Clinical nutrition

1. Integrated Child Development
Services ( ICDS)
k.Soundararajan
K. Soundararajan, SRIHER 1

2. Objectives
• Introduction
• ICDS
• Objectives of ICDS
• Services
• Key services
• Nutritional & feeding Norms
• Various National program
• Mid – day meal program
• Conclusion
K. Soundararajan, SRIHER 2

3. K. Soundararajan, SRIHER 3

4. Introduction
• on 2nd october, 1975 the Goverment of India
initiated an integrated approach for delivery
of health care as well as nutrition
• Education service for health
• Wellbeing of children aged from 0 to 6 Years
of deprived population at the village level
• In urban slums through centers called
"Anganwadi centers"
K. Soundararajan, SRIHER 4

5. ICDS
• It is a National Program
• It begans with 33 Projects
• Now covers approximately 6284 Projects
• It is world's largest program on "Early Child
Development"
K. Soundararajan, SRIHER 5

6. Objectives of ICDS
• To improve the nutritional & health status of
children 0-6 years of age
• To lay the foundation for proper psychological
development of the child
• To reduce incidence of mortality, morbidity,
malnutrition and school dropouts.
• To enhance the capacity of the mother to look
after the normal health
• And nutritional needs of the child, through
proper health & nutritional education
K. Soundararajan, SRIHER 6

7. Continue ...
• To achieve effective coordination of policy
• And implementation among various
department to promote child development
K. Soundararajan, SRIHER 7

8. Services
• Children 0-3 Years
• Children 3-6 Years
• Pregnant & lactating women
• Adolescent girl
• Women ( 15 - 45 Years )
K. Soundararajan, SRIHER 8

9. Key Service of ICDS
• Nutritional and health education and
information education and communication
(IEC)
• Growth promotion and monitoring
• Iron- Folate supplements
K. Soundararajan, SRIHER 9

10. Nutritional and health education and
information education and
communication (IEC)
Intensive innovative media campaign and IEC on key issue
such as
• Increased rest during pregnancy-especially in the last
trimester
• Appropriate new born care
• Promotion of early and exclusive breastfeeding for first 6
months
• Initiation of feeding on completion of 6 months of age
along with breast milk
• Personal hygiene & hand washing before feeding / after
defecation
K. Soundararajan, SRIHER 10

11. Continue …
• Delayed pregnancy better birth spacing and
adequate maternal care during pregnancy
• Prevention of STDs and RTI ( to prevent low-
birth weight)
• Iron folate supplementation during pregnancy
• Bi-annual vitamin A supplementation for all
children 1-5 years of age
• Twice annual de- worming for all (include
school children, adolescent girls and adults)
K. Soundararajan, SRIHER 11

12. Growth promotion and monitoring
• To strengthen the growth monitoring and
promotion component, the project design will
pay adequate attention on counseling skills
• And quality of training of AWWs
• Provide enough information skills and
motivation to refer sick children & weak borns
to health facilities also for counseling and
outreach services
K. Soundararajan, SRIHER 12

13. Others
• Referral sick children & weak borns to health
facilities ( referral card, transport vouchers for
mother of sick children etc)
• Iron folate supplement for adolescent girls
• Convergence with NRHM (National Rural
Health Mission).
K. Soundararajan, SRIHER 13

14. Nutritional and Feeding Norms
• Children 0 - 6 Months
• Children 6 Months – 3 Years
• Children 3 – 6 Years
• For severely underweight children – in
addition to above
K. Soundararajan, SRIHER 14

15. Children 0 - 6 Months
• Early initiation (within 1 hour of birth)
• Exclusive breast feeding for the first 6 months
of life
K. Soundararajan, SRIHER 15

16. Children 6 Months – 3 Years
• Appropriate complementary feeding upon
completion of 6 months
• Continued breastfeeding for 2 years or beyond
• ICDS supplementary nutritional program (SNP)
• The supplements should provide 500 calories of
energy, 12-15 g of protein per child per day
• Existing pattern of taken home ration (THR)- small
frequent meals to the child – ICDS SNP for
severely underweight children
• Locally appropriate feeding and care
• Health referrals and interventions
K. Soundararajan, SRIHER 16

17. Children 3 – 6 Years
• ICDS SNP supplements home feeding
• 500 calories of energy
• 12-15 g of protein per child per day
• May provide as morning snacks and meal
• Hot cooked meals at anganwadi centers
K. Soundararajan, SRIHER 17

18. For severely underweight children – in
addition to above
• Additional 300 calories of energy
• Additional 8-10 g of protein per child per day
(THR)
• Locally appropriate feeding and care
• Health referrals and interventions.
K. Soundararajan, SRIHER 18

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21. Mid – Day Meals Program
• This was started in 1995
• Children between 6-11 years of age are given
food supplementation in schools only
• Each child gets 100g food grain/day
• Cooked food like khichri, upma, rice, sambar
etc are given
• Food provides roughtly one-third of RDA for
energy and one-half of RDA for protein
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26. Various National Programs
• School Mid Day Meals Program
• Kishori Shakti Yojana
• Swarna Jayanthi Gram Swarozgar Yojana
• Sampurna Gramin Rozgar Yojana
• Mahatma Gandhi National Rural Employment Gurantee Program
• Rajiv Gandhi Scheme for Empowerment of Adolescent Girls
• National Rural Health Mission (NRHM)
• National Urban Health Mission (NUHM)
• Rajiv Gandhi Drinking Water Mission
• Total Sanitation Campaign
• Rashtriya Krishi Vikas Yojana
• National Horticulture Mission
• Food Security Act (FSA)
• National Food Security Mission
• National Food Security Bill
K. Soundararajan, SRIHER 26

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28. Reference
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