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1. DIRECTORATE OF INDIAN SYSTEMS OF MEDICINE J&K
Government Initiatives in
Health and Nutrition
COURTESY :- ASSISTANT DISTRICT MEDICAL OFFICER
DISTRICT SRINAGAR
3. Key issues in childhood undernutrition
Normal height
NORMAL
WASTED
(Thin)
STUNTED
(Short)
48%
20%
38%
21%
0%
10%
20%
30%
40%
50%
60%
Stunting Wasting
2005-05 2015-16
4. Stunted
Wasted
Undernutrition trend by age
6 months to 18 mo crucial
Childhood
undernutrition
1. ~20% due to
small size at
birth;
2. ~25% due to
diarrhea and
other
infections;
and
3. Rest ~55%
due to
suboptimal
feeding
5. • Undernutrition occurs in
the first and the second
year
• Period of rapid brain
growth and maturation:
80% by 2 years
• Linear growth failure in
this period is associated
with adult short stature
• Less schooling
• Low productivity, income
• Lower offspring
birthweight (females)
5
First 2 years of life are the key
But ICDS services in this period have low
focus: a design flaw
6. Challenge of optimum complementary feeding for children 6-24
-30
-20
-10
0
10
20
30
40
0
10
20
30
40
50
60
70
80
90
100
Percentage
change
Percentage
%
Adequate diet 2006 Adequate diet 2016 Change
Adequate diet = child 6-24 fed either breastmilk/source of dairy; and age-appropriate number of food groups and age-appropriate number of meals per day
NFHS-3 indicator calculation by IFPRI; NFHS-4 indicator as reported in fact sheets.
Source: NFHS-3; NFHS-4
Courtesy Avula
7. Birth
spacing
Pre-pregnancy
care
Antenatal
Care Immunization Strengthen, and Expand Antigens
Home
Based
New Born
Care
Feeding counseling Breast feeding
Complementary feeding
Birth
Institutiona
l
Deliveries
6 weeks
Facility
Based New
Born Care
Early detection and treatment of diarrhea and pneumonia
Community, Integrated Management of Neonatal and Childhood Illnesses
Home-based Young Child Care
6 months 1 year 2 years
WASH Safe water, hand washing, safe disposal of feces
Supplementary nutrition Recipe reformulation
Growth monitoring Address moderate malnutrition
Care of the malnourished child
Management of Severe Acute Malnutrition
HEALTH*
ICDS*
SWACHH*
Not to
scale
Pregnancy
Pre-pregnancy
*predominant
role
Iron-folic acid; Vitamin A; Deworming
Package of Interventions
7
Beti
Bachao,
beti
padhao;Adolescent
8. 4 Point Strategy
I. Convergence
[Inter-sectoral convergence for better service delivery]
II. Use of Technology (ICT)
[Real time growth monitoring and tracking of women and children; programme monitoring through
Dashboards]
III. Intensified Health & Nutrition Services for first 1000 days
[Immunization in High burden Districts- Rotavirus & Pneumococcal, Extended Home Based Care of
Infants from 06-24 months ; IYCF promotion]
IV. Mission as ‘Jan Andolan’
[Involving field workers, community and PRIs; strengthening VHSND]
9. Home based infant care
Packaging Evidence Based interventions
Growth Monitoring
Breast Feeding
Complementary feeding
Prophylactic ORS
IFA Supplementation
Immunization
Hand Washing
Care Seeking in Sickness
Platform using structured
home visits done by
ASHAs up to 1 year of
age.
Home Visit
Schedule :
5 visits by ASHA-
Beginning of 4, 6,8,10
and 12 months
Reduction Of
Diarrhoea And
Pneumonia and
Better Nutrition
Status
Outcome
10. Targets of the POSHAN Abhiyaan
Prevent and reduce Stunting in children (0- 6years) Target: ↓ by 6%
@ 2% per annum.
Prevent and reduce under nutrition in children (0-6years). •Target:
↓ by 6% @ 2% per annum.
Reduce the prevalence of Anaemia among Children
(6-59 months). •Target: ↓ by 9%@ 3% per annum.
Reduce the prevalence of Anaemia among Women
• and Adolescent Girls in the age group of 15-49 years. •Target: ↓ by
9%@ 3% per annum.
Reduce Low Birth Weight(LBW). •Target: ↓ by 6% @ 2% per annum.
10
11. Focus of Poshan Abhiyaan
• Anaemia.
• Diarrhoea.
• Hand wash and sanitation.
• First 1000 days of Child.
• Poshtik Aahar
11
12. POSHAN Abhiyaan:
List of activities to be performed in Poshan Abhiyaan are
• Anemia Camp
• Area Level Federation (ALF) Meetings
• CBE – Community Based Events (ICDS)
• Community Radio Activities
• Cycle Rally
• DAY-NRLM SHG Meet
• Defeat Diarrhoea Campaign (D2)
• Farmer Club Meeting
• Haat Bazaar Activities
• Harvest Festival
• Home Visits
• Local Leader Meeting
• Nukkad Natak / Folk Shows
• Panchayat Meeting
• Poshan Mela
• Poshan Rally
• Poshan Walk
• Poshan Workshop / Seminar
• Providing Water to the Toilets
• Safe Drinking Water in Anganwadi Centers
• Safe Drinking Water in Schools
• School Based Activities
• Self Helping Groups (SHG) Meetings
• VHSND
• Youth Group Meetings
13. Recommended priorities
• Eliminate Diarrhoeal Deaths by focusing on prevention, rota virus vaccination, initiating
timely treatment by giving ORS and Zinc and finally referral to a nearby health facility in
case of complications.
• A huge campaign around improving complementary feeding practices.
• Improve the quality of home visits through better implementation of the intensified and
augmented Home-Based Newborn Car (HBNC) programme.
• A very strong movement around ‘Anaemia Mukt Bharat’ Campaign.
14. Activates related to Poshan Maah to be taken by AYUSH from 1st sep to
30th sep
• Health and nutrition outreach camps.
• Yoga camps.
• Promotion of Nutri-gardens across the associated
campuses/premises.
• Ayush Health centre centric sensitization on community based
visuals/early identification of severely malnourished children.
• Awareness camps about personal Hygiene, safe water and sanitation.
• Awareness regarding importance breastfeeding.
• Awareness regarding menstrual hygiene.
20. Yoga Focuses on bringing perfect harmony between body and mind.
• Yoga comprises of various techniques, postures and
exercises to be performed with specific principle which
brings about control of body and mind.
• Yoga can be practiced both at indoor and outdoor.
• Various preliminary studies have reported that Yogic
practices are found useful in the management of Diabetes
mellitus.
