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ICDS package of services includes : supplementary nutrition, immunization, health check

up, referral services, nutrition and health education and non formal preschool education.2

Despite vast infrastructure in ICDS programme, the nutritional status of women and

children remain almost the same as that of previous years.

Reasons for lack of improvement include,

Poor education on nutrition to improve feeding practices at home.

Inadequate training of Anganwadi workers.

Poor supervision.3

In view of the above, the present intervention is undertaken to evaluate the effect of nutrition

education and supplementary nutrition on the nutritional status of preschool children in ICDS

centres.

6.2 REVIEW OF LITERATURE:

6.2.1 Gopal Chandra Mandal, Kaushik Bose, Samiran Bisai, Sanjib Ganguli in their study on

undernutrition among ICDS scheme children aged 2-6 years of Arambag,

Hoogly District, West Bengal, India: from November 2005-2006 showed that the rate

of underweight was 63.3%.4

6.2.2 B.N Tandon, U. Kapil in their study- ICDS scheme: A program for development of

mother and child showed that severe undernutrition among preschool children in ICDS

area has declined from 19.1% - 6.3% in 8 years and moderate undernutrition

from 27.0% - 19.7%.2

6.2.3 B. Banerjee, O.N Mandal in their study: An intervention study in malnutrition amonginfants in tribal community of West Bengal, showed that post intervention follow up

after nutritional education of mothers showed an average increase in 80.81 grams of

weight of their severely malnourished infants, over the expected weight gain.5

6.2.4 Bobby Joseph, Aaron Rebello, Poonam Kullu, Vimal D. Raj in their study: Prevalence

of malnutrition in rural Karnataka, South India showed the prevalence of wasting,

stunting, stunting and wasting was 31.2%, 9.4% and 29.2% respectively. 6

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6.3 OBJECTIVES OF THE STUDY:

1) To assess the nutritional status of preschool children among ICDS scheme.

2) To evaluate the effect of nutrition education on mothers of children with PEM and the

effect of supplementary nutrition on nutritional status of children under ICDS.

7 MATERIALS AND METHODS:

7.1 Source of data:

7.1.1 Type of study: Interventional study.

7.1.2 Study period: one year (January December 2010).

7.1.3 Study area: Selected anganwadis in field practice area of VIMS and RC.

7.1.4 Study population: Children aged between 2-6 years from selected anganwadis attached

to field practice area of VIMS and RC.

7.2 METHOD OF COLLECTION OF DATA: (including sampling

procedure if any).

SAMPLE SIZE:

It was observed from earlier study by Gopal Chandra Mandal, Kaushik Bose, Samiran

Bisai, Sanjib Ganguli the prevalence of underweight for preschool children was 63.3%.4

Assuming for present study the prevalence rate 63% at 95% confidence level and 10%

of allowable error, the sample size required will be 226.

N = Z2 Pq/d2 Z = 1.96

P = 63%q = 100-63 = 37

d = 10% of 63 = 6.3

N = (1.96)2 x63x37/(6.3)2

= 226

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STATISTICAL ANALYSIS:

The values will be statistically analysed by the following tests-

1) Mean.

2) Standard deviation.

3) Paired t test.

4) Multivariate analysis.

INCLUSION CRITERIA:

Children aged between 2 6 years in selected Anganwadis in field practice area of

VIMS and RC.

EXCLUSION CRITERIA:

Children who are not attending Anganwadis regularly.

Data collection methodology:

The study will be carried out in Sarjapura Primary Health Centre area which is the field

practice area of VIMS and RC.

The anganwadis in these villages will be selected by stratified random sampling and

from each anganwadi all children aged between 2 6 years will be selected.

Nutritional status of the children will be assessed by anthropometric measurements using

standard methodology as recommended by WHO.

The prevalence of malnutrition among these children will be determined by comparing

the anthropometric measurements with NCHS standards.

The expected weight of the child will be calculated using Fields formula,

2x+8 = Expected weight in kg (reference weight)

x = Age in years.

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The grades of malnutrition will be determined using IAP classification.

The malnourished children from the study group will be selected and mothers of these children

will be interviewed by house to house visit. In absence of the mother, any other responsible

adult member of the family who is involved in taking care of the children will be interviewed

and proper advice on the diet will be given according to the requirement of these children and

also based on the use of low cost, easily available food items.

The anganwadi workers will also be interviewed and trained regarding proper

nutritional supplementation and to give nutrition education to the mothers of anganwadi

children.

Supervision of all selected anganwadis for regular food deliveries and supplementary

feeding practices by anganwadi workers will also be done.

Nutritional status of malnourished children will be reassessed every 3 months for

a period of one year after the intervention to evaluate the effect of nutrition education and

supplementary nutrition on the nutritional status of these children.

7.3 Does the Study require any investigation or intervention to be

conductedon patients or other human subject or animals? If so,

please describe briefly.

Yes.

Non invasive intervention.

Nutrition education to mothers of malnourished children aged between 2 - 6 years

under ICDS scheme.

Training to anganwadi workers regarding proper nutritional supplementation.

Supervision on all selected anganwadis for regular food deliveries and supplementary

feeding practices by anganwadi workers.

Non invasive investigation.

Measurement of weight.

7.4 Has Ethical Clearance been obtained from your Institution?

Yes.

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8. LIST OF REFERENCES:

1) Parthasarathy A, Nair MKC, Menon PSN. IAP text book of paediatrics. 3rd ed. New

Delhi: Jaypee brothers Medical publishers Ltd; 2006. P.120-1.

2) Tandon BN, Kapil U. ICDS scheme: a program for development of mother and

child health. Indian Pediatr 1991 Dec; 28:1425-8.

3) Kishore J. National Health Programmes of India. 7 th ed. New Delhi: Century

publications; 2007. p.351.

4) Mandal GC, Bose K, Bisai S, Ganguli S. Undernutrition among ICDS scheme

children aged 2 6 years of Arambag, Hoogly District, West Bengal, India. IJPH

2008; 5(1):28-33.

5) Banerjee B, Mandal ON. An intervention study in malnutrition among infants in

tribal community of west Bengal. Indian J Com Med 2005 Jan-Mar; 30(1):27-9.

6) Joseph B, Rebello A, Kullu P, Raj VD. Prevalence of malnutrition in rural

Karnataka, south India. J Health Popu Nutr 2002 Sep; 20(3):239-44.

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9 Signature of the Candidate

10 Remarks of the Guide I am willing to guide Dr. Mohammed Imran in his

dissertation entitled Impact of nutrition educationand supplementary nutrition under ICDS scheme

on nutritional status of preschool children in

Rural field practice area.

11 Name and Designation of

(in block letters)

11.1 Guide

11.2 Signature

11.3 Co-Guide (if any)

11.4 Signature

11.5 Head of Department

11.6 Signature

Dr. MANGALA SUBRAMANIAN MDPROFESSOR,

DEPARTMENT OF COMMUNITY MEDICINE

VYDEHI INSTITUTE OF MEDICAL SCIENCESAND RESEARCH CENTRE.

BANGALORE-560066.

Dr. G SUBRAHMANYAM MD DPHPROFESSOR AND HEAD,

DEPARTMENT OF COMMUNITY MEDICINE

VYDEHI INSTITUTE OF MEDICAL SCIENCESAND RESEARCH CENTRE.

BANGALORE-560066.

12 12.1 Remarks of the Chairman

And Principal.

12.2 Signature