Abstract
Background: The SAM is an important issue all over the world, especially in LMICs. SAM accounts for a large proportion of childhood morbidity and mortality with south Asia, Pakistan inclusive, experiencing high malnutrition rates. When it comes to the consequences of SAM in children, there are still some issues in District Poonch particularly in Azad Kashmir about socio- economic and health facilities etc. It is therefore important to develop prima facie understanding of risk factors for SAM within the local population.
Aim: The purpose of this dissertation was to establish the various factors associated with the development of SAM in children who are below five years of age in a specified secondary healthcare facility in District Poonch, Azad Kashmir. This study aims at establishing causative factors, the socio-demographic, health and environmental indicators to SAM in the region.
Method: This cross-sectional study was carried out at a tertiary care hospital in District Poonch, Azad Kashmir during six months. Cases of children less than five years of age with SAM according to the WHO weight for height classification were enrolled in the study. Information was obtained from review of patient records, parental interviews and by taking measurements of the child’s physical characteristics. Assessed risks were maternal education, breastfeeding, immunization, hygiene, and co-infections such as diarrhea and respiratory diseases. Because the data collected were categorical, chi-square tests were used in the assessment, together with logistic regression analysis using SPSS software.
Results: The research targeted 250 SAM affected children. The findings showed that the following factors acted as independent predictors of high risk: low maternal education, poor breastfeeding practices, and the presence of poor environmental hygiene, non-exclusive breastfeeding and complementary feeding initiated at a later time, and other related comorbidities such as diarrheal diseases and respiratory tract infections. Having determined the original data, it was ascertained that the most important predictors of SAM were low education of the mother (smoking) and inadequate breastfeeding (p < 0.05). The clinical and anthropometric findings indicated that SAM children had lower WHz, HAZ, as well as MUAC than the reference standards.
Conclusion: The study summarized the influential risks that affected severe acute malnutrition in District Poonch, Azad Kashmir, with reference to the social demographic elements comprising maternal education, breastfeeding, and the environmental factors including sanitation. Interventions on the above determinants which includes Maternal education programmes, nutrition, and health care should be employed to help reduce the effects of SAM in the region. However, these agents require additional research to identify them and better understand their role in relation to population nutrition and malnutrition, to improve the overall effectiveness of the main non-pharmacological public health interventions.
Keywords: Severe Acute Malnutrition, Risk Factors, Maternal Education, Breastfeeding, Diarrhea, Public Health, Azad Kashmir, District Poonch, Child Nutrition, Public Health Intervention.