BHARTI MPH MALNUTRITION AMONG INDIAN CHILDREN
CONTENTS <ul><li>INTRODUCTION </li></ul><ul><li>DEFINITION OF PEM </li></ul><ul><li>TYPES OF MALNUTRITION </li></ul><ul><l...
INTRODUCTION <ul><li>Protein energy malnutrition (PEM) – Major health and nutrition problem in India . </li></ul><ul><li>O...
DEFINITION OF PEM <ul><li>Bad nutrition  </li></ul><ul><li>As a state in which a prolonged lack of one or more nutrients r...
TYPES OF MALNUTRITION   <ul><li>Undernutrition  -insufficient food is eaten  </li></ul><ul><li>Overnutrition -consumption ...
World Health Report 2003.
DIFFERENCE BETWEEN OVER AND UNDER NUTRITION <ul><li>Overnutrition is encountered much more frequently than under nutrition...
PERCENTAGE OF CHILDREN AFFECTED BY MALNUTRITION 9 50 PAKISTAN 13 27 SRI LANKA 14 65 BANGLADESH 14 69 NEPAL  8 41 CHINA 27 ...
INCIDENCE OF PEM   <ul><li>India is one of the countries with highest proportion of malnourished children in the world alo...
CAUSES OF PEM <ul><li>An inadequate intake of food both in quantity and quality. </li></ul><ul><li>Infections notably diar...
Conceptual Framework for the Causes of Malnutrition in Society
NUTRITIONAL DEFICIENCY DISEASES <ul><li>Kwashiorkor,  </li></ul><ul><li>Marasmus </li></ul><ul><li>Xerophthalmia, </li></u...
CLASSIFICATION OF PEM   <ul><li>Classified according to severity, course and the relative contributions of energy or prote...
CONT- <ul><li>(1) Weight for age classifications- Gomez’z  </li></ul><ul><li>Weight of more than  90 percent  of expected ...
<ul><li>(2) Height for age classification : </li></ul><ul><li>Children with less than  80%  height of expected for age as ...
<ul><li>(3) Weight for height classification -acute or chronic based on anthropometry.  </li></ul><ul><li>In acute malnutr...
EFFECTS OF MALNUTRITION   <ul><li>It is of two type : </li></ul><ul><li>(1) Direct and  </li></ul><ul><li>(2) Indirect </l...
<ul><li>Indirect - High morbidity and mortality among young children,  </li></ul><ul><li>Retarded physical and mental grow...
CHILD MALNUTRITION IN INDIA <ul><li>World’s malnourished children-40% </li></ul><ul><li>Low birth weight infants -35% </li...
CONT- <ul><li>More than  half of all preschoolers, and 75 % suffer from iron deficiency anemia. </li></ul><ul><li>Maternal...
NUTRITIONAL STATUS  <ul><li>In 1997 – about 170 million children under five years of age i.e. 30% of the world’s children ...
ACCELERATING PROGRESS IN REDUCING CHILD MALNUTRITION IN INDIA <ul><li>Integrated child development services (ICDS) </li></...
STRATEGIC CHOICES FOR IMPROVED CHILD NUTRITION <ul><li>SHORT-TERM STRATEGY: </li></ul><ul><li>Nutrition and health program...
<ul><li>5. Additional research. </li></ul><ul><li>6.Focused on states, districts,& communities  </li></ul><ul><li>7. Incre...
<ul><li>Prime Minister Manmohan Singh  stated, “The problem of malnutrition is a matter of  national shame....  I appeal t...
REFERENCES <ul><li>Park k .Park’s text book of preventive and social medicine 17 th  edn. Jabalpur:banarsidas bhanot publi...
THANKS
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Malnutrition Among Indian Children

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Malnutrition Among Indian Children

  1. 1. BHARTI MPH MALNUTRITION AMONG INDIAN CHILDREN
  2. 2. CONTENTS <ul><li>INTRODUCTION </li></ul><ul><li>DEFINITION OF PEM </li></ul><ul><li>TYPES OF MALNUTRITION </li></ul><ul><li>INCIDENCE OF PEM </li></ul><ul><li>CAUSES OF PEM </li></ul><ul><li>NUTRITIONAL DEFICIENCY DISEASES </li></ul><ul><li>CLASSIFICATION OF PEM </li></ul><ul><li>EFFECTS OF MALNUTRITION </li></ul><ul><li>CHILD MALNUTRITION IN INDIA </li></ul>
  3. 3. INTRODUCTION <ul><li>Protein energy malnutrition (PEM) – Major health and nutrition problem in India . </li></ul><ul><li>Occurs particularly in weaklings and children in the first years of life. </li></ul><ul><li>Not only an important cause of childhood morbidity and mortality , but leads to permanent impairment of physical and mental growth. </li></ul>
  4. 4. DEFINITION OF PEM <ul><li>Bad nutrition </li></ul><ul><li>As a state in which a prolonged lack of one or more nutrients retards physical development or causes the appearance of specific clinical conditions such as anaemia,goitre etc. </li></ul><ul><li>As ‘a pathological state resulting from a relative or absolute deficiency or excess of one or more essential nutrients.’ </li></ul>
  5. 5. TYPES OF MALNUTRITION <ul><li>Undernutrition -insufficient food is eaten </li></ul><ul><li>Overnutrition -consumption of excessive quantity of food . </li></ul><ul><li>Imbalance -disproportion among essential nutrients . </li></ul><ul><li>Specific deficiency -relative or absolute lack of nutrients. </li></ul>
  6. 6. World Health Report 2003.
  7. 7. DIFFERENCE BETWEEN OVER AND UNDER NUTRITION <ul><li>Overnutrition is encountered much more frequently than under nutrition . </li></ul><ul><li>The health hazards from over nutrition are a high incidence of obesity, diabetes, hypertension, cardiovascular and renal diseases. </li></ul>
  8. 8. PERCENTAGE OF CHILDREN AFFECTED BY MALNUTRITION 9 50 PAKISTAN 13 27 SRI LANKA 14 65 BANGLADESH 14 69 NEPAL 8 41 CHINA 27 65 INDIA WASTING,1980-90 (AGES12-23 MONTHS) STUNTING ,1980-90 (AGES 24-59 MONTHS) COUNTRY
  9. 9. INCIDENCE OF PEM <ul><li>India is one of the countries with highest proportion of malnourished children in the world along with Bangladesh, Nepal . </li></ul><ul><li>IN INDIA – </li></ul><ul><li>Preschool age children – 1-2% </li></ul><ul><li>Great majority of PEM are the ‘intermediates’ ones -80% </li></ul><ul><li>(i.e. the mild and moderate cases which frequently go unrecognized) </li></ul>
  10. 10. CAUSES OF PEM <ul><li>An inadequate intake of food both in quantity and quality. </li></ul><ul><li>Infections notably diarrhea, respiratory infections , measles and intestinal worms- </li></ul><ul><li>Increase requirements of calories, protein and other nutrients. </li></ul><ul><li>While decrease their absorption and utilization. </li></ul>
  11. 11. Conceptual Framework for the Causes of Malnutrition in Society
  12. 12. NUTRITIONAL DEFICIENCY DISEASES <ul><li>Kwashiorkor, </li></ul><ul><li>Marasmus </li></ul><ul><li>Xerophthalmia, </li></ul><ul><li>Nutritional anaemias and </li></ul><ul><li>Endemic goiter. </li></ul><ul><li>(Iceberg’ of malnutrition: a much larger population are affected by hidden malnutrition which is not easy to diagnose. ) </li></ul>
  13. 13. CLASSIFICATION OF PEM <ul><li>Classified according to severity, course and the relative contributions of energy or protein deficit </li></ul><ul><li>WEIGHT FOR AGE CLASSIFICATIONS </li></ul><ul><li>HEIGHT FOR AGE CLASSIFICATIONS </li></ul><ul><li>WEIGHT FOR HEIGHT CLASSIFICATION </li></ul>
  14. 14. CONT- <ul><li>(1) Weight for age classifications- Gomez’z </li></ul><ul><li>Weight of more than 90 percent of expected for that age (50th centile) as normal. </li></ul><ul><li>Weights for age between 76-90% grade- l </li></ul><ul><li>Weights for age between 61-75% grade -ll </li></ul><ul><li>Less than or equal to 60 % are classified as grade -III malnutrition respectively . </li></ul>
  15. 15. <ul><li>(2) Height for age classification : </li></ul><ul><li>Children with less than 80% height of expected for age as dwarf. </li></ul><ul><li>Those with a height of between 80 to </li></ul><ul><li>93 % are classified as short and </li></ul><ul><li>more than 93 % of height is seen in normal children. </li></ul>
  16. 16. <ul><li>(3) Weight for height classification -acute or chronic based on anthropometry. </li></ul><ul><li>In acute malnutrition weight is primarily affected . </li></ul><ul><li>A proportionate reduction in weight and height points towards a chronic courses </li></ul><ul><li>A greater and disproportionate reduction in height indicates acute on chronic PEM. </li></ul>
  17. 17. EFFECTS OF MALNUTRITION <ul><li>It is of two type : </li></ul><ul><li>(1) Direct and </li></ul><ul><li>(2) Indirect </li></ul><ul><li>Direct - the occurrence of frank and subclinical nutrition deficiency diseases such as </li></ul><ul><li>Kwashiorkor </li></ul><ul><li>Marasmus </li></ul><ul><li>Vitamin and mineral deficiency diseases etc. </li></ul>
  18. 18. <ul><li>Indirect - High morbidity and mortality among young children, </li></ul><ul><li>Retarded physical and mental growth and development , </li></ul><ul><li>Lowered vitality of the people leading to lowered productivity and reduced life expectancy . </li></ul><ul><li>The high rate of maternal mortality , </li></ul><ul><li>Stillbirth and slow birth –weight are all associated with malnutrition. </li></ul>
  19. 19. CHILD MALNUTRITION IN INDIA <ul><li>World’s malnourished children-40% </li></ul><ul><li>Low birth weight infants -35% </li></ul><ul><li>( developing world) </li></ul><ul><li>Every year children die in India-2.5 million </li></ul><ul><li>(accounting for one in five deaths in the world) </li></ul>
  20. 20. CONT- <ul><li>More than half of all preschoolers, and 75 % suffer from iron deficiency anemia. </li></ul><ul><li>Maternal mortality in India is one of the highest in the world, with 540 deaths per 100,000 live births . </li></ul><ul><li>83 % of women in India suffer from iron – deficiency anemia, compared with 40% in Sub –Saharan Africa. </li></ul><ul><li>Acc to GHI India ranked 117 th out of 119 countries on child malnutrition. </li></ul>
  21. 21. NUTRITIONAL STATUS <ul><li>In 1997 – about 170 million children under five years of age i.e. 30% of the world’s children are malnourished . </li></ul><ul><li>It is recognized that 56%of the deaths in under five children , in developing countries are attributed to malnutrition . </li></ul><ul><li>In India 47%of all children below 3 years of age are undernourished. </li></ul>
  22. 22. ACCELERATING PROGRESS IN REDUCING CHILD MALNUTRITION IN INDIA <ul><li>Integrated child development services (ICDS) </li></ul><ul><li>Public Distribution System (PDS) </li></ul><ul><li>The Mid –Day Meals Program </li></ul><ul><li>Community public works programs </li></ul><ul><li>The National Old age Pension program </li></ul><ul><li>Annapurna program </li></ul>
  23. 23. STRATEGIC CHOICES FOR IMPROVED CHILD NUTRITION <ul><li>SHORT-TERM STRATEGY: </li></ul><ul><li>Nutrition and health programs and policies </li></ul><ul><li>Effectively address the main nutrition problems. </li></ul><ul><li>Combined efforts with action. </li></ul><ul><li>Strong monitoring and evaluation. </li></ul><ul><li>Research can identify gaps . </li></ul>
  24. 24. <ul><li>5. Additional research. </li></ul><ul><li>6.Focused on states, districts,& communities </li></ul><ul><li>7. Increase attention to girls and women health. </li></ul><ul><li>LONG TERM STRATEGY : </li></ul><ul><li>Policymakers should work on economic growth & poverty reduction policy. </li></ul><ul><li>Strong partnership b/w National agencies. </li></ul>
  25. 25. <ul><li>Prime Minister Manmohan Singh stated, “The problem of malnutrition is a matter of national shame.... I appeal to the nation to resolve and work hard to eradicate malnutrition in five years.” This concept note focuses on international research and policy experiences in reducing child malnutrition and outlines how to move forward in close cooperation with the country’s policymakers and its nutrition community </li></ul>
  26. 26. REFERENCES <ul><li>Park k .Park’s text book of preventive and social medicine 17 th edn. Jabalpur:banarsidas bhanot publishers;2003.p 435 </li></ul><ul><li>Ghai op ,Gupta p Essential preventive medicine,1 st edn. Jangpura , Delhi: Vikas publishing house pvt Ltd; 1999.p.142 </li></ul><ul><li>National Family Health Survey II, Key Findings, International Institute of Population Sciences. Mumbai, India: IIPS Press; l998. Vol 99. p. 17-8.       </li></ul><ul><li>Gopujkar PV, Chaudhari SN, Ramaswami MA, Gore MS, Goplan C. Infant Feeding Practices with special reference to the use of Commercial Infant Foods. Nutrition Foundation of India, Scientific Report No.4. New Delhi: Ratna Offset; 1984. p. 115.       </li></ul>
  27. 27. THANKS
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