Nutritional surveillance and growth monitoring

1. NUTRITIONAL
SURVEILLANCE
Dr. Jazeela Mohamed Siddique
Senior Resident
Department of Community Medicine

2. Surveillance and Monitoring
• Nutritional surveillance
Keeping watch over nutrition, in order to make decisions that will lead to
improvement in nutrition in population.1
• Nutritional monitoring
Measurement in changes over time in the nutritional status of the
population or a specific group of individuals.2
• Growth monitoring
Following the growth rate of a child in comparison to a standard by periodic
anthropometric measurements to assess growth adequacy.
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1. Mason and Mitchell 1983
2. WHO
2

3. Nutritional surveillance
• Planning  health and development
• Impact of nutrition programmes
• Timely information of nutrition
status of the community
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Main Objectives

4. Growth monitoring
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• AWC
• From birth to 3 years
• Weight for age
• WHO growth chart

5. Growth monitoring vs Nutritional surveillance
Factor Growth monitoring Nutritional surveillance
Strategy Preservation of normal growth Detection of undernutrition
Approach Educational - motivational Diagnostic – interventional
Enrolment All infants Representative sample
Age Start before 6 months and continue
monthly
Representative age at longer intervals
Number Small groups, 10-20 Any size, 50-100 most efficient
Weigher/ Recorder Mothers guided by worker Trained worker
Weight card Simple, emphasis growth Precise, nutritional status
Nutritional emphasis Maintaining good nutrition Detect malnutrition
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6. Growth monitoring vs Nutritional surveillance
Factor Growth monitoring Nutritional surveillance
Response Early home intervention based on local
knowledge
Nutritional rehabilitation often with supplements
Response time Brief, resumption of normal growth Long, regain of good nutrition in community
Interventions Primary health care,
Oral rehydration therapy
Vaccines, Vitamin A, deworming
Contraceptives
Chloroquine, other treatment
Food supplements of community – wide response
such as food subsidy
Referral Health system for check up and possible
brief food supplements
Malnutrition rehabilitation often in special centre
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7. Nutritional surveillance
ASSESSMENT
ANALYSIS
ACTION
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ASSESSMENT of the nutritional
situation in the target population
ACTION based on the analysis and
available resources
ANALYSIS of the causes of the
problem
• Delayed complimentary feeding
• Inadequate dietary intake
• Non utilization of services
provided by the govt
• Education of mother
• Frequent feeding of energy rich
foods

8. Nutritional status Indicators
Phenomenon Indicator
Maternal nutrition • Birth weight
Infant and preschool child nutrition • Proportion being breast fed and
• Proportion on weaning foods by age in months
• Mortality rates in children aged 1,2,3 and 4 years
with emphasis on 2 year olds
• If age known : Weight for age
Height for age
• If age unknown : Weight for height
Arm circumference
Clinical signs and syndromes
School child nutrition • Height for age
• Weight for height at 7 years or school admission
• Clinical signs
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