A community based cross-sectional study was undertaken in rural Madhya Pradesh (MP). The nutritional status of infants was assessed using WHO Child Growth Standards. Only 26% of infants received breast-feeding within 1 hour of birth. About 57% of children 6 to 11 months old received complementary feeding (CF). The prevalence of underweight, stunting, and wasting was 41%, 29%, and 33%, respectively. Multivariate analysis showed that the risk of underweight and stunting was 1.4 times higher among children belonging to scheduled castes and scheduled tribes compared with others, 1.4 to 1.6 times among children from households with the lowest wealth index, and 1.5 times among children of illiterate mothers. Hygienic practices, birth weight, home delivery, and CF practices were also significantly (P < .01) associated with undernutrition in multivariate analysis. Undernutrition is an important health problem in MP, and urgent steps are required to formulate policies and strategies to improve infant and young child feeding practices, socioeconomic conditions, and literacy and encouraging institutional delivery and personal hygiene.

Objective: To assess the magnitude and determinants of vitamin A deficiency (VAD) and coverage of vitamin A supplementation (VAS) among pre-school children. Design: A community-based cross-sectional study was carried out by adopting a multistage, stratified, random sampling procedure. Setting: Rural areas of eight states in India. Subjects: Pre-school children and their mothers were covered. Results: A total of 71 591 pre-school children were clinically examined for ocular signs of VAD. Serum retinol concentrations in dried blood spots were assessed in a sub-sample of 3954 children using HPLC. The prevalence of Bitot spots was 0?8 %. The total ocular signs were significantly higher (P , 0?001) among boys (2?6 %) compared with girls (1?9 %) and in older children (3-4 years) compared (P , 0?001) with younger (1-2 years), and were also high in children of labourers, scheduled castes and illiterate mothers. The odds of having Bitot spots was highest in children of scheduled caste (OR 5 3?8; 95 % CI 2?9, 5?0), labourers (OR 5 2?9; 95 % CI 2?1, 3?9), illiterate mothers (OR 5 2?7; 95 % CI 2?2, 2?3) and households without a sanitary latrine (OR 5 5?9; 95 % CI 4?0, 8?7). Subclinical VAD (serum retinol level ,20 mg/dl) was observed in 62 % of children. This was also relatively high among scheduled caste and scheduled tribe children. The rate of coverage of VAS was 58 %. Conclusions: The study revealed that VAD is a major nutritional problem and coverage of VAS was poor. The important determinants of VAD were illiteracy, low socio-economic status, occupation and poor sanitation. Strengthening the existing VAS programme and focused attention on dietary diversification are essential for prevention of VAD.

A community-based cross-sectional study carried out in tribal areas of Maharashtra covering 1751 pre-school children to assess nutritional status. Nutritional status was assessed using new WHO Growth Standards. Household wealth index was constructed using principle component analysis. The prevalence of underweight, stunting and wasting was 64, 61 and 29%, respectively. There was a significant (p < 0.05) reduction in the prevalence of underweight and stunting over two time periods (1999 and 2008). Logistic regression showed that the risk of underweight was 1.7 times higher among children of illiterate mothers and those suffering from morbidities, while stunting was 1.4 times higher among children belonging to lowest and middle household's wealth indexes. Undernutrition is a public health problem and is associated with literacy of mother, household wealth index and morbidities. Therefore, improving socio-economic condition along with literacy of mothers and preventing infections through personal hygiene might help in improving the nutritional status of children.