Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Community nutrition programme

8,244 views

Published on

community nutrition programme

Published in: Healthcare
  • The #1 Woodworking Resource With Over 16,000 Plans, Download 50 FREE Plans... ♣♣♣ http://tinyurl.com/y3hc8gpw
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here

Community nutrition programme

  1. 1. Community Nutrition ProgrammesCommunity Nutrition Programmes
  2. 2. Community Nutrition ProgrammesCommunity Nutrition Programmes (Objectives)(Objectives)  To improve overall nutritional statusTo improve overall nutritional status vulnerable groupvulnerable group  To overcome specific nutritionalTo overcome specific nutritional deficiencies among mothers and childrendeficiencies among mothers and children  To help to achieve better nutrition throughTo help to achieve better nutrition through indirect schemesindirect schemes
  3. 3. ProgrammeProgramme MinistryMinistry •Vitamin-A prophylaxisVitamin-A prophylaxis programmeprogramme MHFWMHFW •Prophylaxis against nutritionalProphylaxis against nutritional anaemiaanaemia MHFWMHFW •Iodine deficiency disorderIodine deficiency disorder control programmecontrol programme MHFWMHFW •Special nutrition programmeSpecial nutrition programme MSWMSW •Balwadi nutrition programmeBalwadi nutrition programme MSWMSW •ICDS programmeICDS programme MSWMSW •Midday meal programmeMidday meal programme MEME
  4. 4. Integrated ChildIntegrated Child DevelopmentDevelopment Services(ICDS) -1975Services(ICDS) -1975
  5. 5. objectivesobjectives  To improve the nutritional and health status ofTo improve the nutritional and health status of pre-school children in the age-group of 0-6 yearspre-school children in the age-group of 0-6 years  To improve the physical, mental and socialTo improve the physical, mental and social development of the childdevelopment of the child  To reduce the incidence of mortality, morbidity,To reduce the incidence of mortality, morbidity, malnutrition and school drop-out;malnutrition and school drop-out;  To enhance the capability of the mother to lookTo enhance the capability of the mother to look after the normal health and nutritional needs ofafter the normal health and nutritional needs of the child through proper nutrition and healththe child through proper nutrition and health educationeducation
  6. 6. Administrative set upAdministrative set up  At state level -state ICDS programme officer whoAt state level -state ICDS programme officer who report to DPHreport to DPH  District level ICDS programme officerDistrict level ICDS programme officer  Block level(100 Villages) – Child DevelopmentBlock level(100 Villages) – Child Development Project OfficerProject Officer  For every 20-25 ICDS center 1 supervisor (mukhyaFor every 20-25 ICDS center 1 supervisor (mukhya sevika)sevika)  At ICDS centre – Anganwadi worker (every 1000At ICDS centre – Anganwadi worker (every 1000 pop)pop)  In tribal areas 1 Anganwadi for 700 popIn tribal areas 1 Anganwadi for 700 pop
  7. 7. Targeted BeneficiariesTargeted Beneficiaries  The Scheme targets the most vulnerable groupsThe Scheme targets the most vulnerable groups of populationof population  include children upto 6 years of age,include children upto 6 years of age,  pregnant women and nursing mothers belongingpregnant women and nursing mothers belonging to poorest of the poor families and living into poorest of the poor families and living in backward rural areas, tribal areas and urbanbackward rural areas, tribal areas and urban slums.slums.  The identification of beneficiaries is doneThe identification of beneficiaries is done through surveying the community and identifyingthrough surveying the community and identifying the families living below the poverty line.the families living below the poverty line.
  8. 8. Package of ServicesPackage of Services  Supplementary NutritionSupplementary Nutrition  ImmunizationImmunization  Health Check-upHealth Check-up  Treatment & Referral ServicesTreatment & Referral Services  Non-formal Pre-school EducationNon-formal Pre-school Education  Nutrition & Health EducationNutrition & Health Education
  9. 9. Supplementary nutritionSupplementary nutrition  All children below 6 years of ageAll children below 6 years of age  Adolescent girlsAdolescent girls  expectant mothers belonging to scheduleexpectant mothers belonging to schedule caste and tribes who’s monthly incomecaste and tribes who’s monthly income less than 300 and land less agriculturistless than 300 and land less agriculturist  Given for 300 days ( lunch)Given for 300 days ( lunch)
  10. 10. RecipientsRecipients CaloriesCalories GramsGrams ofof ProteinProtein Children upto 6Children upto 6 YearsYears 300300 8-108-10 Adolescent GirlsAdolescent Girls 500500 20-2520-25 Pregnant andPregnant and nursing mothersnursing mothers 500500 20-2520-25 MalnourishedMalnourished ChildrenChildren Double the daily supplementDouble the daily supplement provided to the otherprovided to the other children(600 and/or specialchildren(600 and/or special nutrients on medicalnutrients on medical recommendationrecommendation
  11. 11. Non formal educationNon formal education  Children between 3-6 years are importedChildren between 3-6 years are imported pre- elementary education without formalpre- elementary education without formal hours of teaching without syllabus and testhours of teaching without syllabus and test  Teaching is mixed with play. Locally madeTeaching is mixed with play. Locally made charts, pictures, diagrams, toys and playcharts, pictures, diagrams, toys and play equipments are usedequipments are used
  12. 12. ImmunizationImmunization  Anganwadi arranges with health worker femaleAnganwadi arranges with health worker female serving her area to give immunization to herserving her area to give immunization to her wards and pregnant motherswards and pregnant mothers Treatment & Referral servicesTreatment & Referral services  With help of HWF get all needy children treatedWith help of HWF get all needy children treated for minor illness like diarrhea, ARI, minor cuts,for minor illness like diarrhea, ARI, minor cuts, fever etcfever etc  All other cases and sever malnutrition refers toAll other cases and sever malnutrition refers to medical officer of PHCmedical officer of PHC Growth monitoringGrowth monitoring  Checks the weight of all preschool childrenChecks the weight of all preschool children every month and records in growth chartevery month and records in growth chart
  13. 13. The impact of the programmeThe impact of the programme  Evident from the remarkable improvementsEvident from the remarkable improvements made in child survival and developmentmade in child survival and development indicatorsindicators 1.1. Decrease in Prevalence of Malnutrition amongDecrease in Prevalence of Malnutrition among Pre-school ChildrenPre-school Children 2.2. Improved immunization Coverage in ICDSImproved immunization Coverage in ICDS AreasAreas 3.3. Decrease in IMR in ICDS AreasDecrease in IMR in ICDS Areas 4.4. Improvement in School Enrolment andImprovement in School Enrolment and Reduction in School Dropout Rate in ICDSReduction in School Dropout Rate in ICDS Areas, 1992.Areas, 1992.
  14. 14. Mid-day Meal Scheme-1962Mid-day Meal Scheme-1962 TheThe mid-day meal schememid-day meal scheme is theis the popular name for school meal programme inpopular name for school meal programme in IndiaIndia.. It involves provision of lunch free of cost toIt involves provision of lunch free of cost to school-children on all working days.school-children on all working days. 106 million children, 8 lakh schools in 576106 million children, 8 lakh schools in 576 districtdistrict
  15. 15. objectives of the programme are:objectives of the programme are:  To improve the nutritional status of childrenTo improve the nutritional status of children  protecting children from classroom hunger,protecting children from classroom hunger,  increasing school enrolment and attendance,increasing school enrolment and attendance,  improved socialization among children belongingimproved socialization among children belonging to allto all castescastes,,  The scheme has a long history especially inThe scheme has a long history especially in Tamil NaduTamil Nadu andand GujaratGujarat,,  Has been expanded to all parts of India after aHas been expanded to all parts of India after a landmark direction by thelandmark direction by the Supreme Court of IndiaSupreme Court of India onon November 28November 28,, 20012001..  The success of this scheme is illustrated by theThe success of this scheme is illustrated by the tremendous increase in the school participationtremendous increase in the school participation and completion rates in TAMIL NADU..and completion rates in TAMIL NADU..
  16. 16.  One of the pioneers of the scheme is theOne of the pioneers of the scheme is the MadrasMadras corporation that started providingcorporation that started providing cooked meals to children in corporationcooked meals to children in corporation schools in the Madras city inschools in the Madras city in 19231923..  The programme was introduced in a largeThe programme was introduced in a large scale in 1962 in TNscale in 1962 in TN  Major thrust came inMajor thrust came in 19821982 decided todecided to universalize the scheme for all children inuniversalize the scheme for all children in government schools in primary classes ingovernment schools in primary classes in TN. Later the programme was expandedTN. Later the programme was expanded to cover all children up to class 12.to cover all children up to class 12.
  17. 17. PrinciplesPrinciples  The meal should be a supplement and not a substitute toThe meal should be a supplement and not a substitute to the home dietthe home diet  The meal should supply at least one third of the totalThe meal should supply at least one third of the total energy requirement and half of the protein needenergy requirement and half of the protein need  The cost of the meal should be reasonably lowThe cost of the meal should be reasonably low  The meal should be such that it can be prepared easilyThe meal should be such that it can be prepared easily in schools, no complicated cooking process should bein schools, no complicated cooking process should be involvedinvolved  as far as possible, locally available foods should beas far as possible, locally available foods should be used, this will reduce the cost of the mealused, this will reduce the cost of the meal  The menu should be frequently changed to avoidThe menu should be frequently changed to avoid monotonymonotony
  18. 18. Model menuModel menu FoodstuffsFoodstuffs g/day/childg/day/child Cereals and milletsCereals and millets 7575 PulsesPulses 3030 Oils and fatsOils and fats 88 Leafy vegetablesLeafy vegetables 3030 Non – leafy vegetablesNon – leafy vegetables 3030
  19. 19. Special nutrition programmeSpecial nutrition programme  Programme was started in 1970Programme was started in 1970 BeneficiariesBeneficiaries  Children below 6 years of ageChildren below 6 years of age  Pregnant and nursing mothersPregnant and nursing mothers  In urban slums, tribal areas and backwardIn urban slums, tribal areas and backward rural areasrural areas
  20. 20.  Supplementary food supplies about 300Supplementary food supplies about 300 kcal and 10-12 grams of protein per childkcal and 10-12 grams of protein per child per dayper day  Mothers receive daily 500 kcal and 25Mothers receive daily 500 kcal and 25 grams of proteingrams of protein  Supplement is provided for 300 days inSupplement is provided for 300 days in yearyear  It is gradually being merged with ICDSIt is gradually being merged with ICDS programmeprogramme
  21. 21. Balwadi nutrition programmeBalwadi nutrition programme  Started in 1970Started in 1970  6000 Balwadi centre -across the country6000 Balwadi centre -across the country  For children under the age group of 3-6For children under the age group of 3-6 yearsyears  Provide pre-primary education to childrenProvide pre-primary education to children  Food supplement provides 300 kcal andFood supplement provides 300 kcal and 10 grams of protein per child per day for10 grams of protein per child per day for 270 days270 days
  22. 22. Tamilnadu integrated nutritionTamilnadu integrated nutrition programmeprogramme  Was started in the year 1981Was started in the year 1981  Beneficiaries are children < 6 years,Beneficiaries are children < 6 years, pregnant and lactating motherspregnant and lactating mothers  Merged with ICDS programmeMerged with ICDS programme
  23. 23. Prophylaxis against nutritionalProphylaxis against nutritional anaemiaanaemia 19701970
  24. 24. prevalence of nutritional anemia inprevalence of nutritional anemia in IndiaIndia  65% infant and toddlers65% infant and toddlers  60% 1-6 years of age,60% 1-6 years of age,  88% adolescent girls (3.3% has88% adolescent girls (3.3% has hemoglobin <7 gm./dl; severe anemia)hemoglobin <7 gm./dl; severe anemia)  85% pregnant women (9.9% having85% pregnant women (9.9% having severe anemia.severe anemia.  The prevalence of anemia was marginallyThe prevalence of anemia was marginally higher in lactating women as compared tohigher in lactating women as compared to pregnancy.pregnancy.  The commonest is iron deficiencyThe commonest is iron deficiency anemia.anemia.
  25. 25.  The programme was launched in 1970The programme was launched in 1970  1992 became part of CSSM programme1992 became part of CSSM programme  1997 became part of RCH programme1997 became part of RCH programme  All pregnant mothers get 1 tablet of IFA per dayAll pregnant mothers get 1 tablet of IFA per day for 100 daysfor 100 days  All anaemic mothers get 2 tablets of IFA per dayAll anaemic mothers get 2 tablets of IFA per day for 100 daysfor 100 days  All anaemic child get 1 tablet of IFA per day forAll anaemic child get 1 tablet of IFA per day for 100 days100 days  All acceptors of family planning (IUD) are givenAll acceptors of family planning (IUD) are given one tablet of IFA for 100 daysone tablet of IFA for 100 days  All adolescent girls were given 1 tablet of IFAAll adolescent girls were given 1 tablet of IFA per weekper week
  26. 26. DoseDose  60 mg of elementary iron &0.5 mg of folic60 mg of elementary iron &0.5 mg of folic acid and which was raised to 100 mgacid and which was raised to 100 mg elementary iron from 1992 however folicelementary iron from 1992 however folic acid content remained sameacid content remained same  Children in the age group of 1-5 years areChildren in the age group of 1-5 years are given one tablet of iron containing 20 mggiven one tablet of iron containing 20 mg elementary iron (60 mg of ferrous sulphateelementary iron (60 mg of ferrous sulphate and 0.1 mg of folic acid) daily for a periodand 0.1 mg of folic acid) daily for a period of 100 days.of 100 days.
  27. 27. Vitamin-A prophylaxisVitamin-A prophylaxis programmeprogramme 19701970
  28. 28.  VAD is the most common cause ofVAD is the most common cause of preventable blindness in children(1-3yrs)preventable blindness in children(1-3yrs)  20-40 million children worldwide-20-40 million children worldwide- estimated to have at least mildestimated to have at least mild vitamin Avitamin A deficiency (VAD)deficiency (VAD), half reside in India., half reside in India.  VAD causes an estimated 60,000 childrenVAD causes an estimated 60,000 children in India to go blind each year.in India to go blind each year.
  29. 29.  Prevalence rates vary greatly among thePrevalence rates vary greatly among the states and range from less than 1% to 6%.states and range from less than 1% to 6%.  Prevalence of Xerophthalmia 0.6% as perPrevalence of Xerophthalmia 0.6% as per GBD 2000 estimatesGBD 2000 estimates  VAD in India remains a significant publicVAD in India remains a significant public health problem.health problem.
  30. 30.  The National Vitamin A prophylaxisThe National Vitamin A prophylaxis programme was started in 1971programme was started in 1971  Became part of RCH programme fromBecame part of RCH programme from 19971997 GoalGoal  To make vitamin –A deficiency no more aTo make vitamin –A deficiency no more a public health problempublic health problem  To reduce Bitot’s spot to less than 0.5%To reduce Bitot’s spot to less than 0.5%  To bring down the prevalence of nightTo bring down the prevalence of night blindness to less than 1%blindness to less than 1%
  31. 31. Short term measuresShort term measures  children between 1-5 years were given oralchildren between 1-5 years were given oral doses of 200,000 IU vitamin A every six months.doses of 200,000 IU vitamin A every six months.  Currently, vitamin A is given only to children lessCurrently, vitamin A is given only to children less than three years old who are at greatest risk.than three years old who are at greatest risk.  The administration of the first two doses is linkedThe administration of the first two doses is linked with routine immunization to improve thewith routine immunization to improve the coverage. A dose of 100,000 IU is given alongcoverage. A dose of 100,000 IU is given along with measles vaccine at nine months of age andwith measles vaccine at nine months of age and 200,000 IU with DPT booster at fifteen months200,000 IU with DPT booster at fifteen months
  32. 32. Medium term measureMedium term measure Fortification of foodFortification of food  Vanaspati is with vitamin A and D to the extentVanaspati is with vitamin A and D to the extent of 2500 IU of vit-A and 175 IU of vit-D perof 2500 IU of vit-A and 175 IU of vit-D per 100grams100grams  Fortified milk Currently, 62 dairies are fortifyingFortified milk Currently, 62 dairies are fortifying milk with 200 IU/100 ml with future plans formilk with 200 IU/100 ml with future plans for expansion.expansion.  Other food considered for fortification includeOther food considered for fortification include sugar, salt, tea, margarine, dried skimmed milksugar, salt, tea, margarine, dried skimmed milk etcetc
  33. 33. Long term measuresLong term measures  Dietary improvement is, undoubtedly, the mostDietary improvement is, undoubtedly, the most logical and sustainable strategy to prevent VAD.logical and sustainable strategy to prevent VAD.  Nutrition education -A change in dietary habitsNutrition education -A change in dietary habits and increased access to vitamin A-rich foodsand increased access to vitamin A-rich foods through education.through education.  Immunization against infectious diseasesImmunization against infectious diseases  Prompt treatment of Diarrhoeal diseasesPrompt treatment of Diarrhoeal diseases  Better feeding practices of infants and childrenBetter feeding practices of infants and children
  34. 34. National Iodine Deficiency DisorderNational Iodine Deficiency Disorder Control programme (NIDDCP)Control programme (NIDDCP) 19921992
  35. 35.  National goitre control programme was launchedNational goitre control programme was launched in 1962in 1962  GOI adopted policy of universal salt iodizationGOI adopted policy of universal salt iodization (USI) 1984(USI) 1984  Amended 1988- level of iodization of salt atAmended 1988- level of iodization of salt at manufacture level at 30ppm and consumer levelmanufacture level at 30ppm and consumer level 15ppm15ppm  1990 sale and manufacture of non iodized salt1990 sale and manufacture of non iodized salt was bannedwas banned  Referred as NIDDC programme in 1992 with anReferred as NIDDC programme in 1992 with an am to bring down the incidence of IDD belowam to bring down the incidence of IDD below 10% by 200010% by 2000
  36. 36. Components of IDDC programmeComponents of IDDC programme  Iodization of salt and oilIodization of salt and oil  Monitoring and surveillanceMonitoring and surveillance  Manpower trainingManpower training  Mass communicationMass communication
  37. 37. Iodized saltIodized salt  Most economical, convenient and effectiveMost economical, convenient and effective means of mass prophylaxis for IDDmeans of mass prophylaxis for IDD  Under PFA act level of iodization is 30ppmUnder PFA act level of iodization is 30ppm at manufacturer level and 15ppm atat manufacturer level and 15ppm at consumer levelconsumer level  Addition of 30 mg of iodine per Kg usuallyAddition of 30 mg of iodine per Kg usually in the form of potassium iodatein the form of potassium iodate  Potassium iodate is more stable in warm,Potassium iodate is more stable in warm, damp and tropical climatedamp and tropical climate
  38. 38. Iodized oil (injection)Iodized oil (injection)  IM iodized oil ( poppy seed oil, safflowerIM iodized oil ( poppy seed oil, safflower oil)oil)  1ml of IM injection will provide protection1ml of IM injection will provide protection for 4 yearsfor 4 years  More expansive than iodized saltMore expansive than iodized salt  Less practicable as it is very difficult toLess practicable as it is very difficult to reach each and every one to give injectionreach each and every one to give injection Iodized oil (oral) or sodium iodate tabletsIodized oil (oral) or sodium iodate tablets also triedalso tried  More costly than IM injectionMore costly than IM injection
  39. 39. Iodine monitoring and surveillance-Iodine monitoring and surveillance- componentscomponents  Iodine excretion determinationIodine excretion determination  Determination of iodine content in soil andDetermination of iodine content in soil and foodfood  Determination of iodine in salt at factoryDetermination of iodine in salt at factory level, wholesale and retail level andlevel, wholesale and retail level and community or consumer level.community or consumer level.
  40. 40. Manpower trainingManpower training  Training of health worker in all approachesTraining of health worker in all approaches of IDD controlof IDD control  Training on public educationTraining on public education Mass communicationMass communication  Mass communication through postersMass communication through posters radio, television, news papers and otherradio, television, news papers and other meansmeans

×