Assessment of the nutritional status of the people in Baran
As per the data from the Census of India 2001, Rajasthan with its area of
342,239 sq.km is the largest state in the country supporting a population of more
than 55 million people. After 1991, five new districts have come into existence
giving rise to a total number of 32 districts. One of them is Baran which was
earlier a part of Kota district and was separated only three years ago due to
administrational problems. Rajasthan now has a total of 241 tehsils ( blocks ) with
the creation of 28 new tehsils after 1991.
75 % of the population lives in rural areas and is dependent on agriculture and
animal husbandry. With only about 16 % of land having irrigation facilities
agriculture is primarily dependent on rainfall
Baran is a district headquarters located in southeast Rajasthan which has a large
number of villages in its jurisdiction that are hit by the drought because of failure
of the rains for the last three years. The villages that are severely hit are
centered around the two blocks of Baran namely Shahbad and Kishenganj. A
tribal community called Saharia predominantly inhabit these parts of Rajasthan.
Saharias who were mainly dependent on forests for their livelihood as hunter-
gatherers and few being agriculturists by occupation are worst affected due to
failure of rains. The reserves of food grains having been depleted, they are now
facing the situation of acute distress due to hunger.. There were media reports of
deaths amongst the children in the previous year, the causes of which could be
indirectly attributed to starvation as per the local NGO’s, though denied by the
Government. This prompted Medico-friend circle to undertake this study in
collaboration with Community Health Cell, Bangalore to assess the damage caused
by this chronic drought and to plan accordingly.
If the rains fail once again this year, the situation could become more disastrous
giving rise to more morbidity and mortality. So there lies the need to know the
magnitude of the problem along with the possible resources available so as to
work out suitable relief measures.
Objective of the study :
.To assess the nutritional status of the under-fives and adults in selected
This was a rapid nutritional assessment study conducted in four villages which
spanned for a short period of time from 21-01-03 to 25-01-03. The four villages
chosen were Jethpur, Gadar-eshatori, Neem ki mari and Gannakeri and according to
the local NGO people, these villages were affected very badly considering the
number of deaths and severely malnourished cases.
Local volunteers were given the proforma ( Annexure 1 ) and asked to fetch the
basic identification data followed by the doctors taking the measurement of height,
weight and mid-arm circumference ( MAC ) that served as the tools for the rapid
Since this is a rapid assessment study and for the lack of clearly defined
standards for assessing adolescent malnutrition, only the age groups of 1 to 5
years and above 18 years are considered in this study. While MAC reflected the
nutritional status of children aged 1 – 5 years, Body Mass Index ( BMI = height /
weight2 ) was calculated for adults that served as their nutritional indicator.
Household was considered as a unit and efforts were made to achieve 100 %
coverage among the people who were available at the time of study. Care was
taken to avoid individual and technical variations in measurement.
The study population consisted of 640 individuals in the four villages that were
studied. Of the 640 individuals, 125 were not available for the study due to various
reasons like having gone out for work, out of village, gone to school etc. The
results of the study are tabulated as follows.
Table 1. Demographic characterstics of the study population.
Age Sex : Total Percentage
(years ) Male Female
n % n % n %
<1 9 2.95 16 4.78 25 3.9
1-5 62 20.33 65 19.40 127 19.84
6 – 17 88 28.85 78 23.28 166 25.93
>18 146 47.87 176 52.54 322 50.31
305 + 335 = 640
The universe predominantly consisted of subjects aged 18 years and above ( 50 % )
with slight preponderance towards female sex. Under-fives formed a substantial
portion of the population ( 24 % ) with slightly more number of females than
a. Mid-arm circumference ( MAC ) :
Table 2. Mid Arm Circumference of children aged 1- 5 years.
MAC Sex : Total Percentage
( cms ) Male Female
n % n % n %
< 12.5 9 17.65 7 12.28 16 14.81
12.6 – 13.4 14 27.45 15 26.32 29 26.85
> 13.5 28 54.90 35 61.40 63 58.33
51 + 57 = 108
MAC was measured of the children in the age group of 1 – 5 years. Totally there
were 127 children in this group of which 19 children ( 14.9 % ) were not
available for measurement at the time of study. MAC of 13.5 and above indicates
good nutritional status, 12.6 – 13.4 indicates mild to moderate undernourishment
and MAC of less than 12 .5 indicates severe malnourishment.
45 children ( 41 % ) of the 108 children available for assessment did suffer from
varying grades of malnourishment. While 29 children ( 26.8 % ) were mild to
moderately undernourished, 16 children ( 14.8 % ) belonged to the category of
b. Body Mass Index ( BMI ) :
Table 3. Distribution of Body Mass Index among adults.
BMI ( kg / Sex : Total Percentage
m2 ) Male Female
n % n % n %
< 18.5 62 62.00 63 44.37 125 51.65
18.6 – 24.9 38 38.00 78 54.93 116 47.93
> 25 0 0 1 0.70 1 0.41
100 + 142 = 242
BMI was measured in the individuals falling in the age group of 18 years and
above for both the sex. BMI is a very good indicator of over-weight and obesity
among adults and also an indicator of chronic energy deficiency if the value is
less than 18.5. Values of 18.6 to 24.9 are regarded as normal and above 25 as
125 subjects (51.6% ) in this group suffered from chronic energy deficiency which
included 62 % of all adult males and 44.3 % of all adult females.
80 individuals ( 24.84% ) in this age group were not available for assessment as
most of them had gone out for work.
It is evident from the results of this study that a significant number of people in
different age groups suffer from varying grades of malnutrition. About 14.8 % of
the children in the 1 – 5 year age group are severely malnourished while around
26 .8 % fall in mild to moderate range.
Among adults about 51.6 % of the population are going through the phase of
chronic energy deficiency while about 47.9 % show a satisfactory nutritional status.
Again about 99 subjects ( 22.04 % ) among the under-fives and adults were not
available for the study whose nutritional status could not be ascertained.
. As the Government has already started food for work programmes,
now it needs to sustain such programmes ensuring adequate
distribution of food among the people in line with the directive issued by the
. Arrangement of water resources using suitable rain water harvesting
methods needs high priority.
. Measures towards giving nutrition education to the people in usage of local
foods in preparing diets with high nutritive value.
. Education of the local people in screening of the population,
especially the under-fives to detect both macro and micronutrient
deficiencies and various illnesses due to the same.
. Strengthening of the medical and paramedical facilities to detect the
severely affected and intervene at the right time.
. Measures towards improving the sanitary facilities.
1. WHO publication. Management of severe malnutrition : a manual for
physicians and other senior health workers,1999.
2. Marleen B et al. Nutrition guidelines. 1st edition., Paris, 1995.
3. O.P. Ghai and Piyush Gupta. Essential Preventive Medicine, New Delhi, 2000.
4. K. Park. Text book of Preventive and Social Medicine. 17th edition., Jabalpur,
5. WHO publication. Management of the child with severe malnutrition, 2000.
6. WHO publication. Nutritional surveillance, 1984.
7. Census of India 2001 report on the state of Rajasthan.
Community Health Cell acknowledges Medico-friend circle for the cooperation and
support to take up this study.
We are grateful to the various Non-Governmental Organizations based in Rajasthan
namely Sankalph, Action-Aid and Bharatiya Gyan Vigyan Samiti( BGVS ) without
whose assistance with adequate material and manpower, this study would not be
We are thankful to Dr. Mario Vaz, Department of Physiology and Nutrition, St. John’s
Medical College, Bangalore for assisting us in planning the study and for the initial
preparatory work and the assistance with respect to technical aspects of the study.
We would like to express our gratitude to Dr. Meera Meundi, the Principal,
Bangalore Medical College ( BMC ) and Dr. B.G.Chandrashekar, Professor and Head,
Department of Preventive and Social Medicine , Bangalore Medical College for
their cooperation in making this event happen.
Dr. Krishnamurthy. J
Dr. Praveen Bhat