This Slide is prepared on the basic of visit to nutrition rehabilitation centre Bharatpur, Chitwan , Nepal. This visit was done by BPH students; 7th batch of Chitwan Medical College (CMC).

1. FIELD VISIT TO
NUTRITION
REHABILIATTION
CENTRE
BY SAZAAN POUDEL
BHARATPUR, CHITWAN, NEPAL
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2. Introduction about rehabilitation centre
 Malnutrition is the condition that develops when the body does not get the
right amount of the vitamins , minerals and other nutrients it need to
maintain healthy tissues and organ functions.
 Nutritional rehabilitation center (NRC) is a place where malnourished child
is taken to restore its normal nutritional status through diet therapy along
with the training to their mothers or care taker about nutrition and child
care .
 The first NRC in Nepal was established in Kathmandu in 1998 by
Nepalese Youth Foundations(NYF). Now there are 20 nutrition
rehabilitation centers present in Nepal
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3. ACKNOWLEDGEMENT:
We group of 27 student from Chitwan Medical College , BPH 1st year along
with Mrs. Sakuntala Chapagain went on a field visit trip to Bharatpur hospital.
After reaching on our destiny our teacher contacted the hospital staff inorder
to get permission to visit nutrition rehabilitation center. After getting permission
from the hospital management we went into the nutrition rehabilitation home
where we conducted our observation by three means :
 By Lecture
 Through questioner
 By direct observation
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4. OBJECTIVES
 To know the background
 To study the services
 To find the programs conducted
 To observe the institutional instruments
 To study the patient condition
 To inquiry about the current situation
 To recommend our views to uplift the rehabilitation centre
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5. Bharatpur Rehabilitation Centre
 Bhartpur Rehabilitation Centre is one of the rehabilitation centre amoung
the 20 rehabilitaiion centre present in Nepal.
 LOCATATION:- Bharatpur Hospital, Bharatpur 10
 ESTABLISHMENT:- 2068 B.S by Nepal Youth Foundation (NYF)
 Service started from 10th of Baishak 2069
 Bharatpur Rehabilitation Centre is ranked second among all the NRC
present in Nepal
 It is 10 Beded
 Its Budget is allocated by Government of Nepal at present day
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6. ECONOMICAL HISTORY
 At the beginning of its establishment 75% of budget was provided by
Nepal Youth Foundation(NYF) and 25% by Government of Nepal
 Later on scenario was changed and budget allocation changed as follow
50% by NYF and 50% by Gov. of Nepal
25% by NYF and 75% by Gov. Of Nepal
100% by Gov. Nepal after 2073 B.S
 Budget is allocated by the government of Nepal as patient flow and
services provided
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7. Activities in Bharatpur Nutritional
Rehabilitation center
 Nutritional councelling
 Determination of nutritional status
 Diet therapy .
 Provides trainings to the parents (hand washing ,personal hygiene ,
balanced diet, family planning and so on) so that they can maintain the
health of their children.
 Malnurished children more than 5 years age are not admitted but their
parents are given councelling and teach home treatment to better their
children health.
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8. Entry of patients
 At the beginning phase Staff themselves used to go to different villages and collect
patient.
 Very less people have idea about the rehabilitation center. Those who know about the
rehabilitation center go for the treatment.
 Nowadays, everyday OPD is visited , entry of new children is recorded , their height and
weight are measured and those having severe malnutrition are directly sent to the
nutrition rehabilitation center.
The children are ranked according to their condition into mild, moderate and severe.
Mild malnutrition = SD ≤ 1
Moderate malnutrition = SD ≤ 2
Severe malnutrition = 2 ≤ SD ≤ 3
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9. Treatment procedure
Treatment of the severely malnourished children is carried out in 3 phases:
1. Initial phase
2. Transition phase
3. Free feed phase
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10. Initial phase
 The first 2 days after the admission of the children is considered as the
initial phase.
 In every two hours, ‘ F-75 ’ ( milk powder)is provided to the children
 Composition(F-75) :
For 1 liter :
Milk powder 300 gm.
Sugar 100 gm.
Powdered puffed rice 35 gm
Veg oil 17 ml
Energy 75kcl/100ml
Protein 0.9gm/100ml
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11. Transition phase
 The first 3 – 6 days after the admission of the children is considered as the
transition phase.
 For 3 – 4 days
 In every three hours interval, ‘ F-75 ’ ( milk powder) is provided to the
children
 For 5 – 6 days
 In every three hours interval ‘F-100’ (milk powder) is provided to the
children
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12.  For 5 – 6 days
 In every three hours interval ‘F-100’ (milk powder) is provided to the
children
 Composition(F-100) :
For 1 liter :
Milk 900 ml
Sugar 75 gm.
Veg oil 20 gm.
Energy 100kcal/100ml
Protein 2.9gm/100ml
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13.  After the complition of initial and transition
phase patient move away from severe to mild
and moderate stage
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14. This phase is common for mild , moderate and those patient who just came
away from sever stage
The children categorized in this group eat all types of foods. They are feeded
with F-100 milk. In different time interval they are feeded with different food
items as:
 7A.M - Sarbottam Pitho and egg.
Formula of sarbottam pitho is:
Maize : wheat : soyabean (1:1:1)
 10 A.M - Bhaat, Daal, Tarkari & Achhar.
Every day “Saag” is compulsory given to the children.
Free feed phase 14

15.  1P.M - Milk and Fruits.
 4P.M - ’Jaulo’
Principle for making “Jaulo”
Equal amount of rice and pulse
Two types of pulse are included:Masuro and Mung
Ratio - 2:1:1 (rice : masuro : mung)
Pulse should be uncoated.
 7P.M - Bhaat,Daal,Tarkari & Achhar
 10P.M – Milk
 1 A.M – Milk
 4 A.M - Milk
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16.  Every day calorie is measured. If it is found that calorie is insufficient in
accordance to their height and weight then calorie can be exceed up to
twice the value of normal calorie.
If the children gain 90% of their weight , they can be discharged. But if
their parents desire , they can stay till their children gain 100% weight.
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17. View of kitchen and store of NRCB 17

18. Admitted Children and their Mothers 18

19. Posters on wall 19

20. Height and Weight instruments 20

21. Review and Recommendation
 Many malnourished children were found to have no space at rehab. So,
the number of bed of the rehab should be increased.
 There should be a effective program conducted to address the other
malnourished children
 Parents awareness is seen lacking about the rehab importance and
program
 In todays society over nutrition is also a growing problem so for better
health results over nutrient children should also be addressed under the
programs
 There should be a doctor mandatory for each NRC
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22. Refrence
 Information given by the maam working on NRCB.
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23. Thank You
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