early detection,maintainn ing health ,prevention of mal nutrition ,early diagnosis , requirement assessment ,reducing work load of health care worker ,important aspect of health system,building healthy nation

2. The nutritional status of an individual or a community
has to be assessed to determine whether the nutritional
needs are being met.
Optimal nutritional status can be achieved only when
there is a balance between the nutritional intake and the
nutritional requirement.

3. Objectives Of Nutritional
Assessment
 To identify nutritional problems in an individual
and thereby the community through screening to
identify at risk individuals.
 To evaluate effective implementation of several
national nutritional programmes in the country.

4. Cont…
 To evaluate effectiveness of the national
programmes in reaching its target group.
 To assess the degree of malnutrition in preschool
and school going children to facilitate timely
intervention.

5. Methods Of Assessing
Nutritional Status
Sampling technique
Identification of risk groups
Direct assessment
 Diet survey
Anthropometric measurment
Clinical and biochemical estimation
 Use of growth chart
 Vital statistics

6. Sampling Technique
This is the best way to get proper estimation of
nutritional status of entire population in the country .
The population of country both in rural and urban
area comprises various age group. So it is very
essential to cover all these major vulnerable groups.

7. Diet Survey
Diet is vital determinant of health and nutritional
status of people. Diet surveys of community will help
in finding the data containing extent of dietary
deficiency,quantity and type of diet modification.

8. Cont….
Types of dietary survey :-
Qualitative aspect of food
Quantitative aspects of food
Duration of survey- survey should be carried out for
7-10 days.

9. Anthropometric Assessment
Anthropometry is the measurment of human body at
various ages, level of nutritional status. This permits
estimation of body fat, muscle, tissue and bone.
It includes various measurements.

10. Cont….
1) Body weight : body weight indicates mass and is
composed of body nutrients. It is sensitive even to
small changes in nutritional status.
2)Stature : Inadequate dietary intake or infections
reduce nutrient availability at cellular level, resisting
in growth retardation.

11. Cont….
3) Mid Upper Arm Circumference : It indicate
status of muscle development. MUAC identifies
malnutrition as well as mortality risk in children..
4) Head Circumference : It is mainly related to brain
size and to small extent to thickness of scalp tissue
and skull.

12. ANTHROPOMETRIC
MEASURMENT

13. Cont….
1.Chest Circumference: In nutritional anthropometry
chest/head circumference ratio is used for detecting
Protein Energy Malnutrition in early circumference.

14. Clinical Assessment
A complete physical examination and medical history
is assessed for determining nutritional status.
The following are noted :
 Appearance of skin
 Conjunctiva and pharynx examination
Examination of hair, skin, gums and teeth

15. Biochemical Assessment
Biochemical tests help to detect deficiency or excess
before symptoms are apparent.
The following tests are done :
Hemoglobin level is estimated
Stools and urine are examined for intestinal
parasites.
Urine is examined for albumin and sugar .

16. Vital Statistics
This also is helpful in the assessment of nutritional
status. These data are analyzed to evaluate the status
of public health and nutrition in a community.

17. • ANY QUERIES

18. Nutrition programmes in
india

19. Introduction
Nutrition programmes are of great importance for
maintenance of good nutritional status of national
population. Poor nutritional status in vulnerable
groups like pregnant women, lactating women,
children leads to increase in mortality and morbidity.

20. Nutritional Programmes
Nutritional Programmes can be classified into two
categories :
 Nutritional programmes are being run at national
level.
 Nutrition programmes are being run at state level.

21. National Iodine Deficiency
Disorder Control Programme
The govt. of India initiated a national iodine
deficiency control programme in “1992” to identify
goiter endemic regions and to assess the impact of
goiter control measures. Surveys showed widespread
iodine deficiency. So, to control that initial step taken
was to iodized common salt.

22. Components Of NIDDCP
The important objectives and component of National
Iodine Deficiency Disorders Control Programme
(NIDDCP) are as follows :
 Surveys to assess the magnitude of the Iodine
Deficiency Disorders.
Supply of Iodated salt in place of common salt.

23. Cont….
 Resurvey after every 5 years to assess the extent
of Iodine Deficiency Disorders and the impact of
Iodated salt.
 Laboratory monitoring of Iodated salt and urinary
iodine excretion.
 Health education and publicity.

24. Objectives Of Programme
 To conduct surveys to assess magnitude of IDD.
 To ensure supply of common iodized salt.
Repeated survey after 5 years to assess impact of
interventions being carried out.

25. Role Of Nurse In Controlling
Iodine Deficiency
 To carry out assessment in the region which are
endemic in iodine deficiency.
 To help in successful implementation of
interventions being carried to control deficiency.
 To identify weak links which are affecting
successful implementation of the programmes.

26. Cont…
 To create awareness in public regarding seriousness
of IDD and to launch health education campaigning
to create awareness.
 Monitoring the programme implementation and to
tackle various shortcomings, for successful
programme implementation.

27. National Programme For Control
Of Blindness
The National Programme For Control Of Blindness
was launched in “1976”. The main aim of this
programme was to reduce blindness in country from
1.4% to 0.3% by 2000 A.D and to provide
comprehensive eye care through primary health care.
Vitamin a deficiency prevalence is more in children
between 6 months and 3 years.

28. Cont….
In order to control vitamin a deficiency, the child
between 9 months to 5 years is given 9 doses of
vitamin A.
1. 1st dose – 1Lakh IU – 9 months age
2. 2nd dose – 2 Lakh IU – 16th month
3. Seven more doses -2 Lakh IU-interval of 6 months.

29. Other intervention to prevent vitamin
deficiency
 Promote exclusive breastfeeding and feeding of
colostrum.
Prevents measles by vaccinating at proper timings.
As infections often develop in case of vitamin A
deficiency.
 Encourage consumption of vitamin a rich foods.

30. Role Of Nurses In Combating Vitamin
A Deficiency
• To timely assess the children or infants for vitamin
A deficiency.
• To encourage the people to get vitamin A doses to
infants at right time.
•To educate them regarding vitamin A deficiency
affects.

31. Cont…
• To give them knowledge regarding role of
breastfeeding, immunization and vitamin A rich foods
in preventing vitamin A deficiency.
• To ensure successful implementation of programme.
• Timely monitoring of the programme. So, as to see
successful implementation of programme carried out of
combat vitamin A deficiency.

32. Anaemia Control Programme
This programme was launched in “1992”. Anaemia is
one of the major health problems affecting vulnerable
group like pregnant women, lactating women,
adolescent girls. Anaemia is one of the most leading
causes of maternal death and complications during
pregnancy.

33. Objectives Of Anaemia Control
Programme
Reduce iron deficiency anaemia in pregnant
women.
To deworm during second and third trimester, if
there is any history of worm infestation.
To give 2 tablets of iron and folic acid for 100 days
to pregnant women.

34. Cont….
To give 2 tablets of iron and folic acid for 100 days
to pregnant women found to be anaemic during
examination.
To give nutritional advice for consumption of iron
rich food.

35. Nursing Responsibilities
Nurse should assess pregnant women for anaemia.
During pregnancy women both anaemia and non
anaemia both should be given iron and folic acid
tablets.

36. Cont….
To educate them regarding importance of iron in
the diet and what impact its deficiency can put.
To ensure proper approach of health team workers
for successful implementation of scheme.
Timely monitoring of programme implementation.

37. Integrated Child Development
Scheme
The Integrated Child Development Scheme was
started in “2nd October 1975”. This scheme aims at
covering most vulnerable groups i.e. preschool
children, expectant and nursing mothers and women
in the age group of 15-44 years.

38. Objectives
 To improve nutrition and health status of children
in the age group of 0-6 years.
 To reduce morbidity, malnutrition and school
drop outs.
 To give care care to expectant women and
nursing mother.

39. Beneficiaries Group

40. Administration of the scheme
 Community development block- Rural areas
 Tribal blocks- Tribal areas
 Wards/slums- Urban area

41. Components Of ICDS
Programme
Nutrition supplementation for mothers and
children.
Nutrition health education imparted by Anganwadi
and Balwadi workers in home and clinics.
Total health care services including referral
services.

42. Cont….
Non formal education is given by teachers in Balwadi
through charts, diagrams, rhymes, stories etc.
Growth monitoring is done by Anganwadi workers.
Severely malnourished children are admitted and
therapeutic nutrition is given under supervision.
Referral services are provided to paediatric and
obstetric patients.

43. Water and
Sanitation
Non-formal
pre-school
education
Supplementary
nutrition
Health
checkup and
immunization
Referal
services
MOTHER
AND
CHILD

44. Nursing Responsibility In ICDS
Programme
 To elicit community support and participation in
running the programme.
 To weigh each child every month and record
appropriately and maintain child cards for children.
 Carry out survey of all families.

45. Cont….
To organize supplementary nutrition feeding for
children and expectant and nursing mothers by
planning the menu.
To provide health and nutrition education and
counseling on breastfeeding.
To check the implementation of components of
ICDS Programmes.

46. Mid-Day Meal Programme
This programme was started in Tamil Nadu and
implemented all over the India from “1995” to
encourage enrolment of more and more children into
school and to prevent school dropouts. The
beneficiaries are children of the poor and lower
middle class families. This programme also known as
School Lunch Programme.

47. Objectives
 Major objectives of this programme is to improve
the literacy rate by attracting more enrolments into
schools and prevent dropouts.
 It also aims to improve the nutritional status of
school children.

48. Guidelines/Principle of MDMP
For planning mid day meal for school following
considerations should be kept in mind :
 At least 1/3rd of the total energy requirements and
half of protein requirement should be provided.
 Local commodities should be used to keep the cost
low.

49. Cont….
Feeding should be done for a minimum of 250
days/year.
 Menu should be nutritious and changed frequently.

50. Child Survival and Safe
Motherhood
The CSSM Programme attempts to deliver the
maternal and child health services as a package
programme considering the total needs of mothers
and children during health and disease. The
programme was launched in 1991 in 100 districts of
the country covering the states of Uttar Pradesh,
Bihar, Rajasthan and Madhay Pradesh

51. Aim
 To reduce infant mortality rate
 Provide antenatal care to all pregnant women
 Ensure safe delivery services
 Provide basic care to all neonates
 Identify and refer these neonates who are at risk

52. Objectives
 The program integrates all intervention of fertility
regulation, maternal and child health with
reproductive health for both men and women.
 The service to be provided are client oriented,
demand driven, high quality and based on needs of
community through decentralized participatory
planning and target free approach.

53. Cont.…
 The program up gradation of the level of facilities for
providing various interventions and quality of care.
The first referral units being set up at sub district level
provide comprehensive emergency obstetric and
newborn care.
 Facilities of obstetric care MTP and IUD insertion in
the PHCs level are improved
 Specialist facilities for STD and RTI are available in
all district hospitals and in a fair number of sub district
level hospital.

54. Services Provided
 For the children
 Essential newborn care
 Exclusive breastfeeding
 Immunization
 Appropriate management of ARI
 Vitamin A prophylaxis
 Treatment of anemia

55. Cont.…
 For the mother
 Tetanus Toxid immunization
 prevention and treatment of anemia
 antenatal care and early identification of maternal
complications.
 delivery by trained personnel, management of
obstetrical emergencies
 Promotion of institutional deliveries and birth
spacing

57. AGENCIES WORKING TOWARDS FOOD
AND NUTRITION

58. Introduction
Health is a vital subject for the world community.
Any country, especially developing or undeveloped,
cannot fulfill its health duties on its own resources.
So, there are several international and national
agencies working towards the common goal of
providing food security to the people and improving
maternal and child health.

59. Food And Agricultural
Organization (FAO)
FAO was founded on 16 October 1945, in Quebec, Canada,
by the United Nations to raise the level of nutrition all over
the world. The motto of FAO is “Fiant Panis”, which
means “let there be bread”.
FAO helps several nations to increase production of food
with the increasing number of world population thus
ensuring food security.

60. Functions
The organization collects, analyses, interprets and
spreads information regarding agriculture, food and
nutrition. FAO covers various fields like fisheries,
marine products and forestry products.
FAO gives technical assistance to government on
request to alleviate poverty and hunger problems
by promoting agriculture development.

61. Cont….
FAO plays role in land and water development
plant and animal products, fisheries, forestry etc.
FAO deals with various food and agricultural
emergencies.
It plans and promotes adoption of international
policies with reference to agricultural commodity.

62. Cont….
It promotes various scientific, technological, social
and economic research relaying to nutrition, food
and agriculture.
It aims at improving processing, marketing and
distribution of food and agricultural products.

63. Cont….
It deals with improvement of education and
administration relating to nutrition, food and
agriculture.
It deals with spread of public knowledge regarding
nutritional and agricultural license and practice.

64. NATIONAL INSTITUDE OF PUBLIC
COOPERATION AND CHILD DEVELOPMENT
(NIPCCD)
It is popularly known as NIPCCD. It is a organization
devoted to promotion of voluntary action research,
training and documentation in the overall domain of
women and child development. It was establish in
New Delhi in the year 1966.

65. Functions
Training functionaries of the integrated child
development services (ICDS) programme.
Training and capacity building of functionaries at
the national and regional level, under the new
scheme of Integrated Child Protection Schemes
(ICPS).

66. Cont….
Imparting training on two important issues of child
rights and prevention of trafficking of women and
children.

67. Areas of Interest
 Early childhood care and development
 Healthy and nutrition of the young child and
mothers.
 Infant and young child feeding.
 Prevention of micronutrient malnutrition.
 Adolescent health, reproductive health and
HIV/AIDS.

68. Cont….
 Growth monitoring.
 Nutrition and health education.
 Child guidance and counseling.
 Early detection and prevention of childhood
disabilities.
 Juvenile justice.

69. Cont….
 Child rights and child protection .
 Women’s empowerment and gender
mainstreaming.
 Prevention of child marriage, female foeticide and
female infanticides.
 Prevention of trafficking of women and children.

70. COOPERATIVE FOR ASSISTANCE AND
RELIEF EVERYWHERE
CARE was founded in 1945 by Wallance Campbell to
provide relief to survivors of World War 2. It is an
international organization which works in India for
women, girls and poverty stricken people.

71. Objectives
 It focuses on developing the potential of women.
 It enables the poor to access quality education,
understand and receive their health care entitlements.
 To provide educational programme to reduce the
spread of HIV/AIDS.
 To provide emergency relief to survivors of war and
natural disasters.

72. Cont….
 To eradicate or reduce the world hunger and
poverty by sponsoring feeding programmes and
sustainable agriculture.

73. NATIONAL INSTITUDE OF NUTRITION
(NIN)
NIN was founded in 1918 in Coonoor district of Tamil
Nadu and later shifted to Hyderabad. National Institute of
Nutrition is located at Hyderabad. It is one of the
permanent research institutes of Indian Council of
medical research.

74. Objectives
 To identify various nutritional problems affecting
different status of population and to monitor diet
and nutrition situation of the country.
 To develop methods of prevention and control of
nutrition problem.

75. Cont….
 To carry out researches for planning and
implementation of applicable national nutrition
programmes.
 To study various nutritional deficiencies, nutrient
interactions and food toxicities at basic level for
understanding the biochemical mechanism
involved.

76. CENTRAL FOOD TECHNOLOGICAL
RESEARCH INSTITUTE
(CFTRI)
CFTRI, Mysore was founded on 21st October, 1950. It
is a constituent laboratory of the council of Scientific
And Industrial Research, New Delhi. It promotes and
helps in conservation of food resources and maximizes
the utilization of economic growth.