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BRIEF REPORTS 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. Director of Health Services, A.urangabad for 4. Lee LH, Lim KA, Tye CY. Prevention of their immense help to our team in carrying poliomyelitis in Singapore by live vac- out the field investigations. cine. Br Med J 1964, 1: 1077. REFERENCES 5. Arora RR, Chaudhari DS, Gujral W, 1. Mandke VB, Dave KH, DamaBM, Bansal et al. Epidemiology of poliomyelitis in MP, Patankar. Poliomyelitis in Marathwa- Delhi. Indian J Med Res 1978, 67: 11. da region of Maharashtra state. Virus In formation Exchange Newsletter 1986, 3:3. 6. Sharma M, Sen S, Ahuja B, Dhamija K. Paralytic poliomyelitis 1976-1988: Report 2. Melnick JL, Herbert A, Wenner, Allan from a Sentinel Centre. Indian Pediatr Phillips C. Enteroviruses. In: Diagnostic 1990,27: 143-150. Procedures for Viral, Rickettsial and Chlamydial Infections. Eds Lennett EH, 7. Dong De-Xiang. Immunization with oral Schmidt NS. American Public Health As- polio vaccine in China. Prog Med Viro- sociation Inc, 1979, p 471. logy 1985, 31: 212-221. 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 1094 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 Discussion 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 1096 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- ■ Acknowledgement 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. 1097
"Nutritional Status_ Social Awareness and Attitude Towards Marriage "