Awareness of nutrition and health issues among pregnant and lactating mothers: a case study of district basti, u.p.

It is a well-known fact that the growth and development of a child begins from the mother’s womb. Right from the development of the child in the mother’s womb even at the time of birth and also till the child grows older. The child needs special care nutrition and regular health checkups.

It is an obligatory duty of the parents as well as the birth right of the child to get the proper care and the nutrition. Infect the first nutrition of the child is provided by the mother through the breast milk till six months after which the child needs some supplementary food in addition to mother’s milk. If the child does not get the balanced diet, the child becomes the victim of malnutrition.

Mother’s milk is a complete balanced diet and even protects the child from various fatal diseases. A mother and a child has a very deep relation with each other. A mother’s health and diet has a direct influence over the child.

That is why a mother play an important role in framing a healthy life cycle. A mother’s mortality and the child’s mortality have an inseparable connection. There are enormous reasons that lead to the abnormality in the child’s physical as well as mental health. A few of these include unavailability of mother’s milk lack of awareness, poverty, no proper health checkup, illiteracy and unemployment. Child marriage, sex discrimination frequent deliveries, without a proper gap between two children, unavailability of supplementary food etc.

All of these issues intern increase the child’s as well as the mother’s mortality rate. At the time of pregnancy as well as at time of delivery, proper nutrition as well as proper care are equally important. But unfortunately in India, the women’s social, economic as well the nutritional situation is far below the standards. No doubt the Indian Government has taken various steps for the betterment of women. But the situation has not improved much.

A healthy mother delivers a healthy baby and vice versa. That is why it is very essential for a woman that during pregnancy and even after delivery she should take Nutritious food and go for regular health checkups. During pregnancy the women should have a regular intake of nutritious food like fruits, proteins food etc., because during this period a women needs a lot of energy.

A woman should take iodized salt during pregnancy and afterwards so as to avoid any mental and physical problem in the child. As per the W.H.O. report every year throughout the world about 50-60 lakhs women die during pregnancy or at the time of delivery. This does not affect only individual family but affects the whole society. That is why till the health situation of women ins not improved we cannot think of a healthy and developed world.

My Ph.D. research was regarding the nutrition rights of girl child particularly in the district of Basti U.P. During this research the nutrition and health condition of both pregnant and lactating mother was found to be worsen and was found to be the main cause of health problem of children. So the researcher found that there is a need of research to know about the nutrition as well as the health condition of the pregnant and lactating women as well. But this in itself is a vast study and demands a separate research that the research aims to fulfill through her P.D.F.

During this research the researcher intends to bring out the actual picture of the health and nutrition situation of the women in the district of Basti, U.P. It is worth to mention that not a single study has been done in the district Basti U.P.so far on this issue by any researcher. So it will be really a basal framework for further research . It can also serve the upcoming researchers to understand the nutritional issue of district Basti to a certain extent. This is the main aim of the P.D.F. research .

AWARENESS OF NUTRITION AND HEALTH ISSUES AMONG PREGNANT AND LACTATING MOTHERS: A CASE STUDY OF DISTRICT BASTI, U.P.INTRODUCTION:It is a well-known fact that the growth and development of a child begins from the mother’s womb. Right from the development of the child in the mother’s womb even at the time of birth and also till the child grows older.

The child needs a special care, nutrition and regular health checkups. It is an obligatory duty of the parents as well as the birth right of the child to get the proper care and the nutrition. In fact the first nutrition of the child is provided by the mother through the breast milk till six months after which the child needs some supplementary food in addition to mother’s milk. If the child does not get the balanced diet, the child becomes the victim of malnutrition.

Mother’s milk is a complete balanced diet and even protects the child from various fatal diseases. A mother and a child has a very deep relation with each other. A mother’s health and diet has a direct ^influence over the child. That is why a mother plays an important role in framing a healthy life cycle.

A mother’s mortality and the child’s mortality have an inseparable connection. There are enormous reasons that lead to the abnormality in the child’s physical as well as mental health. A few of these include unavailability of mother’s milk lack of awareness, poverty, no proper health checkup, illiteracy and unemployment, Child marriage, sex discrimination, frequent deliveries, without a proper gap between two children, unavailability of supplementary food etc.

All of these issues intern increase the child’s as well as the mother’s mortality rate. At the time of pregnancy as well as at time of delivery, proper nutrition as well as proper care are equally important. But unfortunately in India, the women’s social, economic as well the nutritional situation is far below the standards. No doubt the Indian Government has taken various steps for the betterment of women. But the situation has not improved much. A healthy mother delivers a healthy baby and vice versa.

That is why it is very essential for a woman that during pregnancy and even after delivery she should take nutritious food and go for regular health checkups. During pregnancy the women should have a regular intake of nutritious food like fruits, proteins food etc., because during this period a women needs a lot of energy.

A woman should take iodized salt during pregnancy and afterwards so as to avoid any mental and physical problem in the child. As per the W.H.O. report every year throughout the world about 50-60 lakhs women die during pregnancy or at the time of delivery. This does not effect only individual family but effects the whole society. That is why till the health situation of women is not improved we cannot think of a healthy and developed world. My Ph.D. research was regarding the nutrition rights of girl child particularly in the district of Basti U.P.

But during this research the nutrition and health condition of both pregnant and lactating mother was found to be worse. During the research I found that there is a need of research to know about the nutrition as well as the health condition of the pregnant and lactating women. So the researcher aims to fulfill it through her PDF. During this research the researcher intends to improve the health and nutrition situation of the women in the district of Basti U.P. This is the main aim of the PDF research. 1. Review of Literature

Erin Sines, Uzma Syed. Steve Wall, and Heidi Worley in their research paper, “Saving Newborn Lives, Postnatal Care: A Critical Opportunity to Save Mothers and Newborns,” reveal that newborn survival is inextricably linked to the health of the mother. Nowhere is this more evident than the high risk of death for newborns and infants whose mothers die in childbirth. For both newborns and mothers, the highest risk of death occurs at delivery, followed by the first hours and days after child-birth.

The postnatal period (the time just after delivery and through the first six weeks of life) is especially critical for newborns and mothers. [1] Despite improvement in the infant and child health status, a high number of neonatal deaths (41 per 1,000 live births) pose a serious public-health concern in developing countries, including Bangladesh. Globally, almost three-quarters of neonatal deaths occur within the first seven days of delivery. However, there is a significant break in the continuum of care in the service-delivery strategy. The burden of maternal complications and deaths is also highest in the first few days of delivery.

Thus, immediate and early postnatal interventions (defined to be from delivery to first seven days), have the potential to change the maternal and child mortality scenario significantly. [2] The highest risk of death for both the mother and her newborn occurs at the time of childbirth or immediately in the period after birth.

Ensuring appropriate postnatal care is critical to safeguarding maternal and newborn health. More than two-thirds of newborn deaths occur within the first week after birth and of these, most deaths occur in the first 24 hours of birth. This is also the case with maternal deaths where almost two-thirds tend to occur in the postnatal period. India is no exception to this. About 39% of neonatal deaths occur on the first day of life in India, about 57% during the first three days and the majority of maternal deaths occur between the third trimester and the end of the first week after birth. [3]

The implications of the findings of the study for policy and practice by Vikram Patel, Merlyn Rodrigues and NanditaDeSouzais that mental health must be integrated into maternal health care in low-income countries. Given the shortage of mental health manpower, the role of care will need to be met by midwives, gynecologists, and pediatricians. Parent counseling to promote marital communication and to reduce the preference for male children must be an essential component of routine antenatal care.

Future research should focus on studies examining the efficacy of interventions delivered in the antenatal period on the prevention of postnatal depression. Improving marital communication and reducing gender preference should be important components of any such interventions. [4] The study by MalathiSivaramakrishnan, Vimla L. Patel examines reasoning about the cause and treatment of three types of childhood protein energy malnutrition (PEM) by 108 mothers in rural South India.

The mothers were interviewed and their explanations of the childhood nutritional problems were verbally recorded, transcribed and then analyzed using cognitive methods of analysis. The results indicated that knowledge and practices associated with traditional systems of Indian medicine prevalent in rural areas greatly influenced the mothers’ reasoning. Their explanations were shown to have storylike structures, with sequences of events linked by strong causal explanations.

Mothers with higher levels of formal education showed greater verbal use of concepts related to biomedical theories of nutritional disorders. However, their interpretations of these concepts were still based on the traditional theory. The study revealed both positive and negative aspects of traditional knowledge and beliefs for adequate child nutrition and health.[5]

A study conducted by Shankar Prinja , Ramesh Verma and Sunder Lal, [Role Of I.C.D.S .Program In Delivery Of Nutritional Services And Functional Integration Between Anganwadi and Health Worker In North India ], The internet journal of nutrition and wellness, year 2008, Volume 5 number 2. DOI :10 .5580 / 415 In Rohtak found the children were having the problem of malnutrition because of law involvement of mother and less awareness of mothers regarding benefits of breast feeding. [6]

One research conducted by [ Institution Of Health Management Pachod, Pune ], 2005, reducing deficiency anemia and changing dietary behaving, India has the highest iron deficiency among women, adolescent girls are eating lessthan three meals, not taking iron rich food and fruits.[7]

Another research study by Nutrition Foundation of India, New Delhi 2005, [ anemia in pregnancy interstate differences, New Delhi : NFI. 31P. ] , according to Indian Council of Medical Research and other research agencies, India has a highest iron deficiency problem between 50 – 90 % among pregnant women, 49.7 % pregnant women were anemic according to NFHS 2 .[8]

As such many studies have showed the health and nutrition problem in women and adolescent girls. A mother and a child have a very deep relation with each other. A mother’s health and diet has a direct influence over the child. A mother plays an important role in framing a healthy life cycle. That is why we should take care of women and adolescent girls also. It is because today’s girls will become mother in future. While the ICDS providing services to children, pregnant, lactating mother and adolescent girls also.

ICDS programs were started in 1975. It is a major program of human development. ICDS mainly focuses on women and young child’s health and nutrition problems. It was started in 33 blocks on an experimental basis but now it has been covered a lot of blocks in the country. ICDS provides health check-ups, immunization, nutrition, and health education to expectant and nursing mothers, but lack of proper implementation and access to policies and schemes, the needy persons are deprived of these policies and schemes. Research Question

1. Are prenatal and postnatal checkups and proper nutrition and prerequisite for both pregnant and lactating women. 2. How far has the awareness been created among the women regarding the health checkups of pregnant and lactating mothers. 3. Objectives:

1. This study aims at creating awareness among would be mother about the significance of health and nutritious food .because prenatal and postnatal check-up of women is a key to health of mother and child. For a healthy society, both mother and child must be healthy to live a happy life. 2. To create an awareness among such women about the government programs and policies on health and food. 3. To create awareness of women about the institutional arrangements and facilities. 4. Analyze the implementation process and its effects on women in the concern field.

Hypothesis:1. Most of the women are not getting the proper care and check- ups at prenatal and postnatal stage, and thus, are the victims of malnutrition. 2. There is a lack of awareness among the pregnant and lactating women about the importance of health checkups and proper nutrition.

5. NATURE ANDSCOPE OF STUDY:Theoretical concerns of social development and public policy on health: For providing it no doubt women make up a majority of the world’s population. Research has shown that if men and women receive similar nutritional & medical attention and general health care, women tend to live noticeably longer than men.

But unfortunately it is found that women get considerably less nutrition facilities than men same is the situation in India. It has been found that to create more and more awareness spread more knowledge as quoted by Amartya Sen “To build a nation build a school” a pregnant women has specific nutritional requirement to achieve good health.

An evaluation that focuses only on means, without considering what particular means can do with them is not sufficient. The focus must lie on the specificity. The current research aims at the analysis of the specific nutritional requirements of pregnant and lactating women and the provisions simultaneously social development plays an important role with respect to women health, by taking all the stages in the consideration.

Amartya Sen, the noble laureate, in 1960’s and early 1970’s developed the theory of social choice, which first came to prominence in work by the American economist Kenneth Arrow. In 1981 Sen published an excellent work on, entitled poverty and famines:

An essay on entitlement and deprivation (1981), a book in which he argued that famines occur not only due to lack of food, but because of inequalities built into mechanism, for distributing food. So the current research aims at find the main problem with respect to distribution of food in the Indian context and the major problems that arises about women’s nutrition.

It is well a known fact that women are more prone to nutritional deficiency because of the kind of reproductive cycle they have and because of the extra amount of house hold they perform the work pattern and the pressure on them demands for more food but sadly their basic needs are is not met.

Pregnant women also need more of nutrion as they have to bring up themselves in healthy manner along with providing a good nutrition to a new life developing in their wombs. In such cases low food intake and lack of nutrition rebounds on the society use by causing more healthy issues to the off spring, be it girl or a boy. The unfortunate part is that despite of the continuous progress and growth of countries, economies, women are still living a life full of misery and pain.

Researchers & reports have dictated that in the recent years the per capita food consumption rates in the country have drastically increased but women are not able to get sufficient nutrition. The current research would try to focus on the various issues related to it and to provide a solution so as to have at least a better nutrition for this section of society decide which will the future of the nation.

Public or political scope of the study: As a public policy on health every women who is the citizen, must be provided all facilities under a particular scheme, without any discrimination of caste, religion, language, region etc. There should not be any loss of money and material in the access to health facilities, but due to corruption the actual objectives of a policy are not realized .Moreover there are lots of policies on health programs and schemes. For their self-interest, the political parties exploit the situation and hamper the process of development.

So what should be a pure public policy on health turns into a political subject of concern. Ultimately the poor and needy women are deprived of the benefits of a health policy. My Ph.D. research was about the nutrition rights of girl children in the district of Basti U.P. Since the topic in itself was a wider concept. During the research, I could not study the main problems of nutrition and health of the women particularly during pregnancy and lactation.

This really generated an interest in the researcher to look into such issue. It is a reality that the basic cause of malnutrition and ill health of children is “mother” only because a healthy mother can deliver a healthy child. That is why the researcher felt the need and importance of studying the health and nutrition of the mother. The researcher attempts to fulfill this gap through her P.D.F. study. This is the main cause of my upcoming research study.

Actually the entire development of the child in the mother’s womb depends upon mother’s proper nutrition, surrounding environment, mental as well physical fitness that in turn depends on the timely health checkups of the mother. That is why there is very close connection between the mother and child not this even after the delivery of the child. It is the mother that provides the first nutrition to the child in the form of breast milk.

This milk is highly nutritious and also protects the child from various diseases. But at the same time feeding the child with the her milk, knowing the exact time for starting the supplementary food, knowing how to prepare that supplementary food, proper health checkups of both the child as well as mother are very significant and needed.

Her health is possible only when the mother has a complete awareness and knowledge about it. In other words it can be said that in the proper growth and development of a child, mother plays a vital role. But it is found that in India. Women mostly are the victims of malnutrition and at the same time there is a tremendous shortage of health facilities that need to be provided to them.

According to one report, every year in India about 67,000 women die either at the time of delivery or due to other pregnancy related problems. A woman’s health is actually related to her social, educational, economic and other aspect which needs to be taken into consideration.

This really demands a need of research on such a debatable issue. That is why the researcher tries to satisfy this demand to some extent through the upcoming research.

The main aim of research is to create awareness about such problems and makes it clear that it is actually the mother’s health that decides the fate of the child. The researcher actually wants to create awareness particularly among the women of Basti. So that they can improve their health, so that they can avail the benefits of the public policies and gain proper health.

6. Research Methodology:

Primary sources and secondary sources.Both descriptive and analytical method would be employed for studying the problem. A questionnaire would be prepared and circulated among a cross section of political women. To study the actual health conditions of women in the district of Basti, U.P.in the context of prenatal and postnatal care and health. To collect data from substantial number of women, from rural and urban areas, on a sample basis. Questionnaire and interview- to gather views of women about the subject under study. Analysis of the information collection.

Reports of various ministries and development on the concern topic will be utilized.

7. Tentative Cauterization:

1. Current state of health of pregnant and lactating mothers. 2. Fertility behavior of women.3. A critical analysis of health care of pregnant and lactating mothers in India With special reference to district of Basti, (U.P).4. Major causes of morbidity and mortality.5. Health and Nutrition education.6. Various state schemes for maternal health and their implementation.

BIBLIOGRAPHY

1. Sines, E., Syed, U., Wall, S. Warely, H., “ Saving New born lives, Postnatal Care: A critical opportunity to save mother& new born”, Policy perspective on new born health, 2007. 2. Syed, U., Asiruddin, S., Helal, S. Md., Mannan, I. I., Murray, J., “Immediate and Early Postnatal Care for Mother and New born in Rural Bangladesh”, Journal of Health, Population and Nutrition, 2006. 3. Mail, S.A., Padmadas, S.S., Mishra, S.U., Pallikadavath, S., Johnson, A.F., Mathews, Z., “ Socio-Economic In equalities in the use of postnatal care in India”, http://www. Plosone.org/article/infor:doi/10.1371 /Journal.pone. 4. Patel, V., Rodrigues, М., Sauza, D.N., “ The Study for Policy and practice”, The American Journal of Psychiatry, 2002.

5. Sivaramakrishnan, М., Patel, L.V., “ Reasoning about childhood nutritional deficiencies by mother in rural India: A cognitive analysis, Social Science and Medicine, Vol 37, No.7. 6. Rao, B.D., Latha, P.D., Women and Family Health, New Delhi Discovery Publishing House, New Delhi, 1999. 7. Sujata, М., Health and Nutrition for the School Children, Isha Books, New Delhi. 8. Stuart, G., Lawrence, H.J., The double Burden Malnutrition in Asia, Sage Publication, New Delhi, 2003.