Indian morphological differences and similarities health and social care essay

Background & A ; nonsubjective: Worldwide fluctuation in human growing and its familial and environmental factors have been described by many writers before. In this survey, an effort has been made to measure the morphological differences and similarities among 1-5 twelvemonth kids of rural countries of Uttar Pradesh State in India. The purpose of this survey was to find whether kids populating in diverse countries show their differences or similarities of organic structure size.

Methods: For this intent, a transverse sectional territory nutrition profile survey conducted during 2002-03 was used. The information on 10, 096 kids drawn from 1080 small towns in 54 territories is a portion of the territory degree Diet and Nutrition Assessment study, was considered. The average values for tallness and weight for 54 territories is taken as the input informations for subsequent analysis. The information was first normalized by agencies of Principal Component Analysis ( PCA ) and so K-means bunch was performed.

Consequences: The PCA and bunch analysis yielded four distinguishable bunchs or forms in the kids anthropometric informations. These bunchs were ordered harmonizing to the mean organic structure size ( weight and tallness ) of kids. The average stature and organic structure weight of these kids in bunch I was 3. 2 centimeter and 1. 4 kilogram higher than those of bunch IV bespeaking clear difference between bunchs. Besides, the fluctuations between bunchs in their societal, demographic, wellness and nutrition parametric quantities were compared.

Interpretation & A ; decision: The practical usage of PCA and bunch analysis and its virtues in analyzing the Uttar Pradesh pre-school kids growing fluctuations are discussed. These consequences will ease the decision maker to gestate and implement part specific action programmes for betterment in the nutritionary position of the community in general and pre-school kids, in peculiar.

Cardinal words: anthropometric measurings, K-means Cluster Analysis, PCA, Nutrition, Socio-economic.


Worldwide fluctuations in human growing forms were described in the past by Tanner and Eveleth1, 2. Growth and development of kids in a community are mostly influenced by theenvironmentthey live in, which include a host of factors related to socioeconomic, socio-cultural and agro climatic conditions. In this present paper, we tried to pull out the nutritionary forms of under five twelvemonth kids anthropometric informations collected at territory degree in the province of Uttar Pradesh in India. This survey was undertaken peculiarly in Uttar Pradesh because it is themost thickly settled province in India, holding about 170 million population3. Therefore, “ geographic ” clusterization of territories in big countries such as a State or part of a state based on nutritionary position of the kids may assist in placing assorted factors that have important influence on the growing and development of the communities and to plan and implement appropriate region/state specific schemes for forestalling and control of undernutrition in the communities.

The bunch analysis technique involves segregating a information set into different homogeneous groups based either on similarities or unsimilarities in the information. This technique is an easy replicable manner of building categorizations, which has attracted widespread popularity across diverse scientific disciplines4. Mahalanobis, Majumdar and Rao5 employed this method to do an anthropometric study of the united state manner back in 1949. Vasulu and Pal6 studied the relationship between anthropometric distinction and cultural diverseness in the Yanadi folk in different parts of India. This method has been successfully used on anthropometric measurings in China to sort growing profiles of children7 and in India to transport out societal selling schemes for control of Vitamin A deficiency8, 9 every bit good as to place the forms in nutritionary informations of kids. Keri L. Monda and Barry M. Popkin10 used bunch analysis to make forms of overall activity and inaction in a diverse sample of Chinese young person and to measure their usage in foretelling fleshy position. Tucker KL11 demonstrated dietetic forms of different populations in US utilizing PCA-Cluster Analysis technique.

For the intent of this survey, the informations collected during the District nutrition profile ( DNF ) study carried out in the State of Uttar Pradesh during the twelvemonth 2002-03 and reported during 2003-04 was utilised. The study included aggregation of informations onfamilysocio economic, socio cultural and demographic specifics, nutritionary position of persons in footings of anthropometry and clinical scrutiny, mean nutrient and alimentary consumptions at the family degree and chest eating and kid raising patterns prevalent in the community.

Following are the specific aims of the current survey:

To organize geographical bunchs in the State of Uttar Pradesh, based on the anthropometric information of weight and tallness of preschool kids

2 ) To i

Iiiiide dentify differences or similarities in the nutritionary position of kids populating in different bunchs.

To analyze the family demographic, socioeconomic derived functions of the kids between the bunchs, in relation to the nutritionary position.

Materials and Methods

Sample Design

A cross sectional design was used for transporting out DNF study. In each territory, small town formed the Primary Sampling Unit ( PSU ) and the Household, the Secondary Sampling Unit ( SSU ) . Therefore, a sum of 400 HHs were covered from 20 small towns by covering 20 indiscriminately selected families from each small town. Sing the big fluctuation in the territory, due representation was given to all the blocks in the territory while choosing the small towns, by following graded random trying process coupled with chance proportion to size ( PPS ) .


The anthropometric informations, viz. highs and weights available on 10, 096 preschool kids ( 1 to 5 old ages of age ) from a sum of 87, 491 persons of different ages of both the sexes from 54 territories of Uttar Pradesh was considered for analysis. The geographic distribution of the territories is shown in Fig. 1. The average values for tallness and weight for 54 territories is taken as the input informations for subsequent analysis.


Two anthropometric measurings viz. highs and weights were collected by research workers by utilizing standard equipment and processs. The research workers were trained and standardized in the study methodological analysiss by the Scientists of National Institute of Nutrition ( NIN ) , before originating existent informations aggregation in the field.

Statistical method

The information was first normalized by agencies of Principal Component Analysis ( PCA ) and so bunch was performed utilizing SPSS 15. 0 statistical software12, utilizing the undermentioned process:

The agencies of each variable for 54 territories were computed.

An inter-variable correlativity coefficient matrix was derived.

The PCA was extracted by following the undermentioned standards.

The standard for truth of choosing principle constituent was 0. 005.

The minimal discrepancy for pull outing each constituent was 0. 5.

The value of all steps was transformed into principle-component tonss.

The instances were clustered by k-means bunch method utilizing Euclidian distance which was calculated by the expression given below.

Wherein dij is the distance between any two instances ( I and J ) in a group, Xik and Xjk are the chief constituent tonss of the kth chief constituent ( k= 1, 2, 3aˆ¦m ; here m= 1 ) .

The process for bunch was done by MacQueen method13 as follows:

Step1: Partition the points into thousand initial bunchs

Steo2: Proceed through the list of points, delegating point to the bunch whose centroid ( average ) is close. Recalculate the centroid for the bunch having the new point and the one which the point is removed

Step3: Repeat the Step 2 until no reassignments take topographic point.


The average highs and weights by territory are listed in Table I. The Principle constituents extracted from the correlativity matrices are listed in Table II. Merely one rule constituent could be extracted from the information. The ‘EIGEN ‘ value ensuing from this constituent was 1. 4 and could explicate 70 % of the fluctuation.

The information was foremost transformed into Personal computer mark for the 54 territories which formed the input for executing bunch analysis utilizing K-means bunch analysis method. Four different bunchs or forms were observed in the information. A ocular representation bunch analysis represented as dendogram ( Fig. 2 ) shows the bunchs being combined and the values of the distance coefficients at each measure. Looking at the dendogram, it appears that the four bunch method described may be appropriate, since the bunchs are easy explainable and occurs before the distance at which bunch go excessively big. The dendrogram rescales the existent distances to Numberss between 0 and 25, continuing the ratio of the distances between stairss.

These bunchs were ordered harmonizing to the mean organic structure size ( weight and tallness ) of kids. The organic structure sizes which formed into different little bunchs are listed in table III. The average stature and organic structure weight of these kids in bunch I was 3. 2 centimeter and 1. 4 kilogram higher than those of bunch IV bespeaking clear difference between bunchs.

Geographic factors:

The bunch analysis which resulted in the formation of four distinguishable bunchs is presented in the map ( Fig. 3 ) . The map clearly showed the geographic unsimilarities in the organic structure size of kids. Many of the territories for whom the information was clustered were geographically next. It was observed that in most of the territories from Cluster I came from the western portion of the province, such as Ghaziabad, Farrukhabad, Etawah, which is comparatively comfortable part of the State. The bulk territories viz. Bijnor, Saharanpur, Meerut, Aligarh, Mathura, Maharajgunj etc. which are grouped into Cluster II ranked as 2nd best segregation, are from Western and Eastern parts of the State considered to be developed parts. In contrast, in the Cluster IV which is considered to be holding lowest organic structure size of kids, most of the territories viz. Sitapur, Rae bareli, Jalaun, Lalitpur, Hamirpur belonged to Central and Budelkhand parts which are considered to be under-developed part. The above segregation of territories are in conformance with the informations of NFHS-II survey14, 15 wherein the territories in the State were categorized into backward and non-backward territories.

Socio-Economic Factors:

The bunchs so formed were compared in relation to their socio-economic parametric quantities such as extent of land retentions, type of house, community, per-capita monthly income, denseness of population to see whether it was an artefact or if any relationships could be established. It was found that the territories in bunch I were comparatively more developed than in the other bunchs ( table IV ) . The differences observed between bunchs were both in footings of ‘population denseness ‘ and per capita income. It was besides observed that the proportion of under-privileged communities such as Schedule Caste and Schedule Tribe population was much lower in the I & A ; II bunchs, compared to bunchs III and IV.

Demographic factors:

Demographic factors like sex ratio of population, birth order, kids covered for nutrition appraisal, literacy position, per centum married below 18 old ages of age were compared among the bunchs. It was observed that the territories in bunch I were better off when compared to constellate II, III and IV, with regard to all the above variables ( Table V ) . The sex ratio ( females for 1000 males ) , a good index of demographic alteration was 921 in bunch I, as against 882 in bunch IV. Similarly, the literacy position was 64 % in bunch I, compared to 52 % in bunch IV.

Nutrition and Health factors:

The extent of undernutrition among pre-school kids was assessed by Standard Deviation ( SD ) categorization by utilizing WorldHealthOrganisation ( WHO ) growing standards16, in footings of acrobatics ( tallness for age, & lt ; Median – 2SD ) reflecting long continuance undernutrition, blowing ( weight for tallness, & lt ; Median -2SD ) bespeaking current undernutrition and scraggy ( weight for age & lt ; Median -2SD ) bespeaking overall undernutrition. The proportion of kids with scraggy, stunting and blowing utilizing the above three standards were least in the territories of bunch I, as compared to constellate IV.

The extent of underweight was 33 % incluster I, 45 % in bunch II, 52 % in bunch III and 58 % in bunch IV, bespeaking the extent of under nutrition is higher in bunchs II, III and IV when compared with Cluster I, though the differences were besides higher between bunch II and Cluster IV. Similar form was observed for stunting and blowing ( Table VI ) . The wellness parametric quantities like per centum adult females undergoing prenatal medical examinations in different clustered territories ranged from a high ( 50 % ) in bunch I to 47 % in Cluster IV. The institutional bringings were comparatively more in bunch I ( 20 % ) , compared to constellate IV ( 14 % ) , bespeaking better wellness attention use in bunch I territories ( Table VI ) .


There are figure of methods available for clustering13, but the methods of PCA and bunch analysis was selected for this survey for the undermentioned grounds, viz. , ( I ) By utilizing the Principal Component Analysis method, the values of anthropometric variables in each instance is transformed into chief constituent tonss, which reflects kids ‘s organic structure size more comprehensively than any individual variable, and ( two ) the bunch analysis was performed in this method, by ciphering the distances every bit good as sing the magnitude of difference between variables, therefore avoiding the drawbacks of other methods which use correlativity coefficients as the similarity step and be given to be sensitive to determine at the disbursal of magnitude6.

The topics included in the present analysis were preschool kids, whose well being is considered as a placeholder to nutritionary position for the full community. The consequences of the present survey show that the difference in kids ‘s organic structure size are really different between different bunchs, i. e. between developed and under developed countries. All these factors exert the fact that there are important differences in organic structure size of kids in different bunchs ( countries ) . For illustration, most of the territories in Cluster I and Cluster II, which are considered as good bunchs in footings of their better nutritionary, wellness, societal and demographic indexs, are located in the western and eastern portion of the Uttar Pradesh State, which are considered to be comfortable parts.

Restriction in this survey is that, other factors, such as the ecological conditions, life manner, which might act upon the nutritionary position of the preschool kids, are non considered. However, the present survey has identified possible countries of intercession for betterment in the nutritionary position of kids. The consequences of bunch analysis, are non merely of involvement, in footings of geographical, biological, ecological and anthropometric similarities but besides facilitate the decision maker to gestate and implement appropriate action programmes for betterment in the nutritionary position of the community in general and pre school kids, in peculiar.