If this definition is applied to
India's most populous city - Mumbai, at least half of the Mumbai population
of estimated 12.5 million people lives in slums
. Although newborn survival
rates in slums have increased in recent years, the nutritional status and the
impact of malnutrition on these slum children is of great concern.
Malnutrition among children in
Mumbai slums is a complex problem of poverty
, which cannot be addressed by
focusing on food security alone; trans-generational, environmental, and dietary
factors probably all play a part. The National Family Health Survey (NFHS-3:
2005-6) estimated that 47 percent of children from Mumbai slum areas were
stunted, 16 percent wasted, and 36 percent had low weight for age.
Studies on timing of growth
faltering suggested that early growth faltering was more pronounced and that
the window of opportunity within which the interventions may be effective
included pregnancy and the first 24 months.
So, Sushmita Das and her
colleagues, from the Society for Nutrition, Education and Health Action (SNEHA)
that works to improve the health of women and children in slums of Mumbai,
India, and Glyn Alcock and David Osrin from the Institute for Global Health,
UCL Institute of Child Health, UK
, took up an anthropometric study to
determine the proportions of underweight, stunting, and wasting in young
children, and to examine their relationships with age.
The investigators used two linked
datasets: one based on birth weight records for 17318 infants and one based on
follow-up of 1941 children less than five years of age (functionally children
up to the age of three years).
The findings, published in the Nutrition
, were as follows -
Mean birth weight was 2736g
with 2776 g for males and 2691 g for females on an average. Low birth weight
(less than 2500 g) proportion was 22 percent
21 percent of infants had been
born with low weight for age [z] scores associated with poverty, younger
maternal age, less education, lower parity, multiple pregnancy, and preterm
delivery. [Z score is an anthropometric
value to assess the child's growth and general nutritional status by using
standardized age- and sex-specific growth reference to calculate height-for-age
Z-scores (HAZ), weight-for-age Z-scores (WAZ) etc.
Positive associations were found
- rest, food intake, and consumption of iron supplements during pregnancy, and
with uptake of antenatal care.
At follow-up, 35 percent of
young children had low weight for age, 17 percent low weight for height, and 47
percent low height for age
Downward change in weight for age
was greater in children who had been born with higher z scores.
From the above findings, the investigators
concluded that - 'Much of growth faltering was explained by faltering in
height for age, rather than by wasting. Stunting appeared to be established
early and the subsequent decline in height for age was limited'
They recommended further research
to be done on potential intervention in the first 1000 days with special focus
on nutrition and education for young girls.
Das S, Bapat U, Shah More N, Alcock G, Fernandez A, Osrin D. Nutritional status
of young children in Mumbai slums: a follow-up anthropometric study. Nutr J.