Nourish To Flourish
Reducing Malnutrition In India
Akash Raval (Co-ordinator)
Kirpalsinh Vaghela
Monalisa Thakur
Varun Oza...
Malnutrition And India
1 of every 3 malnourished children live in India
About 50% of all childhood deaths are attributed t...
Causes of Malnutrition
Promoting Breastfeeding
If every child was breastfed within an hour of birth, given only
breast milk for their first six m...
Public Distribution
Systemm
Inadequate functioning of PDS leading to lack of essential food to the needy
The Package prov...
Government
Policies
Though the Government of India runs about 6 direct and 6 indirect policies for
fighting Malnutrition ,...
Government Policies
Nutrition should be integrated within the National Economic and Social Development Plan, and
linkages ...
Mid Day Meal for 200 days in a year as suggested by
Supreme Court For Primary School :
480 calories and 8-13 gm protein
Fo...
Promoting
Sustainable
Agriculture
Failure to include nutrition
concerns in major cropping
and farming Systems
The Problem ...
The agricultural sector of each state or few together should be under direct control of an
agricultural university or agro...
1) Measure height and weight to get a BMI (body
mass index) score. (BMI kg/m2)
BMI >20 (>30 obese), score 0
BMI 18.5 to 20...
• 2i - http://www.unicef.org/infobycountry/india_statistics.html
• 4i - http://www.who.int/mediacentre/factsheets/fs342/en...
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Yodha

  1. 1. Nourish To Flourish Reducing Malnutrition In India Akash Raval (Co-ordinator) Kirpalsinh Vaghela Monalisa Thakur Varun Oza Vijayrajsinh Gohil
  2. 2. Malnutrition And India 1 of every 3 malnourished children live in India About 50% of all childhood deaths are attributed to malnutrition In India, around 46% of all children below the age of three are too small for their age 7% are underweight and at least 16% are wasted. Many of these children are severely malnourished Gross domestic product (GDP) loss to malnutrition runs as high as 3 to 4% Under-nutrition is the underlying cause for about 50% of the 2.1 million Under-5 deaths in India each year. Productivity losses to individuals are estimated at more than 10% of lifetime earnings 2i 2ii
  3. 3. Causes of Malnutrition
  4. 4. Promoting Breastfeeding If every child was breastfed within an hour of birth, given only breast milk for their first six months of life, and continued breastfeeding up to the age of two years, about 220 000 child lives would be saved every year globally. (4i) Children who are breastfed have a 20 percent lower risk of dying between the ages of 28 days and 1 year Breastmilkistheidealfoodfornewbornsandinfants Breastfeeding provides protection from diseases like Diarrhea and Pneumonia What UNICEF has to say of India In addition to containing health enhancing enzymes, proteins and hormones(4ii) Ignorance in Breastfeeding Malnutrition Why Timely Breast-feeding is so Important ?? Spreading Awareness Alloting a high budget on breast feeding awareness programs Initiating programs such as village play, which promotes the breastfeeding and child care Advertising the related materials at prime times and especially during cricket matches(4iii)
  5. 5. Public Distribution Systemm Inadequate functioning of PDS leading to lack of essential food to the needy The Package provided at fair price shops should be revamped, to include other supplement's like iodized salt, edible oil, Pulses coarse grains Providing fortified blended foods (FBFs, such as Corn Soy Blend or Wheat Soy Blend) to groups with higher nutritional needs, such as the moderately malnourished, and pregnant and lactating women Network of the PDS should be more broader and should primarily focus on slum and hilly areas where malnutrition affects the most Inclusion of ORS(Oral Rehydration Salts) in the PDS structure can help children from Diaheria Expand availability of low cost nutritious food in rural areas through PDS, Public Private Partnership, Women self help group and other mechanisms Inclusion of high quality complementary foods for children of age group 6-24 months in PDS World Food Programe has a variety of food developed to tackle malnutrition this can be incorporated in the PDS Structure and can be provided to the needy For treatment of moderate acute malnutrition and stunting it should include:  Super Cereal Plus which has key ingredients of Corn/wheat/rice soya, milk powder, sugar, oil, V&M for children of 6-59 months . The profile includes 394-787 kcal, 16-33g protein (17%), 10-20g fat (23%).  Super Cereal which has key ingredients of Corn/wheat/rice soya, V&M for Pregnant and Lactating Women and Malnourished Individual . It includes 376-752 kcal, 15-31g protein (16%), 8-16g fat (19%).  Micronutrient Powders which has key ingredients of Vitamins and minerals. Source : WFP Specialized Nutritious Foods Sheet Plans to Improve the PDS
  6. 6. Government Policies Though the Government of India runs about 6 direct and 6 indirect policies for fighting Malnutrition , but it doesn't reaches the targeted audience !! Thailand: Halved child malnutrition between 1982 and 1986 (from 50 to 25 percent in less than a decade) Policy instruments: Thailand’s 2nd National Health and Nutrition Policy (1982–86) focused on targeted nutrition interventions to eliminate severe malnutrition as well as on behaviour change and communication to prevent mild to moderate malnutrition.(6ii) Government Of India funding for Integrated Child Development Services (ICDS) in 2001-2002 increased to 1311.2 crore !! Still its ineffective.(6i) China: Reduced child malnutrition by more than half between 1990 and 2002 (from 25 to 8 percent in 12 years) Policy instruments: China pursued a successful poverty alleviation strategy along with rapid economic growth. Effective nutrition, health, and family-planning inter- ventions were implemented at a large scale.(6ii) Failure of the Government Policies is due to : 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. Furthermore, the different programs are often poorly integrated, with some households receiving benefits from a number of sources and others remaining excluded.
  7. 7. Government Policies Nutrition should be integrated within the National Economic and Social Development Plan, and linkages between agriculture and nutrition needs to be established, ensuring sustainability. A strong local, action-oriented surveillance system allowed for monitoring and evaluating progress. Nutrition and health programs and policies should be redesigned to implement them synergistically and at scale to effectively address the main nutrition problems. Efforts should be focused on states, districts, and communities with the highest concentration of poor and vulnerable households, and on more vulnerable individuals within those households. What needs to be looked upon currently 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 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. Stratergies
  8. 8. Mid Day Meal for 200 days in a year as suggested by Supreme Court For Primary School : 480 calories and 8-13 gm protein For Upper Primary : 700 calories and 12-20 gm protein.(8ii) Mid Day Meal Scheme MDM was introduced to improve the nutritional status of children by the food being given to them. As this scheme can directly affect the children and a proper implementation can have a sufficient improvement in the nutritional status special emphasis should be given on it implementation 94% of children in the age group of 6 to 9 are mildly, moderately, or severely underweight. About 67.5% of children under 5 years and 69% of adolescent girls suffer from anaemia due to iron and folic acid deficiency. (8i) Of the 2000 calorie specified only provision for 700 is made. Pilferage and adulteration of grains occurs since grains are supplied and distributed in loose form to schools . What Goes Wrong ? Introducing private enterprises in the running of the MDM scheme may be a better idea than governmental agencies themselves getting involved as it would save time that is wasted by teachers in serving and could concentrate on teaching . Efficiency of the nutrition delivery could be increased by offering fortified packaged foods. In fact, menu could include local ready-to-eat chikki and sukhdi or an occasional nutrition bar. Golden Rice an GM variety of rice is a naturally fortified in terms of nutrients such as beta-carotene. Use of Gold Rice rice in MDM scheme may improve nutritional delivery to the targeted children. Partial substitution of delivery of loose grains by packaged items may also improve accountability in the supply chain. Solutions
  9. 9. Promoting Sustainable Agriculture Failure to include nutrition concerns in major cropping and farming Systems The Problem Lies Here Limited availability of nutrient rich foods Seasonal food shortages Large spending on agriculture increases the overall yield but the approach is not a sustainable one hence affecting the food crop in the long run Agricultural institutes to be made accountable for reform in agricultural practices Reason for choosing this reform 1.Better knowledge on the specific natural plantation of the area 2.Scientific approach to agricultural practices 3.New and Indigenous varieties of food crop seeds available Methodology to be implemented 1.Directly guiding the farmer on know hows of sustainable agriculture 2.providing small land holding farmers with quality seeds and tools. 3.Encouraging R&D in this field. 4.Submission of an annual report on the statistics of production. Resources needed 1.Setting up of such new educational institutes 2.Funding for R&D in food technology for sustainable developement Solutions
  10. 10. The agricultural sector of each state or few together should be under direct control of an agricultural university or agro-research Organizations or such Institutes Each institute should look into condition and need of the local region Special programs for farmers' education Devising and implementation of reformed and scientific agricultural practices More emphasis on the locally grown crops ex-reviving the plantation of litchi in Bihar, guar in places with water scarcity like Gujarat and Rajasthan Promoting food crops rich in protien content like soyabeans and other low cost nutritious food like flax seed Promoting alternative option to high cost dal with keshari and other low cost but high potein dal Being well informed with the latest technology around world in agricultural practices and inventions Can be helpful in getting subsidies or aid from international organisation Regional Institutes Promoting indigenous and locally grown food crop Tieing up with other international bodies Improving Agriculture Products for Fighting Malnutrition
  11. 11. 1) Measure height and weight to get a BMI (body mass index) score. (BMI kg/m2) BMI >20 (>30 obese), score 0 BMI 18.5 to 20 - score 1 BMI <18.5 - score 2 2) Note percentage unplanned weight loss in last 6 months <5% - score 0 5% to 10% - score 1 >10% - score 2 3) Establish acute disease (any underlying illness, such as a psychological condition) effect and score If the patient is acutely ill and there has been or is likely to be no nutritional intake for over 5 days - score 3 4) Add scores from steps 1, 2 and 3 together to obtain overall risk of malnutrition Low Risk - Score 0 Medium Risk - Score 1 High Risk - Score 2 or more Low risk, score 0 : Keep a track of your intake and have proper screening periodically Medium risk score 1 : Document dietary intake for 3 days and consult clinic, if approved follow or change it High Risk Score 2 Improve and increase overall nutritional intake Monitor and review care plan 5) Use management guidelines and/or local policy to develop care plan. British Association for Parenteral and Enteral Nutrition's MUST (Malnutrition Universal Screening Tool ) Method for diagnosing malnutrition
  12. 12. • 2i - http://www.unicef.org/infobycountry/india_statistics.html • 4i - http://www.who.int/mediacentre/factsheets/fs342/en/ • 4ii - http://www.babycenter.com/0_how-breastfeeding-benefits-you-and-your-baby_8910.bc • 4iii –http://tribune.com.pk/story/596576/natural-advantages-breastfeeding-week-from-aug-26-31/ • 5i – World Food Program Specialized Nutritious Foods Sheet • 6i – India’s Undernourished Children: A Call for Reform and Action by Michele Gragnolati, Meera Shekar, Monica Das Gupta,Caryn Bredenkamp and Yi-Kyoung Lee • 6ii - Accelerating Progress toward Reducing Child Malnutrition in India , Jan 2008 • 8i - National Programme 0f Mid Day Meal in School [MDMS] Annual Work Plan & Budget 2010-11 Name of the State : Chhattisgarh , Page 7 • 8ii - Mid-Day Meal Programme (Annual Work Plan & Budget 2013-14) , Page 1 References

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