Morbidity among Under Five Children in a Rural Area of Jammu

Children under five years of age constitute approximately 15% of the country's total population and are the most vulnerable section of the society and suffer from highest morbidity. First few years of life is the most crucial period of life as this age is known for accelerated growth and development, warranting regular monitoring. During this period about 40% of physical growth and 80% of mental development occurs (1).Any adverse influences during this period may result in severe limitations in their development. This age group is most affected by various common and easily treatable illnesses. Three in four episodes of childhood illness are caused by one of these conditionsacute respiratory infections (mostly pneumonia), diarrhea, measles, malaria, malnutrition or a combination of these conditions (2). A number of child survival strategies implemented by GOI has resulted in impressive improvement in morbidity and mortality indicators but the results have not been consistent. The pace of improvement is expected to accelerate further upon full implementation of activities under NRHM (National Rural Health Mission).The present community based study thus is an attempt to readdress morbidity among under five children through monthly home visits and its association with various socioenvironmental factors. Material and Methods The study was conducted in village Domana (Rural field practice area of Post Graduate Department of Community Medicine, Govt. Medical College, Jammu) for one year. The target population consisted of children catered by three anganwadi centers located in the field practice area. These anganwadi centers were selected randomly by employing simple random sampling technique. A house to house survey was conducted and a total of 206 under five children were enrolled for the study in the first month of study period i.e. Nov.2006. Children who had completed five years on 31st oct.2006 or born after enrolment were excluded from study. At first visit, mothers of enrolled children were interviewed and information regarding family composition, their age, sex, literacy, occupation, marital status etc. was collected. Housing conditions such as overcrowding, ventilation, sanitation, kitchen, water supply, excreta disposal etc was also assessed by the investigator. Socio-economic status of the family was assessed by using "Modified Uday Pareek Scale". Exact age of the child was established from birth certificate/ delivery discharge slip, immunization card or recall method (to the nearest month using calendar of local events). Every child was weighed and graded using weight for age criteria adopted by Nutrition sub-committee Abstract Children under five years of age constitute approximately 15% of the country's total population and are the most vulnerable section of the society and suffer from highest morbidity. A Prospective study was conducted to find out the magnitude of morbidity in under five children in rural area and its association with various socio-environmental factors. 206 under-fives (134 Males & 72 Females) were followed monthly for a period of one year. The annual incidence rate of morbidity (Acute spells of illness) was 4.6 episodes /child /year. The leading causes of morbidity in decreasing order of incidence were acute respiratory infections, diarrheal diseases, skin infections and fever. Episodes of illness were observed more during infancy, in females, malnourished and in children living in over-crowded and poorly ventilated houses. An inverse relationship of the morbidity and socio-economic status of the families was also observed. However, no association of morbidity was observed with parental literacy, location of Kitchen, type of excreta disposal and Infant feeding practices.