Community nutrition programme

Community nutrition programme IN COMMUNITY HEALTH NURSING

1. COMMUNITY NUTRITION PROGRAMMES Presesnted by: Harsh Rastogi , M.Sc. Nursing 1 st year, King George’s Medical University, Institute of Nursing, Lucknow . 1

2. 2 COMMUNITY NUTRITION PROGRAMMES

3. Large scale supplementary nutrition programmes . Main aim is to improve nutritional status in targeted groups. And overcome specific diseases to combat malnutrition. Introduction

4. Vitamin A prophylaxis programme Prophylaxis against nutritional anaemia Control of iodine deficiency disorders Special nutrition programme Balwadi nutrition programme ICDS programme Mid-day meal programme Mid-day meal scheme 4 List of CNP:

5. 5 C N P and its ministry Programme Ministry Vitamin A Prophylaxis Programme Prophylaxis Against Nutritional anaemia I D D Control Programme Health and family welfare Special Nutritional Programme Balwadi Nutritional Programme Social welfare I C D S Scheme Women and child development Mid Day Meal Programme Mid Day Meal Scheme Human Resource Development

6. VITAMIN - A PROPHYLAXIS PROGRAMME 6

7. 7 Vitamin- A Prophylaxis Programme Initiated in 1970 Beneficiary: age group 6mo - 5 year Objective: Prevent blindness due to VAD Implemented by : P H C and subcenter A single massive dose of Vitamin - A 2 lac IU (retinol palmitate 110mg) orally every 6 months above 1 year

8. 8 Role of Vitamin- A in health Prevent respiratory infection Maintain G I T epithelium integrity Immunity Prevent Nutritional blindness

9. PROPHYLAXIS AGAINST NUTRITIONAL ANAEMIA 9

10. 10 Prophylaxis Against Nutritional Anaemia Initiated in 1970 Centrally sponsored Over 50%pregnant woman suffer from anemia Causes LBW and perinatal mortality, maternal death Objectives: Assess prevalence, Give treatment, Give prophylaxis, Monitoring, Education

11. 11 Prophylaxis Against Nutritional Anaemia Beneficiaries: Children aged 1 to 5 years Pregnant and nursing mother Female acceptor of terminal method of family planning and IUDS Implemented by: PHC and subcenters

12. 12 Prophylaxis Against Nutritional Anaemia Dosage of tablets: Pregnant women: 100 mg Fe & 0.5mg folic acid Children 6 to 60 months : 20mg Fe & 0.1 mg folic acid Should be given 100 days Adolescent girls: 100 mg Fe & 0.5mg folic acid Children between 1 to 5 years Screening test for anemia done at 6 mo, 1, 2 years Iron fortification of salt

13. IODINE DEFICIENCY DISORDER CONTROL PROGRAMME 13

14. 14 IDD control programme National goiter control programme in 1962 IDD Control Programme Replace the entire edible salt by iodide salt Fortification of salt with iodine

15. SPECIAL NUTRITIONAL PROGRAMME 15

16. 16 Special Nutritional Programme Started in 1970 in urban slums, tribal areas and backward rural areas Main aim is to improve nutritional status in children <6 years pregnant and lactating women Gradually being merged into ICDS

17. APPLIED NUTRITIONAL PROGRAMME 17

18. 18 Applied Nutritional Programme This project was started in Orissa on 1963 Later extended to TN and UP Objectives: Promoting production and of protective food such vegetables and fruits Ensure their consumption by pregnant & lactating women and children. In 1973 extended to all states in INDIA

19. 19 Applied Nutritional Programme Major components Nutritional Services Health services Communication Monitoring and evaluation Later converted into ICDS

20. BALWADI NUTRITION PROGRAMME 20

21. 21 Balwadi Nutrition Programme This was started in 1970 by the department of social welfare Beneficiary: Preschool children 3-6 years of age Activities 300 kcal and 10 g protein Preschool education Phased out because universalization of ICDS

22. INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS) SCHEME 22

23. 23 ICDS Launched on 2 nd October 1975 O n e of t h e w orl d ’ s la r g e s t and mo s t un i que programmes for early childhood development India’s response to the challenge of Providing pre-school education on one hand and Breaking the vicious cycle of malnutrition, morbidity, reduced learning capacity and mortality, on the other F o r emo s t s ymbol of Ind i a ’ s c om m i t me n t t o h e r children

24. Routine MCH services not reaching target Population N u t ritional c o mpone n t no t c o v e r e d by Health services Need for community participation 24 Need for ICDS

25. 25 Objectives of ICDS I mp r o v e the nut r it i ona l and h e alth s t a tus of children in the age-group 0-6 years Foundation for proper psychological, physical and social development of the child R e d uc e t h e i n cid enc e of mor t al i t y , m o rbidit y , malnutrition and school dropout C o - o r d i n a tion of d e p artme n ts t o p r omo t e chi l d development Nutrition and health education to the mother

26. 26 Beneficiaries of ICDS Pregnant women Nursing Mothers Children less than 3 years Children between 3-6 years Adolescent girls( 11-18 years)

27. 27 Functionaries of ICDS District Programme Officer (DPO) Child Development Project Officer (CDPO) Supervisor ( Mukhyasevika ) Anganwadi Workers (AWW) Anganwadi Helpers (AWH)

28. 28 Services under ICDS Package of services: Supplementary nutrition Immunization Health check-up Referral services Pre-school non-formal education Nutrition & health education

29. 29

30. 30 Services & beneficiaries Services Target Group Supplementary Nutrition Children below 6 years, PLW Immunization Children below 6 years, Pregnant Women Health Check-up Children below 6 years, PLW Referral Services Children below 6 years, PLW Pre-School Education Children 3-6 years Nutrition & Health Education Women (15-45 years), Children 3-6 years, PLW

31. COMPONENTS OF ICDS 31

32. 32 Supplementary Nutrition Supplementary feeding and growth monitoring Prophylaxis against vitamin A deficiency and control of nutritional anemia Growth Monitoring and nutrition surveillance children <3 years of age of age are weighed once a month children 3-6 years of age are weighed quarterly Supplementary feeding for 300 days in a year

33. 33 Supplementary Nutrition per Day Beneficiary Calorie Protein Children (6-72 months) 500 12-15 Severely malnourished children (6-72 months) 800 20-25 Pregnant & Lactating women 600 18-20

34. 34 Immunization Immunization of pregnant women and children Protects against tetanus and reduces maternal and neonatal mortality Protects children from seven vaccine preventable diseases Provided by the health department

35. 35 Health Check-Up For children <6 years, antenatal care, postnatal care of nursing mothers Consists of weight recording, immunisation, management of malnutrition, treatment of diarrhea, de-worming, simple medicines for common illnesses

36. 36 Referral Services Sick or malnourished children, in need of prompt medical attention, are referred to the Primary Health Centre or its sub-centre

37. 37 Non-formal Pre-School Education Anganwadi – a village courtyard Backbone of the ICDS For 3-6 year olds Providing a natural, joyful and stimulating environment

38. 38 Nutrition and Health Education Key element of the work of the anganwadi worker This forms part of BCC (Behaviour Change Communication) strategy

39. 39 Role of AWW To elicit community support Weigh & record each child every month Refer cases Organize pre-school activities Provide supplementary nutrition Provide health & nutrition education and counseling Make home visits Coordinate with other staff

40. 40 Role of AWH Cook & serve food Clean the Anganwadi premises Cleanliness of small children Bring small children to Anganwadi

41. 41 Norms for AWC For Rural/Urban Projects – 400 to 800 - 1 AWC – 800 to 1600 - 2 AWCs – 1600 to 2400 - 3 AWCs Thereafter in multiples of 800 per AWC For Mini-AWC 150 to 400 - 1 Mini AWC

42. 42 Challenges in ICDS Practically children 3-6 year Pregnant & Lactating not covered Irregular food supplies Quality of Nutrition supplement? Poor supervision Lack of community ownership/ participation Nutrition education only on papers Children come only for food

43. MID DAY MEAL PROGRAMME 43

44. 44 Mid Day Meal Programme - 1961 aka School Lunch Programme Objectives Improve school attendance Improve child nutrition Principles Supplement, not substitute to home diet 1/3 rd of energy and ½ of protein requirement/day low cost, easily prepared at schools locally available food, change menu frequently

45. MID-DAY MEAL SCHEME 45

46. 46 Mid-day meal scheme - 1995 aka National Programme of Nutritional Support to Primary Education Objectives: Universalization of primary education by increasing enrollment (class 1 to 5) and Improve nutritional status of children (class 1-5) 300 kcal and 8-12 g protein

47. G ood f o r i m p r o ving nutritio n of the underprivileged children But it requires sustainability Repeated incidence of food poisoning in the mid day meal causing serious threat 47 Challenges to Mid-day meal programmes