A nutrition program should provide consumers with information regarding food selection and should consider why people make their choices

1. SHIMLA NURSING COLLEGE, ANNANDALE
PRESENTATION
ON
NATIONAL NUTRITIONAL PROGRAMMES IN PEDIATRIC
SUBJECT: CHILD HEALTH NURSING
SUBMITTED TO: SUBMITTED BY:
DR. DEEPKANT CHATURVEDI MS. PRIYA GILL
ASSOCIATE PROFESSOR M.Sc. (N) 1ST YEAR
SHIMLA NURSING COLLEGE SHIMLA NURSING COLLEGE

2. NATIONAL
NUTRITIONAL
PROGRAMMES
IN PEDIATRIC

3. INDEX
S. No. Content
1. Introduction of Nutritional Programme in Pediatric
2 Objective of Nutritional Programme in Pediatric
3. National Nutritional Policy
4. Detail of nutritional programme in Pediatric
5. Conclusion
6. Summarization
7. References

4. INTRODUCTION
The government of India have initiated several
nutrition programs throughout the country to prevent
and control major nutritional problems.
These nutritional programme are designed by the
Government of India through various ministries,
namely Ministry Of Health And Family Welfare,
Ministry Of Social Welfare and Ministry Of
Education.

5. OBJECTIVES
• To improve nutritional status, to
overcome specific deficiency
conditions and malnutrition.
• To afford balanced diets to their
children towards optimum
health.

6. Cont…
• In future, to hope improvement
of nutritional status of Indian
children can be achieved by the
improvement of socio-economic
status.

7. NUTRITIONAL PROGRAMME
• Ministry of rural development:
-Applied nutrition programme
• Ministry of social welfare:
-ICDS
-Balwadi nutrition programme
-Special nutrition programme
• Ministry of education:
-Mid- day meal programme

8. • Ministry of health and family welfare
programme:
-National nutritional anemia prophylaxis programme
-National prophylaxis programme against nutritional
blindness due to vitamin A deficiency
-National iodine deficiency disorder control programme
Cont…

9. NAME OF PROGRAM MINISTRY DATE OF LAUNCH
Mid day meal programme Ministry of education 1961
Iodine deficiency programme Health and Family welfare 1962
Applied nutritional program Ministry of rural development 1963
National programme for Vit A
deficiency
Health and Family welfare 1970
National nutritional anemia
control program
Health and Family welfare 1970
Special nutrition program Health and Social welfare 1970
Balwadi nutrition program Social welfare 1970
ICDS Social welfare 1975

10. NATIONAL NUTRITION
POLICY
• National Nutrition Policy (NNP) has been launched in
1993 by the Government of India under the aegis of
the (effect of nutrition agriculture, food production,
food supply education, information, health care,
social justice, rural and urban development, tribal
welfare, women and child development) Department
of Women and Child Development.

11. Cont…
• Strategy of NNP was a multi-sectoral
strategy for eradicating malnutrition and to
achieve proper nutrition for all.
• Main approach was taken under NNP is
to overcome the problem of nutrition
through direct Nutrition interventions for
susceptible groups through various
development policies.

13. THE APPLIED NUTRITION
PROGRAMME
• One of the earliest nutritional programmes, by Ministry
of Rural Development.
• This project was started in Orissa on 1963.
• Later extended to Tamil Nadu and UP.
• In 1973extended to all states in INDIA.

14. OBJECTIVES
 To increase production of nutritious foods and its
consumption.
 To make people conscious of their nutritional
needs.

15. Cont….
 To provide supplementary nutrition to vulnerable
groups through local production of food.
 The programme aimed at the approach of "self
reliance" to be developed at the community and
individual level.

16. BENEFICIARIES
 Children between 2-6 years.
 Pregnant and lactating mothers.

17. SERVICES
 Nutritional education,
 Nutrition worth
-25 Paise for children and
-50 Paise for pregnant and lactating
women for 52 days in a year.

18. Cont…
• Organization : The programme is
implemented under the supervision
of block development officer. The
Bal Vikas with the help of a helper
undertake the programme activities
at the village/community level.

19. BALWADI NUTRITION
PROGRAMME

20. BALWADI NUTRITION
PROGRAMME
 Started in 1970 under the departmental of
social welfare through voluntary
organisations.
 6000 Balwadi centre -across the country.
 Voluntary organisations receiving the
grants are responsible for the running of
this program.

21. BENEFICIARY GROUP
 For children under the age group of 3-6 years of age.
Balawadis are being phased out because universalization of
ICDS.

22. SERVICES
 Provide pre-primary education to children.
 Food supplement provides 300 kcal and 10 grams of
protein per child per day for 270 days.

24. SPECIAL NUTRITION
PROGRAMME
• Started in 1970 by Ministry of Social
Welfare.
• Operation in urban slums, tribal areas
and backward rural areas.
• Operated under minimum need
programme.

25. AIM
• To improve nutritional status in target group.

26. BENEFICIARIES
 Children below 6 years of age
 Pregnant and nursing mothers
 In urban slums, tribal areas and backward rural areas

27. SERVICES
 Supplementary food supplies about 300 kcal
and 10-12 grams of protein per child per day.
 Mothers receive daily 500 kcal and 25 grams
of protein.
 Supplement is provided for 300 days in year.
 It is gradually being merged with
ICDS programme.

29. INTEGRATED CHILD
DEVELOPMENT SERVICES
• Initiated –2 Oct.,1975, in 33 experimental blocks under 5th
Five Year Plan.
• Under the ministry of social welfare.
• In succession to objectives of National Children’s Policy
(Aug. 1974).
• World’s largest program for early childhood development
• Centrally sponsored scheme implemented by state/UT
governments.

30. RATIONALE
• Routine MCH services not reaching
target population.
• Nutritional component not covered by
health services.
• Need for community participation.

31. OBJECTIVES
 To improve the nutritional and health status of
pre-school children in the age-group of 0-6
years.
 To improve the physical, mental and social
development of the child.
 Enhance the capability of mother and family.
 Achieve effective coordination among various
departments.

32. Cont….
 To reduce the incidence of
mortality, morbidity, malnutrition
and school drop-out.
 To enhance the capability of the mother to
look after the normal health and
nutritional needs of the child through
proper nutrition and health education.

33. BENEFICIARIES
• Children <6 years
• Pregnant and lactating women
• Women in reproductive age group
(15-44 years).
• Adolescent girls ( in selected Blocks)

34. ADMINISTRATION OF THE SCHEME
• Community development block- rural areas.
• Tribal blocks-tribal areas
• Wards/ slums-urban areas

35. Service through Anganwadi:
Type AWC/population Mini AWC
Population
(previously)
Urban 500-1500 NIL
Rural 500-1500 150-500
Tribal 300-1500 150-300
Population
(currently)
Urban 400-800 NIL
Rural 400-800 150-400
Tribal 300-800 150-300

36. ORGANIZATION OF ICDS
Department of women & child development, ministry
of human resource development central level
Department of social welfare
State level
District level
CDPO (100 villages)

37. Cont…
Medical officer(20-25) villages
Mukhiya Sevika (20-25 AWC)
Multipurpose Worker (F) (4-5 No.)
Anganwadi worker (5-6 Anganwadi centres)

38. PACKAGE OF SERVICES
 Supplementary Nutrition
 Immunization
 Health Check-up
 Treatment & Referral Services
 Non-formal Pre-school Education
 Nutrition & Health Education

39. SUPPLEMENTARY NUTRITION
 Weight for age growth cards are maintained
for all children below 6 years of age
 Adolescent girls
 Expectant mothers belonging to schedule
caste and tribes who’s monthly income less
than 300 and land less agriculturist.
 Given for 300 days ( lunch)

40. Cont…
• Supplementary feeding and growth monitoring
• Prophylaxis against vit A deficiency
• Control of nutritional anemia.

41. SUPPLEMENTARY NUTRITION
Beneficiary
Pre-revised Revised w.e.f. Feb. 2009
Calories (Kcal ) Protein (G) Calories(Kcal) Protein (G)
Children(6-72
months)
300 8-10 500 12-15
Severely
malnourished
children(6-72
months)
600 20 800 20-25
Pregnant &
lactating
500 15-20 600 18-20

42. REVISED FINANCIAL NORMS FOR
FOOD SUPPLEMENT
Category Pre- revised Revised w.e.f June 2010
Children (6-72 months) Rs. 2.00 Rs. 4.84
Severely malnourished
children (6-72 months)
Rs. 2.70 Rs. 5.82
Pregnant & lactating Rs. 2.30 Rs. 6.00

43. NON FORMAL EDUCATION
 Children between 3-6 years are
imported pre- elementary education
without formal hours of teaching
without syllabus andtest.
 Teaching is mixed with play. Locally made
charts, pictures, diagrams, toys and play
equipment areused.

44. IMMUNIZATION
 Anganwadi arranges with health worker female
serving her area to give immunization to her wards
and pregnant mothers.

45. RECIPIENTS CALORIES GRAMS OF PROTEIN
CHILDREN UP TO 6
YEARS
300 8-10
ADOLESCENT GIRLS 500 20-25
PREGNANT AND
NURSING MOTHERS
500 20-25
MALNOURISHED
CHILDREN
Double the daily
supplement provided to the
other children(600 and/or
special nutrients on medical
recommendation

46. TREATMENT & REFERRAL
SERVICES
 With help of HWF get all needy
children treated for minor illness
like diarrhea, ARI, minor cuts,
fever etc.
 All other cases and severe
malnutrition refers to medical
officer of PHC.

47. GROWTH MONITORING
 Checks the weight of all
preschool children every
month and records in
growth chart.

48. The impact of the programme
Evident from the remarkable improvements made in
child survival and development indicators
1. Decrease in Prevalence of Malnutrition among Pre-
school Children
2. Improved immunization Coverage in ICDSAreas
3. Decrease in IMR in ICDSAreas
4. Improvement in School Enrolment and Reduction in
School Dropout Rate in ICDS Areas, 1992.

50. KISHORI SHAKTI YOJANA
• The scheme for adolescent girls was put into
operation on 1st November 1991 and scheme has
been renamed as Kishori Shakti Yojna. As no separate
budget is available and nutrition is to be provided
from the State Sector, the beneficiaries are provided
supplementary nutrition through ICDS under the
Supplementary Nutrition Programme.

51. SCHEME:
• Scheme for Adolescent Girls was
sanctioned in the year 2010 and is
implemented in 205 districts across the
country. The target group of this scheme
was adolescent girls in the age group of 11
to 14 years.

52. OBJECTIVE OF THE SCHEME
• To advance the nutritional,
• Health and development status of adolescent girls, support increasing
knowledge of health,
• Hygiene, Nutrition and family care,
• To integrate them with opportunities for learning life skills and going
back to school,
• Helping girls grow to understand their society and become prolific
members of the society.

53. SCHEME MAIN PART:
• It was decided to involve Panchayati raj institutions,
NGOs and other institutions for implementation of
the Scheme.
• There is two main part of this Scheme‐
Nutrition Part
Non-Nutrition Part

54. 1. NUTRITION PART
• In Nutrition part Home Ration or Hot
Cooked Meal for 11 ‐ 14 years Out of
school girls - Nutrition Provision was
Rs. 9.50 per day (600 calories; 18‐20
gram of protein and recommended
daily intake of micronutrients per
day).

55. 2. NON NUTRITION PART
• While in Non Nutrition part for school going
Adolescent Girls: (2–3 times a week) of 11-
14years, IFA supplementation, Health
check‐up and Referral services, Nutrition &
Health Education (NHE), Counselling/
Guidance on family welfare, ARSH, child
care practices, Life Skill Education and
accessing public services should be provided.

56. GIRL TO GIRLAPPROACH
• (For Girls in the Age Group of 11–15 Years)
In each selected Anganwadi area 2 girls in
the age group of 11–15 years are selected.
These adolescent girls provided with a meal
on the same scale as the pregnant women or
nursing mother namely one that would
provide 500 calories of energy and 20 g of
protein.

57. BALIKA MANDAL
• (For Girls in the Age Group 15-18 Years):
This scheme has more focus on the social
and mental development of girls at age
group 15–18 years. Special focus was laid
to motivate and involve the uneducated
groups belonging to this age group in non–
formal education and improvement and up
gradation of home-based skills.

58. NUTRITION PROGRAMME FOR
ADOLESCENT GIRL

59. NUTRITION PROGRAMME
FOR ADOLESCENT GIRL
• Introduced in the year 2002-2003
with 100% central assistance.
• Empower adolescent girls through
increased awareness to take better
care of their personal health and
nutrition needs.

60. AIMS:
 Improve nutritional and health status adolescent girls
 Provide nutrition and health education to the beneficiaries

61. BENEFICIARIES
Adolescent girls <35kg Pregnant women <45 kg

62. SERVICES
• 6kg ration per month for three months
consecutively
• Implemented through the A.W. centres
• Weighing four times in a year
• On the basis of the body weight, issuance of live
rice will continue for 3 months.

63. ICDS
 ICDS and J&K:
– Total of 143 blocks
– Total 28599 AWCs, 10465 are functioning AWCs
 ICDS and ASSAM:
– Total of 230 blocks
– Total 58118 functioning AWCs.
– Feeding days covered in 2011-12- 177days (target
300days)
– Food sponsored for programme -90% of budget in NE
states.

64. NEW
• Provision of breakfast @rs.2 since 2010-11 to be
continued till 2013.

66. WHEAT- BASED
NUTRITION PROGRAMME
• Centrally sponsored programme, launched in
1986.
• Implemented by the ministry of women & child
development.
• Programme follows the norms of SNP.
• Implemented through ICDS.
• Food grains supplied under the programme-used
to prepare food for supplementary nutrition in
ICDS

67. BENEFICIARS
• Providing nutritious/energy food
to children below 6 years of age
and expectant / lactating women
from disadvantaged sections

69. NATIONAL IODINE DEFICIENCY
DISORDER CONTROL
PROGRAMME
• The beginning – Kangra valley study(1956-72)
• National Goiter control programme was
launched in 1962, at the end of 2nd 5 year plan by
Ministry of Health & Family Welfare. (GOI)

70. Cont….
• Focus on use of iodised salt- replace of
common salt with iodised salt, cheapest
method to control IDD.
• Use of iodized oil injection to those
suffering from IDD, oral Administration as
prophylaxis in IDD severe areas.

71. RATIONALE
• Iodine deficiency leads to a spectrum of disorders mostly
affecting physical and mental development.
• The fact that human brain development is completed by 3
years of age, iodine deficiency in early age leads to
permanent and irreversible damage.
• Fortification of salt is a preventive programme, can be
considered as a “vaccine”.

72. AIM:
To reduce the prevalence if IDD
To less than 10% among adults by 2010.
To less than 5% among children 10-14 years.
To 0% of cretins among the newborns by
year 2000.

73. TURNING POINT
• In 1983 universal iodisation of salt (30ppm at
manufacture level and 15 ppm at consumption level).
• In 1992 programme renamed as national iodine
deficiency disorder control.

74. OBJECTIVES
 To assess the magnitude of IDD problem in the country.
 To assess the impact of control measure after five years.
 To monitor the quality of iodized salt available to consumers.
 To conduct IEC campaign for promoting community
participation in the implementation of the program.
 Health education

76. STRATEGY
• Iodise entire salt edible salt in the country by 1992.
• Ban of non-iodised salt under PFA act (1954).

77. COMPONENTS OF IDDC
PROGRAMME
 Iodization of salt and oil
 Monitoring and surveillance
 Manpower training
 Mass communication

78. IODIZEDSALT
 Most economical, convenient and
effective means of mass prophylaxis
for IDD.
 Under PFA act level of iodization is
30ppm at manufacturer level and
15ppm at consumer level.

79. Cont…
 Addition of 30 mg of iodine per
Kg usually in the form of
potassium iodate.
 Potassium iodate is more stable in
warm, damp and tropical climate.

80. IODIZED OIL
(INJECTION)
 IM iodized oil ( poppy seed oil, sunflower oil).
 1ml of IM injection will provide protection for 4 years.
 More expansive than iodized salt.
 Less practicable as it is very difficult to reach each and
every one to give injection.
 Iodized oil (oral) or sodium iodate tablets also tried.
 More costly than IM injection.

81. IODINE MONITORING AND
SURVEILLANCE- COMPONENTS
• Iodine excretion determination
• Determination of iodine content in soil
and food
• Determination of iodine in salt at factory
level, wholesale and retail level and
community or consumer level.

82. MANPOWER TRAINING
 Training of health worker in all approaches of IDD
control
 Training on public education

83. MASS COMMUNICATION
 Mass communication through
posters radio, television, news
papers and other means.

84. VITAMIN-A PROPHYLAXIS
PROGRAMME

85. VITAMIN-A PROPHYLAXIS
PROGRAMME
• Launched in 1970 as a centrally sponsored scheme
by ministry of Health & Family Welfare, GOL.
• National Vitamin A prophylaxis programme was
started in 1970.
• Component of national programme for control of
blindness 1976.

86. Cont…
 VAD is the most common cause of
preventable blindness in children(1-3yrs)
 20-40 million children worldwide-
estimated to have at least mild vitamin A
deficiency (VAD), half reside in India.
 VAD causes an estimated 60,000 children in
India to go blind each year.

87. Cont….
 Prevalence rates vary greatly among
states and range from less than 1% to 6%.
 Prevalence of Xeropthalmia 0.6% as per
GBD(global burden of disease)2000
estimates.
 VAD in India remains a significant
public health problem.

88. Cont…
 Target group –all children 1-3 years of age.
 Activity – megadose of Vit. A (2lac IU) orally every 6
months.
 8th 5 year plan –vit A supplementation linked with
immunization programme.
 10th 5 year plan – mega dose to give binannually in pre-
summer and pre-winter period.
 2006-2007 to cover all the children in 6 months to 5
years age.

89. 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%.

90. STRATEGY
• Until 1992, the strategy consisted of administration of
2 lakh IU of oral vitamin A concentration to children
between 2 & 6 years, at interval of 6 months.
• With commencement of CSSM program during 1992,
the strategy was changed to administration of 5 mega
doses of vitamin.

91. Cont…
• A concentrate orally to all
children between 9 months and 3
years not only to eliminate
nutritional blindness but also other
consequences of vit A deficiency.
However, it can be extended upto
5 years.

92. VITAMINAPROPHYLAXISSCHEDULE
Dose No. Age Dose(Orally) Remarks
1. At 9th month 1,00,000IU Along with measles
vaccine
2. At 18th month 2,00,000IU Along with booster
dose of DPT & OPV
3. At 24th month(2yr) 2,00,000IU NIL
4. At 30th month 2,00,000IU NIL
5. At 36th month 2,00,000IU NIL

93. 1. MEDIUM TERM MEASURE
• Fortification of food
-Vanaspati fortification with vitamin A and D to the
extent of 2500 IU of Vit-A and 175 IU of Vit-D per
100grams.
-Fortified milk Currently, 62 dairies are fortifying
milk with 200 IU/100 ml with future plans for
expansion.

94. Cont…
• Other food considered for fortification include sugar,
salt, tea, margarine, dried skimmed milk etc.
• Administration of supplemental dose of Vit A rich in
Arachis Oil
• 6-11 months- 1 dose of 1 lac IU
• 1-5 years -2 lac IU biannually.

95. 2.LONG TERM MEASURES
 Dietary improvement is, undoubtedly,
the most logical and sustainable
strategy to preventVAD.
 Nutrition education -A change in
dietary habits and increased access
to vitamin A-rich foods through
education.

96. Cont…
 Immunization against infectious
diseases.
 Prompt treatment of Diarrheal diseases.
 Better feeding practices of infants and
children.
 Promotion of regular intake of Vit A
rich food.

97. Cont.…
• Feeding locally Available food.
• Kitchen gardening of Vit A rich food.
• Treatment of vit a deficiency.
• Immediately after diagnosis -2 lac IU
followed by another dose of 2lac IU 1-4
weeks later.

98. NATIONAL NUTRITIONAL
ANAEMIA PROPHYLAXIS
PROGRAMME

99. NATIONAL NUTRITIONAL
ANAEMIA PROPHYLAXIS
PROGRAMME
• Programme was launched during 4th
5-year plan in 1970 by the ministry
of health and family welfare.
• Prevention of nutritional anemia in
mothers and children

101. RATIONALE
• Supplementary iron on daily basis is
considered necessary in developing
countries because approaches like food
fortification and dietary modification are
long term options.
• Requirements during 2nd and 3rd trimester
can’t be made by daily intake.

102. Cont…
• Majority of girls are anemic, even in
their adolescence.
• Deleterious effect on neural tube
development in folic acid
development during 1st 4 week of
pregnancy.

103. SERVICES
• Children 1-5 years of age
• Expecting and lactating mothers
• Family planning (IUD) acceptors

104. POLICY
• Expecting and lactating mothers as well
as IUD acceptors -60g of elemental iron
+0.5 mg folate everyday for 100 days.
• Children 1-5 years-20 mg of elemental
iron +0.1 mg folate everyday for 100
days.

105. PREVENTION OF ANEMIA IN
COUNTRY
-1991- renamed as “national nutritional anemia control
programme”
-Beneficiaries redefined – extended to both anemic and
non-anemic lactating & expecting mothers and 1-5 years
children.
-Dosage of iron- from 60mg to 100 mg of elemental
iron daily.
-IEC regarding increase consumption of iron-rich food.

106. Cont…
 In 1992-it became integral part of CSSM
programme
-100mg Fe+0.5folate for 100 days started along 1st
dose of inj. T.T.
-Therapeutic dose- 2 tabs of Irofol for 100 days

107. Cont…
 In 1997 it became part of RCH programme.
 All pregnant mothers get 1 tablet of IFAper
day for 100 days.
 All Anaemic mothers get 2 tablets of IFAper
day for 100 days.
 All Anaemic child get 1 tablet of IFAper day
for 100 days.

108. Cont…
 All acceptors of family planning
(IUD) are given one tablet of IFA for
100 days.
 All adolescent girls were given 1 tablet of
IFAper week.
 2005 programme is integrated with NRHM.

109. In 2007 new directives from MOH &FW GOL
• 6-12 months infants be included in the programme
• Dose for under 5 children in liquid formulation
• Children 6-10 years and adolescent 11-18 years
included.

110. Recommended dose
• 6-59 month children-liquid 20mg Fe+0.1mg Folate for
100 days
• 6-10 years- 1 tab. 30 mg Fe+0.25 mg folate for 100 days
• Adolescent & adults -1 tab. 100 mg Fe+0.% mg Folate
for 100 days
• Folic acid tab. (50ug) is given in 1st trimester in first 4
weeks.

111. Prevalence Of Nutritional Anemia In India (Annual
Report Ministry Of Health 2009-2010)
 65% infant and toddlers
 60% 1-6 years of age,
 88% adolescent girls (3.3% has hemoglobin <7
gm./dl; severe anemia)
 85% pregnant women (9.9% having severe anemia.
 The prevalence of anemia was marginally higher in
lactating women as compared to pregnancy.
 The commonest is iron deficiency anemia

112. BENEFICIARIES
1-5 years age 20mg Elemental
Iron
0.1mg(100mcg) of
Folic acid
6-10 years 30mg element Iron 0.25mg(250mcg) of
Folic acid
Pregnant woman
Lactating mothers
100mg element Iron 0.5mg(500mcg)Folic
acid

113. Weekly iron and folic acid supplementation
programme for adolescents
• Also known as WIFS-Blue campaign
• Nodal agency- ministry of Health & Family welfare.
• Beneficiaries-
-Adolescent girls/boys enrolled in school,6 -12 std
-Adolescent girls not enrolled in schools

114. IMPLEMENTATION
Out of school students
Ministry of social welfare
In- school students
Ministry of education

115. SERVICES
• IFA tablet to target population on
weekly basis on a fixed day
(Monday) for 52 weeks.
• Biannual deworming (February and
August).

116. MID-DAY MEAL

117. MID-DAY MEAL SCHEME-1961
• First started in Tamil Nadu.
• The mid-day meal scheme is the popular name for
school lunch meal programme in India.
• Programme in operation since 1961 under Ministry of
education.
• It involves provision of lunch free of cost to
school- children on all working days.
• 106 million children, 8 lakh schools in 576 district

118. AIM :
• To provide at least one
nourishing meal to school
going children per day.

119. OBJECTIVES OF THE
PROGRAMME
• To improve the nutritional status of
children.
• Protecting children from classroom
hunger.
• Increasing school enrolment and
attendance.
• Improved socialization among children
belonging to all castes.

120. PRINCIPLES
 The meal should be a supplement and
not a substitute to the home diet.
 The meal should supply at least one
third of the total energy requirement
and half of the protein need.
 The cost of the meal should be
reasonably low.

121. Cont….
 The meal should be such that it can be
prepared easily in schools, no
complicated cooking process should be
involved.
 As far as possible, locally available
foods should be used, this will reduce
the cost of the meal.
 The menu should be frequently
changed to avoid monotony.

123. TITHI BHOJAN
• The Modi Government included a new initiative Tithi-Bhojan
in the Mid-day meal scheme to encourage local community
participation in the programme.
• This concept was first implemented in Gujarat from where the
Indian Government has borrowed it to replicate across the
country.
• It seeks to involve the members of the community in the effort
to provide nutritious and healthy food to the children. The
members of the community may contribute/sponsor either
utensils or food on special occasions/festivals.

125. AKSHAYA PATRA
• Started in 2000,feeding 1500 children in 5 schools in
Bangalore.
• Successfully involved private sector participation in the
programme.
• Programme managed with a centralized kitchen that
runs through a public/ private partnership.
• Food delivered to schools in sealed and heat retaining
containers just before the lunch break every day

126. OBJECTIVE
• Providing underprivileged children with
a healthy, balanced meal.
• Reduced the dropout rate and increases
classroom attendance.
• Improve socialization among castes,
address malnutrition.
• Empower women through employment.

127. Modelmenu
Foodstuffs g/day/child
 Cereals and millets 75
 Pulses 30
 Oil and fats 8
 Leafy vegetables 30
 Non-leafy
vegetables
30

128. MISCELLANEOUS

129. ANNAPURNA SCHEME
-Launched in 2000-2002 by the ministry of
rural development
-Senior citizens of >_65 years of age, not
getting the pension under the national old
age pension scheme (NOAPS)
-10kgs of food grains/person/month are
supplied free of cost

130. MAA
-Under Assam Bikash Yojna
-Beneficiaries are pregnant mothers
-Rs. 1000 provide for nutrition and
ambulance.
- In India, about 45% receive BF within
one hour, 65% receive EBF, 50%
receive BF with weaning(6-8 months).

131. ANTYODAYA ANNA YOJNA
• Launched in 25th Dec., 2000.
• Aim to create hunger free India in next 5 year and
reform PDS.
• Target group: poor families who couldn’t afford
food grains even at BPL rate.
• Services 35 kg /family/month of wheat @Rs. 2/- and
rice @Rs.3/-

132. Cont…
• CM’s vision for women and children 2016

133. POSHAN ABHIYAN
• The Prime Minister’s Overarching Scheme for Holistic
Nutrition or Poshan Abhiyan or National Nutrition
Mission, is Government of India’s flagship programme
to improve nutritional outcomes for children, pregnant
women and lactating mother.
• Launched by the Prime Minister on the occasion of the
International Women’s Day on 8 March, 2018 from
Jhunjhunu in Rajasthan.

134. Cont…
• The Poshan Abhiyan directs the
attention of the country towards the
problem of malnutrition and address
it in a mission – mode.
• NITI Aayog has played a critical role
in shaping the Poshan Abhiyan.

135. Cont…
• The National Nutrition Strategy, released by NITI
Aayog in September 2017 presented a micro analysis
of the problems persisting within this area and out an
in-depth strategy for course correction.
• Strategy: the task of closely monitoring the Poshan
Abhiyan and undertaking periodic evaluations.

136. S.
NO.
OBJECTIVE TARGET
1. Prevent and reduce Stunting in children(0-6yrs) By 6%@2%p.a.
2. Prevent and reduce under-nutrition(underweight
prevalence) in children(0-6yrs)
By 6%@2%p.a.
3. Reduce the prevalence of anemia among young
children(6-59months)
By 9%@3%p.a.
4. Reduce the prevalence of anemia among Women
and Adolescent Girls in the age group of 15-
49yrs.
By 9%@3%p.a.
5. Reduce Low Birth Weight (LBW) By 6%@2%p.a.

137. AIM POSHAN ABHIYAN:
• To build a people’s movement
(Jan Andolan) around malnutrition
• Poshan Abhiyan intends to
significantly reduce malnutrition
in the next three years.

138. FOUR POINT STRATEGY OF THE
POSHAN ABHIYAN MISSION
• Inter-sectoral convergence for better service
delivery.
• Use of technology for real time growth
monitoring and tracking of women and
children.
• Intensified health and nutrition services for
the first 1000 days.
• Jan Andolan.

139. Cont…
• NITI Aayog is required to submit
implementation status reports of Poshan
Abhiyan every six months to the PMO.
• The first bi-annual report was prepared and
presented at 3rd National Nutritional
Council on India’s Nutrition Challenges in
November 2018.

140. POSHAN MAAH
• Month of Sept. 2018 was celebrated as
Rashtriya Poshan Maah.
• Activities focused on Social Behavioral
Change and Communication.
• Poshan Maah has given a major impetus
to the Abhiyan.

141. THEME OF POSHAN MAAH
• Broad theme were:
Antenatal care
Optimal breastfeeding (early and exclusive)
Complementary feeding
Anemia
Growth monitoring
Girls education
Diet
Right age of marriage
Hygiene and sanitation
Eating healthy-food fortification.

142. Cont…
• More than 12.2 Crore Women, 6.2 Crore Men, and
over 13 Crore children (male & female) were reached
through the various activities undertaken during
Poshan Maah.
• It is worth mentioning that 30.6 Crore people were
reached in 30 days.

143. CONCLUSION
• Nutrition education is an important element in an
overall strategy aimed at improving food security and
preventing all forms of malnutrition.
• The benefits of developing healthy dietary and lifestyle
patterns from an early age onwards can positively
impact on people’s nutrition and health throughout
their adult lives, and enhance the productivity of
individuals and nations.

144. SUMMARIZATION

145. REFERENCES
Book references:
• Wilson David, ‘Essentials Of pediatric Nursing’, 8rd Edition, Published by
Elsevier.
• Gulani KK, ‘Community Health Nursing’ 1st Edition, Kumar Publishing
house, New Delhi-2005, Page no. 662-664.
Net references:
• http://en.wikipedia.org/wiki/nursing_in_India//mw-head
• http://www.ncbi.nlm.nlm.gov/pubmed/19305227
• http://www.slideshare.com followed on 20/4/2020 by Ulfat Amin
• https://www.slideshare.net/NagamaniManjunath/national-nutritionalpolicy.