Community Nutritional Programmes in India

3rd Prof. BAMS, Swasthavritta, syllabus topic

1. COMMUNITY NUTRITIONAL PROGRAMMES Dr. Jasminkumar Viramgami Reader & H.O.D., Dept. of Swasthavritta , Govt. Akhandanand Ayurved College, Ahmedabad , Gujarat

2. Introduction India is the 2 nd most populated country in the World next to China. majority of the people belongs to rural community from low socio economic status , illiteracy and lack of basic human needs . From the nutritional point of view majority are undernourished. The high income groups are suffering from the diseases of over nourishment . Dr. J M Viramgami, Reader Swasthavritta, GAAC

3. Nutritional deficiency Nutritional deficiency is any deficiency of the nutrients that are required to sustain human life. Nutritional deficiencies occur when a person's nutrient intake consistently falls below the recommended requirement. Children between 10-19 years of age face serious nutritional deficiency worldwide according to WHO. Dr. J M Viramgami, Reader Swasthavritta, GAAC

4. Major nutritional problems in India Protein Energy Malnutrition (PEM) Nutritional Anaemia Iodine Deficiency Disorder (IDD) Vitamin-A deficiency Low birth weight (LBW) Endemic Fluorosis Lathyrism Cardio Vascular Diseases (CVD) Cancer etc. Dr. J M Viramgami, Reader Swasthavritta, GAAC

5. Causes For Nutritional Deficiency Low socio economic status Illiteracy Over population Lack of health care facilities Large families Infections Cultural influences, Superstitious beliefs, misconceptions, Dietary practices etc. Dr. J M Viramgami, Reader Swasthavritta, GAAC

6. …..Causes For Nutritional Deficiency Lack of awareness regarding nutrients and their requirement Decreased food production Limited availability/ inadequacy of food products Over nourishment among the high socio economic status Dr. J M Viramgami, Reader Swasthavritta, GAAC

7. Major Nutritional Programmes In India The govt of India has launched many nationwide health programs to improve and restore the health status of the vulnerable population … …such as infants, preschoolers, school children, antenatal and postnatal mothers etc. Currently major nutrition supplementation programmes in India are: Dr. J M Viramgami, Reader Swasthavritta, GAAC

8. N utritional programmes in india Ministry of Rural Development Applied nutrition programme Ministry of Social Welfare Integrated child development services scheme (ICDS) Balwadi nutrition programme (BNP) Special nutrition programme (SNP) 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 Dr. J M Viramgami, Reader Swasthavritta, GAAC

9. Integrated Child Development Services Scheme (ICDS) Mid-day meal Programs (MDM) Special Nutrition Programs (SNP ) Wheat Based Nutrition Programs (WNP) Applied Nutrition Programs (ANP) Balwadi Nutrition Programs (BNP) National Nutritional Anaemia Prophylaxis Program (NNAPP) National Program for Prevention of Blindness due to Vitamin A Deficiency National Goitre Control Program (NGCP) Antyodaya Anna Yojana Other Programmes Dr. J M Viramgami, Reader Swasthavritta, GAAC

10. Dr. J M Viramgami, Reader Swasthavritta, GAAC

11. Integrated Child Development Service launched on 2nd October, 1975 (5th Five year Plan) in pursuance of the National Policy for Children Dept of Women and Child Development, Ministry of Human Resources Development strong nutrition component in the form of supplementary nutrition, Vit -A prophylaxis and iron and folic acid distribution Dr. J M Viramgami, Reader Swasthavritta, GAAC

12. Beneficiaries- preschool children below 6 yrs, adolescent girls 11-18 yrs, pregnant and lactating mothers Women in the age group of 15-44 years Dr. J M Viramgami, Reader Swasthavritta, GAAC

13. Objectives Improve the nutrition and health status of children in the age group of 0-6 years Lay the foundation for proper psychological physical and social development of the child Effective coordination and implementation of policy among the various departments Enhance the capability of the mother to look after the normal health and nutrition needs through proper nutrition and health education. Dr. J M Viramgami, Reader Swasthavritta, GAAC

14. The Package of services provided by ICDS are: Supplementary nutrition, Vit -A, Iron and Folic Acid Immunization Health check-ups Referral services Treatment of minor illnesses Nutrition and health education to women Pre-school education of children in the age group of 3-6 years, and Convergence of other supportive services like water supply, sanitation, etc. Dr. J M Viramgami, Reader Swasthavritta, GAAC

15. Implemented and supervised by: Anganwadi workers at village level Mahila mandal networks in ICDS to help anganwadi workers Work of anganwadis is supervised by mukhya sevika Field supervision by C hild D evelopment P roject Officer(CDPO) Dr. J M Viramgami, Reader Swasthavritta, GAAC

16. Vitamin A Prophylaxis Programme National Program for Prevention of Blindness due to Vitamin A Deficiency Dr. J M Viramgami, Reader Swasthavritta, GAAC

17. Component of national programme for control of blindness National Blindness Control Programme started in 1976 as 100 percent centrally sponsored programme. Ministry of Health and Family Welfare implemented through PHCs and SCs . Services to all pre school children in the community every 6 months through peripheral health workers Dr. J M Viramgami, Reader Swasthavritta, GAAC

18. administering Vitamin ‘A’ concentrates to children less than 5 years every six months. A child must receive a total of 9 oral doses of Vitamin ‘A’ by his 5 th birthday . Priority should be given to children in-between 6 months and 3 years since they have the highest prevalence of clinical sign of Vitamin ‘A’ deficiency. 2,00,000 IU Orally Dr. J M Viramgami, Reader Swasthavritta, GAAC

19. Beneficiaries Children below 5 years of age. Objectives Prevention of blindness due to Vitamin ‘A’ deficiency. Supplementation of Vitamin ‘A’ to all the children below 5 years of age. Providing comprehensive eye care services at primary, secondary and tertiary health care level Achieving substantial reduction in the prevalence of eye disease in general and blindness in particular. Dr. J M Viramgami, Reader Swasthavritta, GAAC

20. Dr. J M Viramgami, Reader Swasthavritta, GAAC

21. Prophylaxis against nutritional anaemia Launched during 4 TH five year plan in 1970 to prevent nutritional anaemia in mothers and children. taken up by MCH, Division of M of H and FW. Now it is part of RCH programme . Distribution of iron and folic acid tablets Control of anaemia through iron fortification of common salt has also been developed. Implemented by MCH Centres in urban areas, PHC’s in rural areas and ICDS projects Dr. J M Viramgami, Reader Swasthavritta, GAAC

22. Beneficiaries Children in the age group of 1 -5 years Pregnant and nursing mothers. Female acceptors of lUDs and terminal methods of family planning. Dr. J M Viramgami, Reader Swasthavritta, GAAC

23. Under this programme, the expected and nursing mothers as well as acceptors of family planning are given one tablet of iron - folic acid containing 100 mg elementary iron, 0.5 mg of folic acid) Children of 1-5 years given one tab of iron containing 20 mg elementary iron (60 mg of ferrous sulphate and 0.1 mg of folic acid) daily for a period of 100 days. For children (6-60 months), ferrous sulphate and folic acid should be provided in a liquid formulation Dr. J M Viramgami, Reader Swasthavritta, GAAC

24. National Iodine deficiency disorder control programme (NIDDCP) Dr. J M Viramgami, Reader Swasthavritta, GAAC

25. formerly known as National Goitre Control Programme (NGCP) since 1962 renamed by Govt. of India in 1992 as NIDDCP . 100% centrally assisted programme with a focus on the provision of iodized salt, IDD survey, laboratory monitoring of iodized salt, health education and publicity. Conventional goitre belt in H imalayan region Dr. J M Viramgami, Reader Swasthavritta, GAAC

26. Objectives Surveillance of Goitre cases identification of goitre endemic areas Supply of iodized salt in place of common salt. Monitoring through analysis of salt and urine samples. Assessment of impact of control measures over a period of time. Dr. J M Viramgami, Reader Swasthavritta, GAAC

27. Special Nutrition Programme (SNP) 1970 For benefit of children below 6 yrs, pregnant mothers Operated in urban slums, tribal areas and backward rural areas Supplementary food supplies 300 kcal and 10-12 gms of protein/child/day Mothers receive daily 500 kcal and 25 gms of protein Supplement given for 300 days in a year Objective- improve nutritional status of target areas Dr. J M Viramgami, Reader Swasthavritta, GAAC

28. Balwadi nutrition programme Dr. J M Viramgami, Reader Swasthavritta, GAAC

29. Introduced in 1970 under the control of the Department of Social Welfare . The program is implemented through Balwadi Phased out in favour of the Integrated Child Development Services (ICDS) to provide nutritional support to children . they provide education and nutritional support . Supplement food provides 300 kcal and 10 gm protein/child/day Dr. J M Viramgami, Reader Swasthavritta, GAAC

30. Objectives Supply one-third of the calorie and half of the protein requirements of pre-school children between the age of 3-5 years Improve the nutritional status . Beneficiaries Children of 3-6 years of age in rural areas Dr. J M Viramgami, Reader Swasthavritta, GAAC

31. Mid-day Meal Programme Dr. J M Viramgami, Reader Swasthavritta, GAAC

32. started in the 1960s. It involves provision of lunch free of cost to school children on all working days . Minimum feeding days – 250 The Scheme covers students (Class l-V) in the Government Primary Schools / Primary Schools aided by Govt, and the Primary Schools run by local bodies. Dr. J M Viramgami, Reader Swasthavritta, GAAC

33. Objectives Protecting children from classroom hunger , Increasing school enrolment and attendance , Strengthening child nutrition and literacy Improved socialisation among children belonging to all castes. Addressing malnutrition, and Social empowerment . Beneficiaries Children attending the primary school . Children belonging to backward classes, SC, and ST families are given priority . Dr. J M Viramgami, Reader Swasthavritta, GAAC

34. Food grains (wheat and rice) are supplied free of cost @ 100 gm /child /school day cooked/processed hot meal is served with a min content of 300 calories and 8-12 gm of protein each day of school for a minimum of 200 days and where food grains are distributed in raw form- 3 kg per student per month for 9-11 months in a year, In drought affected areas the mid day meal is distributed in summer vacations also. Dr. J M Viramgami, Reader Swasthavritta, GAAC

35. Principles- Meal should be a supplement and not a substitute to home diet Meal should supply at least 1/3 rd of total energy requirement and half of protein need . Cost of meal should be reasonably low . Prepared easily in schools; no complicated cooking process should be involved . As far as possible, locally available food should be used. Menu should be frequently changed to avoid monotony. Dr. J M Viramgami, Reader Swasthavritta, GAAC

36. Menu- Foodstuffs gm/day/child Cereals and millets 75 Pulses 30 Oils and fats 8 Leafy vegetables 30 Non leafy vegetables 30 Dr. J M Viramgami, Reader Swasthavritta, GAAC

37. Dr. J M Viramgami, Reader Swasthavritta, GAAC

38. Mid-day meal scheme Also known as national programme of nutritional support to primary education Launched as centrally sponsored scheme on 15 th august 1995 and revised in 2004 Cooked meal with minimum 300 calories and 8-12 gms of protein will be provided Objective- universalization of primary education by enrolment, retention and attendance and simultaneously impacting on nutrition of students in primary classes Dr. J M Viramgami, Reader Swasthavritta, GAAC

39. Special Nutrition Program (SNP) launched in the country in 1970-71 to improve the nutritional status of specific target group provides supplementary feeding of about 300 calories and 10 grams of protein to preschool children and about 500 calories and 25 grams of protein to expected and nursing mothers for six days a week . Now integrated with the ICDS (Integrated Child Development Services) Dr. J M Viramgami, Reader Swasthavritta, GAAC

40. Objectives Improve the nutritional status of specific target groups. Provides supplementary nutrition and health care services. Supplementary nutrition for 300 days every year. Supply of Vitamin ‘A’ solution, iron and folic acid tablets . Beneficiaries Children under 6 years and Pregnant and Lactating mothers. operated in the urban slums, tribal areas, backward rural areas. Dr. J M Viramgami, Reader Swasthavritta, GAAC

41. Antyodaya Anna Yojana launched in December, 2000 for 1 crore poorest of the poor families amongst the BPL families providing them food grains at a highly subsidized rate of Rs.2/kg for wheat and Rs. 3/kg for rice . 35 kg /family /month with effect from 1 st April, 2002. Dr. J M Viramgami, Reader Swasthavritta, GAAC

42. Other Programmes Other programmes include: Dr. J M Viramgami, Reader Swasthavritta, GAAC

43. Emergency feeding programme introduced in May, 2001 in selected states (Orissa) a food based intervention targeted for old, infirm and destitute persons belonging to BPL households to provide them food security in their distress conditions . Cooked food containing , rice- 200gms, Dal (pulse)- 40 gms , vegetables- 30 gms is provided in the diet of each EFP beneficiary daily by the Government. Dr. J M Viramgami, Reader Swasthavritta, GAAC

44. Village grain banks scheme implemented by the Ministry of Tribal Affairs to provide safeguard against starvation during the period of natural calamity or during lean season when the marginalized food insecure households do not have sufficient resources to purchase rations. Dr. J M Viramgami, Reader Swasthavritta, GAAC

45. National food for work programme to provide supplementary wage employment and food security Implemented in tribal belts . The scheme will provide 100 days of employment at minimum wages for at least one able bodied person from each household in the country . Dr. J M Viramgami, Reader Swasthavritta, GAAC

46. Pulse mission ( India’s Food Security Mission ) aimed at increasing pulse production. Aimed to improve pulse production by 2 million tones by 2011-12 Dr. J M Viramgami, Reader Swasthavritta, GAAC

47. National water supply and sanitation programme Launched in 1954 Provide safe water supply and adequate drainage facilities for the entire urban and rural population of the country . Dr. J M Viramgami, Reader Swasthavritta, GAAC

48. Minimum needs programme: Launched on 1974 To provide basic minimum needs and thereby improve the living standards of people It Includes Rural Health Rural water Supply Rural electrification Elementary education Adult education Nutrition Environmental improvement of urban slums House for landless labourers. Dr. J M Viramgami, Reader Swasthavritta, GAAC

49. 20 Point programme 1975 : Objectives : Eradication of poverty, raising productivity, reducing inequality, improving quality of life. National Children's Fund 1979 This Fund Provides support to the voluntary organizations that help the welfare of children . National Plan of Action for Children 1990 United Nations Children's Fund National Rural Health Mission Dr. J M Viramgami, Reader Swasthavritta, GAAC

50. Indirect programmes National Cancer Control Programme National Diabetes Control Programme Poverty alleviation Programmes Environmental Sanitation Programmes Protected water supply programme Literacy programme Dr. J M Viramgami, Reader Swasthavritta, GAAC

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