Risk Stratification and Intervention Planning Using the Indian Academy of Pediatrics Malnutrition Proactive Assessment

Abstract

Background: Childhood malnutrition continues to be a major health concern in India, significantly contributing to morbidity and mortality among children under five years of age. Despite various national nutritional programs, a large proportion of children remain undiagnosed or inadequately managed. The Indian Academy of Pediatrics (IAP) Malnutrition Proactive Assessment tool offers a structured approach to identify, stratify, and guide interventions in malnourished children.

Aim: To evaluate the effectiveness of the IAP Malnutrition Proactive Assessment tool in stratifying nutritional risk and guiding intervention planning among pediatric patients in a tertiary care setting.

Methods: A retrospective observational study was conducted at a tertiary care hospital in Katihar from February 2024 to January 2025. Medical records of 100 children aged 6 months to 5 years were reviewed. Risk stratification was done using the IAP Malnutrition Proactive Assessment tool, and corresponding interventions were documented. Statistical analysis was performed using SPSS version 23.0. Associations between risk categories and intervention types were assessed using the Chi-square test.

Results: Out of 100 participants, 56 were male and 44 females, with a mean age of 2.1 ± 1.1 years. Risk stratification identified 27% of children as high risk, 42% as moderate risk, and 31% as low risk. High-risk children predominantly received therapeutic nutrition (88.9%), while most moderate-risk cases were managed with dietary counseling and supplementation. A significant association was found between risk category and intervention type (p < 0.001).

Conclusion: The IAP Malnutrition Proactive Assessment tool proved effective in categorizing children by nutritional risk and guiding appropriate, evidence-based interventions. Its application in clinical settings can improve early detection and management of pediatric malnutrition.

Recommendations: Routine implementation of the IAP Malnutrition Proactive Assessment in pediatric outpatient and inpatient settings is recommended. Training healthcare workers on its use can enhance early diagnosis and resource-appropriate interventions, ultimately improving child health outcomes.

Keywords: Malnutrition, Pediatrics, Risk Stratification, IAP Assessment, Nutritional Intervention