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Letters to the Editor Indian Pediatrics 1999;36: 1180-1181 |
Child and Maternal Health in Rural Areas of Chandigarh |
| I was interested to read the recent article on this subject(1). The authors are satisfied with the achievement of some of the targets under Health for All by 2000 and state that knowledge of women regarding various components of mother and child health needs to be strength-ened, without mentioning any specific aspect. In a situation where the health services are adequate and well distributed, and there is 100% access of safe water, prevalence of malnutrition in almost half the under five child-ren is a cause of concern and deserved special mention. It would seem that neither the health personnel, nor the community is aware or particularly concerned about it. While assessing the knowledge of the women in the family, no question has been asked regarding the duration of exclusive breastfeeding, initiation and fre-quency and amount of complementary feeding and the mother's perception of how much the child needs to eat or whether they felt concerned about the child's nutritional status. It is regrettable that malnutrition is not regarded as a major health problem and it is just included in the general category of knowledge of mother and child health. Shanti Ghosh, Reference 1. Swami HM, Bhatia V, Bhatia SPS. Child and Maternal Health in Rural Areas of Chandigarh. Indian Pediatr 1999; 36: 727-728. Reply Dr. Shanti Ghosh has raised a very important issue regarding the high prevalene of malnutrition in rural areas of Chandigarh despite achieving some of the national targets set by the year 2000 AD under `Health for All' including availability of safe drinking water to 100% of the villagers. We too were dis-illusioned to record such a high prevalence of malnutrition. On probing, we came to know that a large section of population in villages is migratory in nature and mostly belonged to states of Uttar Pradesh and Bihar. This population is generally not registered with the Anganwadi under the ICDS programme in order to get benefit of supplementary nutrition. The socio-economic strata is generally low. According to the census of 1991, a female literacy rate of only 37.0% was recorded. All these factors could be responsible for the malnutrition in the rural areas. Subsequently we conducted a detailed study on the breastfeeding practices, weaning beha-vior and assessed the level of awareness of mothers on infant feeding in the community. Delayed initiation of breast-feeding (only 16% within 3 hours of birth), introduction of bottle feeding to 45.5% of the infants and a large number of mothers being unaware of right age of weaning were some of the observations in the study (unpublished data). All these factors must be of significance in causation of malnutrition. Until the community especially mothers are aware of hygienic methods of storage of water and maintaining healthy practices, even the availability of safe and chlorinated water available to all households population will not ensure protection against diarrhea which is one of the important factor associated in causation of malnutrition. H.M. Swami, |
