Assessment of Under Nutrition with Composite Index of Anthropometric Failure (CIAF) Among Under-Five Children in a Rural Area of West Bengal
Background: Under-nutrition continues to be a major public health problem in India despite years of incessant preventive measures. Composite index of anthropometric failure (CIAF) provides the burden of under-nutrition as a single measure and helps in detection of children with multiple anthropometric failures. Research with multivariate modelling for various factors associated with CIAF is limited especially in rural West Bengal. Methods: This cross-sectional community based study was done in Singur block of West Bengal to determine the prevalence of under-nutrition among the under-five children and to find out the determinants of under-nutrition assessed by CIAF using multivariate analysis. WHO Z-score system and the composite index of anthropometric failure (CIAF) were used to estimate the magnitude of under-nutrition. Results: Out of 113 children, 37 (32.7%) were suffering from under-nutrition according to CIAF. Both underweight and wasting was present in 17.7% while stunting was prevalent in 15%. Multivariate logistic regression model showed that high birth order, low birth weight, lesser duration of breast-feeding, and low education level of mother were significantly associated with under-nutrition assessed by CIAF after adjusting for other variables. Conclusion: CIAF gives a better estimate of under-nutrition than the currently used weight-for-age Z score, hence we recommend the inclusion of height measurement in growth monitoring activities for calculating CIAF. The study also reinforces the importance of appropriate maternal care, proper infant and child feeding practices and family planning services in prevention of under-nutrition.