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Nutritional Status_ Social Awareness and Attitude Towards Marriage



Health Services, Government of Maharash-            3. Annual Report of the Enterovirus Re-
tra and Dr. J.T. Kale, the then Deputy                 search Centre, (ICMR), Bombay, 1989.
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their immense help to our team in carrying             poliomyelitis in Singapore by live vac-
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Nutritional Status, Social                         the adolescent phase has generally been to-
Awareness and Attitude Towards                     tally neglected. Healthy adolescents apart
                                                   from developing into healthy adults and
Marriage of Adolescents in a                       parents can also play a key role in social
Tribal ICDS Block of Himachal                      and health education of their younger sib-
Pradesh                                            lings and uneducated parents. Since there is
                                                   paucity of information in general(l) and
                                                   none from Himachal Pradesh on rural
Lalita Bahl                                        adolescent children, the present study was
R.K. Kaushal                                       undertaken to evaluate the nutritional and
                                                   educational status, social awareness and at-
                                                   titudes towards marriage and child bearing
    Adolescence is an important phase of           in adolescents (11-18 years) of a tribal
child growth and development. While per-           ICDS block.
suing different child development services,
                                                   Material and Methods

From the Department of Pediatrics, I.G.               The three villages, Rispa, Namgia and
   Medical College, Shimla.                        Shilling situated at a height of 10,000 to
Reprint requests: Dr. (Mrs) Lalita Bahl, Profes-   11,000 feet above sea level were surveyed
   sor and Head of Pediatrics, I.G. Medical        by a team of doctors from Pediatrics
   College, Shimla (HP.).                          Department, Indira Gandhi Medical Col-
Received for publication: October 27, 1993;        lege, Shimla in June, 1991. The sampling
Accepted: March 9, 1994                            design, frame and methodology of the study

INDIAN PEDIATRICS                                                 VOLUME 31—SEPTEMBER 1994

and questionnaire was provided by the Cen-        of the adolescent population had normal
tral Technical Committee of ICDS, New             nutritional status and the rest had Grade I
Delhi. The team of doctors were trained           (20.5%) and Grade II (4.5%) malnutrition,
with the proforma before undertaking the          respectively (Table I).
study. The nutritional status was assessed by         Educational Status: It was interesting to
measuring left midarm circumference. Fifti-       note that the literacy status of the adoles-
eth percentile of NCHS standard was used          cents in this population was very high, i.e.,
as reference to grade more than 80% of ex-        98%; only 2 females were illiterate. Only
pected as normal, 70-79% as Grade I, 60-          14.8% adolescents who had left studies did
69%, as Grade II and less than 60% as             so before reaching the middle standard.
Grade III malnutrition. The adolescents           More than 80% were persuing their studies
were interviewed about their educational          at different levels (Table I).
status, family and social activities, social
goals, intrafamily or village status in differ-       Family Activities: Both sexes shared all
ential of female/male care, awareness about       the family activities almost equally except
marriage and child bearing and child devel-       for cooking and looking after young chil-
opment programmes being implemented in            dren in which females outnumbered males
the community.                                    (Table II).
Results                                               Social Activities: These included play-
                                                  ing, marketing, attending festivals and visits
    Out of 607 total population of these vil-     to temples and community centre to listen
lages, there were 171 adolescents in the age      to radio or watch television. Going to festi-
group of 11-18 years. Of these, only 112 ad-      vals and temples were the favourite of both
olescents were available for the interview        males and females.
and examination. The results are depicted in
Tables I & II.                                       Social Goals: 42.8% males and 46.5%
    Nutritional Status: Seventy five per cent     females wanted to be professionals like
* Figures in the parentheses are percentages.

doctors, engineers and Indian Administra-       in favor of it before and after 20 years of
tive Officers. The next most common desire      age. Eighty per cent of adolescents pre-
mentioned by girls and boys was a good          ferred 2 and none, single or more than three
house lady (40.9%) and best farmers             children per couple. Similarly, majority
(25.4%), respectively. Military services was    (78.9%) felt that the gap between two chil-
desired by 17.5% males and other Govern-        dren should be 2 to 3 years, 21.1% girls in
ment services found favour with 8.9% of the     particular were in favor of it being more
adolescents.                                    than 3 years. None of the respondents want-
                                                ed it to be less than a year. Here again most
    Male-Female Care: All the respondents
                                                of the respondents favored good antenatal
felt that there was no sex discrimination in
                                                care to pregnant ladies and delivery to be
getting care at family and community level.
                                                conducted by trained personnel like doctors,
    Awareness and Attitude Towards Mar-         nurses or trained Dais. Awareness about de-
riage and Child Bearing: Fifty two adoles-      velopment programmes for children in the
cents (30 females and 22 males) answered        community like ICDS, Balwadis, etc. was
this part of the questionnaire. All boys and    also adequate. Two third of the adolescents
girls were of the opinion that no one should    were aware about the year 1990 being
marry before 18 years of age irrespective of    declared as the year of the girl child.
sex. Majority favoured males to marry after
20 years of age, or more and females after
18 years of age. Majority of girls preferred        It is gratifying that adolescents in this
the age of 20 years or more at first child      remote tribal area had good health and ex-
birth while the males were equally divided      cellent literacy status. The school drop out

INDIAN PEDIATRICS                                                   VOLUME 31—SEPTEMBER 1994

rate of 15% from class first to matriculation,   General's data of 1981 was 16.7 years(4).
and numbers without schooling (1.8%) are         Two third of adolescents knew about the
lower in comparison to that reported in the      "Year of the Girl Child-1990", which may
singular, similar study from Rohtak (Hary-       be due to its celebration organized in some
ana) with corresponding figures of 18% and       of the Anganwadis.
8%, respectively(l). It is also noteworthy           It is inferred from this study that adoles-
that they are actively involved in many use-     cents had good health and educational sta-
ful household activities, of which cooking       tus, participated in the household chores
and care of young children at home in par-       like caring for children and cooking, had
ticular can be utilized to promote the health    high career aspirations and were rightly
and nutrition of their younger siblings.         aware about some of the maternal and child
Some studies(2,3) in the past have pointed       health aspects. They had right attitudes
out lack of adequate and proper knowledge        about medico social aspects of marriage and
of infant feeding in mothers and even health     child bearing. These can be strengthened
personnel in the tribal area. About 45% of       further and the knowledge of adolescents
respondents had aspirations for professional     can be used as an important tool in further-
careers like Indian Administrative Service       ing the cause of "Child Survival and Safe
(IAS), Doctors and Engineering, which is         Motherhood" programme envisaged by the
not unexpected by looking at the high socio-     ministry of Health and Family Welfare.
economic status of these professionals. An-                                       ■

other important incentive for the tribals to
aspire for these coveted professions is reser-      The authors are thankful to the Central
vation for them by the Government for ad-        Technical Committee, ICDS, New Delhi for
mission and promotion. One fourth (25%)          permitting us to publish this data.
of boys and 40% of girls chose to be best        REFERENCES
farmers and good house ladies, respectively.       1.   Lai S, Khanna P, Sood AK. A study of at
The aspirations for similar professions was             titudes, health and social status of chil-
much lower in the Rohtak study(l) where                 dren (11-18) years in block Kathura,
34.6% girls and 48.3% boys wished to be                 Rohtak. Indian J Mat Child Health 1992,
teachers and police men, respectively.                  3: 19-22.
    Strikingly all adolescents thought that        2.   Jethi SC, Shrivastava DK. Knowledge,
there was no sex discrimination in care at              attitudes and practice regarding infant
family or community level which was                     feeding among mother substitutes. Indian
reported by 25% girls and 14% boys in the               Pediar 1987, 24: 921-925.
study quoted above(l). Awareness and atti-         3.   Maheshwari RK, Gupta BD, Arora AK,
tude towards the marriage, child bearing                Karunakaran M, Bhandari SR. Knowledge
                                                        and attitudes towards infant feeding
maternal and child health services was high,
                                                        among rural health personnel. Indian
which may be related to good educational                Pediatr 1987, 24: 917-920.
status. Majority of males and females
                                                   4.   Census of India 1981 Series I, India.
favored 20 years or more as the age of                  Paper 2 of 1983, Part II-Key population
marriage and first child birth and none                 statistics based on 5 per cent sample data.
below 18 years. It is an interesting finding            Office of the Registrar General India,
in a country where the average age of girls             Ministry of Home Affairs, New Delhi,
at marriage according to the Registrar                  1983.


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