Comparative study of nutritional status among under five age school going children who consume mid-day snacks either from home or from school’s cafeteria in Kathmandu, Nepal

Abstract

Background: Malnutrition is one of the serious global health problems especially in low and middle income country. In most of the developing countries malnutrition occurs prominently among under-five children in the form of under-nutrition. Based on Nepal demographic health survey 2016, there is a tremendous decline in the trend of nutritional status of children under five. However, school health among these groups of children has not been focused. There has been a research related to assessment of nutritional status of children under five years of old and also in school aged children (5-11 years old) but not from 2-5 years old who attend Montessori school. Therefore this study is conducted to contribute in better nutritional status of children by generating evidence of nutritional status comparing home cooked food versus food prepared in cafeteria. Methods: A cross-sectional survey was conducted at Kathmandu valley in Nepal among the under 5 age school going children from June to April 2019. Through systematic random sampling Montessori school was selected. From the provided list of students randomly 320 students who either eat mid-day snacks made at home or in school’s cafeteria were selected. Face to face interviews were conducted among 320 parents of the children. A semi-structured questionnaire and anthropometric measurements were used to collect information of children. In the study, World Health Organization Body Mass Index cut-off points have been used to classify underweight (<18.5 kg/m2

), normal weight (18.5–24.9 kg/m2

) and overweight

(>=25.0 kg/m2

). Factors associated with underweight were examined using a Chi-square test, Odd ratio (ORs) with 95% Confidence Interval (CI) and significance level P<0.005 followed by multivariate regression. Results: Out of 320 under five age schooling children, 43.80% (n=140) were underweight, 56.80% (n=180) had a normal BMI. Out of underweight children 49.3% (n=69) consumed lunchbox packed from home and remaining 50.7% (n=71) ate from school’s cafeteria. The study shows no statistical difference in the nutritional status of under five age school going children who consume mid-day snacks either from home or from school’s cafeteria in Kathmandu, Nepal. However, the study has illustrated that mother’s education background and their working status has significant adverse effect on the children’s nutritional status. Children whose mother had reported being employed their children were more likely to be underweight [Adjusted Odd Ratio (AOR) = 7.284, 95% confidence interval (C.I.) = 3.468-15.301]. Similarly, there is a higher probability of a children to be underweight whose mother were illiterate [AOR = 10.931, 95% confidence interval 3.638-32.850] than the children whose mother has higher level of education. On the basis of food consumption analysis the study shows that school provides diverse dietary food to improve the nutritional condition of children. Conclusion: Addressing the nutritional status of under five age schooling children this study reflects still under five age children are in vulnerable situation of being affected by underweight. Despite tremendous reduction in the rates ( from 47% in 1996 to 30% in 2016) among under five age children, the findings of the study ( underweight children 44.4%) states still children are in the risk of being underweight and thus need special focus and intervention to tackle with malnutrition problems.