nutritional programmes for children

1. Ulfat amin
P.G pediatric nursing, DNA
NATIONAL NUTRITION PROGRAMS FOR CHILDREN
INTRODUCTION
Under nutrition is by far the most important single cause of illness & death globally accounting
for 12% of all deaths & 16% of disability. The problem of Malnutrition in India has been
recognized since the inception of five year plans and a number of nutritional programs have been
introduced for combating it. These programs help in bringing down the morbidity and mortality
due to Malnutrition. The major nutritional programmes in India are as:-
Ministry of Rural Development
• Applied nutrition programme
Ministry of Social Welfare
• Integrated child development services scheme
• Balwadi nutrition programme
• Special nutrition programme
Ministry of Health and Family Welfare
• National nutritional anemia prophylaxis programme
• National prophylaxis programme for prevention of blindness due to vitamin A deficiency
• National iodine deficiency disorder control programme
Ministry of Education
• Mid-day meal programme
NAME OF THE PROGRAMME MINISTRY DATE OF
LAUNCH

2. Vitamin A prophylaxis programme
National nutritional anemia control program
Iodine deficiency disorder control program
Integrated child development services program
Special Nutrition Program
Balwadi nutrition program
Mid-day Meal program
Mid-day Meal School
Ministry of Health & family welfare 1970
Ministry of health & family welfare 1970
Ministry of health & family welfare 1962
Ministry of social welfare 1975
Ministry of health & social welfare 1970
Ministry of social welfare 1970
Ministry of education 1961
Ministry of Health & family welfare 1995
APPLIED NUTRITION PROGRAMME(ANP)
One of the earliest nutritional programmes, by Ministry of Rural Development. This project was
started in Orissa on 1963.Later extended to Tamilnadu and UP. In 1973 extended to all states in
INDIA. Beneficiaries of this programme were children between 2-6 years, pregnant and lactating
mothers. Promoting production and of protective food such Vegetables and fruits. Ensure their
consumption by pregnant & lactating women and children. Services of this programme are;
Nutritional education, Nutrition worth 25 Paise for children and 50 Paise for pregnant and
lactating women for 52 days in a year
BALWADI NUTRITION PROGRAMME
This program was started in 1970 for the benefits of children in the age group of 3-6 years in
rural areas. It’s under the charge of social welfare department, Govt. of India. Four national level
organizations including the Indian council of child welfare are given grants to implement the
program. Voluntary organizations or NGO’s are actively involved in the day to day
Management. Main highlights of this program were
 The program is implemented through Balwadis, an Indian pre-school run for economically
weaker sections of the society.
 The two types of Balwadis namely Central Balwadi and Angan-Balwadi.
 Central Balwadis function during regular school hours and are centrally located where as
 Angan-Balwadis are located in the neighborhood of children.
 The purpose of this program is to provide child facilities for physical and mental growth to
provide food supplement of 300kcl and 10gm of protein per child per day.
 Balwadis are being phased out because of universalization of ICDS program.
WHEAT-BASED NUTRITION PROGRAMME
Centrally sponsored programme, launched in 1986.Implemented by the Ministry of Women &
Child Development, Programme follows the norms of SNP. Providing nutritious/ energy food to
children below 6 years of age and expectant /lactating women from disadvantaged sections.
Implemented through ICDS, Food grains supplied under the programme- used to prepare food
for supplementary nutrition in ICDS

3. NUTRITION PROGRAMME FOR ADOLESCENT GIRLS
Introduced in the year 2002-2003 with 100% Central Assistance .With the aim of Improving
Nutritional and health status adolescent girls. Provide nutrition and health education to the
beneficiaries. Empower adolescent girls through increased awareness to take better care of their
personal health and nutrition needs. Beneficiaries of this programme are Adolescent girls <35
Kg, Pregnant women <45 kg, 6 Kg ration per month for three months consecutively.
MID DAY MEAL PROGRAM:
The mid day meal program is also known as School lunch program. This program has been in
operation since 1961 throughout the country, With a view to enhancing enrollment in schools,
retain them so that attendance will improve and simultaneously improving nutritional levels
among children. This program comes under ministry of Education. The program should be based
on following principles
 The meal should be supplement and not a substitute to home diet
 Meal should supply at least one-third of total energy & half of protein need.
 The cost of the meal should be reasonably low.
 Meal should be such it can be prepared easily in schools.
 As far as possible, locally available foods should be cooked.
 The menu should be frequently changed to prevent Monotony.
MID DAY MEAL SCHEME :
This Scheme was launched on 15th august 1995, and is centrally sponsored scheme with a view
to enhance enrollment, retention and attendance in Schools and simultaneously improving
nutritional levels among children. In September 2004 the scheme was revised to provide cooked
mid day meal with 300 calories and 8-12 grams of protein to all children studying in classes I –
V in Government and aided schools. In addition to free supply of food grains, the revised scheme
provided Central Assistance for
 Cooking cost @ Re 1 per child per school day,
 Transport subsidy was raised from the earlier maximum of Rs 50 per quintal to Rs. 100 per
quintal for special category states, and Rs 75 per quintal for other states,
 Management, monitoring and evaluation costs @ 2% of the cost of foodgrains, transport
subsidy and cooking assistance,
 Provision of mid day meal during summer vacation in drought affected areas.
In July 2006 the scheme was further revised to provide assistance for cooking cost at the rate of
 Rs 1.80 per child/school day for States in the North Eastern Region, provided the NER
states contribute Rs 0.20 per child/school day, and
 Rs 1.50 per child/ school day for other States and UTs, provided that these States and UTs
contribute Rs 0.50 per child/school day.
In October 2007, the scheme has been further revised to

4.  Cover children in upper primary (classes VI to VIII) initially in 3479 Educationally
Backwards Blocks (EBBs).
 Around 1.7 crore upper primary children are expected to be included by this expansion of
the scheme.
 The programme was extended to all areas across the country from 2008-09.
 The calorific value of a mid-day meal at upper primary stage has been fixed at a minimum
of 700 calories and 20 grams of protein by providing 150 grams of food grains (rice/wheat)
per child/school day.
Objectives: The objectives of the mid day meal scheme are:
 Improving the nutritional status of children in classes I – VIII in Government, Local Body
and Government aided schools.
 Encouraging poor children, belonging to disadvantaged sections, to attend school more
regularly and help them concentrate on classroom activities.
 Providing nutritional support to children of primary stage in drought-affected areas during
summer vacation.
Reasons for starting this program were
• Promoting school participation: Mid day meals have big effects on school participation, not just
in terms of getting more children enrolled in the registers but also in terms of regular pupil
attendance on a daily basis.
• Preventing classroom hunger: Many children reach school on an empty stomach. Even children
who have a meal before they leave for school get hungry by the afternoon and are not able to
concentrate - especially children from families who cannot give them a lunch box or are
staying a long distance away from the school. Mid day meal can help to overcome this problem
by preventing “classroom hunger”.
• Facilitating the healthy growth of children: Mid day meal can also act as a regular source of
“supplementary nutrition” for children, and facilitate their healthy growth.
• Intrinsic educational value: A well-organized mid day meal can be used as an opportunity to
impart various good habits to children (such as washing one’s hands before and after eating), and
to educate them about the importance of clean water, good hygiene and other related matters.
• Fostering social equality: Mid day meal can help spread egalitarian values, as children from
various social backgrounds learn to sit together and share a common meal. In particular, mid day
meal can help to break the barriers of caste and class among school. Appointing cooks from Dalit
communities is another way of teaching children to overcome caste prejudices.
• Enhancing gender equity: The gender gap in school participation tends to narrow, as the Mid
Day Meal Scheme helps erode the barriers that prevent girls from going to school. Mid Day
Meal Scheme also provide a useful source of employment for women, and helps liberate
workingwomen from the burden of cooking at home during the day. In these and other ways,
women and girl children have a special stake in Mid Day Meal Scheme.

5. • Psychological Benefits: Physiological deprivation leads to low self-esteem, consequent
insecurity, anxiety and stress. The Mid Day Meal Scheme can help address this and facilitate
cognitive, emotional and social development.
SPECIAL NUTRITION PROGRAM:
The program was started in 1970 for the nutritional benefits of children below 6 years of age,
pregnant and nursing mothers. It is in operation in urban slums, tribal areas and backward rural
areas. This program was originally launched as a central program and was transferred to the state
ministry in 5th five year plan. Now this comes under ministry of social welfare. The main aim of
special nutrition program is to improve the nutrition status of target groups. This program is
gradually being merged into the ICDS program. The main highlights of this program were as
The supplementary food supplies about 300 kcl and 10-12 gm of protein per child per day of
age group 6 months to 72 months old.
Severely malnourished children are provided 600 kcl and 20gm of protein per day.
Iron and folic acid tablets and vitamin A solution are also provided.
The pregnant mother in the last trimester, lactating mothers and malnourished children are
given priority.
The beneficiary mothers receive daily 500 kcl and 25gm of protein.
This supplement is provided to them for about 300 days a year.
INTEGRATED CHILD DEVELOPMENT SERVICE (ICDS) SCHEME
Launched in 1975, in pursuance of the National policy for children, the Integrated Child
Development Services (ICDS) is the only major national programme that addresses the needs of
children under the age of six years. There is a strong nutritional component in this program in the
form of supplementary nutrition Vitamin A prophylaxis & iron and folic acid distribution;
beneficiaries are children below 6 years & adolescent girls 11 to 18 years. The main objectives
of the programme are to;
 Improve the health, nutrition and development of children 0-6 years.
 Provide health, nutrition and hygiene education to mothers.
 Provide Non-formal pre-school education to children aged 3 to 6,
 Supplementary feeding for all children and pregnant and nursing mothers
 Monitoring and promotion services,
 To links to primary healthcare services such as immunization and vitamin A
supplementation.
 Reduce the incidence of Mortality, morbidity,, malnutrition, & school dropouts.
 Lay the foundation for proper psychological, physical, social development of child.
 Referral services
These services are delivered in an integrated manner at an Anganwadi or childcare centre. The
workers at the village level who deliver the services are called as Anganwadi worker. Each
centre is run by an Anganwadi Worker and a helper. The Anganwadi Worker undergoes a one-
time induction training of 8 days, job orientation training of 32 days and refresher training of 7
days, while the Helpers undergo a one-time job orientation training of 8 days and a refresher
training that lasts 5 days. Field supervision is done by Child development project officer. Three

6. of these services, namely, immunization, health check-up and referral services, are delivered
through the public health infrastructure i.e. the Health Sub Centre and Primary and Community
Health Centre under the Department of Health and Family Welfare. The remaining services are
delivered through the Anganwadi Centers (AWCs).
The ICDS is the largest programme of its kind in the world, with over 1.2 million centers
nationwide – nearly 91 per cent of the sanctioned number. Since its inception in 1975, the
programme has matured and expanded and covers over 16 million expectant and nursing mothers
and over 75 million children under the age of six. Of these children, about half participate in
early learning activities.
ICDS IN JANDK
 Total of 143 blocks
 Total 28599 AWCs, 10465 are functioning AWCs
 Feeding days covered in 2011-12- 177days (target 300days)
 Food sponsored for programme -90% of budget in NE states.
NATIONAL NUTRITIONAL ANEMIA CONTROL PROGRAM:
Nutritional anemia is a serious public health problem. Although anemia is widespread in the
country, it especially affects women in the reproductive age group and young children (1-12yrs).
It was launched by the Ministry of health and family welfare during the fourth five year Plan. It
aims at
 Significantly decreasing the prevalence and incidence of anemia in women in reproductive
age group, and preschool children.
 Promotion of regular consumption of foods rich in iron.
 Provisions of iron and Folate supplements in the form of tablets (Folifer tablets) to the "high
risk" groups.
 Identification and treatment of severely anemic cases.
 Distribution of two tablets per day for 100 days.
 Distribution of three tablets per day for 100 days to those with Anemia.
The Programme is implemented through the Primary Health Centre’s and its sub-centers. The
Multiple Purpose Worker (F) and other paramedical working in the Primary Health Centers are
responsible for the distribution of iron tablets (adult and pediatric doses) to pregnant and
lactating women, IUD users and children aged 1 to 12 years.
BENRFICIARIES OF THIS PROGRAMME ARE;-
Children 1-5years of age, Expecting and lactating mothers, Family planning (IUD) acceptors.
Policy of this programme is expecting and lactating mothers as well as IUD acceptors -60 mg of
elemental iron + 0.5 mg folate everyday for 100 days. Children 1-5 years- 20mg of elemental
iron + 0.1 mg folate everyday for 100 days.

7. IN THE PURSUIT OF 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 1-5years children. Dosage of iron- from 60 mg to 100mg of elemental iron
daily.IEC regarding increase consumption of iron-rich food
 1992-programme was made integral part of CSSM programme
100mg Fe+0.5 folate for 100days started along 1st dose of inj T.T, Therapeutic dose- 2 tabs of
Irofol for 100 days.
 1997- Programme is integrated with RCH…..
 2005- Programme is integrated with NRHM……
2007 -new directives from MoH&FW, GoI
6-12 months infants be included in the programme. Dose for under 5 children in liquid
formulation. Children 6-10years & adolescent 11-18years included
Recommended dose:
6month-5year children-liquid 20 mg Fe+ 0.1 mg 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+ 0.5 mg Folate for 100
days. Folic acid tab.(500μg) is given in 1st trimester in first 4 weeks.
WEEKLY IRON AND FOLIC ACID SUPPLIMENTATION PROGRAMME FOR
ADOLESCENTS
Also known as WIFS-Blue campaign. Nodal agency- Ministry of H&FW. Beneficiaries of this
programme are adolescent girls/boys enrolled in school, 6th- 12th std. Adolescent girls not
enrolled in schools. Services of this programme are
 IFA tablet to target population on weekly basis on a fixed day(Monday) for 52 weeks.
 Biannual deworming (February and August)
NATIONAL PROPHYLAXIS PROGRAMME AGAINST NUTRITIONAL
BLINDNESS DUE TO VITAMIN A DEFICIENCY
Vitamin A is an essential nutrient needed in small amounts for normal functioning of the visual
system, growth and development, maintenance of epithelial cellular integrity, immune function
and reproduction. Severe deficiency of vitamin A is known to produce corneal Xeropthalmia or
Keratomalacia and blindness in children. Vitamin A deficiency is seen mainly in young children
in developing countries. This micronutrient gained public health importance in the mid-1960s
because of its ability to prevent nutritional blindness. Subsequently, vitamin A supplementation

8. became the centre of attention because of its reported child survival benefits. The National
vitamin A Prophylaxis Programme against Nutritional Blindness was initiated in 1970 by
Ministry of Health & Family welfare as an urgent remedial measure to eliminate the
unacceptably high magnitude of Xerophthalmia blindness. During the early 1990s this
intervention was restricted to children between 9 months and 3 years as clinical deficiency was
almost exclusively restricted to this age range, in 2006 the age group was broadened to include
children between 6 months and 5 years after reconsidering recommendations of the WHO,
UNICEF and Ministry of Women and Child Development. Main highlights of this program are
• All 1–5-year-old children will be given 200 000 IU of vitamin A orally once in 6 months
• The first dose of 100,000 IU will be given at nine months of age.
• The second dose of 200,000IU will be given at 16 months of age.
• Three more doses of 200,000IU will be given at 6 months interval.
• It is to be available at every Health Centre both in rural & urban areas.
IODINE DEFICIENCY DISORDER CONTROL PROGRAM
Iodine deficiency disorder (IDD) is a major public health issue in India. 150 million have milder
neurological deficiency & the total number of still births and neonatal deaths attribute to iodine
deficiency is over 90000. Deficiency of iodine can also cause physical & mental retardation,
cretinism, abortions, deaf mutism in children, squint & various type of goiter. Over 40-50 million
of people have Goiter. The government of India initiated a National Goiter Control program in
1962 in the conventional Goiter belt in Himalayan region, but it was later initiated in whole
Nation, as IDD’s was seen in other regions of country as well under the name of Iodine
deficiency disorder control program. The main highlights of this program are:
 To assess the magnitude of IDD.
 Supply of iodized salt in place of unionized salt by 1992
 Repeated surveys to assess impact of iodized salt after 5 years
 A multi modal health education campaign to create awareness
 Establishment of Goiter control cells at state & district level to monitor the operations of
production, distribution & quality control of iodized salt.
CHILD TO CHILD HEALTH PROGRAMME:
In 1978, David Morley from institute of child health, and Hugh Hawes from institute of
education, university of London conceptually integrated Health & education concerns of
children. Highlights of this program are
 Improve health, Nutrition, development of a children through child to child activities
 Enable children to make qualitative improvements in life of their younger sisters & brothers.
 Help children feel a sense of being in control of their lives.
 Topics are such which are easy for children to learn like Diarrhea management, clean
drinking water, care of eyes, ear & teeth, accident prevention, etc

9.  Children are taught with the help of Games, puppet shows, role plays, songs, stories, etc so
that they can easily learn.
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,With following objectives
 Providing underprivileged children with a healthy, balanced meal .
 Reduce the dropout rate and increases classroom attendance.
 Improve socialization among castes, address malnutrition
 Empower women through employment.
NUTRITION PROGRAMME FOR ADOLESCENT GIRLS
(KISHORI SHAKTI YOJNA)
Launched by Dept. of Women and Child Development,Ministry of Human Resource
Development in 1991. Targeted All adolescent girls in the age group of 11-18 years
Common services of this programme were, Watch over menarche, Immunization, General health
check-ups once in every six-months, Training for minor ailments, De-worming, Prophylactic
measures against anemia, goiter, vitamin deficiency, etc., and Referral to PHC. District hospital
in case of acute need. Girls are also provided supplementary nutrition at Rs. 2.50 per girl, per day
ANNAPURNA SCHEME
Launched in 2000-2001 by Ministry of Rural Development. Senior citizens of ≥65 years of age,
not getting the pension under the National Old Age Pension Scheme (NOAPS). 10 kgs of food
grains/person/month are supplied free of cost.
MAA-MONI
 Under Assam Bikash Yojna.
 Beneficiaries are pregnant mothers
 Rs. 1000 provided for nutrition and ambulance
ANTYODAYA ANNA YOJNA
 Launched in 25th Dec 2000
 Aim- to create hunger-free India in next 5 year and reform PDS

10.  Target group- poor families who couldn’t afford food grains even at BPL rates
 Service- 35 kg/Family/month of wheat @Rs 2/- & rice @Rs 3/-