You are on page 1of 37

1

CHAPTER-I
INTRODUCTION
1.1 Background of the Study
Health is accepted as a basic need and fundamental human right of every
human being that fulfills requirements and improves the quality of life. It is basic of
our life which is the most essential component included among the infrastructure of
the development of nation as well as the whole world. Health is most concerning
aspect of human life in context of both developed and developing countries. School
Health Program is one of the appropriate away in order to preventing, detecting, and
resolving health problem, promoting health, increasing educational achievement and
the quality of life of school children and other concerning personnel through the
various activities.
School health program is such activities which have more contribute to the
student and other concern personnel then other activities. School health services
directly affect the child today, tomorrow and in the future. School health services
included all such activities and procedure to affect the present health status of the
children's. This encompass appraisal of student health, prevention and control of
disease prevention and correction of physical defects, health guidance, supervision
and emergency care. An appraisal of health is an evaluation or assessment of the
present health status of person it is not only used to measure the growth but also assist
them in attaining optimum growth, not only helps the parents to understand the health
status and need of their children but also helps to develop positive understanding and
interest in students on their own health status. Appraising health condition is
continuous process which appraises deviation and deficiencies of students and
informs assurance of satisfactory or warning to danger position.
Screening test / procedures are the preliminary evaluation of the students
health status with the help of some technical method or instrument which are usually
done by paramedical personnel, trained teacher, health worker and oriented personnel
in order to determine the health deviation on quantitative basis, to provide facts and
truth health information of children to the parents and to provide health counseling
and guidance to students and parents if necessary.
Screening test of vision and hearing condition, heart functioning, body
posture and nutritional status are the aspects and procedures of the screening test.
Well conducted screening test is made for aiding the students in directing their own
2

health which is basically concern with Prevention is better than cure with aims
determine/ identify the level of defect before it begin or before it become worse.
Application of screening test of primary levels students which means starting
the organized system of pre health examination of the pillar of the nation which will
help to develop positive attention on their health status from the beginning.
Screening of nutritional status is very important for every age sex of people in
case of children of primary levels school it is the key to change their knowledge,
attitude and practice toward health condition and behavior they adapted. Only a
healthy person always cheerful and able to perform the all sorts of tasks without
exhaustion , Malnutrition is the burning problem which is faced by developed, under
develop and developing countries. Malnutrition is not a disease itself it is known as a
social problem which may cause many deficiencies. According to FSH (1996) 40
percent of the under 5 years children are suffering from malnutrition. The Nepal
multiple indicator survey (1995) report sows 63% children of under 3 years were
under nutrition (Maharjan).
Like Nepal and other countries have been facing various socio-economic and
environmental problems because of its being land-locked and least developed country.
Which directly influence the health status of children? In such countries ten million
children among five years of age, were dead in 1997. A total of 97 percent of this
number are from the developing countries and the major causes of death were
infections disease like diarrhea and pneumonia WHO (1998).
Nepal is one of the least developing country lying between 26"22' to 30"27'
latitude and 80"4' to 88"12' longitude covering the space of 1,47,181 sq. km. Nepal is
a small land locked country having 2,64,94,504 the total population male 1,28,49,041
female 1,36,45,463 and the population density is 180 per sq km the growth rate 1.35
per year has significantly affected the lack of education according to NPHC (2011).
Life expectancy is 66.5 years. High reproductive rate of 2.9 percent is the major factor
for increasing population. Similarly the infant mortality rate is 61.5 per thousand.
According to national planning commission HMF Nepal. The literacy rate of Nepal is
75.1% male and 57.4 percent women (CRB 2011). Our per capital income has only
$1,137 (HDR 2013). Nutrition food is a strong factor which plays an important role in
the production of healthy manpower for a country. Healthy manpower is strong pillar
of a country, natural resources of a country is not utilize in the absence of healthy and
skilled manpower. So, everybody should have knowledge of health status. Proper
3

health education is very important /essential to promote and maintain the health status
of the infant, children and the adults. That's why every student should get school
health services without any bias and every health teacher should have proper
knowledge about nutrition food, and about SHP. Our body requires clean and
nutrition food which can be obtained only through balance diet. However people do
not get balance diet adequately in Nepal due to lack of knowledge and practice.
Nutrition is one of the most important environmental factors in realizing the full
growth and development potentials of an individual and also plays a vital role in
health because malnutrition leads to poor health and poor health leads to illness, food
nutrition is essential for the growing children. Children under 5 years of age are more
vulnerable to this case because of their low immunity power nutrient requirements of
different groups of population are influenced by age sex, physical activities, and
physiological status and by environmental factors. On the other hand a number of
factors which affect acceptability and the utility of food are common habit,
availability, familiarity, taste cultural practices and knowledge about health. Sound
nutrition can change children's life such as to improve their physical and mental
development, protect from disease and make a form foundation for future life's
activities.
An analysis of the causes of stunting in Nepal revels that around half is rooted
in poor maternal nutrition and half in poor infant and young child nutrition. Around
the quarter of babies are born low birth weight as per the finding of NDHS 2011.
About 41 percent of child below 5 years of age are stunted .The survey showed that
29 percent of the children are under weight and 11 percent are wasted. Malnutrition is
not evenly distributed throughout Nepal it varies both ecologically and regionally.
The report has shown stunting, under weight and wasting being more common in mid
and far west hills and mountain area then other part of the country. All there
indicators are also poor in the central terai.
1.2 Statement of the Problem
School health services directly affect the child today, tomorrow and in the
future. No one knows when and where the influence and benefits of SHP ends. SHP
modifies youngster throughout all of his school years. It also prepares them to make
the necessary health decisions they will be called upon to resolve throughout life.
Health promotion is a recognized component of present day functional public school
education which is designed prepare to each children to deal with life's academic,
4

cultural and practical need. No phase of the school's activities has more to contribute
to the student then does the well conduct school health program. Closely interwoven
with all phases of school life health program aims to develop each student in term of
their present and future needs. Primary responsibility for the health of the child rests
with the parents, but the school is in a strategic position to contribute effectively.
The school does not assume the role of the parent nor substitute for the parent. Rather,
the SHP is planned to fortify and supplement efforts of the parents.
The child health status is subject of concern of all. School health work,
attention is given to an understanding of normal child growth, development and health
status. Common departure from health are introduced to enable teacher to understand
their proper role in contributing to the needs of the child who fall outside
In the context of Nepal health education is not accepted as important subject.
Still now almost the school do not have health teacher. Although, health and
education is accepted as fundamental human right. Person, organization, agencies and
the government concerning health and children are not serious on improving the
status. It been a long time health education included in the curriculum of different
levels, many program related to health, nutrition and children being lunched but
because of not implemented properly and due to many reason health condition of the
children is not satisfactory.
Generally children of 5 to 10 years aged are known as primary levels students.
Of course they are enabling to make their own decision related to health. They may
be neglected the proper behavior which make them healthy. Many hazards are faced
by the primary students. Even once a time if they knows their health status it will be
easy to modify their unhealthy behaviors it will help to develop an understanding and
interest in student on their health status , can be discover deviation from normal. Only
the Screening test can determine the health deviation on quantitative basis so fact and
truth health information can provide to the parents. One the first hand screening test
of health service provide counseling and guidance to the students and parents if
necessary, on the other hand refer for concern agencies or doctor if it is seen
necessary from the result of screening test.
As an aspect of school health service screening test can be taken increasing
student enrollment and decreasing dropout, repetition, failure and absenteeism at the
primary level. Many national international and local reports shows that children of
this age the status of health nutrition and education is not at expected levels it is
5

Because of the lack of the proper knowledge and practice of health nutrition and
education . SHP is lunched but due to many reasons like political, social economic,
demographical, cultural it is not being effective.
Nepal is one of the developing country so many problems are faced by the
people over here. Among the major problem of Nepal health condition of children is
the burning one. Similarly malnutrition, underweight, stunted is other problem faced
by school's children. poor economic and health status poor health services and
facilities , poor eating patterns, poor environmental sanitation directly or indirectly
primary levels students are suffered so emphasize is given to them on this study by
application of screening test in order to determine the fact and truth health
information related to health and nutritional status. Hopefully study area and even the
topic that I have chosen is completely new that's why I have chosen "Application of
Screening Test of Primary Level's Students in Syanja Municipality" as my study
1.3 Objective of the Study
General objective of the study is to apply screening test in order to find
nutritional status of primary levels students of Syanja Municipality. Specific
objectives were as follows:
1.3.1 To find out the nutritional status of the primary levels students.
1.3.2 To find out height and weight of that levels students.
1.3.3 To compare nutritional status between private and public school.
1.4 Signification of the study
Most of the people of our country are suffer from different health problem.
Most of the children are deprived of potential and optimum change of healthy growth
and development regarding too many reasons. Many Problems regarding health,
nutrition, and education related to children are should be taken as seriously then other
in the context of our country. Still now many people are depend on traditional healing
system. people are hesitated in check his health status and he / she think of been loose
his prestige if he is suffer from some long term health problem in context of Nepal
people attain to check up their health only after the case / condition become worse .
This study will help in promoting of total SHP, by developing the system. It will help
to alert students about their health status. This study will support all concern
personnel, organization and agencies in the sector of health, nutrition and education
related to children. This study will shows the need and important of total SHP, SHS
and it will of course emphasize on become practical. This study attempt to assist
6

applying screening test on primary levels students of Syanja Municipality to find out
the nutritional status.The main significances of the study were follows:
1.4.1 The study results would be assisting to school administrator, in
supervision, health educator and policy maker to identify the problem
and support to improvement and implementation of SHP in the school.
1.4.2 This study would be providing guideline for teacher to conduct school
health program.
1.4.3 This study would be support participant to identify their health and
nutritional status.
1.4.4 This study would be useful for future researchers in conducting
similar tasks.
1.4.5 This study would be Inspire to the respondents to develop positive
understanding and interest on their health status.
1.5 Delimitation of the Study
Every study has its own delimitation due to the limited time and lack of
resources. This is focused only particular are which could be investigate limit of the
researcher capacity. The present study has been delimited to the following criteria.
The delimitation of the study was follows:
1.5.1 The study was focused only in primary level's students.
1.5.2 The study area was delimited in Syanja Municipality municipality word
no 1 & 2 in Syanja district.
1.5.3 This study was delimited to 3 public school's (150 respondents) and 3
private school's (150 respondents).
1.5.4 Screening test was applied in this study in order to find out the
nutritional status.
1.5.5 Mid-arm Circumference Measurement, Gomez's Classification, Water
low's Classification test was used as test tools.
1.6 Operational Definition of the Terms Used
School Health Service
The school procedure carried out by physician, nurse, dentist, teachers, social
health worker to appraise, protect and promote the health of the students and school
personnel
Appraisal of Health
7

An appraisal of health is an evaluation or assessment of the present health


status of a person in order to improvement and maintenance of the health.
Screening Test
Screening test is the preliminary evaluation of student's health status with the
help of some technical method and instrument. This procedure are usually done by
paramedical personnel, trained teacher, health worker and oriented personnel.
Anthropometric Measurement
Anthropometric Measurement is known as measure of on the basis of person's
age, height, weight and circumference of arm.
Height
Height is the measure of the linear growth of body, the degree of skeletal
development. Measuring unit of height is cm.
Weight
Weight is an importance index of physical growth and development which
indicate the body mass of the person and measuring unit of weight is in kg.
Nutrition
Nutrition is a dynamic process of getting nutrition and utilizing them far
various & purpose of biological and physiological functions of the body.
Malnutrition
Malnutrition has been defined a pathological state resulting from a relative of
absolute deficiency or assess to one on more essential nutrition or proper nutritional
status due difference food lack of diet or some condition of the body which presents
assimilation of the food taken.
Under nutrition
This is the condition which results when insufficient food is eaten over an
extended periods of time. In extreme cases, it is called starvation.
Over nutrition
This is the pathological state resulting from the consumption of excessive
quantity of food over an extended period of time.
Height for age
The relative change in height with the change of age is called height for age.
Children who suffers from dietary deficiency becomes stunted because of poor
growth in height.
Weight for age
8

The relative change in weight of a child is determined as a percentage of


standard weight for that age.
The Nutritional status
The nutritional status of an individual is assessed by measuring physical
dimensions such as weight and high. This is called anthropometrics assessment of the
nutritional status. The anthropometrics measurement is then compared with the
reference standard to the measurement of well nourished community. For Nepalese
children no such reference standard is available.
9

CHAPTER-II
REVIEW OF RELATED LITERATURE AND CONCEPTUAL
FRAMEWORK
There are number of task and studies on SHP related to health status,
nutritional value and status of children of people of various institutions. Research
scholars, policy makers and public workers have undertaken several works
concerning food habit in Nepal and aboard. Although the Application of screening
test of primary levels students in Syanja Municipality has not been done until now,
the researcher will attempt indirectly related to subject matter of present study here as
the review of the related literature.
Any scientific research starts from review of related literature that provides
theoretical and Empirical base to the researchers. Literature review is an integrated
element of whole research procedure which assists to take appropriate decision about
each stage. So the ordered identification and analysis of document consisting
information pertaining to research problem is known as review of literature.
Basically, it provides concrete base to choose proper problem, define problem
clearly, justify appropriateness of research, select right study method, avoid
unexpected repetition, help in data collection analysis and interpret the conclusion.
Theories related to research are mentioned under the theoretical literature and related
study report, journal books articles, magazines related to research problem are
included as the source of empirical literature and conceptual framework is presented
in pictorial form to clarify how researcher run this study and result expected from this
research problem .
2.1Theoretical Literature
According to Anderson (1972), school health program means the prepared
course of action taken by the school in the interest of the school child and school
personnel. It includes health services, health instruction healthful school living. He
also states that the school health program could not be wholly effective unless it was
integrated with the home and the community and with the forces in both that
contribute to the health of the school child. Services of the personal of public health
departments and staff members of voluntary health agencies were utilizes as regular
part of the activities of the school.
Under the school health programme worker who are related with canteen
should wear clean dress and wash hands before working, handling food and before
10

serving food. Similarly, the major responsibility for the health of children belongs to
the family, the prime responsibility for the school health programme belongs to the
school administrator. Sharing in this responsibility are teachers, nurses, physicians,
dentists, counselors, psychologists, social worker, the health coordinator, food service
personnel, parents, community health agencies and students. Collectively, this group
is often referred to as the school health team. The promotion, protection and
maintenance of the health and well being of the students require the orchestrated
efforts of many school and community individuals and groups. To ensure that the
efforts of these individuals and groups enhance the quality and effectiveness of the
health services provided to both the student and the community.
According to mother and children bullet (1989), the study of infant feeding
and material nutrition and children development are interrelated. The relationship
between health and nutrition is well known. Nutrition helps children to be more alert
and active. It can make effects in their nutritional status. So, the good nutrition is
necessary for growth and development of the children.
Swami Nathan, M. (1992) wrote in his book "Hand Book of Food and
Nutrition" to examine the nutritional status of children. He used Gomez's
Classification test, water low's Classification and MUAC Tape test to find out
nutritional status.
For Gomez's Classification test formula,
Weight of child
Weight for Age (%) = 100
Standard weight for that sex and age
According to the Gomez's classification
a. Normal = More than 90% of than standard
b. First degree = 76- 90% of the standard
c. Second degree = 61- 75% of the standard
d. Third degree = below 60% of the standard
The first degree, second degree, and third degree of malnutrition is called
mild, moderate and severe respectively.
For Water Low Classification test:
Weight of child in Kg
Weight for Height (%) = 100
Height of a child in cm2

Height of child
Height for Age (%) = 100
Standard weight for that sex and age
11

For MUAC Test:


Color of tape Nutritional status
Green (> 13.5 cm) Normal
Yellow(12.5- 13 cm) Mild to moderate
Red (<12.5 cm Severe under nutrition

HPED Committee (1994) shows that balanced diet or proper nutrition was one
of the most important environmental factors that affect the health and well being of
human from conception to various stages of life. Especially during the first five years
of life when 90 percent of the mental growth occurs, balanced diets were an essential
requirement.
Pocket Book of pediatrics problems, third edition (1995) has started that more
than two third of Nepalese children under 5 years of age suffer from under nutrition.
These children's weight is less than 80 percent of the median weight for their age.
Similarly, when weight is considered as a measure of nutritional status more then 50
percent show evidence of stunting. However, only 5-15 percent of these children
show evidence of easily detectable severe malnutrition. Therefore, if one is not aware
of the nutritional problem, mild to moderate cases of malnutrition can be easily
missed. Malnutrition is one of the major cases of death under 5 year of age. Even in
those children who die of pneumonia, diarrhea, or measles, malnutrition is significant
underlying factor. Therefor, a health worker and concern personnel dealing with
children need to be familiar with different aspects of managing nutritional problem.
WHO (1997) convened on expert committee on comprehensive school health
education and promotion to assess what is known about promoting health through
schools. The committee was made up of persons with ministers of education and
health, non-governmental organizations, universities, and research institutions. The
committee reviewed research from both developing and develop countriesand
concluded that, without question school health programme can simultaneously reduce
common health problems, increase the efficiency or the education system and thus
advance public health, education and socio-economic development in all nations.

The body mass index (BMI) of Nepalese is low for both genders (Ohno et al.,
1998). Women in the age group of 15-49 years have been found to be suffering from
12

chronic energy deficiency (NMSS, 1998). One-fourth (27%) of the women in Nepal
have a BMI of less than 18.5 kg/m2. One in seven women with height of < 145 cm is
likely to suffer from under-nutrition. It has been found that 78% of pre-school
children, almost 68% of women and 75% of pregnant women are anemic (NMSS,
1998). Severe anemia (blood Hb level of less than 7g/dl) was observed in 2.2%
women and 3.1% children of 623 months. As in the case of vitamin A, low blood Hb
among the Nepalese, particularly among women, has been found to be associated with
intestinal infections (Curtale et al., 1993)
Himalayan Health Centre (2013), Report that five hundred and seventy five
children below 15 years of age attending the medical camp in Humla and Mugu
districts in October 2012 were assessed for nutritional status. For children less than
five years, weight for age, weight for height and height for age as per WHO
classification, and for children between five to 15 years age specific values of height,
weight and Body Mass Index (BMI) were calculated. According to the study in
Humla district, 28.2% children were undernourished, 8.8% wasted and 22.4% stunted
in less than five years. In the same age group, 31.7% children were undernourished,
9.4% wasted and 29.4% stunted in Mugu district. In the age group five to 15 years,
thinness was seen in 22.4% and 29.4% children in Humla and Mugu respectively.
Among children in developing countries, malnutrition is an important factor
contributing to illness and death. Malnutrition during childhood can also affect growth
potential and the risk of morbidity and mortality in later years of life. Malnutrition
among children is rampant among the South Asian countries. About half of all
children deaths are associated with malnutrition, of which three quarters are linked to
mild and moderate forms. Malnutrition among children is also very common in Nepal.
Nepal Micronutrient Status Survey (NMSS) reports 47 percent of children below five
age being underweight, 54 percentage of them being stunted (less height as per age),
and 7 percent being wasted (thin for height). Nepal Demographic and Health Survey
(NDHS) also reports 48 percentage children under weight, 50 percent stunted and 10
percent wasted. Studies show less stunting in Terai but comparatively high rate of
wasting than mountains.
Nepal Demography Health Survey (2006) Showed that nutritional status was
still very poor in Nepal. About 49 percent children under five year age were stunted
while 39 percent were found wasted. Nepal Demography Health Survey (2011) found
out that 41 percent of children below age of 5 years are stunted. The survey also
13

showed that 29 percent of children are underweight and 11 percent of the children
below 5 years are wasted. Malnutrition is not evenly distributed throughout Nepal it
varies both ecologically and regionally.
Nutrition country profile of Nepal (June 17, 2014) In Nepal, the nutritional
status of mothers and children under five is extremely poor. The prevailing high rate
of child undernutrition in the country is one of the major contributing factors of
underfive mortality. Anthropometric deficits among children vary with ecological
zone, stunting and underweight are more prevalent in the Mountains and Hills and
wasting in the Terai. The mountain zone has the highest stunting rate of 56 percent,
while the Terai has the lowest rate (37.4%). The NDHS (2011) report has shown 41
percent of children under 5 years of age are suffering from chronic under
nutrition (stunting) While more than 10 percent are acutely undernourished.
Nepalese women are highly affected by malnutrition especially in non-
mountainous regions. In Nepal, food shortages due to seasonality contribute to
malnutrition. Through maternal anthropometric status, seasonality affects birth
weight, and seasonality continues to affect growth throughout childhood. It is
estimated that low birth weight is (i.e. very small or smaller than average) at 12
percent. Poor growth rates during the hungry season increase the deficits compared
to international reference data. NDHS 2011 showed 18.2 percent of nonpregnant
women are undernourished or chronically energy deficient (BMI<18.5kg/m2) and 14
percent are overweight or obese which is in increasing trend ( NDHS 2011).
Nepal is globally recognized in reducing the high rate of micronutrient
deficiencies (IDA, IDD and VAD) through its successful community based
supplementation programs. Nepal has reduced the prevalence of anemia among
women of reproductive age by almost half from the 1998. From 68 percent in 1998 to
35 percent in 2011, Nepal has made a remarkable progress in the reduction of anemia,
however, this reduction has ceased in the last five years. In the same duration, the
prevalence of anemia in the pregnant women has increased by 6 percent. Anaemia
rates were higher among pregnant women (48%) and breastfeeding women (38%)
compared to women who were neither pregnant nor breastfeeding (33%). The
prevalence of anemia among adolescent girls has remained stagnant at around 39
percent over the last five years. Similarly, 46 percent of children underfive years of
age still remain.
14

2.2 Empirical Literature


Thapa (1989) conducted a study on Nutritional Status of the primary School
Children of Kathmandu Town Panchayat. The main objectives of the study were to
find out the weight and height of 8 years old children in the primary school of
Kathmandu, to compare the nutritional status of the private and public primary school
children, to find out the socio-economic impact on the nutritional status of the primary
school children. It was a descriptive in design. Simple Random sampling method was
used for sampling. Questionnaire and check-list tools were used for data collection.
The major finding was average height and weight of public primary school's children
was 132.88cm. And19.80kg, respondents of private schools of the same age height
and weight was 115.92cm. And20.55kg respectively similarly 20.5 percent and 48
percent of the public school children were wasted and stunted, 15 percent and 35
percent of private primary school children were wasted and stunted respectively. He
found that most of the occupations of the parents influence the nutritional status of
their children of farmers and labors' are found to be more undernourished than the
children of business people and service-holders
Dhamala, (2001) had studies on "Nutritional status of children under five
years of age in relation to MCH Care Practice in KatungeVDC, Okhaldhunga
district". He found that most of the mothers are unknown about the importance of
feeding colostrums and lito of super flour, kholay of using supplementary food is
quite improper. Delivery of the mothers gives birth at home and do not consult
doctors at the time of pregnancy. He also the find that health status of children
depend on various factor such as the health of mother, infectious disease
immunization, health knowledge and practices, economic and social status and so on.
He stresses that the major cause is MCH care practice.
Bohare (2002) conduct a study on Nutritional Status of under Five years
Children of Semlar VDC Rupendehi. The specific objectives of the study were
examine and analysis the socio- economic status of the children, compare the
nutritional status of the children base on different variables of the area , measure
height and weight for the assessment of nutritional status of the children . It was a
descriptive design used. Purposive sampling method was applied andquestionnaire
method was used to collect the data. The major finding were on the basis of source of
income, wages dependent families were not found to have normal and mild
malnourishedchildren only moderate and severe were 79.1 and 28.8 percent including
15

wages agriculture dependent families belong 35.4 percent mild and 64.6 percent
moderate, but no one found in severe degree of malnutrition, almost all children were
found not in normal condition
Yogi (2003) conducted a study on Nutritional status of child Development
Center of Surkhet Valley. The specific objectives were to find out the weight and
height of 3 to 5 year's children of Child Development Center of Surkhet Valley, to
determine the nutritional status of boys and girls of the same group, to compare the
nutritional status of the municipality and Adjoin VDC children of the Said group. It
was descriptive design. Stratified random sampling technique was applied observation
and interview schedule was used as tool of data collection of the study. The major
findings were the nutritional status of the children was very poor , the nutritional
status of the boys was found slightly better than the girls, the municipality children
have better then VDC children, the nutritional status of the children has got
influenced by the different variable like socio-economic factor ,educational level
occupation of the parents .
Sujakhu (2007) conducted a research on Nutritional Status of Children of
Child Care and Child Development Center run by Bhaktapur Municipality. The main
objectives of the study were to determine the nutritional status of children with the
help of anthropometric measurement, to compare the nutritional status between male
and female children, to find out the food practices of the respondents. It was a
descriptive design Systematic sampling method was used forsampling, interview
schedule were used for the collection of data. The major findings were about 55.15
percent respondents gave dal bhat and tarkari to their children after weaning and
24.26 percent respondents have given sarbottamlitto, the majority respondents 54.51
percent had feed 4 times and about 51.47 percent respondents said that they serve
food as the other group food .
Devekota (2010) conducted a study in Nutritional Status of under Five year
children of Tharu and Pahadi Community in KoholpurVDCBanke. It was descriptive
indesign. The main objectives of the study were to measure nutritional status of less
than five year children of tharu and pahadi by using anthropometric measurement, to
fond out the relationship between socio-economic status and nutrition among them.
Purposive sampling technique was applied, interview schedule, anthropometric
measurement were used as tool of data collection. The major findings were about 47
percent (out of 83 respondents) were found normal, 42.20 percent children were
16

mildly malnourished and 10.78 percent were severe. Similarly, tharu children were
more malnourished than pahadi respectively.
Bashyal (2012) conducted a study on a Comparative Study on Nutritional
Status of Kumal and Magar Community of under five year Children in
ChirtungdharaVDCPalpa District. The main objective of the study was to find out the
nutritional status among under five year children of that community, to compare
socio- economic and nutritional status of magar and Kumal community. It was
descriptive as well as comparative in design .Purposive sampling method was used.
Questionnaire was use as tool of data collection. The major findings were about 82.4
percent starts supplementary food in between 5- 8 months in magar and 89.5 percent
of kumal starts supplementary food in between 6 - 9 month. 44 percent of magar and
38 percent of kumal children were normal, 17.5 percent magar and 21 percent of
kumal children were found second degree malnutrition.
Bhatt (2012) conducted a study on Nutrition Status ofUnder Five Years
Children of educated and uneducated mother at Jhalari VDC in Kanchanpur District.
The main objectives of the study were to find out the nutritional status under five year
children, to determine nutritional status of under five year children, It was a
descriptive and quantitative in design. Purposive sampling method was used Interview
and anthropometric measurement apply as tool of data collection. The major findings
were height for age of indicator shows that 60 percent normal and 7 percent were
stunted. MUAC standard found 55.9 percent normal 37.5 percent mild and only 6.80
percent had severed malnourished.
From the above reviewed literature, it is detected that due to the lack of
knowledge and improper practical food habit, poverty of low economic status
ignorant and traditional beliefs in food causes the problems. Health condition of
primary levels children depends on their food habit. Conducting SHP on their school,
available health services thus practice of SHP in school, teaching nutritional education
is necessary for the respondents. The respondents most careful in health practice.
These types of study about application of screening test on primary levels student has
not been done in national and distracter community level.
According to review study of above published unpublished literatures, it has
helps to the researcher for own research. From the study of review literature it has
helped to choose the problem of on research, because from these study it become
17

known that in this problems, ever today there is not any research in national or
community. So, that it is chosen as a problem.
The review of the above literature clearly also present that the nutritional
status of primary levels student is influenced by economic status, family size,
educational status, occupation and socio-cultural background as well as the SHP
conduct held in school . It is also suggests that the nutritional status differ with age,
sex, hereditary and geographical location. So, these above mentioned factors must be
taken in mind while going through this research study.
2.3 Implication of the Review for the Study
The reviewed literature in above section is of immense value to the current
study, many findings suggestions provided in the previous literature review have
given me insights of improving my methodology and selection of tools and
instruments of data collection and analysis for the application of screening test.
Almost school they do not conduct SHP to improve their health and nutritional status.
Which motive me to improve awareness to the concern personnel. The review
literature provides ideas to lunch a study on the target area. Therefore, the research
was conducted screening test to find out the nutritional status of primary level
students of Syanja Municipality.
I come to known through the review literature that nutritional status is depends
on various factor among them SHP can be one of the most inflecting factor for the
student. Which can sustainable improve the practice of health check up as a whole
health and nutritional status will be improve.
2.4Theoretical Conceptual Framework
The conceptual framework is the basic of investigator's research problem
which represent the diagrammatic concept and variables related our study. It helps
establishing the linkage between objective and methodology to support ideas from
analysis portion. The main basis of conceptual framework construction is theoretical
modality.
The following type of conceptual framework can be made on the basis of
above mentioned theory selected to interpret research problem.
18

Internally perceived
about health risk
Demographic Variables
age, class, caste, Perceived abbout
gender, etc severity if health
become worse

Perceived about Increase in health


benefits of health check up practice
check up

Psychological Characteristics Positive perceived


about barriers while
personality, peer, reference, health check up
pressure group, etc.
Cues of preventive Increase total
measure to mantain health status
good health

Build confidnece in
ones ability to take
action

This model suggests that whether or not people change their behavior will be
influenced by an evaluation of its feasibility and its benefits weighed against its costs.
In other words, people considering changing their behavior engage in a cost benefit or
utility analysis. This may include their beliefs concerning the likelihood of the illness
or injury, happening to them (their susceptibility), the severity of illness or injury, and
the efficiency of the action and whether it will have some personal benefit, or how
likely it is to protect the person from the illness or injury.
According to above mentioned conceptual framework each person is being up
brought in socio-economic background after birth and according he/she gets
environment to gain education. If a person internally perceived about his health status,
belief about health risk he /she will more conscious on his nutritional status and
looked up the health services. The awareness ofidentifying risk and benefits to ward
the facilities provided by school, government and other organization. Once they get
the cue to action definitely they will improve their self efficiency which makes to
utilize SHS and increase in practice of health check up regularly.As a whole it will
improve health and nutritional status of persons.
19

CHAPTER - III
METHODS AND PROCEDURE OF THE STUDY
This chapter deals with the methodologies to be applied to carry to this study
which includes design and method of the study, population, sampling & sampling
strategy. Study areas/field, data collection tools and techniques data collection
procedure and data analysis and interpretation procedure which are presented below.
3.1 Design and Methods of the Study
This study was conducted on Application of screening test of primary levels
students' of Syanja Municipality. This study was based on descriptive method,
quantitative types of field based research and exploratory in nature.
3.2 Population, Sample and Sampling Strategy
The area of the study has taken ward no 1 and 2 of Syanja Municipality.
Children of primary level (age group 5 to 10 years) were taken as population. From
area out of 7 public schools and 9 private schools 3 public and 3 private schools were
selected by means of simple random sampling method (lottery method) similarly, out
of 353 students of public school and 361 students of private school 150 students were
selected by using systemic random sampling method. Out of 150 students of private
school 65 were boys and 85 were girls. Similarly, Out of 150 students of public
school 70 respondents were boys and 80 girls. Overall sampling procedure is given
below:
T T
Sampling Sam
SN School Name otal otal
Boys pling Girls
Boys Girls

1 49 65 22 28
..

2 54 59 26 24


3 61 65 22 28
..
164 189 70 80
Total
353 46.66% 53.33%
Total Total Sampling Sampling
SN School Name
Boys Girls Boys Girls
20

.
1 55 62 24 26
.

2 58 66 20 30
.

3 61 59 21 29
.
174 187 65 85
Total
361 43.33% 56.66%

3.3 Data Collection Tools and Technique


In this study required data and information was collected by Applying
screening test of nutritional status.Mid-arm Circumference Measurement, Gomez's
Classification, Waterlow's Classification and interview schedules wasused astools.
Weighting machine, measuring bar scale and MUAC Tape was used as instruments of
data collection. Information and records from school was used as secondary source.
3.4Finalization of the tools
The tools was prepared and correction according to the recommendation of the
supervisor. In ordered to accumulate reliable and valid of the data the tools pre test
was conducted on same age 20 children. After pre-test the researcher was consult with
supervisor to refine tools.
3.5 Data Collection Procedure
This was mainly based on primary data. After getting the permission letter
from the department of HPPE. The researcher was visit each of selected school of
target group then researcher introduced to the school personnel and explain about the
purpose of visit and request them to assist to my study by giving permission Students
were motivated by the help of class teacher. After building rapport the researcher
start the test (anthropometric measurement) used weighting machine, measuring bar
scale, MUAC tape and interview schedule to get correct data for the study.
3.6 Data Analysis and Interpretation Procedure
After collecting the required data it was checked and verified to reduce the
error and the data was tabulating under different heading and sub-heading as per
objectives of the study. Further information was classified, categorized and sub
categorized according to the objectives and data is presented, displayed in different
21

types of tables, figures, graphs and diagrams. For the analysis the frequencies of the
response was tally and convert in two percent with the help of computer.
Interpretation was done by the means of table, chart, figure etc. Analysis of data was
based on numerical and percentage.
22

CHAPTER - IV
ANALYSIS AND INTERPRETATION OF RESULTS
In this chapter present the analysis of the data which were collected from the
field visit. They were tabulated and calculated in percent regarding each test and
interview schedule variable. The analysis and interpretation have been presented
below in different away.
4.1 Nutritional Status of Respondents
The nutritional status of an individual is assessed by measuring physical
dimensions such as weight, high and mid upper arm circumference. Height is the
measure of the linear growth of body, the degree of skeletal development. Weight is
an importance index of physical growth and development which indicate the body
mass of the person which is called anthropometrics assessment of the nutritional
status. According to the objectives of the study nutritional status of the respondents
were classified on the basis of Gomez's and Water low's classification below.
4.1.1 Nutritional Status of Respondents According to Gomez's Classification
Table 1
Nutritional Status of Respondents (Public School) According to Gomez's
Classification
Gender Normal Mild Mod Severe
Age
Girl Boy Girl Boy Girl Boy Girl Boy Girl Boy
1
5 8 3 3 5 4 4 1 2 -
4
1 1
6 5 4 6 5 4 2 1 1
6 2
1 1
7 5 6 6 7 3 3 1 1
5 7
1 1
8 3 5 6 4 1 2 1 -
1 1
1 1
9 4 4 6 5 2 1 1 -
3 0
10 11 12 4 4 5 5 2 2 - 1
80 70 24 26 34 30 16 12 6 3
Total
150 30% 37.14 42.5 42.85 20 17.14 7.5 4.25
23

% % % % % % %
Above table shows According to Gomez's Classification public school
respondents were30 percent girls normal, where as 37.14 percent boys are normal.
Similarly 42.05 percent girls were mild and 42.85 percent boys are mild. 20 percent
girls were moderate where 17.15 percent were boys. Similarly 7.5 percent of girls
were in severe and 4.25 percent boys are severe respectively.
Table 2
Nutritional Status of Respondents (Private School) According to Gomez's
Classification
Gender Normal Mild Mod Severe
Age
Girl Boy Girl Boy Girl Boy Girl Boy Girl Boy
5 11 9 3 3 5 4 2 2 1 -
6 18 14 6 5 8 7 4 2 - -
7 14 10 4 3 7 6 2 1 1 -
8 11 10 4 3 6 5 1 2 -
9 16 12 5 4 8 6 3 2 - -
10 15 10 5 2 6 6 3 1 1 1
85 65 27 20 40 34 15 10 3 1
Tota 3 1
30.76 47.05 52.30 3.52 1.53
l 150 1.76 17% 5.38
% % % % %
% %
Above table shows According to Gomez's Classification private school
respondents were31.76 percent girls normal, where as 30.76 percent boys are normal.
Similarly 47.05 percent girls were mild and 52.30 percent boys are mild. 17 percent
girls were moderate where 15.38 percent were boys. Similarly 3.52 percent of girls
were in severe and 1.35 percent boys are severe respectively.
We found from above table according to Gomez's classification nutritional
status of private school's respondent is better than the same age and sex group of
public school's respondents.
24

4.1.2 Nutritional Status of Respondents According to Waterlow's Classification


Table 3
According to Water low's Classification of Height for Age
(Public School)
Gender Normal Stunted
Age Group
Girls Boys Girls Boys Girls Boys
5 14 8 12 7 3 1
6 16 12 13 10 3 2
7 15 17 14 15 1 2
8 11 11 9 10 2 1
9 13 10 11 8 2 2
10 11 12 10 12 1 0
80 70 68 62 12 8
Total
150 85% 88.57% 15% 11.42%

Table 4
According to Water low's Classification of Height for Age(Private School)
Gender Normal Stunted
Age Group
Girls Boys Girls Boys Girls Boys
5 11 9 8 7 3 2
6 18 14 16 13 2 1
7 14 10 13 9 1 1
8 11 10 9 10 2 0
9 16 12 14 11 2 1
10 15 10 14 9 1 1
85 65 74 59 11 6
Total
150 87.05% 90.76% 12.94% 9.23%

According to Water Low's Classification of Height for Age from the above
table 85 percent of the public school girl respondents are normal where 87.05 percent
private school same age girls were normal similarly 15 percent of the girls found to
stunted and 12.94 percent girls from private school were stunted. Similarly 88.57
percent of the public school boys' respondents are normal where 90.76 percent private
25

school same age boys were normal similarly 11.42 percent of the boys found to stunt
and 9.23 percent boys from private school were stunted so we found that nutritional
status is seems good in private schools respondents.
According to Water Low's Classification of Height for Age from the above
table 85 percent of the public school girls respondent are normal where 88.57 boys are
normal similarly 15 percent of the girls found to stunted and 11.42 percent boys were
stunted so we found that boys nutritional status is better than the same age of girls.
Table 5
According to Water Low's Classification of Weight for Height (Public School)
Gender Normal Wasted
Age Group
Girls Boys Girls Boys Girls Boys
5 14 8 12 7 2 1
6 16 12 15 11 1 1
7 15 17 15 16 0 1
8 11 11 10 10 1 1
9 13 10 11 9 2 1
10 11 12 10 12 1 0
80 70 73 65 7 5
Total
150 91.25% 92.85% 8.75% 7.14%
26

Table 6
According to Water Low's Classification of Weight for Height (Private
School)
Gender Normal Wasted
Age Group
Girls Boys Girls Boys Girls Boys
5 11 9 10 8 1 1
6 18 14 16 13 2 1
7 14 10 13 9 1 1
8 11 10 10 9 1 1
9 16 12 16 11 0 1
10 15 10 15 9 0 1
85 65 75 59 5 6
Total
150 93.75% 90.76% 6.25% 9.23%

According to Water Low's Classification of Weight for Height ( Public


School) 91.25 percent girls were normal where as 93.75 percent girls were normal in
private school similarly 92.85 percent boys from public schools were normal and
only 90.76 percent boys were normal from private school. The respondents 6.25
percent girls were wasted in private school where as 8.75 percent girls from public
schools were wasted similarly 7.14 percent boys were wasted in public school where
as 9.23 percent boys were wasted in private school respectively.
4.1.3 Nutritional Status of Respondents According to Mid-Upper Arm
Circumference Tape Test
MUAC tape test is a simple method of screening the nutritional status of pre-
primary and primary level students on this method according to the indicators (Red,
Yellow and Green) part shows the different levels of nutritional status. Where below
12.5cm (Red) shows severe, 12.5cm13.5cm (Yellow) part shows mild to moderate
and over 13.5cm (Green) shows normal. The nutritional status of the respondents
according to MUAC tape test is shown below.
Table 7
Nutritional Status of Respondents According to Mid-Upper Arm Circumference
Tape Test
Nutritional Status Private School Public School
27

Number Percentage Number Percentage


Normal 59 39.33 65 43.33
Mild moderate 72 48.00 69 46.00
Severe 18 12.66 16 10.66
Total 150 100.00 150 100.00
According to the table above shows that respondents from public school 39.33
percent normal, 48 percent mild to moderate and 12.66 percent were severe.
Similarly, out of 150 respondents from public school 43.33 percent normal, 46
percent mild to moderate and 10.66 percent were severe.
4.2 Height and Weight of Respondents
Height and weight is main indicator of person's nutritional status. The weight
indicates the mass of the body and heights express the liner growth. Average Height
and weight of respondents has been shown in the table below. Average Height and
Weight of respondent's comparison with WHO Standard on the table below.
28

4.2.1 Height of Respondent's


Table 8
Height of Respondent's
Standard Respondents Standard
Age Respondents
Height (Cm) Height (Cm) Height (Cm)
Group Height (Cm)Boys
Girls Girls of Boys
5 109..7 105.8 111.3 109.1
6 115.9 113.5 117.5 114.9
7 122.3 120.9 124.1 123.0
8 128.0 126.8 130.0 128.3
9 132.9 130.1 135.5 133.9
10 138.6 135.4 140.3 137.6

4.2.2 Weight of Respondent


Table 9
Weight of Respondents
Standard Respondents Standard Respondents
Age
Weight (Kg) Girls Weight Weight (Kg) Weight
Group
Girls (Kg) Boys (Kg)Boys
5 18.78 17.05 19.41 17.21
6 21.09 19.15 21.91 19.53
7 23.68 21.04 24.54 22.14
8 26.35 24.10 27.26 25.34
9 28.94 27.3 29.94 27.89
10 31.89 29 32.61 30.05

The table shows that the age of 5 years girls weight is average 17.5 kg where
boys same age have 17.21 kg the age of 10 year girl weight is 29 kg where the same
age boys is 30.05 kg in average similarly the age of 5 year girl height is 105.8 cm the
same age boy height is 109.1 cm Similarly the age of 10 year girl height is 135.4 cm
and the same age boys height is 137.6cm respectively. According to the above table it
is clearly found that height and weight of respondent of less than the standard height
and weight of that age and sex.
29

The above table shows the difference the height and weight of respondent's
comparison with international standard height and weight for the same age and sex.
So we found that comparatively primary levels student nutritional status is lower than
the standard status of that age and sex.
4.3 Comparison of Nutritional Status of Respondents
4.3.1 Comparison of Nutritional Status According to Gomez's Classification
Figure 1
Comparison of Nutritional Status According to Gomez's classification

60
49.33
50
42.66
40
32.6631.33
Public
30
Private
18.66
20 16.66

10 6
2.66
0
Normal Mild Moderate Severe

The above figure no 1 shows the comparison of nutritional status between


public and private schools respondents according to Gomez's classification. As the
figure 32.66 percent public schools respondent were normal where as 31.33 percent
private school were normal. Similarly, 42.66 percent mild in public and 49.33 percent
were mild in private, 18.66 percent moderate were and 6.00 percent severe were in
public whereas 16.66 moderate and only 2.66 percent severe were in private
respectively.
30

4.3.2 Comparison of Nutritional Status According to Water low's Classification


(Height for Age)
Figure 2
Comparison of Nutritional Status According to Waterlow's Classification

100 88.66
86.66
90
80
70
60
Public
50
40 Private
30
20 13.33 11.33
10
0
Normal Stunted

According to water low's classification (height for age) the above figure shows
that 86.66 percent respondent from public school and 88.66 percent private school
respondent were found to be normal. Similarly, 13.33 percent respondents were
stunted respectively as result private schools respondents were found to be better
nutritional status than public school.
31

4.3.3 Comparison of Nutritional Status According to Water low's Classification


(Weight for Height)
Figure 3
According to Water low's Classification (Weight for Height)

100 92 91.33
90
80
70
60
Public
50
40 Private
30
20 8 8.66 6 6.66
10
0
Normal Wasted Stunted & Wasted

According to the water low's classification (Weight for Height) above figure
no3 shows 90.00 percent public school and 91.33 percent private school respondent
were normal. Similarly,8.00 percent wasted and 6.00 percent wasted and stunted
found in public school where as 8.66 percent wasted and 6.66 percent wasted and
stunted found in private school.
4.3.4Comparison of Nutritional Status According to MUAC Tape Test
Figure 4: MUAC Tape Test

60
48 46
50 43.33
39.33
40
30
20 12.66 10.66
10
0
Normal Mid to moderate Severe
Public private

According to the figure above shows that respondents from public school
39.33 percent normal, 48 percent mild to moderate and 12.66 percent were severe.
32

Similarly, out of 150 respondents from public school 43.33 percent normal, 46
percent mild to moderate and 10.66 percent were severe.
4.3.4: Respondent Suffering from DiseaseWithin Last Year
Table 10
Respondent Suffering from Disease within last year
Public School Private School
S.N Description
Number Percentage Number Percentage
1. Diarrhea 28 18.66% 23 15.33%
2. ARI 16 10.66% 8 5.33%
3. Worm Infection 8 5.33% 6 4.0%
4 Typhoid 32 21.33% 29 19.33%
Total 84 56% 66 44%

The above table shows the respondents suffering from disease which may
affect their health status. According to the interview taken respondents from public
school 18.66 percent children were suffer from diarrhea , 10.66 percent from ARI ,
5.33 percent from worm infection, and 21.33 percent suffer from typhoid similarly ,
from the public school only 15.33 percent from diarrhea, 5.33 percent ARI. , 4.0
percent worm infection, and 19.33 percent were suffered from typhoid respectively in
private school.
From the table result we found that 56 percent of the public school children
where 44percent children from private school were suffer from communicable disease
within last year
4.3 Summary of Findings
4.3.1 Summary
This study was conducted on "Application of Screening test of primary levels
Students ofSyanja Municipality" The main objective of the study is to apply
screening test in order to find out nutritional status of primary levels students of
Syanja Municipality. Another objective was to find out the nutritional status of the
primary levels students. To determine height and weight of that level students. To
compare nutritional status between private and public school children. This study was
based on descriptive as well as comparative design, quantitative types of field based
research and exploratory in nature. Out of 150 respondents from three public school
33

and 150 respondents from three private schools altogether 300 respondents were
selected as sample by using simple random sampling and systemic random sampling
method in this study. The study was based on primary source of data and supportive
information is getting from secondary source. Interview schedule is used to find out
general information. Primary data were taken in the field visited by using
anthropometric measurement.
From this study it is found that nutritional status of the primary level student is
low , boys nutritional status is comparatively better than girls of same age group ,
private school's respondents health status is slightly better than the public school.
4.3.2Finding of Nutritional Status
a. According to Gomez's Classification 30 percent girls and 37.14 percent boys
from public school were normal.
b. Out of total respondents 42.05 percent girls and 42.85 percent boys are
mild in public school.
c. The respondents20 percent girls and 17.15 percent boys are moderate.
d. The respondents7.5 percent of girls and 4.25 percent boys are severein
public school.
e. According to Gomez's Classification 31.76 percent girls and 30.76 percent
boys are normal in private school.
f. The respondents47.05 percent girls and 52.30 percent boys are mild.
g. The respondents17 percent girls and 15.38 percent were boys moderate.
h. Out of total respondents 52 percent of girls and 1.35 percent boys are severe
in private school.
i. According to Water Low's Classification 85 percent girls and
88.57percentboys respondent are normal in the public school.
j. Out of total respondents 12.94 percent girls and 9.23 percent boys were
stunted in private school.
k. According to Water Low's Classification of Weight for Height 91.25 percent
girls and 92.85 percent boys were normal in public school.
l. Out of total respondents 6.25 percent girls and 9.23 percent boys were
wasted in private school.
4.3.3 Finding of height and weight of Respondents
a. The respondent of 5 year girl average weight is 17.5 kg where same age
boys have 17.21 kg weight.
34

b. the age of 10 year girl weight is 29 kg where the same age boys is 30.05 kg
in average.
c. The age of 5 year girl height is 105.8 cm and the same age boy height is
109.1 cm.
d. The age of 10 year girl height is 135.4 cm and the same age boys height is
137.6cm in average
e. It is found that height and weight of respondents is less than WHO
standard.
f. According to MUAC tape test 48 percent respondents from public school
and 46 percent respondents from private school were mild to moderate.
g. Out of 150 respondents 10.66 percent from private and 12.66 percent
respondents from public school were severe.
h. Out of 150 respondents6 girls 3 boys from public and 3 girl 1 boys from
private severe, 4 girls 3 boys from public and 3 girls 2 boys private stunted,
3 girls 2 boy from public and 2 girls 1 boys from private wasted were
referred for medical examination.
4.3.4 Finding of Comparison between Private and Public School
a. According to Gomez's classification respondents of public school 32.66
percent were normal, 42.66 percent mild, 18.66 percent moderate and 6.00
percent severe. Whereas 31.33 percent normal, 49.33 percent mild, 16.66
percent moderate and 2.66 percent severe were found in private school.
b. According to water low classification (H/A) the respondents of public school
86.66 percent were normal and 13.33 percent were stunted whereas 88.66
percent normal and 11.33 stunted were found in private school.
c. According to water low (W/H) 92.00 percent normal, 8.00 percent wasted were
found in public school. Whereas 91.33 percent normal and 8.66 percent
wasted in private school.
d. Out of 150 respondents 6.00 percent wasted and stunted were found in
public and 6.66 percent wasted and stunted were found in private school.
e. According to MUAC Tape test 39.33 percent normal, 48.00 mild to
moderate and 12.66 percent severe were found in public school. Similarly,
45.33 percent normal, 46.00 percent mild to moderate and 10.66 percent
severe where found in private school.
35
36

CHAPTER - V
CONCLUSION AND RECOMMENDATION
5.1 Conclusion
This study was a unique in its own type in the area of application of screening
test of primary level students of Syanja Municipality. On the basis of findings of the
study it is concluded that Nutritional status depends upon various factors like socio-
economic, demographic, education of the family, services provided by the school etc.
According to the findings the respondent were children of primary level age
from 5 year to 10 years. On the basis of Gomez's classification more percentage of the
girl and boys from public school were mild. Similarly public schools respondents
were less normal while percentage of severe is less in private school respondents. And
according to Water low's classification of height for age , weight for height both
respondents were found of normal but comparing among them private school
respondent were found slightly better than public school .It is found that respondents
height and weight of is less than WHO standard.
5.2 Recommendations
After the summary finding and conclusion it is found that nutritional status of
the primary levels student is not satisfactory and significant difference was seen
among private and public school's children . After the result of the screening test
with the help of school administration the parents of respondents were informed about
nutritional and health status of their children and suggested them as well as school
personnel to take action to improve Similarly some children were referred for the
health examination who were in the condition of severe, stunted and wasted.Finally
on the basis of this study some recommendations are presented below:
5.2.1 General Recommendation
a. The school teacher should be well trained
b. There should be workshop and seminars on the nutritional problem of the
children.
c. All the schools have to compulsory conduct school health program.
d. SHPhas to planed and well implemented in both private and public sector.
e. The weight and height (Nutritional status) should be recorded and their
nutritional assessment should be done regularly.
f. Parents should be informed about their children health status.
37

g. Health and nutrition education should be given to school children as well


as their parents.
h. Child feeding program should be conduct effectively
5.5.2Policy Recommendation
The government should conduct nutritional program in backward community
through co-operation with target people.
a. The government should provide training to the school teacher and regular
supervision should be done.
b. The government should compulsory the SHP in both private and public
school
c. The farmers should be aware and trained to increase the agricultural
production for their proper cropping.
d. School management committee should co-operate in conduct SHP.
e. Child friendly school policy should be lunched and implemented properly.
5.2.3Recommendation for the further study
a. Experimental type of research can be conduct on this topic
b. Similar type of study can also conduct with in secondary level students.
c. Similar type of study can also conduct with in secondary level students.
d. Screen test can conduct on vision screening test, hearing screening test,
screening of posture and screening of heart in different level.