Nutritional Status of Male and Female Children in Rural Bangladesh: A Comparative Study on Tentultala Village of Khulna District

Nutritional Status of Male and Female Children in Rural Bangladesh: A Comparative Study on Tentultala Village of Khulna District

Sajal Kanti Roy

MSS, University of Dhaka

Abstract: It is found from considerable evidence that malnutrition affects human performance, health and survival, including physical growth, morbidity, mortality, cognitive development, reproduction, physical work capacity and risks for several adult-onset chronic diseases. In Bangladesh malnutrition is now considered as a great problem for children to overcome their future problems in life and career. In this study I have tried to show the current status of the rural children with an aim to differentiate the malnutritional differences between the male and female children. I have used anthropometric measurement to assess the nutritional status of the children and calculated in a qualitative method. It is found that, still gender differences is prevailing in rural area and children specially female children are oppressed from their right to get proper food. More over I have found economic and social issues that directly and indirectly impact on the children’s access to proper food.

Evergreen Bangladesh is faded by the threat of Child Malnutrition. After four decades of liberation we still could not ensure adequate food and health services for our people. In this regard Children among our national population are most vulnerable position. Children are suppressed, oppressed and discriminated in food and health services. As a result they are suffering from chronic malnutrition and other health problems. 

Globally, nutritional status is considered the best indicator of the well-being of young children and a parameter for monitoring progress towards the Millennium Development Goals (MDGs), especially MDG 1.  More than 90% of the global burden of malnutri­tion is attributable to 36 countries of the world, and Bangladesh is one of them.

The target of MDG 4 for Bangladesh is to reduce mortality of children aged less than five years (under-five mortality) from 151/1,000 live births in 1990 to 50/1,000 live births in 2015. The rates of under-five and infant mortality for the 1999-2003 periods were 88 and 65 per 1,000 live births respectively.  This means that one in 11 children born in Bangladesh dies before reaching the fifth birthday while one in 15 dies before the first birthday. Children with severe acute malnutrition are more likely to fall sick and contribute to high mortality and morbidity. Al­though children are usually taken to a healthcare facility for acute illnesses, including pneumonia or tuberculosis, severe malnutrition is often an under­lying causal factor, which reduces the probability of the child to be cured.

Malnutrition is such a problem that demands regular assessment. Our country is already one step ahead towards the Millennium Development Goals (MDGs) of UN. We reduced our child mortality rate 151 to 87 in per thousand live birth children from 1990 to 1999, (see figure 1) that has since slowed considerably, with the figure standing at 82 in 2001.  If we have to meet the 2015 MDGs then we have to reduce child mortality rate into at least 79 per thousand. And no doubt malnutrition is the main cause of child mortality.

Year	1990	1993	1996	1999	2001	2005	2008	2011	2014	2015
Under Five Mortality Rate
Data	151	139	117	87	82	-	-	-	-	-
MDG Path	-	-	-	-	-	81.24	71.08	50.39	50.77	47.40

Figure: 1. Rate of child mortality to achieve MDGs by 2015.

Children’s Nutritional status is a health related issue which demand scientific measurement. Anthropometric measurement is considered as capable to meet the scientific demand of Nutritional assessment.

Nutritional assessment procedures were first used in surveys designed to describes the nutritional status of populations on a national basis. The methods used were initially described at a conference held in 1932 by the Health Organization of the League of Nations. In 1955, the Interdepartmental Committee on Nutrition for National Defense was organized to assist developing countries in assessing their nutritional status and I identifying problems of malnutrition and the ways in which they could be solved.  

I in my research Monograph used the Growth Measurement system, which study the physical growth rate of human body. Among various growth measurements I have used the widely used three measurements namely,

1.      Weight for Age. (Underweight)

2.      Height for Age. (Stunting)

3.      Weight for Height. (Wasting)

Among these three measurements any one type of measurement (e.g. weight for age) is enough to get a overall knowledge about individuals nutritional status. But I here use all the three most common form of nutritional measurements to complete my research.

My research is aimed to measure the impact of gender difference on child malnutrition.  As nutritional status changes regularly, so regular assessment of nutritional status is needed.  I think that the research will provide this chance for next researchers on this field to evaluate the present nutritional status of children. Furthermore it will ensure the relation of gender disparity with other social factors, such as educational, economic, social, ethical and religious factors. Gender disparity is shown intensively in my research. This may make new dimension for next research. My research will provide empirical data for nutritional status of children of our rural Bangladesh.

Finally, my research is conducted with a few structured aims. I am aimed to assess the nutritional status of both the male and female children of rural Bangladesh and how this malnutrition impact on factious diseases, physical growth and educational performance of the children.  I also aimed to understand the socio-economic condition that play their role behind the screen and causes the malnutrition in rural Bangladesh. I also tried to find out some solution of the problem in rural Bangladesh.

Methodology:

Conceptual Framework:

Here in my research monograph I have shown the dependency of Malnutrition (Dependent variable) on other independent variables namely, knowledge, family income, national level policy making, proper use of national resources and equal access to food and resources. I also divided the independent variables into three categories (Immediate, underlined and basic causes) based on their impact on nutritional status of children.

The following model relates the causal factors for under-nutrition with different social-organizational levels. The immediate Independent Variables affect individuals, the underlying Independent Variables relate to families, and the Basic Independent Variables are related to the community and the nation. As a result, gradually the malnutrition framework widen to the population whose nutritional status is affected in marginal level of a nation.

I have conducted my research in a remote village of Bangladesh. The name of the village is “Tentultala”. It is in PaikGacha Thana under Khulna district situated in the South region of Bangladesh.

  Figure: 2.Conceptual Framework of Malnutrition

As I have conducted my research is in the “Tentultala” Village, so the villagers of the Tentultala Village are my Research population. According to the union parishad survey there was almost 1200 people in the village. But as my research unit belong to specific category, so the target universe of my research is not all the people of the village. Rather the Mother of children aged between 2 to 18 years belongs to specific target population or universe. So I here decided the “Mother” of children aged between 2 to 18 years old as my Unit of Analysis. I have interviewed the mothers to get the information about gender disparity in household and to indicate the children’s nutritional status I collected the children’s weight, height and age. I have chosen 110 samples from my population with a purposive sampling method, among them 55 were male and 55 were female respondents, as I need to compare between the sexes. 

I have made an interview schedule (attached in the annex) with structured and semi-structured questions to get my required information from the respondents. I have conducted a pre-test on the questionnaire to check out whether there is any problem. The collected data was tested by SPSS (v.17) and represented in a tabulated presentation.

Results

It was found from the analysis of empirical data that on average female children are more vulnerable and malnourished than the male children of the village. Although in a few cases obesity is found higher among the female children than of the male. But total scenario represent a risky condition of the female children.

Table 1: The Nutritional Status of male and female children based on three measurements.

Categories of Measurements	Nutritional Status	Male	Female
Weight for Age	Underweight	32.7%	67.3%
	Normal	67.3%	32.7%
Height for Age	Stunting	34.5%	70.9%
	Normal	65.5%	29.1%
Weight for Height	Wasting	32.7%	52.7%
	Normal	67.3%	45.5%
	Obesity	0%	1.8%

Here we can see that, 32.7% male children are Underweight, 34.5% are Stunting, 32.7% are Wasting which are all three categories of malnutrition. In contrary the female children are, 67.3% Underweight, 70.9% are Stunting and 52.7% are Wasting. But there is one female child who is obese or fat in body mass. In summary most of the female are leaned to malnutrition line than male children.

Primarily access the good and healthy food was assumed as the basic cause to malnutrition of the children that determined Gender perspective of the parents of the children. And it was seen that the male children have a higher access to good food than of the female children.

Table 2. Taking good food in daily meal.

Taking Good Food in daily meal	Number of Respondents	Percentage
Son	58	52.7%
Daughter	4	3.6%
Both children	48	43.6%
Total	110	100%

It was tested (by chi-square) the relation between the nutritional status of children and gender disparity and found that 37 male respondents have normal nutritional status where there is only 18 female contains normality in nutrition. And a chi-square test represents 13.27 with 5% level of significant and 1 degree of freedom and found highly significant that the nutritional status of the children is highly related with the gender disparity.

Table 3 : Relationship between gender disparity and nutritional status of children

Sex of Children	Weight for Age Z scores
	Underweight	Normal	Total
Male	18	37	55
Female	37	18	55
Total	55	55	110

Like the above table the relationship of malnutrition of the children was calculated with some other socio-economic factors, such as access to health care services, adequate child care knowledge, income and education of parents and found that all these independent variables fuel behind the enhancement of child malnutrition in rural Bangladesh. 

Discussion of the Result:

I have found some new dimensions of malnutrition and its relation with gender differences and other social-economic factors. Previous studies on malnutrition have identified malnutrition is prevailing in Bangladesh. The rate although reducing day by day but not equal in every area of the country. The study of Nutritional Surveillance Project Bulletin No. 19; August 2006, shows that, present condition of malnutrition is 45.7% are underweight, and 39.2% are in stunting categories of malnutrition.

In my research monograph I also found these two types of malnutrition. I have found that, 55.0% are in underweight and 58.0% are in stunting categories. The above mentioned study was conducted on whole Bangladesh, where towns of Bangladesh represent a good number of nourished children. But as I have conducted my research monograph only on rural area of Bangladesh so my result represents higher percentage of malnutrition. All the three categories of malnutrition I have used in my research are summed up and represents that, the average percentage of malnutrition in Bangladesh is 53.33% and the number of nourished children is 46.77%. 

Gender differences also found in some others area such as, taking good food in daily meal, treatment I common diseases, giving money in daily expense, opinion in family affairs, and in working in house. Result shows that, 52.7% respondents said they give good meal to their son and only 3.6% respondent’s supply good food to their daughter.

In developing countries, most studies show preferential food allocation to males over females. Nonetheless, some studies have found no sex differences in the nutritional status of girls and boys (Leonard WR, 1991), and others have described differences only at certain times of the lifecycle. For example, research in rural Mexico found no nutritional differences between girls and boys in infancy or preschool, but school-going girls consumed less energy than boys. This was explained by the fact that girls are engaged in less physical activity as a result of culturally-prescribed sex roles rather than by sex bias in food allocation (Backstrand et al, 1997). Studies from developing countries of gender differences in nutrition in adulthood argue that household power relations are closely linked to nutritional outcomes.

My research monograph too reveals same type of result. I here too found that gender differences is high in my research area and at the same time their female children (65.4%) are more prone to malnutrition than of male children (34.6%).

But although there is a higher tendency of gender inequality in household but most of the respondents (99.1%) support that, both male and female children should get educational facilities. That means women in the area are gradually becoming aware about the necessity of children’s education.

Cross tabulation analysis of my research shows that, there are 13% children nourished whose mother is Masters passed and only 8% nourished children whose mother is Illiterate. 5% malnourished children came from having mother Bachelor Degree passed and there 13% malnourished children came from having mother Primary level passed.

Cadwell (Cadwell J. C. et al; 1979), Bairagi (Bairagi et al, 1995) and Solon (Solon et al, 1998) found that, there is no relation between mothers educational status and child’s malnutrition. But in my research I have found a strong relation between educational status of mother and the level of malnourishment. My research data shows that, child’s possibility of being affected in malnutrition is reduced with the increasement of their mother’s educational status.

I have found in my research that, most of the mothers are aware about child rearing factors and other health related knowledge. They are aware about taking vaccination and giving DPT to their child. But most of the mothers have confusion on children’s breast milk feeding knowledge. 93.6% respondents said feeding breast mile minimum 12 months is enough and 6.4% said 6 month breast feeding is enough. 

The area is under poverty. Most of the people are illiterate and poor. They have very low income to maintain their family. It is founded that, among the respondents who have a family income less than 2000 taka there are 38.8% children normal and majority 61.2% are underweight.

On the other hand, among the respondents who have a monthly income more ten thousand taka, there are 83.3% children are found normal and rest 16.7% are found as underweight. So the higher the family income, the lower the possibility of being affected by malnutrition.

Among the respondents 40% children have a merit position I their class. But the majorities 60% do not have any merit position in their class. That means, malnutrition caused problems in getting merit position I class. 

So in summary, my research data represent high relation of gender difference as a cause of malnutrition. As well as malnutrition is influence on children’s intelligent. On the other hand, mother’s knowledge on child rearing and health, mother’s educational status, economic condition of family are also influential to determine children’s nutritional status.

Conclusion:

From the empirical data of the research it is found that, in rural area of Bangladesh children are highly in risk of malnutrition and female are in the most vulnerable condition. The rural people of Bangladesh still believe superstitions and still consider women should be suppressed to men. With this lower income, illiteracy, tough access to health care services, inadequate govt. and non-govt. services enhances the probability of children’s malnutrition. If we wish to change this scenario then we have to ensure proper education, access to information, food and health care services. We have to ensure proper socio-economic or structural support to the rural community. If we can ensure these factors only then we can assure a normal nutritional status of rural children and expect a group of prospective leaders for our country.

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