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  1. 1. MANTHON TOPIC: NOURISH TO FlOURISH: REDUCING MALNUTRITION Team Details Thalvaipati.Tejdeep Chaitanya.korada Vinayreddy.kalluri Syed Rubia Farheen Swetha Bodagala VIT UNIVERSITY INDIA TEAM NAME: GOODTEAM
  2. 2. PROBLEMS IN EXISTING SYSTEM An estimated 33% of the world’s severely malnourished children under live in India. Malnutrition has been estimated to be associated with about half of all child deaths and more than half of child deaths from major diseases, such as malaria (57 percent), diarrhoea (61 percent) and pneumonia (52 percent), as well as 45 percent of deaths from measles (45 percent). In India, child malnutrition is responsible for 22 percent of the country’s burden of disease. India has made huge strides in the past decades in warding off the spectre of famine. The Green Revolution should have gone a long way to tackling child malnutrition, Norman Borlaug’s creation of dwarf spring wheat strains in the 1960s meant that India could feed itself at last. Better farming techniques and food security policies have made mass starvation a thing of the past. Yet the problem of child malnutrition remains critical, and the reasons it deserves concerted attention are many. Besides the obvious moral obligation to protect the weakest in society, the economic cost to India is – and will be – staggering, and the global food crisis this year can only be significantly worsening the problem12. Moreover, statistics from as recently as 2006 may well underestimate the problem, as rampant food price inflation takes its toll on many millions of Indian families. FACTS AND MYTHS IN EXSISTING SYTEM: • 47 percent of India’s children below the age of three years are malnourished (underweight).3 The World Bank puts the number – probably conservatively – at 60 million.4 This is out of a global estimated total of 146 million. • 47 percent of Indian children under five are categorized as moderately or severely malnourished • SouthAsia has the highest rates – and by far the largest number – of malnourished children in the world. • The UN ranks India in the bottom quartile of countries by under-1 infant mortality (the 53rd highest), and under-5 child mortality (78 deaths per 1000 live births).6 According to the 2008 CIA fact book, 32 babies out of every 1,000born alive die before their first birthday. • At least half of Indian infant deaths are related to malnutrition, often associated with infectious diseases • Malnutrition impedes motor, sensory, cognitive and social development 8, so malnourished children will be less likely to benefit from schooling, and will consequently have lower income as adults. • The most damaging effects of under-nutrition occur during pregnancy and the first two years of a child’s life. • These damages are irreversible, making dealing with malnutrition in the first two year crucially important. • A close reading of available statistics shows the problem to be far from uniform
  3. 3. CAUSES OF THE PROBLEM: • There are many causes for malnutrition. These causes can be divided in two main categories. (A) Causes related to food. (B) General causes. • (A) Causes related to food: A lot of causes related to food are responsible for malnutrition. • 1. Lack of nutritious and Balanced Diet: Lack of nutritious and balanced diet is responsible to a great extent for malnutrition in children. In our country, because of poverty, there is a lack of essential elements like Proteins, carbohydrates, fats etc. in everyday meal; hence, manifestation of malnutrition in children is natural. • 2. Indigestive and Harmful diet: Intake of indigestive and harmful diet is one of the main causes of malnutrition. Children belonging to the rich families do have expensive food items but in general these food items are indigestive and harmful. Intake of such type of food items often leads to lack of hunger and hence sometimes the children fall prey to malnutrition. • 3. Lack of Regulated Diet: Irregular intake of food is one of the main causes leading to malnutrition. The timings for breakfast, lunch and dinner must more or less be fixed. Indiscipline in this matter is very bad. This bad habit of taking irregular meals causes indigestion and finally results in malnutrition. • (B) General Causes 1. Dirty Environment: • Dirty environment of home and school also causes malnutrition. In Indian cities the home and school environment becomes dirty due to lack of fresh and pure air, lack of sunlight, non-availability of playground, dirty lanes, which hampers right nutrition of children. The children working in glass factories, leather industry, brick industry etc. face the kind of dirty, unhygienic and unhealthy environment, which is hard to imagine. Hence child labour must also be completely banned so as to avoid the children from such filthy environment. • 2. Lack of Sound Sleep and Rest: Lack of space and suffocated bedroom causes lack of sleep. Besides this excess of homework and Television watching in late hours causes lack of sleep. Lack of sleep results in indigestion, which leads to malnutrition. Lack of proper and sufficient rest also leads to malnutrition. • 3. Negligence of Children: Negligence of children at home and in school causes anxiety in children. This also results in malnutrition. • 4. Bodily diseases: Many children being infected from the diseases are neither able to have balanced diet nor their bodily functions take place properly resulting in malnutrition. • 5. Heavy work: The digestive process of children gets affected because of continuous hard work. Especially for the children of low income- groups, the heavy labour uncoupled with balanced diet take a toll on their physical and mental development. Nearly forty percent of total children in India suffer from malnutrition. • 6. Lack of Exercise and Games:The lack of exercise and games also leads to malnutrition. Even if a child takes a balanced and nutritious diet, the lack of exercise and games results in slowing down of digestive process and consequently the food is not digested properly causing malnutrition. This also causes physical deficiencies.
  4. 4. Proposed solution To accelerate progress in reducing child malnutrition in India, the most urgent policy changes include expanding the scale, improving the targeting, and strengthening the implementation of existing programs and policies; building analytical and monitoring capacity; and ensuring that programs and policies are effectively pro-poor and pro-nutrition and that they focus on improving women’s status. Special attention is needed in the states that carry the highest burden of child malnutrition. India has many nutrition and social safety net programs, some of which have had success in several states in addressing the needs of poor households. These programs include • • Integrated Child Development Services (ICDS); • • the Mid-Day Meals Program; • • the Public Distribution System (PDS); • • community public works programs; and • • the National Old-Age Pension Program and the • Annapurna Program. • 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. For example, several evaluations of ICDS have shown it to have low coverage, poor targeting, and little impact on reducing. child malnutrition. Similarly, the PDS’s poor targeting has been documented. Furthermore, the different programs are often poorly integrated, with some households receiving benefits from a number of sources and others remaining excluded. Stronger programs and better coordination among them would increase their efficiency and effectiveness. Although these programs absorb substantial public funds, India’s level of public investment in nutrition is far below that of other developing countries. Thus there seem to be three problems that call for action: scale, design, and implementation. India needs greater accountability at all levels—not only for programs, but also for nutritional improvement in general.
  5. 5. PROPOSED SOLUTION • The significant progress can be made toward reducing child malnutrition through accelerated action in sectors that have not been the traditional focus of nutrition interventions. Efforts to improve • women’s education • raise food supplies(or reduce population growth or both). Restricting population size is a proposed solution. • healthful environments should be an integral part of strategies for reducing child malnutrition in the future. • These initiatives should be seen as complementary to more direct nutrition interventions, such as feeding programs. • Improvement of nutritional education in tribal or un developed area’s. • Investments in agriculture, such as subsidized fertilizers and seeds, increases food harvest and reduces food price. • Breastfeeding education helps first two years and exclusive breastfeeding in the first six months could save more children’s lives. • unequal distribution of resources and under- or unutilized arable land as the cause for malnutrition problems. • New technology in agricultural production also has great potential to combat under nutrition By improving agricultural yields, farmers could reduce poverty by increasing income as well as open up area for diversification of crops for household use. • When aiming to prevent rather than treat overeating, which is also a form of malnutrition, starting in the school environment would be the perfect place as this is where the education children receive today will help them choose healthier foods during childhood, as well as into adulthood. • Increased national income must actually be spent on improvements in the underlying determinants, which requires knowledge of their roles in reducing child malnutrition and political commitment to do so. • The MSU study found that 75% of 3,000 children in the rural areas of this district were malnourished, whereas 15% of the 23,000 children studied in the urban areas were overweight. • Midday meal scheme in Indian schools: implementing food quality in primary schools and increasing healthy food quantity. • Providing universal access to public health services irrespective of their religion and caste.
  6. 6. IMPLEMENTATION • Key to the success of the strategy will be a workforce which values the role food, fluids and timely nutritional intervention make towards health and well being, and recovery from illness. An education sub group will be established to ensure education programmes are developed which build on the knowledge and skills profile to achieve improved nutritional outcomes. • Adequate and proper diet (food). • Good and loving care in a healthy environment. • Access to health care services . • Improved schooling quantity and quality. • Nutrition Education: Education is a learning process by which a change in behavior is brought about. For providing nutrition education, one must have sound knowledge of locally available foods. The timing of providing education is of crucial importance, All persons involved in decision making, as well as responsible for cooking must be sensitized • Vulnerable periods of life, specially infancy, pregnancy, and lactation must be taken into account • Nutrition Therapy:If one is not able to prevent the occurrence of malnutrition, one has to go for treatment of malnutrition. Although prevention is still better than cure. • Dietary Management –Transfer to Family type diet: Child should be taking nutritionally wholesome family-type diet (cereals, pulses, vegetables) before discharge from hospital. Involves nutrition education of parents. Snacks made from peanuts, bengal gram, jaggery, and oil are useful. • Nutritional Rehabilitation : Majority of children, after discharge from hospital, again become victim of Malnutrition. To overcome this, Nutritional Rehabilitation is carried out. • Nutritional Rehabilitation Centres (NRC):Severely malnourished children, after taking treatment from hospital, may be transferred to NRCs. The objective is to teach the mother the various methods of preparing nutritious and tasty foods so that the relapse of malnutrition can be prevented. • AWARENESS: Awareness should be created among the people live in tribal areas as well as undeveloped areas,when malnutrition occurs people are believes in superstition and they will taken to hospitals this should be eradicate.
  7. 7. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Supplementary FoodBreastfeeding is everyone's yet no one’s responsibility Babies die here Immunizations Exclusive Breastfeeding Complementary Feeding and Continued Breastfeeding Malnutrition accelerates here 30% 37% 50% ORS/Diarrhoea Vit A Priority health and nutrition interventions under 2 years
  8. 8. References • Childhood Malnutrition: Prevention and Control at the National Level Gerardo Weisstaub, MD, MSc Magdalena Araya, MD, PhD Ann Hill, PhD Ricardo Uauy, MD, PhD. • Child malnutrition in India: Why does it persist? Report by Sam Mendelson with input from Dr. Samir Chaudhuri • Accelerating Progress toward Reducing Child Malnutrition in India