A PROJECT PROPOSAL

FOR
IMPROVING HEALTH AND NUTRITIONAL
STATUS OF SCHOOL
CHILDREN IN SURYABINAYAK MUNICIPALITY

SUBMITTED BY

DEEKSHASHREE THAPA
PABINA THAPA
ANJITA SUNAR
4TH YEAR 10TH BATCH

SUBMITTED IN PARTIAL FULFILLMENT OF THE

REQUIREMENTS IN THE SUBJECT OF PROJECT
MANAGEMENT
(COURSE CODE: BPH 408.3 PM) FOR
DEGREE OF BACHELOR OF PUBLIC HEALTH

SUBMITTED TO
DEPARTMENT OF PUBLIC HEALTH
ASIAN COLLEGE FOR ADVANCE STUDIES
SATDOBATO, LALITPUR
PURBANCHAL UNIVERSITY
2018
 APPROVAL SHEET
Department of Public Health
Asian College for Advance Studies
Satdobato, Lalitpur
Purbanchal University

CERTIFICATE
It is certified that this project proposal entitled “IMPROVING HEALTH
ANDNUTRITIONAL STATUS OF SCHOOLCHILDREN INSURYABINAYAK
MUNICIPALITY” is the bona fide work of Deekshashree Thapa, Pabina Thapa and
Anjita Sunar conducted under our guidance and supervision as partial fulfillment of
the requirement for the degree of Bachelor in Public Health from Asian College for
Advance Studies,Satdobato, Lalitpur, of Purbanchal University.

………………………............................. ………………………………………………….
Lecturer Deepak Jha External Examiner
Supervisor
Department of Public Health
Asian College for Advance Studies
Satdobato, Lalitpur

……………………………………………
Head of Department
Department of Public Health
Asian College for Advance Studies
Satdobato, Lalitpur

ii
 RECOMMENDATION

This is to recommend that the project proposal entitled ‘‘IMPROVING HEALTH

AND NUTRITIONAL STATUS OF SCHOOL CHILDREN IN
SURYABINAYAK MUNICIPALITY” has been carried out by Deekshashree
Thapa, Pabina Thapa and Anjita Sunar for the partial fulfillment of Bachelor in Public
Health. This original work was conducted under my supervision. We would like to
recommend keeping this project proposal report for final evaluation.

…………………………………..
DEPARTMENT OF PUBLIC HEALTH
ASIAN COLLEGE FOR ADVANCE STUDIES
SATDOBATO, LALITPUR
PURBANCHAL UNIVERSITY, BIRATNAGAR, NEPAL
2019

iii
 TABLE OF CONTENTS
APPROVAL SHEET...........................................................................................................ii
RECOMMENDATION......................................................................................................iii
I.BACKGROUND...............................................................................................................1
II. SITUATION OF THE PROBLEM.................................................................................3
III.RATIONALE.................................................................................................................5
IV.OBJECTIVES OF THE PROJECT................................................................................6
1. General Objective.............................................................................................................6
2. Specific Objective.............................................................................................................6
V. PROJECT SUMMARY..................................................................................................7
VI. PROJECT DURATION................................................................................................8
VII. REPORTING SYSTEM...............................................................................................8
VIII. MONITORING AND EVALUATION......................................................................8
IX. CONCLUSION.............................................................................................................9
X. ACTION PLAN............................................................................................................10
XI. BUDGET.....................................................................................................................11
XII.REFERENCES............................................................................................................13

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I.BACKGROUND

Nutrient is the study about food and its relationship to health. Nutrition is a very
important requirement needs to help the process of growth and development of
children[1]. Nutritional status is the condition of health of an individual as influenced by
nutrient intake and utilization in the body[2] .

Nutritional status is an important index for measuring quality of life especially in

children. In this respect, understanding the nutritional status of children has far reaching
implications on better development of future generations as well as future development of
humanity[3]. Malnutrition is refers to both under-nutrition and over nutrition[4]. Chronic
under nutrition in children is linked to slower cognitive development, poor school
attendance, high school withdrawal rate, and serious health impairments later in life that
reduce the quality of individual. Overweight and obesity have also been linked to
increased risk of cardiovascular and pulmonary diseases[5].

School age is a dynamic period of physical growth as well as of mental development of

the child[6]. Globally, about 668 million children are studying at the elementary school
level, which is the largest proportion of the total population[7]. School age is the active
growing phase of childhood. Research indicates that health problems due to miserable
nutritional status in primary school age children are among the most common causes of
low school enrolment, high absenteeism, early dropout and unsatisfactory classroom
performance. During the adolescents growth spurt, body requires lot of nutrients which
should be stored in the body during childhood and if body stores are deficit it can result
in adverse health consequences like growth retardation, scholastic backwardness and
reduced work capacity[6].

In Nepal, Malnutrition prevalence is still one of the major nutritional problems despite a
steady decline in past three years[8]. Although the World Bank has included school
health as one component of its essential public health package for cost effective health
program, the nutrition and health of school age children in the developing world has
received a little attention. WHO in 1997, developed 10 recommendations for school

1
health, and initiated a global health initiative in ten countries, of which 8 were developing
countries. Despite such initiatives, school health has not been focused on in Nepal for
many years and donor initiated school health projects have come and gone sporadically
over the decades[9]. According to2011 census, the total population of Nepal is 26.6
million, out of which contribution of young children in total population is 17.8%. Nepal
Demography and Health Survey 2011 revealed that young children are suffering from
high rates of chronic malnutrition: 41% of children less than 5 years of age were stunted,
29% were underweight, and 11% were wasted based on WHO Child Growth
Standards[10].

Bhaktapur is the smallest district of Nepal. According to National Census 2068 BS, it has
population of 3, 04,651 out of which 154,884 are males and 154,767 are females. As per
the National Census 2011, 0-14 year’s age group constitutes 24.79% of total population.
The net enrolment rate in the primary level is 98% and in the school level (1-10) is 82%.
Suryabinayak Municipality is the municipality of Bhaktapur district. According to the
2011 Nepal census, Suryabinayak Municipality had a population of 78,490[11].

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II. SITUATION OF THE PROBLEM

Malnutrition is a major public health problem in most of the developing countries[12].

Protein Energy Malnutrition is the most important nutritional problems globally[13]. It is
the most important risk factor for the burden of disease causing about 300,000 deaths per
year directly and indirectly responsible for more than half of all deaths in children[14].

Globally, 156 million children suffer from chronic malnutrition, wasting continues to
threaten the lives of almost 52 million children (8 percent)[15]. Child overweight are on
the rise, including in low and middle income countries[16].A review published in 2010
by Best et al summarized the data of nutritional status of children 5-12 years worldwide.
A deficiencies ranged from 20% to 30%, suggesting an important public health issue
among School aged children, especially from Africa and Asia[17].

Stunting affects 165 million children worldwide, 90% of whom live in Africa and Asia,
making it a major concern in developing countries[15]. According to WHO, the estimated
prevalence rate of stunting among school age children aged 5-18 years of age was 23% in
Asia[16]. According to data of Health Research in 2010, the prevalence of stunting in the
age group of 6-12 years was 25.6%, underweight and overweight accounted 11.2% and
9.2 %[1].20-80% of primary school children are suffering from nutritional deprivation.
Assessment of nutritional status of this segment of population is essential for improving
the overall health[4].

South Asia has the highest prevalence of malnutrition as compared to other regions and
the prevalence of wasting was 16%, stunting 35.8% and overweight was 4.3%
respectively[18]. Children aged 5-14 years represent 1.1 billion individuals worldwide, of
which 90% live in low and middle income countries[17]. Chronic malnutrition early in
life can cost countries up to 11% of their gross domestic product every year in Africa and
Asia[15], whereas preventing malnutrition delivers $16 in return on investment for every
$1 spent[3].

3
In Nepal 41% of the total population are below 15 years of age. The school children aged
5 to 15 years constitute about 27% of the total population who are exposed to the risk of
accident, injuries, infection and malnutrition[13]. According to the 2016 World
Population Data Sheet, 31% of the total population constitutes below 15 years[19]. In
2016, Nepal Demographic and Health Survey revealed that about 36% were stunting,
10.5 % were wasting and 27% were underweight among the children under 5 years of
age. A study conducted in 2017 at Dukuchhap village in Lalitpur district of Nepal, out of
319 children aged 6-12 years it was found that 16.9% were underweight and 12.2% were
stunted respectively[10]. 20-80% of primary school children are suffering from
nutritional deprivation. Assessment of nutritional status of this segment of population is
essential for improving overall health[4].

4
III.RATIONALE
Nutrition plays a vital role in growth and development of children. Inadequate nutrition
may lead to malnutrition, growth retardation, reduced work capacity and poor mental and
social development. Among all age groups, the school age period is nutritionally
significant because this is the prime time to build up body stores of nutrients in
preparation for rapid growth of adolescences. Apart from that, the population of school
going children contributes to future manpower which can improve the socio-economic
condition of developing countries[20].

Malnutrition is a direct result of insufficient food intake or repeated infectious diseases or

combination of both. Malnutrition not only directly affects the children by reducing their
physical and mental performance but also makes the situation worse by making the
children susceptible to infection[13]. In Nepal, a study conducted in Kavre district among
rural school going children 4-16 years, out of 438 children it was found that prevalence of
underweight was 30.85%, stunting was 24.54% and thinness was 10.5% respectively[2].

Nutritional well-being of the population is crucial for accelerated attainment of many of

the sustainable development goals[8].Despite advocacy for health and nutrition services
in primary schools, there is a clear lack of data on the actual nutritional status of children
in this age group in developing countries and countries in transition. Most research
focuses on malnutrition in young children under5 years of age, whereas school aged
children are often omitted from health and nutrition surveys or surveillance[21].

This research would enable to monitor the nutritional status of children age group (6-12
years) in Suryabinayak Municipality. Till now no any research has been conducted in this
area. This study will be helpful in identifying severity of malnutrition in children of age
group 6-12 years. The study of nutritional status of school going children help to discover
the problems related to nutrition and identify people who are malnourished and needs
special care and attention. This study may be helpful for the policy makers to take
appropriate measures in order to improve nutritional status of school going children.

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IV.OBJECTIVES OF THE PROJECT

1. General Objective

 To improve health and nutritional status of schoolchildren in Suryabinayak

Municipality.

2. Specific Objective

 To increased availability of safe water and sanitation at school.

 To improve knowledge, attitude of and skills toward key behavior on SHN.
 To increase access to the use of health and nutrition services at schools.

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V. PROJECT SUMMARY

Nutritional status is an important index for measuring quality of life in children. Chronic
under nutrition in children linked to slower cognitive development, poor school
performance, high school withdrawal rate, and serious health impairments later in life.
Overweight and obesity is linked to increase risk of immediate and long term negative
health outcomes.

Improving the health and nutritional status of school children to enhance their school
performance and to improve health and nutrition behaviors and habits.

This project aims at promoting healthy school environment, increasing access to safe
water and sanitation facilities through installation of filter and construction of waste
disposal sites, as well as improving knowledge, attitude of, and skills of teachers, parents
towards, key behavior on School Health Nutrition. Technical and financial support from
the government sector and building partnerships and additional value.

Appropriate structures will be established at school level, with local government to co-
ordinate the project activities. The co-ordinating structure will consist of representatives
from local government, NGOs. The expected results of this project are:
 Students/School children will have access to safe water and functioning latrines.
 Teachers, parents, and child club members will improve their knowledge, attitude
and skills towards key behavior on SHN.
 Local government will support in the management of School Health and Nutrition
Activities and the program progress will be reviewed and monitored by local
government.
 Teachers will know more about how to provide first aid and school children will
have access to first aid.

The tools that will be used to measure the results of the project include training
attendance and evaluations, feedback from teachers, child club members, contractor and
partners, and project records and financial reports.

7
The project will produce:

 Waste disposal site, handwashing facility and access to safe water for school
students
 Training and orientation for teachers, parents, and child club members.
 First aid training for teachers and kit for the schools.

The project results will be disseminated through a written evaluation. It will be given to
all stakeholders in the project.

VI. PROJECT DURATION

- The expected duration of the project is one full calendar year.

VII. REPORTING SYSTEM

- Mid-term financial and narrative report will be submitted after four months
following initiation of the project.
- Final narrative and financial report will be submitted within two months after
completion of the project.

VIII. MONITORING AND EVALUATION

- A continuous monitoring system will be implemented as part of project activities

as indicated above.
- Regular reviews and evaluation will be undertaken at four month intervals
- Monitoring and evaluation reports will be shared with donors and partners in a
timely manner.

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IX. CONCLUSION

- Donation to this project is considered a great support to ensure better learning

achievement and improved health and nutritional status of the school children.
- Child Friendly Organization will ensure technical expertise and accountability for
implementation of the project. And in partnership with local government and in
close co-ordination with teachers, and parent.
- In advocacy and media coverage, in-kind donation(s) for this project will be
highlighted and reflected.

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 X. ACTION PLAN

Objective Activities Responsibility Timeline Outputs Beneficiaries

Help to Support provision Child Friendly April-Sep: Site chosen, Water filters Children,
increased of safe water Organization, equipment, materials installed. Teachers,
availability of through are estimated and Their
safe water installation of Waste Families
and sanitation water filters disposal site
at school. constructed.
Waste disposal Sep- Jan: Water filters
site will be installed, site Handwashin
constructed constructed, g facility
Hand washing handwashing facility established.
facility is established.
established.

Improved Teachers are Child Friendly Feb-March: Develop Improved Children,

knowledge, trained on SHN Organization, training and resources knowledge of Teachers,
attitude of, health education Co-ordinator, teachers, and Their
and skills session on child club Families
towards key personal hygiene, members,
behavior on nutrition and March- August :Hold and parents.
SHN. healthy habits. trainings and
orientation

Child club
members are
trained on SHN.

Parents are
oriented on SHN
health education
sessions on
personal hygiene,
nutrition and
healthy habits.

Increased First aid training Child Friendly Sept- Oct : Prepare for Improved Children,
access to the to teachers. Organization training, resources, access to Teachers
use of health medical equipment. effective first
and nutrition aid.
services at Nov-Dec: Training
schools. First aid kit is Conducted, Distribution
provided to

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 schools.
of first aid kit.

XI. BUDGET
Budget Item Amount Other revenue In Kind Total
Requested Support

Wages for personnel

One coordinators for training at $400 $12,000 $12,000

per day for 30 days
Four facilitators at $400 per day for 2 $3,200 $3,200
days
One resource contractor at $400 per $10,000 $10,000
day for 25 days
Workers for construction $100/day*5 $500 $500
days
Travel and Accommodations

15 training participants ($1,500each) $22,500 $22,500

(5 from each school)
Lunch for 20 for 2 days $900 $900

Materials

Paper, Overheads, other Training $2,000 $4,000(local $3,000

leaders)
supplies ($2,00)
Construction materials, Medical $4,800 $4,800
Equipment
Evaluation

$8500 for evaluation and report for $8,000 $8,000

training, learning resources and
orientation
$500 for mail out $500 $500

Total $63,900 $4,500 $65,400

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CHILD FRIENDLY ORGANIZATION

Address: Mahalaxmi Municipality-9, Lubhoo

Telephone: 01-5580857, 01-5580858

W: www.childfriendly.org

E: info@childfriendly.com

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XII.REFERENCES

1. Hamdani S (2009) Influencing Factors in Nutrition Status of 6-12 Years Old

Children. 53–61
2. Islam Mansur D (2015) A Study on Nutritional Status of Rural School going
Children in Kavre District.
3. Kumar Dey A, Bhusan Nath A (2017) Nutritional Status of School Going Children
(6-15 Years) in a Semi-Urban Area of Cachar District, Assam. J Evol Med Dent
Sci 6:4057–4062
4. Shivaprakash NC, Baby Joseph R (2014) Nutritional Status of Rural School-Going
Children (6-12 Years) of Mandya District, Karnataka.
5. Eze JN, Oguonu T, Ojinnaka NC, Ibe BC . (2017) Physical growth and nutritional
status assessment of school children in Enugu, Nigeria. Niger J Clin Pr 20:64–70
6. Srivastava A, Mahmood SE, Srivastava PM, Shrotriya VP, Kumar B (2012)
Nutritional status of school-age children - A scenario of urban slums in India. Arch
Public Heal. doi: 10.1186/0778-7367-70-8
7. Ranabhat C, Kim C-B, Park M, Kim C, Freidoony L (2016) Determinants of Body
Mass Index and Intelligence Quotient of Elementary School Children in Mountain
Area of Nepal: An Explorative Study. Children. doi: 10.3390/children3010003
8. Dhungana GP (2017) Nutritional Status and the Associated Factors in Under Five
Years Children of Lamjung, Gorkha and Tanahun Districts of Nepal. Nepal J Stat
1:15
9. Bhandari N, Shrestha G (2012) Nutritional status and morbidity pattern in school
age children in Nepal. J Coll Med Sci 8:12–16
10. Nutrition_Status_of_Young_Children_in_Periphery_of.
11. Central Bureau of Statistics (2012) National population and housing census 2011.
Natl. Plan. Comm. Secr.
12. Bhandari TR (2013) Nutritional Status of Under Five Year Children and Factors
Associated in Kapilvastu District, Nepal. J Nutr Heal Food Sci 1:1–6
13. S. S, M. A, N. S, U. T, S. Z (2013) Nutritional status of primary school children in
Abbottabad. J Ayub Med Coll Abbottabad 25:123–126
14. Müller O, Krawinkel M (2005) Malnutrition And Health In Developing Countries.
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 Can Med Assoc J. doi: 10.1503/cmaj.050342
15. Bogale TY, Bala ET, Tadesse M, Asamoah BO (2018) Prevalence and associated
factors for stunting among 6–12 years old school age children from rural
community of Humbo district, Southern Ethiopia. BMC Public Health 1–8
16. FAO, IFAD, UNICEF W and W (2017) The State of Food Security and Nutrition
in the World. Food Agric Organ United Nations. doi: I4646E/1/05.15
17. Fiorentino M (2018) Malnutrition in school-aged children and adolescents in
Senegal and Cambodia : public health issues and interventions To cite this
version : HAL Id : tel-01687697.
18. Yankanchi SG, Ganganahalli P, Udgiri R, Patil SS (2018) Assessment of
nutritional status of primary school children in urban field practice area ,
Vijayapura. 5:779–783
19. Population Reference Bureau (2016) 2016 World Population Data Sheet. 2015
World Popul Data Sheet. doi: 10.2307/1972177
20. Murugkar DA, Gulati P, Gupta C NUTRITIONAL STATUS OF SCHOOL
GOING CHILDREN ( 6-9 YEARS ) IN RURAL AREA OF BHOPAL DISTRICT
( MADHYA PRADESH ), INDIA The article can be downloaded from http :/
www.ijfans.com/currentissue.html.
21. Best C, Neufingerl N, L van G, T van den B, Osendarp S (2010) The nutritional
status of school-aged children: why should we care? Food Nutr Bull 31:400–417
22. Hospital T, State E (2018) Nutritional Status of Primary School Children in
Enugu , Nigeria Using Anthropometric Measurements. 30:
23. Rocha C, Constante Jaime P, Ferreira Rea M (2016) How Brazil’s Political
Commitment to Nutrition Took Shape. Glob Nutr Rep - From promise to impact
End malnutrition by 2030. doi: 10.2499/9780896295841

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