Assessment of the Composite Index of Anthropometric Failure (CIAF) among the Rural Preschool Children of Medinipur, West Bengal

Abstract

According to the WHO Global Report (2020), 45 percent of deaths among preschool children are linked to undernutrition. In the Indian context, the National Family Health Survey (NFHS), 2022 reports that 19 percent, 36 percent, and 32 percent of children are wasted, stunted, and underweight, respectively. This report was published 47 years after the establishment of the Integrated Child Development Service (ICDS). Therefore, it can be concluded that the objectives of the ICDS have not been satisfactorily fulfilled. Aims & Objective: The present study was designed to assess overall undernutrition among rural preschool children in Medinipur, West Bengal, India, using the Composite Index of Anthropometric Failure (CIAF). Materials & Methods: In this cross-sectional study, 303 preschool children were examined, comprising 146 boys and 157 girls, aged 2-5 years, residing in the rural villages of Medinipur Sadar block. Two anthropometric variables, height (cm) and weight (kg), were collected through standard anthropometric procedures. Undernutrition indicators, including height-for-age, weight-for-age, and height-for-weight Z-scores, were calculated using WHO's 2006 cutoff values. If any value was found to be < -2 standard deviations (SD), it was considered undernutrition, and the condition was termed wasting, stunting, or underweight, respectively. Subsequently, all these failures were evaluated using CIAF (Svedberg and Nandy, 2005). Results: The overall prevalence of wasting, stunting, underweight, and CIAF are 20.5 percent, 65.0 percent, 57.1 percent, and 76.9 percent, respectively. Girls exhibit a higher prevalence of stunting, underweight, and CIAF compared to boys, and these differences are statistically significant (p < 0.05 and p < 0.001). There is a significant difference in height-for-age (HAZ) by sex. Out of the 303 respondents, 233 (76.9 percent) fall under the CIAF category, with 54.0 percent of girls classified as malnourished (B-Y). Conclusion: This study reveals that 3-year-old girls are the most vulnerable to all anthropometric failures, while boys across all age groups are less prone to failures compared to girls. The total anthropometric failure rate remains at 76.9 percent, representing a very serious condition. Urgent intervention is needed to evaluate the health infrastructure provided by various health services, such as ICDS, and to conduct awareness programs that educate parents about caring for their child's healthy future.