National nutritional programs

1.  Introduction
 India is the first populated country . Among its
population majority of the people belongs to rural
community and they are from low socio- economic
status, illiteracy and lack of basic human needs.
From the nutritional point of view majority are
undernourished and only a small group are well-
fed. The high income groups are suffering from
the diseases of over nourishment.
National Nutritional Programs and Role
of nurse

2. MAJOR NUTRITIONAL PROBLEMS IN
INDIA
• Nutritional deficiency is any deficiency of the
nutrients that are required to sustain human
life.
• Nutritional deficiencies occur when a person's
nutrient intake consistently falls below the
recommended requirement.
• Children between 10-19 years of age face
serious nutritional deficiencies worldwide,
according to the World Health Organization.

3.  The specific causes for nutritional deficiency disorders
are:
 Low socio economic status
 Illiteracy
 Lack of awareness regarding nutrients and their requirement
 Over population
 Decreased food production
 Lack of health care facilities
 Large families
 Cultural influences
 Infections
 Over nourishment among the group of high socioeconomic
status
 Superstitious beliefs, misconceptions
 Limited availability/ inadequacy of food products
Dietary practices etc.

4. Major nutritional problems in India are
Protein Energy Malnutrition (PEM).
Nutritional Anaemia.
 Iodine Deficiency Disorder (IDD).
Vitamin-A deficiency.
Low birth weight.
Endemic fluorosis.
Cardio Vascular Diseases.

5. Protein Energy Malnutrition .
 Malnutrition is a significant loss of lean tissue or
inadequate diet for a prolonged period in the
setting of severe stress.
 It is a significant component of many diseases.
 Malnutrition is more common in India. One in
every three malnourished children in the world
lives in India.
 Malnutrition limits development and the capacity
to learn. It also costs lives: about 50 per cent of
all childhood deaths are attributed to malnutrition.

6. Anemia
Every age group is vulnerable to iron-
deficiency anemia. In children, anemia can
cause a 5-10 point deficiency in IQ and hamper
growth and language development.
 In adolescents, it leads to a fall in academic
performance with a dip in memory and
concentration levels.
It can also lead to physical exhaustion and
susceptibility to infection.

7. Vitamin 'A' deficiency
• Vitamin A is necessary for good eyesight.
• In children, Vitamin A deficiency causes loss of
eyesight.
• If this deficiency is very severe, it may lead to
permanent blindness.
• In our country every year 30, 000 children lose eye
sight due to Vitamin A deficiency.
• Vitamin A deficiency symptoms are seen more
severely in children of age group 1 to 5 years.
• It is estimated that there are 12.5 million
economically blind persons in India. Of these over 80
per cent of blindness is due to cataract.

8. Iodine Deficiency Disorders
• lodine Deficiency Disorders (IDD) has been
recognized as a public health problem in India.
• According to Union Ministry of Health it is
estimated that 71 million populations are
suffering from endemic goiter and about 8.8
million people have mental/motor handicap
due to iodine deficiency.

9. Low birth weight
• More than 20 million infants are born each year
weighing less than 2,500 grams (5.5 pounds),
accounting for 17 per cent of all births in the
developing world - a rate more than double the
level in industrialized countries (7 per cent).
• Infants with low birth weight are at higher risk of
dying during their early months and years.
• Those who survive are liable to have an impaired
immune system and may suffer a higher incidence
of such chronic illnesses as diabetes and heart
disease in later life.

10.  Fluorosis
• Fluorosis is a disease caused due to excessive
ingestion of fluoride.
• Fluorides are the compounds of fluorine.
• Fluorine is the 13th most abundant element
available in the earth crust.

11. NATIONAL NUTRITION POLICY
• India's nutritional policy was formulated in the
year1993 by an act of the parliament
With the following goals:
• Reduction of incidence of low birth weight.
• Elimination of nutrition blindness.

12. • Reduction of anemia to 20% in pregnant women.
• Universal iodination of common salt to lower-
iodine deficiency disorders to less than 1%.
• Establish special care to geriatric nutrition.
• Increase annual food grain production to 250
metric tons.
• Steps to create household food security through
poverty alleviate Decrease incidence of moderate
and severe malnutrition in children.
• Promotion of appropriate diets and healthy
lifestyle.

13. NATIONAL NUTRITION POLICY
• NNP goals:
Short-term intervention.
Long-term interventions.
NATIONAL NUTRITION POLICY –
 Short-term intervention
• Expanding the nutrition intervention net (ICDS)
• Empowering mothers with nutrition and health
education
• Teaching adolescent girls to avoid anaemia
• Ensuring better nutritional coverage for
expectant women.

14. NATIONAL NUTRITION POLICY
 Long Term Interventions or Development Policy
Instruments.
• Food security.
• Improvement of dietary pattern.
• Increasing purchase power of the population.
• Streamlining and expanding Public
Distribution System. (PDS)
• Strengthening health and family welfare programs.
• Nutrition and public education.
• Education and literacy.
• Nutrition and surveillance.
• Information and communication.
• Ensure community participation.

15.  Integrated Child Development Services
Scheme (ICDS)
• Integrated Child Development Service
(ICDS) scheme was launched on 2nd October,
1975 (5th Five year Plan)
Beneficiaries
1.Children below 6 years
2. Pregnant and lactating women
3. Women in the age group of 15-44 years
4. Adolescent girls in selected blocks
The Ninth Five Year Plan aim to universalise
the ICDS coverage to the whole country.

16. Objectives
 Improve the nutrition and health status of
children in the age group of 0-6 years;
 Lay the foundation for proper psychological,
physical and social development of the child
 Effective coordination and implementation of
policy among the various departments; and
 Enhance the capability of the mother to look
after the normal health and nutrition needs
through proper nutrition and health education.

17. The Package of services provided by ICDS
are:
• Supplementary nutrition, Vitamin-A, Iron and Folic
Acid.
• Immunization.
• Health check-us.
• Referral services.
• Treatment of minor illnesses.
• Nutrition and health education to women.
• Pre-school education of children in the age group of
3-6 years, and
• Convergence of other supportive services like water
supply, sanitation, etc.

18.  Mid-day meal Programs
 The Midday Meal Scheme is the popular name for
school meal programmed in India which started in the
1960s.
 It involves provision of lunch free of cost to school-
children on all working days.
Objectives
 Protecting children from classroom hunger,
 Increasing school enrolment and attendance,
Strengthening child nutrition and literacy
 Improved socialization among children belonging to all
castes, Addressing malnutrition, and
 Social empowerment through provision of
employment to women.

19. Beneficiaries
• Children attending the primary school.
• Children belonging to backward classes,
scheduled caste, and scheduled tribe families
are given priority.
• The Scheme covers students (Class I-V) in the
Government Primary Schools / Primary
Schools aided by Govt. and the Primary
Schools run by local bodies.

20.  Food grains (wheat and rice) are supplied free
of cost @ 100 gram per child per school day
where cooked/processed hot meal is being
served with a Minimum content of 300
calories and 8-12 gms of protein each day of
school for a minimum of 200 days and 3 kgs
per student per month for 9-11 months in a
year, where food grains are distributed in raw
form.
 In drought affected areas the mid day meal is
distributed in summer vacations also.

21. National lodine deficiency disorder control
programme (NIDDCP)
 Iodine is an essential micronutrient with an
average daily at 100-150 micrograms for
normal human growth and development.
 Deficiency of iodine can cause physical and
mental retardation, abortions, stillbirth, deaf
mutism, squint & various types of goitre.
 It is estimated that more than 71 million
persons are suffering from goitre and other
lodine Deficiency Disorders.

22. • The programme was initially called as "Goitre
Control Programme" and was renamed by Govt.
of India in 1992 as NIDDCP. The programme is
monitored by the Deputy Director Health
Services situated in the Directorate of Health
Services, Mumbai.

23. Objectives
• Surveillance of Goitre cases
• Supply of iodized salt in place of common salt.
• Monitoring through analysis of salt and urine
samples.
• Assessment of impact of control measures over a
period of time.
• To monitor regular intake of iodized salt by
people .

24. Vitamin A supplementation (VAS)
programme in India
• The National Prophylaxis Programme against
Nutritional Blindness due to Vitamin A
Deficiency(NPPNB) was initiated in 1970 with
the specific aim of preventing nutritional
blindness due to keratomalacia.
• It was launched as an urgent remedial measure
to combat the unacceptably high magnitude of
xerophthalmic blindness in the country reported
in the 1950s and 1960s.

25. • To begin with, this Programme was initiated in
11 States of the country.
• In subsequent years, the Programme was
extended to all States in the country.

26. • Accordingly, each child was to receive five
doses of VA before her/his 3rd birthday
(children age 6-11 months, 1 dose of 100,000
IU of VA and in age 12-36 months of age one
dose of 200,000 IU of VA every six months).
• In view of operational feasibility, the
administration of first dose of VA was linked
to measles immunization.

27. • Presently, vitamin A supplementation (VAS) is
implemented through the existing network of
primary health centres and sub-centres.
• The female multipurpose worker and other
paramedics at the village level sub-health
centres are responsible for administering
vitamin A solution.

28. Goal
• To make vitamin-A deficiency no more a
public health problem
• To reduce Bitot's spot to less than 0.5%
• To bring down the prevalence of night
blindness to less than 1%

29. It was first launched in 1970 as the National
Nutritional Anemia Prophylaxis Programme
(NNAPP) and in 2018 changed the programme's
name to Anemia Mukt Bharat.
• In 2018, the Government of India launched the
Anemia Mukt Bharat (AMB) strategy to reduce
prevalence of anemia in women, children and
adolescents through life cycle approach.
• Anemia Mukt Bharat is divided into a
6X6X6strategy, including 6 beneficiaries, 6
interventions, and 6 institutional mechanisms.
This strategy aims to help the benefits of the
program reach the target audience
Anemia Mukt Bharat program

33. Weekly Iron and Folic acid Supplementation
programme.
• Started in the Year 2000 as UNICEF initiated a
pilot to control Adolescent Anemia
• Target
• Government school going and out of school.
adolescent girls in 20 districts in 5 states
• Platform
• Government school
• Anganwadi centers (village level child
development center).
• Channels
• Nodal Teachers. Anganwadi workers and peer
educators.

34. Objectives
• To reduce the prevalence and severity of
nutritional Anemia in adolescent population (10-
19) years.
• Target groups
• School going Girls and Boys (6 to 12 class)
• Adolescent girls who are not in school

35. • WIFS –
Intervention
• Weekly IFA (100mg of elemental iron plus
500microgram folic acid) round the year)
• Deworming (Albendazole 400mg) every six
months
• Screening and Referral Services
• Nutrition and Health Education counselling

36. • The role of a nurse in a nutritional program can vary depending
on the specific setting and context, but generally includes the
following
• Assessment: Nurses play a key role in assessing a patient's
nutritional needs and status. This involves collecting
information about a patient's diet, medical history, and any
conditions that may affect their nutritional needs.
• Planning: Based on the assessment, nurses develop a plan to
meet a patient's nutritional needs. This may involve creating a
personalized diet plan, recommending supplements or other
interventions, and coordinating with other healthcare providers
to ensure that the patient's nutritional needs are being met.
• Education: Nurses also play a crucial role in educating
patients and their families about the importance of good
nutrition and healthy eating habits. This may involve providing
information about specific foods and nutrients, as well as
offering guidance on meal planning and preparation.
ROLE OF NURSE IN NUTRITIONAL PROGRAMMES

37. • Monitoring: As patients follow their nutritional
plans, nurses monitor their progress and make any
necessary adjustments to the plan. This may
involve monitoring weight, blood sugar levels, or
other indicators of nutritional status.
• Advocate: Nurses may also advocate for their
patients' nutritional needs, working to ensure that
patients have access to healthy food options and
appropriate nutritional support.
• Overall, the role of a nurse in a nutritional
program is to support patients in achieving
optimal health and well-being
through good nutrition.