|Culture, Environment, and Food to Prevent Vitamin A Deficiency (International Nutrition Foundation for Developing Countries - INFDC, 1997, 208 pages)|
|Part III. Assessing natural food sources of Vitamin A in the community|
|8. India: The rural community of Sheriguda in Andhra Pradesh|
The selected area for the study was the village of Sheriguda in the Ibrahimpatnam block of the Ranga Reddy district in Andhra Pradesh state (Map 6). This state is in the midsouthern part of India, known as the rice-bowl because of its fertile soil in certain areas. However, in many villages in the Ranga Reddy district, such as Sheriguda, the lands are dry and mostly staples, such as sorghum (jowl) and pearl millet (badger), that do not require as much water as rice are grown. Crops commonly grown in this area include paddy, jowl, sajja (pearl millet), red gram, castor, and sunflower. Other vegetables such as okra, tomatoes, and green leafy vegetables, such as palak and gogu are grown seasonally.
Sheriguda is a typical village of Ranga Reddy district where all religion and caste groups are represented. Looking at the caste distribution of the village, it was found that about 40% of the families belonged to the forward communities, such as Reddys and Vysyas (merchants), and 30% to the backward castes, that include skilled occupational castes like blacksmiths, carpenters, goldsmiths, and others such as shepherds, muthrasi, munnurukapu, and chakali. The harijan households (scheduled castes) comprised about 21% and the scheduled tribes about 8%. Less than 1% were Muslims.
The better-off families are either large landowners, possessing more than 100 acres of agricultural land, tenant cultivators, or the business community who buy produce from smaller landowners and sell it in the city. The poorer families are involved in one or two of the following occupations:
· agricultural laborers, who are paid either money or staples and vegetables as wages;
· other laborers, such as workers in a nearby poultry farm and those who work in the Ibrahimpatnam block headquarters;
· petty shops owners and vendors who sell vegetables and other food items;
· artisans, such as pot makers, blacksmiths, goldsmiths, tailors, and masons, etc.;
· professional occupations, such as electricians, teachers, postmen, etc.
The traditional joint family system is still common in this community. However, a large number of families follow the nuclear family system. The average family size varies from five to seven members including children in the nuclear families, and eight to ten members in the joint families. The joint family structure is of particular benefit in rural areas because the total wages earned by all the members make up the family budget. On average, men employed as agricultural laborers earn a wage of twenty to twenty-five rupees ($1 US dollar is currently equal to thirty-one rupees) per day and women earn around ten to fifteen rupees per day. However, agricultural laborers are out of work for three months during summer. For the remaining nine months they work an average of twenty days a month which totals to about six months of continuous work. These landless laborers constitute about 25% to 30% of the total population. Agricultural work is the main source of livelihood for these families. Some laborers are employed in a nearby poultry farm owned by the sarpanch (village headman), and they occasionally get free eggs or poultry.
A recent study of vitamin A deficiency, undertaken by the National Institute of Nutrition, Hyderabad, found a prevalence of 4. 5% for Bitot's spots in preschool children and a few cases of nightblindness in villages around Ibrahimpatnam block. This figure is comparable with other regions in Andhra Pradesh where such studies have been conducted. The prevalence of Bitot's spots in Sheriguda, was found to be 4.2% in preschool children. This figure far exceeds the WHO cut-off level of 0.5%, indicating that vitamin A deficiency is a significant health problem in this area.
Since the auxiliary nurse midwife (ANM) and the anganwadi worker (the grassroots functionary of the Integrated Child Development Services Programme (ICDS) operating nationwide) are expected to impart health and nutrition education to young mothers and interact with preschool children, they were interviewed for information regarding vitamin A deficiency. Neither had ever seen a child with Bitot's spots, nor they had come across any case of nightblindness. Since the survey by the NIN demonstrated a high prevalence of Bitot's spots (4.2%) in preschool children in Sheriguda, it is possible that these children did not participate in the ICDS program.