,De D, Bera TK, Chatterjee K, Ghosh D. Anthropometric assessment of physical growth and nutritional status among school children of North Bengal. Anthropologist. 2011;13(4): 299-305.

5. James LF. India- sector review of nutrition programmes. A background paper prepared for the World Bank, New Delhi. 1998.

6. Benta AA, James C and Elizabeth KM. Effects of mother’s education on nutritional status in the slums of Nairobi. 2012; 12: 80.

7. Glewwe P. Why does mother’s schooling raise child health in developing countries? Evidence from Morocco. J. Human Res. 1999; 34(1): 124- 159.

8. Mall R. Performance of mid-day meal (MDM) on nutritional status of school going children in Muzaffarpur town of Bihar. International Journal of Home Science. 2017; 3(3):79-82.

9. Mehta B, Grover K and Kaur R. Nutritional contribution of Mid-Day Meal to dietary intake of school children in Ludhiana District of Punjab. J Nutr Food Sci. 2013; 3: 1

10. MDG: 2010 Progress chart. mdgs.un.org

11. Best C, Neufingerl N, Van GL, Breil TVD, Osendarp S. The nutritional status of school going children: Why should we care? Food Nutr Bull.2010;31(3): 400-417.

12. Promoting health through schools. Report of a WHO expert committee on comprehensive school health education and promotion. Geneva, World Health Organization,1997 ( WHO Technical Report Series, No. 870)

Received on 13.06.2018 Modified on 17.07.2018

Res. J. Humanities and Social Sciences. 2018; 9(4): 889-892.

DOI: 10.5958/2321-5828.2018.00149.3