6.
Discussion
6. DISCUSSION
The present study was conducted to assess the effectiveness of selected nursing
interventions on mother’s awareness and nutritional status of under-five children. The data
was collected from 521 mothers of under-five children residing in selected villages under
Sarbhon PHC, Bardoli. The samples have been classified in three groups as mild, moderate and
severe category of malnutrition. The study has conducted in two phases. Phase I was conducted
by Survey Research design and phase II by pre-experimental design.
Identification of prevalence of Malnutrition
Total 489 under-five children were screened for the identification of malnutrition from
seven villages by Purposive Sampling Technique. Out of 489 under-fives, 432 (87%) children had
various level of malnutrition. 338 (69%) were mild, 76(15.5%) were moderate and 18(3.6%)
were severe malnourished children. 61 (12.4%) were found normal.
The above finding was supported by Marta Stelmasiak and Robert Słotwinski (2019).
They reported that, out of 163 children with malnutrition mild in 33 (19.6%), moderate in 69
(42.9%), severe in 61 (37.4%)] treated in the school Nutritional disorders in these children may
be due to starvation, malabsorption and digestion, impaired metabolism and associated
infections92.
Major findings of the study
Description of samples with their Socio-demographic variables
The results of the study depicted that, out of 489 samples, Majority 242 (49.5%) of the
subjects belonged to the age group of 25-27 years. Most 263 (53.8%) of the subjects
participated in the study had primary education. Many 382(78.1%) of the subjects were house
wives. All (100%) of the subjects participated in the study were belonged to Hindu community.
Highest 315 (64.4%) of the subjects were belonged to joint family. Majority 361 (73.8%) of the
subjects were consuming mixed diet. Highest 273 (55.8%) of the subjects participated in the
study were having monthly income below 5000 rupees. Most 341(69.7%) of the mothers age
at delivery was 18-21. Most 261(53.4%) of the mothers had two children. Majority 325(66.3%)
of the children were in the age group of 2-5 years. Most 271(54.8%) were male and 218 (45.2%)
were female children. Majority 310(63.4%) were second child. Most 233(47.6%) of the
participants were getting the health information by health professionals.
The above finding was supported by Sujata Murarkar and Jayashree Gothankar (2020).
They reported that, the prevalence and determinants of undernutrition in children under-fives
1
6. Discussion
are still more in India. Factors like sex of the child, birth order, exclusive breast feeding,
economic status of the family, type of family, acute diarrhoea and maternal education have
influence on nutritional status of the child. Improvement of maternal education will improve
the nutritional status of the child. Strategies are needed to improve the economic status of the
community93.
Discussion on pre-test and post-test score knowledge regarding prevention of Malnutrition
Majority of the subjects 14 (87.5 %) had poor knowledge, 2 (12.5 %) had average
knowledge, and nobody had Good and excellent knowledge scores among mothers of children
regarding Severe malnutrition before intervention. Majority of the subjects 10 (62.5 %) had
good knowledge, 6 (37.5 %) had Excellent knowledge scores among mothers of children
regarding Severe malnutrition after intervention. Majority of the subjects 62 (81.6 %) had poor
knowledge, 14(18.4 %) had average knowledge. Majority of the subjects 63(82.9 %) had good
knowledge,13(17.1%) had Excellent knowledge scores among mothers of children regarding
Moderate malnutrition after intervention. (N=76). Majority of the subjects 265 (78.4 %) had
poor knowledge, 72(21.3 %) had average knowledge, 1(0.3%) had good knowledge. Majority of
the subjects 292(86.4%) had good knowledge, 46 (13.6 %) had Excellent knowledge scores
among mothers of children regarding Mild malnutrition after intervention.
The above finding was supported by Baby.S.Nayak, B.Unnikrishnan and Ansuya, (2018)
to evaluate the level knowledge of malnutrition among mothers and their children in the Udupi
district of Karnataka, India, who are between the ages of three and six. They reported that,
some of the main drivers of underweight that were discovered in the study included parental
education, childhood sickness, short birth intervals, open defecation, type of weaning, and
complimentary food offered to children54.
Discussion on Correlation between post-test knowledge score of mothers and nutritional
status of children
There was a moderate positive correlation obtained between knowledge score of
mothers and nutritional status of children (r= 0.422). The correlation obtained was significant
(p<0.05). Improvement in knowledge was positively correlated to change in the nutritional
status of the children.
Regarding the nutritional status of the children after the administration of nursing
interventions, the level of malnutrition among under five children’s nutritional status improved.
338 mild in pre-test, 251 in post-test 1 and 203 in post-test 2. There were 76 moderate in pre-
2
6. Discussion
test, 63 in post-test 1 and 59 in post-test 2. 18 were there in pre-test, 16 in post-test-1 and 16
in post-test 2.
The above finding was supported by SDGs Ministries of Rural Development (2018)
reported that, one out of 3 children under the age of 5 suffers from chronic malnutrition. 6 out
of 10 children between 6 months to 5 years of age suffer from anaemia, the most prevalent
condition associated with chronic malnutrition. Diet habits, childcare, education, access to
healthcare, and water and sanitation require integrated responses. The government is
developing several strategies to change this situation. The SDG Fund is supporting 4
municipalities to provide integrated approaches to food security. It targets children 2 to 5 years
of age by increasing the livelihood opportunities of fruit producers in 4 municipalities. The
programme aims to achieve the following outcomes: Production systems based on fruits,
vegetables and small ruminants integrate native crops of high nutritional value, Food Nutrition
Education integrates and adds value to local food production and cultural traditions of food
nutrition and strengthening of multi-sectorial coordination95.
Discussion on Association of post-test knowledge score of mothers of children with mild,
moderate & severe malnutrition and socio-demographic variables.
There was association found in post-test knowledge score of mothers of children with
mild malnutrition and socio-demographic variables such as Age of mother, Education of
mother, Occupation, Income of family, Dietary pattern, Age of children, Number of children,
Birth order and source of health information.
There was association found in post-test knowledge score of mothers of children with
moderate malnutrition and socio-demographic variables such as Age of mother, Education of
mother, Income of family, Dietary pattern, Number of children, Birth order and source of health
information.
There was association found in post-test knowledge score of mothers of children with
Severe malnutrition and socio-demographic variables such as Education of mother, Income of
family and Number of children.
Discussion on Association of post-test nutritional status of children with mild, moderate &
severe malnutrition and socio-demographic variables.
There was association found in post-test nutritional status of children with mild
malnutrition and socio-demographic variables such as Age of mother, Education of mother,
Income of family, Dietary pattern, Age of children, Number of children and Birth order.
3
6. Discussion
There was association found in post-test nutritional status of children with moderate
malnutrition and socio-demographic variables such as Age of mother, Education of mother,
Income of family, Dietary pattern, Number of children and Birth order.
There was association found in post-test nutritional status of children with Severe
malnutrition and socio-demographic variables such as Education of mother and Income of
family.
Discussion on Comparison of knowledge score of mothers of children with mild, moderate
and severe level of malnutrition before and after intervention
There is an improvement in the knowledge of pre and post test score of mothers with
mild, moderate and severe malnourished children.
Discussion on Comparison of nutritional status before and after intervention among mothers
of children with mild, moderate & severe malnutrition
There is an improvement in the nutritional status of pre and post test score among mothers
with mild, moderate and severe malnourished children.
Discussion on Status of improvement of children after nursing interventions
Regarding the nutritional status of the children after the administration of nursing
interventions, the level of malnutrition among under five children’s nutritional status improved.
338 mild in pre-test, 251 in post-test 1 and 203 in post-test 2. There were 76 moderate in pre-
test, 63 in post-test 1 and 59 in post-test 2. 18 were there in pre-test, 16 in post-test-1 and 16
in post-test 2. The improvement in the nutritional status of mild and moderate level children
shows that, the mothers gained knowledge regarding the importance of nutrition in growth
and prevention of malnutrition among their under-five children through informational booklet
and structured teaching programme. There was slight improvement in the weight of the severe
level malnourished children but there is no change in the BMI status in 60 days of nutritional
supplementation.
The above finding was supported by Deepti Khanna, Menaka Yalawar, Pinupa Venkata
Saibaba et.al (2021) had conducted a study on Oral Nutritional Supplementation Improves
Growth in Children at Malnutrition Risk and with Picky Eating Behaviours. They reported that, the
problem of poor nutrition with impaired growth persists in young children worldwide, including
in India occurs in 20% of urban children (<5 years). Exacerbating this problem, some children are
described by their parent as a picky eater with behaviours such as eating limited food and
unwillingness to try new foods. Timely intervention can help prevent nutritional decline and
4
6. Discussion
promote growth recovery; oral nutritional supplements (ONS) and dietary counselling (DC) are
commonly used67.
This study was based on Imogene King's conceptual framework theory of goal
attainment theory is based on the personal and inter personal systems including interaction,
perception, communication, transaction, growth and development, time and action. The
researcher perceives the subject’s need for teaching the benefits of knowledge and on
prevention of malnutrition. The goal is said to be achieved when there is an improvement in
the knowledge of the mothers and nutritional status of under-five children.
The limitations of the study discussed that, there was no broad generalization could be
made and only mothers were included in the study.
