Malnutrition dropped-esp UW and stunting- in U2 children in Maharashtra as per CNSM surveys 2012. It is only a beginning. But there are challenges ahead, including cultural,socio-economic, women-health, nutrition and child care.
Improving nutrition in Himachal Pradesh: Trends in outcomes, determinants and...POSHAN
This slide deck is an evolving work in progress, with updates being made frequently. If you want to use or cite this, please email us at IFPRI-POSHAN@cgiar.org to receive the most updated version
A brief powerpoint presentation on the integration of WASH and nutrition program. Also provides an overview on USAID WASHPlus.
*for classroom presentation purpose only*
*no copyright infringement intended*
Improving nutrition in Himachal Pradesh: Trends in outcomes, determinants and...POSHAN
This slide deck is an evolving work in progress, with updates being made frequently. If you want to use or cite this, please email us at IFPRI-POSHAN@cgiar.org to receive the most updated version
A brief powerpoint presentation on the integration of WASH and nutrition program. Also provides an overview on USAID WASHPlus.
*for classroom presentation purpose only*
*no copyright infringement intended*
This is the presentation about "Nutritional Epidemiology". By lacking of different minerals in our food we may suffer different types of disease... The types of disease are mentioned in this presentation.
sociology of food and eating with details of psychology of food and eating, sociological perspectives history and background, food production and distribution, culture and civilization
The Future Thought Leaders panel discussions of 2017 kicked off on April 21st at Oceanside’s Star Theatre. Labor leader Dolores Huerta and Food Democracy Now! founder Dave Murphy were among the distinguished panelists who weighed in on access to affordable and nutritious food at all economic levels.
National Food & Nutrition Policy: Balancing the Role of Research, Nutrition S...Corn Refiners Association
At Experimental Biology 2015, the Sponsored Satellite Program "National Food & Nutrition Policy: Balancing the Role of Research, Nutrition Science and Public Health" held in conjunction with the American Society for Nutrition's Scientific Session took place on April 1, 2015.
To watch the Dr. Lichtenstein video on slide 68 "Do Scripted Diets Work for Policy? What about Low-fat Diets?", please download the presentation first.
Severe Acute Malnutrition (SAM) and Nutrition Rehabilitation Centre (NRC)- Dr...Yogesh Arora
A presentation on severe acute malnutrition and nutritional rehabilitation center. Various preventive, promotive, and curative aspects of SAM are discussed in this presentation.
AROUND THE WORLD, more than 2 billion people are thought to be affected by an often invisible form of malnutrition: micronutrient malnutrition, commonly known as hidden hunger.1 Vitamin and mineral deficiencies—at least in mild to moderate forms—may not be as observable as wasting or obesity, but their effects are far-reaching. Globally, vitamin A deficiency (VAD) is the leading cause of blindness in children.2 Iodine deficiency causes 18 million babies to be born mentally impaired each year.3 And severe anemia caused by lack of iron is associated with the deaths of 115,000 women annually during childbirth.4 Vitamin A, iodine, and iron are classified as “the big three,” but deficiencies of other micronutrients, such as folate, zinc, vitamin B12, and vitamin D, are also important.
Declining Child malnutrition in Maharashtra India 2-The Effort Shyam Ashtekar
The ICDS and the nutrition mission focused on a 1000 days window approach, about improving ANC and child care till 2 years much before the child comes to the Anganwadis. This has given dividends!
Declining Malnutrition in Maharashtra-6-The Tribal IssuesShyam Ashtekar
Moderate malnutrition (>30%) still lingers in 15-20 tribal blocks, including some severe grade MN calling for rehab effort. The tribal Malnutrition is a complex web--poverty, culture, migration, terrain, services, lack of awareness, supply gaps etc. We need a roadmap, a practical and pragmatic agenda.
This is the presentation about "Nutritional Epidemiology". By lacking of different minerals in our food we may suffer different types of disease... The types of disease are mentioned in this presentation.
sociology of food and eating with details of psychology of food and eating, sociological perspectives history and background, food production and distribution, culture and civilization
The Future Thought Leaders panel discussions of 2017 kicked off on April 21st at Oceanside’s Star Theatre. Labor leader Dolores Huerta and Food Democracy Now! founder Dave Murphy were among the distinguished panelists who weighed in on access to affordable and nutritious food at all economic levels.
National Food & Nutrition Policy: Balancing the Role of Research, Nutrition S...Corn Refiners Association
At Experimental Biology 2015, the Sponsored Satellite Program "National Food & Nutrition Policy: Balancing the Role of Research, Nutrition Science and Public Health" held in conjunction with the American Society for Nutrition's Scientific Session took place on April 1, 2015.
To watch the Dr. Lichtenstein video on slide 68 "Do Scripted Diets Work for Policy? What about Low-fat Diets?", please download the presentation first.
Severe Acute Malnutrition (SAM) and Nutrition Rehabilitation Centre (NRC)- Dr...Yogesh Arora
A presentation on severe acute malnutrition and nutritional rehabilitation center. Various preventive, promotive, and curative aspects of SAM are discussed in this presentation.
AROUND THE WORLD, more than 2 billion people are thought to be affected by an often invisible form of malnutrition: micronutrient malnutrition, commonly known as hidden hunger.1 Vitamin and mineral deficiencies—at least in mild to moderate forms—may not be as observable as wasting or obesity, but their effects are far-reaching. Globally, vitamin A deficiency (VAD) is the leading cause of blindness in children.2 Iodine deficiency causes 18 million babies to be born mentally impaired each year.3 And severe anemia caused by lack of iron is associated with the deaths of 115,000 women annually during childbirth.4 Vitamin A, iodine, and iron are classified as “the big three,” but deficiencies of other micronutrients, such as folate, zinc, vitamin B12, and vitamin D, are also important.
Declining Child malnutrition in Maharashtra India 2-The Effort Shyam Ashtekar
The ICDS and the nutrition mission focused on a 1000 days window approach, about improving ANC and child care till 2 years much before the child comes to the Anganwadis. This has given dividends!
Declining Malnutrition in Maharashtra-6-The Tribal IssuesShyam Ashtekar
Moderate malnutrition (>30%) still lingers in 15-20 tribal blocks, including some severe grade MN calling for rehab effort. The tribal Malnutrition is a complex web--poverty, culture, migration, terrain, services, lack of awareness, supply gaps etc. We need a roadmap, a practical and pragmatic agenda.
Malnutrition - The Public Health Issue Overshadowed by Obesity - Joanne Casey
IPH, Open, Conference, Belfast, Northern, Ireland, Dublin, Titanic, October, 2014, Health Public
Declining Child Malnutrition in Maharashtra-3 The Anganwadi ImprovementsShyam Ashtekar
The Anganwadi Center (AWC) are the main system of service delivery for child care-nutrition, health, pre-primary ed etc. Over 1 lakh AWCs dot the spread of Maharashtra. The ICDS has made substantial improvements in the AWCs , attracting parents and children. This was a joint effort of the dept and the community. There is a Change indeed.
Declining Child Malnutrition in Maharashtra-5 The Rehab effortsShyam Ashtekar
There is about 4-5 % severe acute malnutrition-SAM-in tribal parts of Maharashtra. Rehab is necessary. Rehab efforts are available from village Anganwadi level to the block level CTC and the district hospital NRC.
iimjobs.com – an exclusive job portal for MBAs from premier business schools in India released the findings of third MBA Salary Survey.
The survey was conducted to understand trends in compensation of MBAs from top business schools in India.
This Powerpoint shows about Child Malnutrition in Ethiopia that includes introduction, cause & effect and conclusion. For instance, some children get malnutrition which can lead to many diseases. And finally how to slove this problem.
Growth prospects of children after discharge from malnutrition treatment cent...POSHAN
This presentation was made by Dr. Jyoti Sharma (Public Health Foundation of India) in the session on ‘Implementation research on delivery of preventive and curative interventions during early childhood’ at the POSHAN Conference "Delivering for Nutrition in India Learnings from Implementation Research", November 9–10, 2016, New Delhi.
For more information about the conference visit our website: www.poshan.ifpri.info
Addressing severe-acute malnutrition in Rajasthan using community-based strat...POSHAN
This presentation was made by Dr. Deepti Gulati (GAIN) in the session on ‘Implementation research on delivery of preventive and curative interventions during early childhood’ at the POSHAN Conference "Delivering for Nutrition in India Learnings from Implementation Research", November 9–10, 2016, New Delhi.
For more information about the conference visit our website: www.poshan.ifpri.info
Top 10 High Paying Jobs in India - Highest Paying Jobs in 2014iimjobs.com
What are the hottest and highest paying jobs of 2014? Based on the jobs posted on iimjobs.com, we've compiled a list of the 10 highest salary jobs in India for 2014.
A lucrative job is expected by each and every individual and most of these high paying jobs are meant for people with more than 10 years of experience and an MBA degree to go along with it. This list of the 10 highest CTC jobs in India contains jobs from various sectors like Banking & Finance, Sales & Marketing, Consulting, Human Resources and Information Technology.
This list includes jobs and salaries in the below categories:
top 10 highest paying jobs in the world
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High Salary & Top Paying Jobs in India
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Top 10 Career Options with Hot Salaries
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Community-based management of severe acute malnutrition in India: New evidenc...POSHAN
This presentation was made by Dr. Alan Pereira (Medicins Sans Frontiers) in the session on ‘Implementation research on delivery of preventive and curative interventions during early childhood’ at the POSHAN Conference "Delivering for Nutrition in India Learnings from Implementation Research", November 9–10, 2016, New Delhi.
For more information about the conference visit our website: www.poshan.ifpri.info
Galactosemia is a rare, hereditary disorder of carbohydrate metabolism that affects the body's ability to convert galactose (a sugar contained in milk, including human mother's milk) to glucose (a different type of sugar).
The results of our fourth annual salary survey, limited to Colorado residents who work in any capacity within the Salesforce ecosystem/platform/products.
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Undernutrition is a lack of quantity or quality of food required for optimal growth and health.
Undernutrition includes: Undernourished people (insufficient calorie intake), being underweight for one’s age, too short for one’s age (stunted), dangerously thin (wasted), and deficient in vitamins and minerals (micronutrient malnutrition).
“I would take the next 1000 children born, randomize them in two different groups and have half of them eat nothing but fresh fruits and vegetables for the rest of their lives, and other half eat nothing but fried snacks and cola; and then I will measure their susceptibility to NCD’s”
Nutrition is a very confusing topic for most people these days. If you pick up a woman’s magazine or watch any morning television programme you are likely to find that an article or presentation about nutrition is trying to convince you that a particular fad diet, or a particular group of nutrients, will be the one secret that positively changes your life forever. Yet, the more you read magazine articles or watch television shows, the more you are likely to be in the dark as to which advice to follow, because many of them are contradictory.
POSHAN District Nutrition Profiles_Guide to DNPsPOSHAN
POSHAN District Nutrition Profiles (DNPs) draw on diverse sources of data to compile a set of indicators on the state of nutrition and its cross-sectoral determinants. The profiles are intended to be conversation-starters at the district level and to enable discussions about why undernutrition levels are high, and which factors, at multiple levels, might need to be addressed to improve nutrition.
PLEASE NOTE that this guide uses the example of Bihar. POSHAN is regularly tracking data sources as they are released and updating the profiles accordingly.
POSHAN District Nutrition Profile_Khandwa_Madhya PradeshPOSHAN
POSHAN District Nutrition Profiles (DNPs) draw on diverse sources of data to compile a set of indicators on the state of nutrition and its cross-sectoral determinants. The profiles are intended to be conversation-starters at the district level and to enable discussions about why undernutrition levels are high, and which factors, at multiple levels, might need to be addressed to improve nutrition.
PLEASE NOTE that POSHAN is regularly tracking data sources as they are released and updating the profiles accordingly.
POSHAN District Nutrition Profile_Shivpuri_Madhya PradeshPOSHAN
POSHAN District Nutrition Profiles (DNPs) draw on diverse sources of data to compile a set of indicators on the state of nutrition and its cross-sectoral determinants. The profiles are intended to be conversation-starters at the district level and to enable discussions about why undernutrition levels are high, and which factors, at multiple levels, might need to be addressed to improve nutrition.
PLEASE NOTE that POSHAN is regularly tracking data sources as they are released and updating the profiles accordingly.
POSHAN District Nutrition Profile_Lucknow_Uttar PradeshPOSHAN
POSHAN District Nutrition Profiles (DNPs) draw on diverse sources of data to compile a set of indicators on the state of nutrition and its cross-sectoral determinants. The profiles are intended to be conversation-starters at the district level and to enable discussions about why undernutrition levels are high, and which factors, at multiple levels, might need to be addressed to improve nutrition.
PLEASE NOTE that POSHAN is regularly tracking data sources as they are released and updating the profiles accordingly.
POSHAN District Nutrition Profile_Unnao_Uttar PradeshPOSHAN
POSHAN District Nutrition Profiles (DNPs) draw on diverse sources of data to compile a set of indicators on the state of nutrition and its cross-sectoral determinants. The profiles are intended to be conversation-starters at the district level and to enable discussions about why undernutrition levels are high, and which factors, at multiple levels, might need to be addressed to improve nutrition.
PLEASE NOTE that POSHAN is regularly tracking data sources as they are released and updating the profiles accordingly.
POSHAN District Nutrition Profile_Balaghat_Madhya PradeshPOSHAN
POSHAN District Nutrition Profiles (DNPs) draw on diverse sources of data to compile a set of indicators on the state of nutrition and its cross-sectoral determinants. The profiles are intended to be conversation-starters at the district level and to enable discussions about why undernutrition levels are high, and which factors, at multiple levels, might need to be addressed to improve nutrition.
PLEASE NOTE that POSHAN is regularly tracking data sources as they are released and updating the profiles accordingly.
POSHAN District Nutrition Profile_Mayurbhanj_OdishaPOSHAN
POSHAN District Nutrition Profiles (DNPs) draw on diverse sources of data to compile a set of indicators on the state of nutrition and its cross-sectoral determinants. The profiles are intended to be conversation-starters at the district level and to enable discussions about why undernutrition levels are high, and which factors, at multiple levels, might need to be addressed to improve nutrition.
PLEASE NOTE that POSHAN is regularly tracking data sources as they are released and updating the profiles accordingly.
POSHAN District Nutrition Profile_Kandhamal_OdishaPOSHAN
POSHAN District Nutrition Profiles (DNPs) draw on diverse sources of data to compile a set of indicators on the state of nutrition and its cross-sectoral determinants. The profiles are intended to be conversation-starters at the district level and to enable discussions about why undernutrition levels are high, and which factors, at multiple levels, might need to be addressed to improve nutrition.
PLEASE NOTE that POSHAN is regularly tracking data sources as they are released and updating the profiles accordingly.
Purnima Menon, IFPRI - Overview and structure of the gender and nutrition eve...POSHAN
Presentation made at an IFPRI event on "What Lies Beneath:
Women’s and Girls’ Wellbeing as a Critical Underpinning of India’s Nutritional Challenge" on December 10, 2018, in New Delhi
This presentation aims at explaining all the components of malnutrition. Such as types, causes, criteria of diagnosis, treatment & Government health initiatives to tackle the problem of malnutrition.
Abstracts of studies that were presented at IFPRI-POSHAN's event on "Strengthening Actions for Nutrition in India: Insights from the National Family Health Survey" (4 Sept 2018, IIC, New Delhi) where multiple researchers from organizations such as International Food Policy Research Institute (IFPRI), Brookings India, International Institute for Population Sciences (IIPS), Society for Applied Studies (SAS), Population Council and more, shared insights from their ongoing/completed analyses of NFHS data on maternal and child nutrition.
POSHAN District Nutrition Profile_Gajapati_OdishaPOSHAN
POSHAN District Nutrition Profiles (DNPs) draw on diverse sources of data to compile a set of indicators on the state of nutrition and its cross-sectoral determinants. The profiles are intended to be conversation-starters at the district level and to enable discussions about why undernutrition levels are high, and which factors, at multiple levels, might need to be addressed to improve nutrition.
PLEASE NOTE that POSHAN is regularly tracking data sources as they are released and updating the profiles accordingly.
Similar to Child Malnutrition Decline in Maharashtra-1 An Overview (20)
This is a modern STP plant at Nashik Maharashtra. This introductory presentation is meant for medical and other students, organised by PSM/ComMed depts.
This is a proposal for pluralistic primary care for India, describing the need, rationale, structure, framework, modality and legalities. My old book 'Health and Healing' a 700 page publication from Orient Longman detailed this program, which needs updating.
Chikitsa -Revamping The Health Sector of Maharashtra 2015Shyam Ashtekar
This is a systematic review of Maharashtra's ( A state in India) Health Sector, and a program for revamping this sector, with a 10 point agenda. The book is in Marathi, and this is an English Summary. I have dealt with public and private health sectors, as well as the global context of health system management.
Declining Child Malnutrition in Maharashtra-4 The Suppl Nutrition issuesShyam Ashtekar
The Anganwadi has a supplementary feeding program for last 3 decades, with several problems of provision, services, quality etc. We need a review of this component and change is necessary. The system has done some efforts with local help in many districts.
This is an idea I tested in 2010 in some vilages with help of NGOs. It is workable, but we need a more serious trial and analysis. I am proposing that village & community based health centers is a key to many of our health system problems. This will provide a wide network of services at the base of the health care pyramid, generate local employment and spread health information in the last mile. I am appealing for help. Pl call me on 09422271544 or email on shyamashtekar@yahoo.com
Health care terrain of a district nashik 2011Shyam Ashtekar
This is my study of the health care sector of a district in Maharashtra-(Nashik) in 2011. How do we go from here to Universal Health care? I invite comments
Health care- Bihar & UP 2012-Dr Shyam AshtekarShyam Ashtekar
This is my brief pictorial personal account on rural health care in Bihar (5 districts) & UP (one district) done in Oct 2012-the ground situation and challenges.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Child Malnutrition Decline in Maharashtra-1 An Overview
1. Child Malnutrition inChild Malnutrition in
Maharashtra (India)Maharashtra (India)
August 2013August 2013-- January 2014January 2014
Situation, Efforts, Decline and ChallengesSituation, Efforts, Decline and Challenges
A ReviewA ReviewA ReviewA Review
For the State Nutrition MissionFor the State Nutrition Mission
P o w e r P o i n t 1 / 6P o w e r P o i n t 1 / 6
Dr Shyam Ashtekar,
MD (Community Med)
shyamashtekar@yahoo.com
3. (A) The context and the MN(A) The context and the MN
problemproblem
Child malnutrition is a complex
problem, and the context too is important
for action
Malnutrition in maharashtra-A Review Jan
2014 3
4. Background and contextBackground and context
There is discussion of 40-50% Child
malnutrition in India
Similar issues are raised in media and
Legislative Assembly in MaharashtraLegislative Assembly in Maharashtra
Melghat, Satpuda and Jawhar-Mokhada
often hit newspapers for malnutrition
What is the real situation ?
Malnutrition in maharashtra-A Review Jan
2014 4
5. We should discuss facts and causes.. RatherWe should discuss facts and causes.. Rather
than images..than images..
25
30
35
40
CNSM Survey 2012
0
5
10
15
20
Under Wt
by age(-
2SD)
Stunting (-
2SD)
Wasting (-
2SD)
2005-6
2012-13
Malnutrition in maharashtra-A Review Jan
2014 5
6. The pyramidThe pyramid
of Causesof Causes Some Child
Deaths
Vicious Cycle of Malnutrition
and
Child deaths, 20-30%
Malnutrition
in 0-5 age group. about 4%
children
severely wasted.
Malnutrition in maharashtra-A Review Jan
2014 6
Low BMI inWomen and adolescence
girls, malnutrition and anemia. Multiple causes
for this– early marriage and child bearing, poor
AN care and high rate of low birth weight.
Neglect of proper breast feeding and
complementary feeding
Lack of hygiene Poor food culture, weak health care, blind faith
and wrong concepts low status of
women, migration, terrain, jobs and incomes, inflation, gaps in
PDS etc.
7. CNSM Survey Statistics (2012)CNSM Survey Statistics (2012)
The CNSM Survey by IIPS
Mumbai (2012) shows
reduction in child malnutrition
in Maharashtra.
20
25
30
35
40
2005-6
in Maharashtra.
The survey included 2600
children.
Malnutrition in maharashtra-A Review Jan
2014 7
0
5
10
15
Under Wt
by age(-
2SD)
Stunting (-
2SD)
Wasting (-
2SD)
8. Comparison of 3 surveys: 2006 to 2012Comparison of 3 surveys: 2006 to 2012
Children 0-23
months
NFHS3
(U+R)
2005-6
IIPS CNSM
2012 (U+R)
IIPS CNSM
only rural
NNMB2012
(Rur)0-36m
Number
surveyed
2654 1332 571
Stunting (-2SD) 39 23.9 27.8 43.9
Malnutrition in maharashtra-A Review Jan
2014 8
Stunting (-2SD) 39 23.9 27.8 43.9
Wasting (-2SD) 19.9 15.9 16.9 15
Under Wt by
age(-2SD)
29.6 22.1 25.9 31.5
%MUAC<11.5cm 3.5 4.3
% of low birth
weight
20.3 21.6
9. Statewise Malnutrition NNMB 2012-Survey
State Underweight Stunting Wasting
Kerala 20.8 23.4 16.4
TN 28.6 21.7 26.4
Maharashtra 31.5 43.9 15
AP 31.7 42.9 14.1
Malnutrition in maharashtra-A Review Jan
2014 9
AP 31.7 42.9 14.1
Karnataka 35.6 36.7 20.7
WB 35.6 40.6 21.4
Pooled 37.7 41.3 22.3
Orissa 40.3 47.3 18.2
UP 47.8 44.9 31.7
Gujarat 48.4 54.9 27.7
MP 51.4 48.7 33
10. Comparison of states on ChildComparison of states on Child
Malnutrition NNMB 2012Malnutrition NNMB 2012--
30
40
50
60
Malnutrition in maharashtra-A Review Jan
2014 10
0
10
20
30
UnderWeight
Stunting
Wasting
11. Comparison of CNSM &Comparison of CNSM & NNMB SurveysNNMB Surveys
NNMB Survey is limited to rural areas.
Here we compared NNMB with the rural Column of CNSM
Survey.
CNSM Survey age group is 0-23 months while that of
NNMB is 0-36 months.NNMB is 0-36 months.
Both Surveys are in done in 2012.
The NNMB Survey shows more malnutrition probably
because of age group and sample size.
But the NNMB survey also is important for the fight
against malnutrition
Malnutrition in maharashtra-A Review Jan
2014 11
12. The CNSM Survey is more reliableThe CNSM Survey is more reliable
IIPS conducted the NFHS Survey 1-2-3
in India
The sample size in CNSM is 1322The sample size in CNSM is 1322
(rural) while in NNMB it was 571
All Govt. Agencies use the NFHS
Statistics done by IIPS
Hence CNSM Survey is more reliable.
Malnutrition in maharashtra-A Review Jan
2014 12
13. CNSMCNSM --ObservationObservation & Comments& Comments
Child Malnutrition in Maharashtra has dropped in
comparison to 2005-06 figures.
Underweight (Weight for age) proportion has dropped
from 29 to 22%
Stunting has dropped from 39-29%Stunting has dropped from 39-29%
Wasting has also dropped from 20 to 16
Percentage of children with MUAC (Mid Upper Arm
Circumference) less than 11.5cm. is about 3.5%
Proportion of low birth weight babies is 21% (from birth
records)
Malnutrition in maharashtra-A Review Jan
2014 13
14. CNSM:BoysCNSM:Boys & Girls& Girls
Nutrition indices for girls look better than those of
boys
Girls and boys show a MN proportions as follows :Girls and boys show a MN proportions as follows :
stunting 20.7 and 26.5, underweight 19.2 and
24.4, wasting 13.9 and 17.4, severely low MUAC
3.9 and 3.2 respectively.
This suggests that there is no particular
discrimination against girls in this age group.
Malnutrition in maharashtra-A Review Jan
2014 14
15. CNSMCNSM--Neonatal CareNeonatal Care
The proportion of newborn
babies that received breast
feeding in the first hour rosefeeding in the first hour rose
from 52% to 60%.
Conversely 40% newborns don't
get early breast feeding.
Malnutrition in maharashtra-A Review Jan
2014 15
16. CNSMCNSM--Care of the young child (0Care of the young child (0--2Y)2Y)
Semi solid or solid feeds were given
between 6-8 months to 63% babies, from
the earlier level of 48.the earlier level of 48.
Safe disposal of excreta of the child was
satisfactory only about 41% children..
Malnutrition in maharashtra-A Review Jan
2014 16
17. CNSMCNSM --Care after 6Care after 6
monthsmonths
Feeding and care after 6 months is a weak area.
Only about 77 % of babies in >6 months group got at least 6 feeds a
day. which needs to be better.day. which needs to be better.
Only 10-34% young infants getting age appropriate feeds, diverse
feeds, feeds with iron and vitamin A content
This implies that the family is failing to take care.
About 85% U 2Y children get complementary food packets from the
Anganwadi in the rural area.
Malnutrition in maharashtra-A Review Jan
2014 17
18. Immunization & micronutrientsImmunization & micronutrients
In the last 6 months 48% babies got
a Dose of vitamin A, this is better
than previous level of 32%
Iodinated salt is consumed in the
families of 75% babies.
The percentage of immunization
has risen from 59 to 69%
Malnutrition in maharashtra-A Review Jan
2014 18
19. Health and Nutrition of MothersHealth and Nutrition of Mothers
Maternal Health care has improved.
AN Care, IFA supplement and institutional
delivery have improved.
The 102 ambulance is available commonly.The 102 ambulance is available commonly.
Malnutrition in maharashtra-A Review Jan
2014 19
20. CNSMCNSM --Women’s BMI is lowWomen’s BMI is low
The proportion of wasting women
(BMI less than 18.5) has dropped
by just 1 from 32.6 to 31.6%
The low BMI Proportion in rural
women is 42%.
About 20% of urban women suffer
from overweight (BMI>25)
Malnutrition in maharashtra-A Review Jan
2014 20
21. CNSMCNSM --Low Birth WeightLow Birth Weight
The proportion of low birth weight babies has
somewhat reduced. But these figures are from
recorded data rather than direct observations. We
can not very much bank on this decline.can not very much bank on this decline.
A study of about 3000 recent births in the
Aurangabad Medical College suggests LBW >30%
The causes of LBW include both inter-generational
and some current causes.
Malnutrition in maharashtra-A Review Jan
2014 21
22. Known facts: Maharashtra’s Map ofKnown facts: Maharashtra’s Map of
MalnutritionMalnutrition
Malnutrition in maharashtra-A Review Jan
2014 22
23. ICDS data: Blocks/Projects with highICDS data: Blocks/Projects with high
burden of Malnutrition (July 2013burden of Malnutrition (July 2013))
Malnutrition in maharashtra-A Review Jan
2014 23
24. Social context ofSocial context of Malnutrition (1)Malnutrition (1)
There is more Malnutrition is some tribal districts
especially some development blocks in those districts.
The blocks of Jawhar Mokhada (Thane) Dhadgaon and
Akkalkuwa (Nandurbar) Chikhaldara-Dharni Known as
Melghat. (Amravati) are most malnourished blocks.
Some blocks in Gadchiroli, Nashik and Chandrapur
districts also have more malnutrition.
Malnutrition in maharashtra-A Review Jan
2014 24
25. Social context of Malnutrition (2)Social context of Malnutrition (2)
Some tribes may be more malnourished than
others but we do not have comparative
statistics.
Possibly more malnutrition in some ScheduledPossibly more malnutrition in some Scheduled
castes.
It is possible that VJNT (nomadic tribes)
categories also suffer from Malnutrition but we
need more information on this.
Malnutrition in maharashtra-A Review Jan
2014 25
26. Malnutrition and Age groupMalnutrition and Age group
About 20-30% babies in Maharashtra are born with less
weight (2.5Kg or less)
There is less malnutrition in first 6 months, because of
protective role of breast feeding .protective role of breast feeding .
The breast milk is not enough between 6 months to 2
years; however because of lack of proper
complementary feeds malnutrition figures start rising
after 6 months.
Malnutrition in maharashtra-A Review Jan
2014 26
27. Malnutrition in 2Malnutrition in 2--5 age group5 age group
The children attending AW are in age group of 36 to 60/72
months .
These children can not improve enough if they are already
malnourished before they reach AWC.malnourished before they reach AWC.
But even this age group does need good nutrition support.
Malnutrition in maharashtra-A Review Jan
2014 27
28. Other context of malnutrition
Migration for employment is a major
challenge, despite MNREGA.
In some blocks communication gaps are
serious because of hills and forests . Foodserious because of hills and forests . Food
supply suffers esp. in rainy seasons.
The neglect of family planning-spacing is
also a major problem in many blocks.
Malnutrition in maharashtra-A Review Jan
2014 28
29. Food Security and Child MalnutritionFood Security and Child Malnutrition
It is difficult to connect child Malnutrition
to lack of food grains in homes in
Maharashtra state of today, except inMaharashtra state of today, except in
some tribal parts.
Employment, PDS, and local agro produce
usually ensure food grain availability even
in difficult areas.
Malnutrition in maharashtra-A Review Jan
2014 29
30. Lack of Proteins, Vitamins & MineralsLack of Proteins, Vitamins & Minerals
But the lack of
proteins, vitamins and
minerals is an important
factor.factor.
Hence we need a new
perspective on this
aspect of food security.
Malnutrition in maharashtra-A Review Jan
2014 30
32. Focus on theFocus on the
AnganwadiAnganwadi CenterCenter
(AWC)(AWC)
The State of Maharashtra1.07 lakh AWCs, including
mini AWCs.mini AWCs.
70% AWCs are in villages.
About 80,00,000 children U6 are associated with
Anganwadis
AWCs are important for rural areas as nurseries for
towns.
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2014 32
33. Improving the AWCImproving the AWC
Supplementary feeding is only one of the tasks of AWC
AWC should provide 25 to 30% of food need in 3-6Y age group.
The remaining 70% must come from home, hence home feeding is
more crucial for the child and control of malnutrition.more crucial for the child and control of malnutrition.
Pre primary education is an equally important task of AWC.
Other tasks include immunization, medical check
up, micronutrients, monitoring weight and height
Malnutrition in maharashtra-A Review Jan
2014 33
34. Improving AWC: MIS to GISImproving AWC: MIS to GIS
The survey statistics of nutrition of AWC and
growth was not very reliable before 2010.
In those days the abstract of categories of
malnutrition was communicated to higher
levelslevels
The system of sending abstract report remains
the same even now.
However there is less tendency to hide
malnutrition in reports.
The AWC statistics is more reliable than before.
GIS is now available for all AWCs
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2014 34
35. The MN statistics of AWCsThe MN statistics of AWCs
The ICDS website (http://www.icds.gov.in/# ) offers
the monthly progress report (MPR) of various
levels.
The MPR includes district wise and block wise
information of services and malnutrition.information of services and malnutrition.
We also get line listing of malnourished children
in tribal blocks, but these are rather dated for
current action.
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2014 35
37. The Geographic Information SystemThe Geographic Information System
RJMCHN has now established
a GIS system for the entire
state.
This GIS is available on
www//:mhnss.ind.in
Basically it has all the 1206
boxes of the monthly
This can help to
Generate MIS from AWC to
state level and update
within 48 hrs
Generate info for action on
every level.
It can generate bothboxes of the monthly
progress Report-MP
The AW sevika can get it
done in 30 Rs provision and
within 30 min.
She can Upload the AWC
abstract info (5-7 KB file)on
the site thru the Sangram
software at village level.
It can generate both
process and outcome
indicators
We can generate about
1500 reports from this data
It also provides camera sites
for physical verification at
each AWC
Malnutrition in maharashtra-A Review Jan
2014 37
38. ICDS and Rajmata Jijau MissionICDS and Rajmata Jijau Mission
ICDS and RJMCHM together are working on
reducing malnutrition
The RJMCHM offers technical assistance and isThe RJMCHM offers technical assistance and is
supported by Unicef.
The important window of 1000 days before
entering AWC is more important, and both
agencies are focused on this window.
Malnutrition in maharashtra-A Review Jan
2014 38
39. Dr Arole Committee ReportDr Arole Committee Report
The Non Governmental Members
Committee under Dr. Rajanikant Arole
appointed by Dr the Hon High Courtappointed by Dr the Hon High Court
worked on this issue from 2008 to 2011.
The Report has been submitted to the
Govt. in 2013
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2014 39
40. The important 1000 days’ window for theThe important 1000 days’ window for the
childchild..
About 270 days of pregnancy and 730 days of year
1 and 2 together make 1000 days. This window of
1000 days is important for growth and nutrition.
If growth suffers in this period, there is less
progress in the future.
RJMCHM and ICDS have introduced various
programs for this period.
Malnutrition in maharashtra-A Review Jan
2014 40
41. Ten rules for preventingTen rules for preventing
malnutritionmalnutritionInstitutional
birth and
Breastfeeding
6 m Exclusive
Breastfeeding
Complimentar
y feeding at
6m, 6m BD
Vit A doses
Complete
Immunization
Focus on 6m-
3y child-
nutrition ed of
the mother
Micronutrients
Sachet
De-worming,
illness treatment
when
necessary, immuniz
ation
Handwash,
water safety,
Sanitation
Growth
monitoring-
wt/ht//MUAC
3/16/2014
महारा ातले कु पोषण नमूलनाचे व वध
य न--डॉ शाम अ टेकर- 41
42. Chief Minister’s 5 pointChief Minister’s 5 point ProgramProgram
1. Ensuring health & nutrition of adolescent girls.
2. Effort to improve birth weights, including better
ANC services.
3. Early and exclusive breast feeding till 6 months.
4. Proper complementary feeding after 6 months.
5. Management of SAM (Severe Acute
malnutrition) children
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2014 42
43. Child deaths due to MalnutritionChild deaths due to Malnutrition
Malnutrition triggers child deaths.
About 20-25% child deaths are linked to severe
Malnutrition.
For this context, rather than underweight or stunting more
important parameters are wasting, severely low MUAC orimportant parameters are wasting, severely low MUAC or
edema on feet
Infectious illnesses like diarrhea and pneumonia can also
push the baby into Malnutrition.
Child deaths will decline with decline in Malnutrition. The
current IMR is 25 while U5 MR is 33.
Malnutrition in maharashtra-A Review Jan
2014 43
44. TThe challengehe challenge
The CNSM study reports decline in
malnutrition in Maharashtra.
But there are tough challenges ahead..
Low birth weight
Poor breast feeding practices,Poor breast feeding practices,
Gaps in proper complementary feeds for U2 children
Lack of proteins and micronutrients in meals
Infections and insanitation
Low Body mass index of women.
The AWC can not meet this challenge alone
We need efforts by society and family.
Malnutrition in maharashtra-A Review Jan
2014 44
45. Best Wishes for More EffortsBest Wishes for More Efforts
Dr Shyam Ashtekar (MD, Community
Medicine)
21 Cherry Hills Society, Anandwalli, Nashik
422013
shyamashtekar@yahoo.com
Cell +919422271544
Website:
arogyavidya.org,
bharatswasthya.net
A study of Anganwadis and campaign against malnutrition
in Maharashtra
For and with support of
Rajmata Jijau State Nutrition Mission (RJMCHN),
August to Dec 2013
Malnutrition in maharashtra-A Review Jan
2014 45