Acute malnutrition associated with mid-upper arm circumference among under-five children in tribal areas, India: a cross-sectional study

Objective: For the past three decades, India has implemented several nutrition programmes to address malnutrition in the under-fives. To understand the programme's impact, this study assesses the prevalence of acute malnutrition, moderate acute malnutrition (MAM) and severe acute malnutrition (SAM), using mid-upper arm circumference (MUAC) among tribal children. Design: The survey was conducted in two tribal blocks (Desaiganj and Bhamragad) of the Gadchiroli district in Maharashtra to identify children registered in the 'Anganwadi' program. Setting: A community-based cross-sectional survey was carried out. Participants: The total sample size was 1055 children (aged 0-59 months). Results: The overall prevalence of SAM and MAM was 1<middle dot>4 % (n 15) and 9<middle dot>8 % (n 103). A higher prevalence of MAM was found in males (38<middle dot>5 %, n 40) and females (27<middle dot>1 %, n 28) in below 6 months. Additionally, a higher prevalence of MAM was observed in females (10<middle dot>7 %, n 113) compared with males (9<middle dot>0 %, n 95). The prevalence of SAM was significantly (P < 0<middle dot>001) higher in females (1<middle dot>7 %, n 18) than in males (1<middle dot>0 %, n 11). Children aged between 12 and 17 months were sixteen times more likely (OR = 16<middle dot>9, P < 0<middle dot>001, CI = 4<middle dot>8, 59<middle dot>6) to have MAM (MUAC < 12<middle dot>5 cm) than children aged between 6 and 11 months. Children from the Desaiganj block were significantly less likely (OR = 0<middle dot>4, P < 0<middle dot>001, CI = 0<middle dot>2, 0<middle dot>7) to have MAM compared with children from Bhamragad. Approximately 4 % (n 42) of children were classified as critically malnourished. Conclusion: There is an urgent need for block-level monitoring of MAM and SAM, as well as evaluation of existing nutrition programmes, to address the disparity in the sex-specific prevalence of MAM and SAM in tribal areas.