Community Nutrition Programmes

Community Nutrition Programmes
Community Nutrition Programmes

(Objectives)
 To improve overall nutritional
status vulnerable group
 To overcome specific nutritional
deficiencies among mothers and
children
 To help to achieve better nutrition
through indirect schemes
Programm Ministr
e
•Vitamin-A
y
MHF
prophylaxis
programm W
•e
Prophylaxis against nutritional MHF
anaemia W
Iodine deficiency disorder
• MHF
control programme W
•Special nutrition
programme
•Balwadi nutrition programme
MSW
MSW
• ICDS programme
MSW
Integrated Child Development
Services(ICDS) -1975
objective
 s nutritional and health status of
To improve the
pre-school children in the age-group of 0-6
 years
To improve the physical, mental and
social development of the child
 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
the childofthrough proper nutrition and
health education
Administrative set up
 At state level -state ICDS programme officer who
report to DPH
 District level ICDS programme officer
 Block level(100 Villages) – Child
Development Project Officer
 For every 20-25 ICDS center 1 supervisor
(mukhya sevika)
 At ICDS centre – Anganwadi worker (every
1000 pop)
 In tribal areas 1 Anganwadi for 700 pop
Targeted Beneficiaries
 The Scheme targets the most vulnerable
groups of population
 include children upto 6 years of age,
 pregnant women and nurs ing mothers
belonging to poorest of the poor families and
living in backward rural areas, tribal areas and
urban slums.
 The identification of beneficiaries is done
through surveying the community and
identifying the families living below the poverty
line.
Package of Services
 Supplementary Nutrition
 Immunization
 Health Check-up
 Treatment & Referral Services
 Non-formal Pre-school Education
 Nutrition & Health Education
Supplementary nutrition
 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)
Recipie Calories Gram
nts s
of
Protein
Children upto 30 8-
6
Years 0 10
Adolescent Girls 20-

500 25
Pregnant and 50 20-

nursing 0 25
mothers
Double the daily
Malnourished
Childr supplement
provided to the
en other
children(600 and/or
special
nutrients on
medical
Non formal education
 Children between 3-6 years are imported
pre- elementary educa tion without formal
hours of teaching without syllabus and
test
 Teaching is mixed with play. Locally
made charts, pictures, diagrams, toys
and play equipments are used
Immunization
 Anganwadi arranges with health worker
female serving her area to give immunization
to her wards and pregnant mothers
Treatment & Referra l services
 With help of HWF get all needy children
treated for minor illness like diarrhea, ARI,
minor cuts, fever etc
 All other cases and sever malnutrition refers
to medical officer of PHC
Growth monitoring
 Checks the weight of all preschool children
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
ICDS Areas
3. Decrease in IMR in ICDS Areas
4. Improvement in School Enrolment and
Reduction in School Dropout Rate in
ICDS Areas, 1992.
Mid-day Meal Scheme-1962
The mid-day meal s cheme is the
popular name for school meal programme
in India.
It involves provision of lunch free of cost to

school-children on all working days.
106 million children, 8 lakh schools in
576 district
objectives of the programme
 are: the nutritional status of children
To improve
 protecting children from classroom hunger,
 increasing school enrolment and attendance,
 improved socialization among children
belonging to all castes,
 The scheme has a long history especially
in Tamil Nadu and Gujarat,
 Has been expanded to all parts of India
landmark
after a direction by the
Supreme Court of India on November 28, 2001.
 The success of this scheme is illustrated by the
tremendous increase in the school participation
and completion rates in TAMIL NADU..
 One of the pioneers of the scheme is
the Madras corporation that started
providing
cooked meals to children in
corporation
schools in the Madras city in 1923.

 The programme was introduced in a
large scale in 1962 in TN
 Major thrust came in 1982 decided to
universalize the scheme for all children
Principles
 The meal should be a supplement and not a substitute
the home
to
 diet
The meal should supply at least one third of the
energy
total requirement and half o f the protein
 need
The cost of the meal should be reasonably
 low
The meal should be such that it can be prepared
in schools, no complicated cooking process should
easily
be involved
 as far as possible, locally available foods should
used,
be this will reduce the cost of the
 mealmenu should be frequently changed to
The
monoto
avoid
ny
Model menu
Foodstuff g/day/chi
s ld
Cereals and 7
millets 5
Pulses 3
0
Oils and fats
8
Leafy
Non – leafy vegetables 3
vegetables
30 0
Special nutrition programme
 Programme was started in
1970 Beneficiaries
 Children below 6 years of
age
 Pregnant and nursing
mothers
 In urban slums, tribal areas and
backward rural areas
 Supplementary food supplies about 300
kcal and 10-12 grams of protein per
child per day
 Mothers receive daily 5 00 kcal and
25 grams of protein
 Supplement is provided for 300 days
in year
 It is gradually being merged with
ICDS programme
Balwadi nutrition programme
 Started in 1970
 6000 Balwadi centre -across the country
 For children under the age group of 3-
6 years
 Provide pre-primary education to
children
 Food supplement provides 300 kcal
and 10 grams of protein per child per
day for 270 days
Tamilnadu integrated nutrition
programme
 Was started in the year 1981
 Beneficiaries are children < 6
years, pregnant and lactating
mothers
 Merged with ICDS programme
Prophylaxis against nutritional
anaem ia 1970
prevalence of nutritional anemia
in India
 65% infant and
 60% 1-6 yearstoddlers
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
anemia
deficiency
 The programme was launched in 1970
 1992 became part of CSSM programme
 1997 became part of RCH programme
 All pregnant mothers get 1 tablet of IFA per day
for 100 days
 All anaemic mothers get 2 tablets of IFA per
day for 100 days
 All anaemic child get 1 tablet of IFA per day
for 100 days
 All acceptors of family planning (IUD) are
given one tablet of IFA for 100 days
 All adolescent girls were given 1 tablet of IFA
per week
Dose
 60 mg of elementary iron &0.5 mg of folic
acid and which was ra ised to 100 mg
elementary iron from 1 992 however folic
acid content remained same
 Children in the age group of 1-5 years
given
are one tablet of iron containing 20 mg
elementary iron (60 mg of ferrous su
lphate and 0.1 mg of folic acid) daily for
a period of 100 days.
Vitamin-A prophylaxis
programme
1970
 VAD is the most common cause of
preventable blindness in children(1-3yrs)
 20-40 million children w orldwide-

estimated to have at le ast mild
vitamin A deficiency
(VAD) , half reside in India.
 VAD causes an estimated 60,000
children in India to go blind each year.
 Prevalence rates vary greatly among
states and range from less than 1% to
the
 6%.
Prevalence of Xerophthalmia 0.6% as
per
GBD 2000 estimates
 VAD in India remains a significant
public health problem.

 The National Vitamin A
prophylaxis programme was
started in 1971
 Became part of RCH programme
from 1997
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%
Short term measures
 children between 1-5 years were given oral
doses of 200,000 IU vitam in A every six
months.
 Currently, vitamin A is given only to children
less than three years old who are at greatest
risk.
 The administration of the first two doses is
linked with routine immunization to improve the
coverage. A dose of 100,000 IU is given along
with measles vaccine at nine months of age
and
Medium term measure
Fortification of food
 Vanaspati is 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.
 Other food considered for fortification include
sugar, salt, tea, margarine, dried skimmed milk
etc
Long term measures
 Dietary improvement is, undoubtedly, the most
logical and sustainable str ategy to prevent VAD.

 Nutrition education -A cha nge in dietary
habits and increased access to vitamin A-rich

foods through education.
 Immunization against infectious diseases
 Prompt treatment of Diarrhoeal diseases

 Better feeding practices of infants and
children
National Iodine Def iciency Disorder
Control program me
(NIDDCP) 1992
 National goitre control programme was
launched in 1962
 GOI adopted policy of universal salt iodization
(USI) 1984
 Amended 1988- level of iodization of salt at
manufacture level at 30pp m and consumer
level 15ppm
 1990 sale and manufacture of non iodized salt
was banned
 Referred as NIDDC programme in 1992 with
an am to bring down the incidence of IDD
below 10% by 2000
Components of IDDC programme
 Iodization of salt and oil

 Monitoring and surveillance
 Manpower training
 Mass communication
Iodized salt
Most economical, convenient and effective
means of mass prophy laxis for IDD
 Under PFA act level of iodization is
30ppm at manufacturer level and 15ppm
at consumer level
 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
Iodized oil (injection)
 IM iodized oil ( poppy seed oil,
safflower 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
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.
Manpower training
 Training of health worker in all
approaches of IDD control

 Training on public education
Mass communication
 Mass communication through posters
radio, television, news papers and
other means

Community Nutrition Programmes

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Community Nutrition Programmes

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Community Nutrition Programmes

Community Nutrition Programmes

Adolescent Girls 20-

Pregnant and 50 20-

It involves provision of lunch free of cost to

schools in the Madras city in 1923.

 20-40 million children w orldwide-

public health problem.

logical and sustainable str ategy to prevent VAD.

habits and increased access to vitamin A-rich

 Prompt treatment of Diarrhoeal diseases

 Iodization of salt and oil

 Less practicable as it is very difficult to

approaches of IDD control

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