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    Sakaar2013 Sakaar2013 Presentation Transcript

    • BY:- SAKAAR GROUP
    • MALNUTRITION One of the greatest threats to the NATION’S FUTURE
    • DEFINITION OF MALNUTRITION • ”People are malnourished if their diet does not provide adequate calories and protein for growth and maintenance or they are unable to fully utilize the food they eat due to illness (undernutrition). They are also malnourished if they consume too many calories (overnutrition).” (Unicef)
    • PRESENT SCENARIO IN THE WORLD
    • TOP MOST MALNOURISHED NATIONS IN THE WORLD • India ranks among the top 6 MALNOURISHED nations in the world. • ASIA-PACIFIC region consists of maximum number of malnourished nations. Among which INDIA is the most densely malnourished country due to it’s dense population.
    • CONDITION OF INDIAN STATES IN TERMS OF MALNUTRITION
    • MALNUTRITION/DEATH POLITICAL AND ECONOMIC POWERS INSUFFICIENT HOUSEHOLD FOOD INADEQUATE MATERNAL CHILDCARE INSUFFICIENT HEALTH SERVICES/ UNHEALTHY ENVIRONMENT INADEQUATE DIETARY INTAKE DISEASES MANIFESTATIONS IMMEDIATE CAUSES UNDERLYING CAUSESUSES BASIC CAUSES
    • THE EVIL CYCLE OF MALNUTRITION Weight loss Immunity lowered Growth faltering Mucosa damaged Disease: Incidence Severity Duration Inadequate Dietary Intake Apetite loss Nutrient Loss Malabsorbtion Altered metabolism
    • What are the Reasons for High Levels of Undernourishment and Child Malnutrition? • Low per capita income. Cross-section data –the percentage decline in malnutrition is roughly half the rate at which GNP per capita grows. • Thus economic growth alone can not reduce malnutrition. For example, in India, GDP growth was 6 to 7% per annum during 1992-93 to 2005-06. • But child malnutrition declined from 52% to 47% --0.5 percentage points per annum. • In fact, the per cent of underweight children in India declined only one percentage point from 47% in 1998- 99 to 46% in 2005-06 inspite of high economic growth
    • Reasons for high Levels of Malnourishment • Income poverty is another reason. • However, studies have shown that malnutrition exists even after removal of poverty. • For example income poverty in India is 26% while child malnutrition is 46%. • The data for India, Bangladesh and some other countries show that malnutrition levels are surprisingly high even in rich income quintiles. • Thus, reduction in malnutrition is going to be a bigger challenge than income poverty.
    • Reasons for high Levels • Therefore, one has to look beyond economic growth, income poverty and food availability • Adequate nutrition during pregnancy and first six months of life are critical because of the impact on birth weight. • Thus, the problems often start before, during and after pregnancy as malnourished mothers are more likely to produce low birth weight babies. • Poor nutritional status at birth is perpetuated by inadequate breastfeeding and supplementary feeding habits. • Subsequently in the first two years, they do not give sufficient quality food –particularly mothers with low education.
    • Reasons for High Levels • Similarly, public health services are poor in South Asian countries. • Health sector performance in some of the Asian countries show that there are basically six problems --low levels of health indicators --slow progress in these indicators --significant regional, social and gender disparities --poor quality delivery systems in health --privatization of health services • Low standards of health and hygeine play important part since sick children are able to absorb essential nutrients.
    • Reasons for high levels • Micro nutrient deficiency is another reason • Age-specific interventions upto five years are important. But, lack of institutional arrangements for age-specific nutritional programs is another problem. • To conclude, there is a strong association between child malnutrition and women’s health/well being. • For example, one third of Indian women suffer from Chronic Energy Deficiency and BMI of less than 18.5kg • 58% of pregnant women in India suffer from anemia • About 68% of pregnant women make first ANC visit after 4th Month of pregnancy. • One third of them visit after sixth month of pregnancy • About half of the deliveries take place at home
    • The Challenge: Accelerating progress in reducing child malnutrition in India: • India has many nutrition and social safety net programs, some of which (such as Integrated Child Development Services [ICDS] and the Public Distribution System [PDS]) have had success in several states in addressing the needs of poor households. All of these programs have potential, but they do not form a comprehensive nutrition strategy, and they have not addressed the nutrition problem effectively so far.
    • Policies and Actions • Sector Specific Policies: Economic growth is not enough. Sector specific policies are needed. • For example, a package consisting of expanded child and maternal immunization, antenatal care coverage, • nutritional supplementation (including breast feeding) and home based neo-natal services (including treatment of pneumonia) bring about significant reduction in both infant mortality and child malnutrition . • In other words, basic health services have to be improved. • Women’s Health and Well Being: Malnutrition can be reduced by enhancing women’s health, promoting gender equality and, empowerment of women including female education.
    • Essential Interventions to Combat Malnutrition (A)Direct interventions – Related to the consumption and absorption of adequate protein calorie/micro- nutrient rich foods essential to combat malnutrition, namely: 1. Weight measurement of child within 6 hours of birth and thereafter at monthly intervals. 2. Timely initiation of breastfeeding within one hour of birth, and feeding of colostrums to the infant. 3. Exclusive breastfeeding during the first six months of life. 4. Timely introduction of complementary foods at six months and adequate intake of the same, in terms of quantity, quality and frequency for children between 6-24 months. 5. Dietary supplements of all children between 6 months – 72 months through energy dense foods made by SHGs from locally available food material to bridge the protein calorie gap. 6. Safe handling of complementary foods and hygienic complementary feeding practices. 7. Complete immunization and Vit. A supplementation. 8. De-worming of all family members bi-annually.
    • Essential Interventions to Combat Malnutrition 9. Frequent, appropriate, and active feeding for children during and after illness, including oral rehydration with Zinc supplementation during diarrhea. 10. Timely and quality therapeutic feeding and care for all children with severe and acute malnutrition. 11. Dietary supplements of iron – rich, energy dense foods made from locally available food material prepared by women SHGs for adolescent girls and women, especially during growth periods and pregnancy to fill the protein calorie gap and ensure optimal weight gain during pregnancy. 12. Anemia screening for children, adolescent girls and women. 13. Weight monitoring of all adolescent girls and pregnant women. 14. Prevention and management of Micro-Nutrient deficiencies, especially through IFA supplementation to prevent anaemia in adolescent girls and women. 15. Making available low cost energy foods for the general population. 16. Fortification of common foods.
    • Essential Interventions to Combat Malnutrition (B)Indirect Interventions – Related to issues of health, safe drinking water, hygienic sanitation and socio-cultural factors such as early marriage and pregnancy of girls, female literacy and poverty reduction, to eradicate malnutrition on a long term, sustainable basis. 1. Access to safe drinking water (treatment, storage, handling and transport), sanitation and hygiene. 2. Increased female education and completion of secondary schooling for the girl child. 3. Increased access to basic health services by women. 4. Expanded and improved nutrition education and involvement at Panchayat and community level to create demand. 5. Increased gender equity. 6. Promotion of nutrition best practices especially for girls and women.
    • Highly cost-effective maternal and child nutrition interventions • Behavior change interventions • 1.Breastfeeding promotion • 2.Complementary-feeding promotion • 3.Handwashing with soap and promotion of hygiene behaviors • Micronutrient and deworming interventions • 4.Vitamin A supplementation • 5.Therapeutic zinc supplements • 6.Multiple micronutrient powders • 7.Deworming • 8.Iron-folic acid supplements for pregnant women • 9.Iron fortification of staples • 10.Salt iodization • 11.Iodine supplements • Complementary and therapeutic feeding interventions • 12.Prevention or treatment of moderate malnutrition in children aged 6–23 months • 13.Treatment of severe acute malnutrition
    • Comprehensive Services for Children under Six • 'Universalisation with quality' of the ICDS • Crèches and day care facilities • Maternity entitlements • Support for “infant and young child feeding” (IYCF), particularly breastfeeding • Prevention of interference of commercial interests through 'packaged' or 'ready to eat' food or 'public private partnerships' in government programmes for child health and nutrition.
    • Strategic choices for improved child nutrition: • India lacks a comprehensive nutrition strategy. Various choices for nutrition strategies can be considered. A review of some of the more successful country experiences suggests that all of them implemented complex, multisectoral actions with more or less emphasis on service- oriented nutrition policies (as in Indonesia), incentive- oriented nutrition policies linked to community or household participation and performance (as in Mexico), or mobilization-oriented nutrition policies (as in Thailand). These choices are not mutually exclusive. India now has the opportunity to “leapfrog” toward innovative nutritional improvement based on the experiences of other countries and on experiences within India itself.
    • Cooperation for policy actions: • To accelerate progress in reducing child malnutrition, India should focus on the following four cross-cutting strategic approaches: • Ensuring that economic growth and poverty reduction policies reach the poor; • Redesigning nutrition and health policies and programs by drawing on science and technology for nutritional improvement, strengthening their implementation, and increasing their coverage; • Increasing investments and actions in nutrition services for communities with the highest concentration of poor; and • Focusing programs on girls’ and women’s health and nutrition.
    • Cooperation for policy actions: • Ensure equitable distribution of food through, inter alia, well-functioning public distribution systems and school meal programmes. • Knowledge, research, education/training and public assessment systems must empower women food providers and strengthen their capacities to participate in policy formulation and decision-making about food and agricultural policies.
    • Cooperation for policy actions: • Governments should ensure full transparency for consumers on the quality and nutritional values of food, Instead of making the poor and ordinary people pay for resolving the crisis, those who own most of the capital, who triggered the crisis and who benefit from it must cover the losses through specific taxes on capital and taxes on foreign exchange transactions.
    • ” All children, regardless of ethnic background or regional origin, grow similarly when their needs are met.” Growth of Children <5 years
    • All they need is some ATTENTION..
    • AND..LOADS of CARE…
    • LOADS of NOURISHMENT…
    • LOADS of NUTRITION..
    • LOADS of INCENTIVES..
    • LOADS of AMENITIES…
    • LOADS of CONCERN…
    • AND…LOADS of LOVE..
    • PRESENTED BY:- • SHREYA JHA • ANUBHUTI JAIN • KHYATI MALIK • ALISHA THOMAS • VRINDA BHATIA