Dr. ibrahim Assignments Of Community Nutrition (1).pptx

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1. Assignments Of Community Nutrition ECOLOGY OF MALNUTRITION By Dr. Ibrahim Abdi Hassan Assigned By: Dr Ahmed Ali Muse Tiltle : HIU & DIU lecturer 20/05/2024 DAFFODIL INTERNATIONAL UNIVERSITY

2. ECOLOGY OF MALNUTRITION Introduction Definitions Grading of ecological factors Individual groups and underlying causes of malnutrition Analysis of malnutrition. Introduction Human nutrition is an ecological problem resulting from multiple overlapping and interacting factors in the community That is physical, biological, cultural environmental factors must be examined on their effect on malnutrition before elaborating an appropriate preventive nutrition programme Diagram showing the relationship between ecological factors

3. Definitions Malnutrition is a pathological state resulting from a relative and absolute deficiency or excess intake of one or more essential nutrients Ecology of malnutrition is the description of ecological factors and their relationship with malnutrition in a community Grading of ecological factors These factors are categorised into seven major groups as listed below. Conditioning infections Food consumption Cultural influences Educational services Medical services Socio economic factors Food production Conditioning infections

4. Continue.. include factors directly associated with malnutrition of a community. E.g. : diarrhoea, measles, whopping cough, malaria, tuberculosis and intestinal parasites infestation. They predispose malnutrition by : Increased loss of nutrients i.e. diarrhoea, worm infestation(round and tape worms) ,vomiting ,dysentery Increased requirement due to metabolic changes by both human and organism i.e. measles , fever ,diarrhoea Decreased intake due to poor apetite,illness like whooping cough, malaria Poor utilisation of ingested food nutrients during diarrhoea and vomiting and worm infestation. Food consumption It is important to have detailed knowledge on the actual food eaten in a community It helps to assess nutritional status and discover dietary factors that can be corrected.

5. It covers type and quantity of food consumed Frequency of consumption Breastfeeding and bottle feeding practices Weaning practices Balanced diet Timing of meals Protein and calorie intake of a child Family size determines how much is available Diagrammatic representation of ecology and nutrition of a child Cultural influences Culture normally defines what a community group consumes, why ,when and how it is prepared. Culture is people’s way of doing things or behaviour. It can be traditional or religious based. Religious culture

6. Religious culture Consumption of food as per what is described as good for eating or bad based on ones faith/beliefs e.g. Muslims do not consume pork as a food taboo Catholics do not eat red meat on Fridays during lent Hindus do not eat beef Seventh day Adventist do not eat white meat, grasshoppers and white ants. Traditional beliefs: This affects how food is perceived , preparation, what is eaten, by whom and why. This information is normally passed on from elders to generations below and is one distinct aspect of particular cultures co-exiting in the same population group. It plays a very important role in nutritional status of the people as nutrient availability in the body is dependant on attitude, preparation and what is eaten. Its subdivide into food attitudes, disease causation, child rearing, food production.

7. Food attitudes What is considered food as per culture Food given on basis of age group i.e. children ,and sex group i.e. women and during pregnancy and lactation. Celebrations i.e. turkey for thanks giving ,sweet beer from sorghum during engagements in Malawi Disease linked foods i.e. those restricted because they are believed to cause infections like eggs and fish for intestinal worms in Malaya. Cultural super foods which are the staples i.e. millet among acholi in Uganda ,sweet potatoes in basoga in uganda and rice in south east Asia. Modern prestige foods normally considered prestigious and used to define socio-economic status e.g. aerated bottle drinks, processed meat Cooking practices Meal patterns like times ,usual dishes ,family order of eating, special dishes for children, way of food consumption ie use of cutlery or fingers

8. Disease causation ie local concepts on cure and prevention using certain foods and herbs i.e. obwosi referring to kwashiokor has no connection to diet. The most affected are the indigenous uneducated Child rearing Breast feeding i.e. nipple preparation, duration and mothers diet during the process. Artificial feeding i.e. Type ,quantity ,dilution ,feeding method(cup, spoon, bottle) Supplementary foods i.e age introduced, type, quantity, method of feeding. Weaning i.e. age, abrupt or gradual, use of deterrent substances ,whether child was sent away or not. Food preparation for children ie special or part of family meals Responsible person for feeding i.e. Mother, grand mother, house help or older sibling

9. Educational services This will involve education of all members of the family Mothers educational level Parent teacher association Schooling of the children How many are in a particular class Nutrition education involvement in formal curriculum School meals School gardens Medical services It will focus on the following Number of hospitals and health centres. Distribution and facilities available in hospitals Number of admissions ,age when it happened Diagnosis and results of the treatment if given Health education Immunization status Height and weight monitoring Birth order Socio-economic factors

10. Social factor: Population of community i.e. number, age , sex distribution Family details i.e. size ,relationship ,spacing of children. education i.e. literacy of men and women, access to books and news papers, children attending school, classes Housing facilities i.e. type ,floor ,ventilation ,rooms ,number of housemates Family type i.e. joint, nuclear, polygynous,patrilineal Caste i.e. OC/ST/SC Kitchen facilities ,location, type of fuel, drainage Water supply i.e. source and distance from house, purity Water facilities in India Economic factors. Occupation e g farmer, seasonally employed Family income e.g. wages, cash crop Tangible wealth i.e. land, live stock, transport mode, electronic media Family expenditure on food ,clothe, rent , feul.education,recreations Food prices: when the food prices go high, then the availability of food decreases.

11. Diagram to illustrate relationship of economic status and nutrition of family members Food production. Food production is considered an availability of production to family If is dependent on preservation distribution marketing and economic In India per capita availability of cultivable land and food production per hectare is far that of developed countries There is deficiency in production of cereals, pulses, vegetables ,milk. It is said that their is a food gap in developing countries and not protein gap. Diagram to explain how soil health affects quality of agric produce. Assessment Data collection on all the above is done through nutritional survey ,questionnaires ,rapid ecological visits, case study surveys. There are a variety of organisations working tirelessly to eliminate the problem of malnutrition together with the governments but the problem is still alarming especially in developing countries. In India for example, UNICEF, Charity,NFHS,ICDS , NRHM and many more are currently existing and working to eliminate malnutrition. Analysis of past and present situation

12. Richard mahapatra , October, 6, 2004, pointed out the ecological poverty which he considered a silent killer in India. In his paper, he stated that over thousands of children under the age of six died in two months (July and September 20,2004) in districts of maharashtra,nandibar and Orissa, malkangiri , nabrangpur districts. In these districts which lie in the tribal belt, agriculture contributes less and forests remain a major source of food security and with limited access to them, arouse severe malnutrition. In the same it was noted where a mother had to sell a four month baby to earn a few rupees for food Continuation of analysis. The government however continued to deny the fact that all those children died of malnutrition making the situation worse. In India with a population of 1.2 billion has the largest number of children. according to a report released on 10/01/2012 by the prime minister Dr Manmohan Singh ,conducted by a group of non profit organisations, being the largest study since 2004, 42%of the children under five were found to be underweight and nearly60% were stunted . Cont’d

13. Of the stunted ,half were severely stunted and the other half stunted or under weight by the time they were two years. this was also attributed to infections from communicable diseases during early life hindering the absorption and utilisation of food nutrients for proper growth Since 2004, the number of underweight had decreased from 53% to 42% in the past seven years which is a positive change in child nutrition. This was more prominent in 100 focused districts especially Bihar , jharkhand,madhya Pradesh, Orissa ,Rajasthan and Uttar Pradesh states Cont’d Malnutrition was higher among children from low income families Children from muslim or SC/ST house holds generally had worse nutriton indicators Birth weight was also pointed out as an important risk factor for malnutrition with prevalence of 2.5kg and below born babies being 50% while those with 2.5kg above is 34kg. Maternal awareness about nutrition was found to be low where 92% mothers had no idea of malnutrition Maternal education was found to affect child nutritional status

14. In the study in India, it was found that during the monsoon, communicable diseases like cholera were prominent due the flooding that occurs during the process. Malaria is still a threat due the poor drainage system, there is alot of water logging which acts breeding sites for the disease causing mosquitoes. Malaria is a serious threat to the children and mothers especially expectant ones. Typhoid is also a serious problem since a big part of the population still has limited access to safe drinking water especially during summer where in some areas, water becomes very scarce. Some areas are dependant on heavily polluted water containing alot of lead from untreated waste Cont’d Diarrhoea is still common especially in slum areas where sanitation is still a big problem. it has caused severe loss of lives especially children below the age of six. This was attributed to still existing practice of open defecation which is done in open drainages and on dry land. it was estimated to be over 665 million people to still be practising such in India which is the major cause of these infections so when rains come, all these are run off with surface water into the rivers, dug wells and streams which supply water to the local people

15. In august/2012, a case of vibro-cholerae was reported in odisha states . Three deaths were reported and suspected to be due to vibrio- cholerae bacteria which is responsible for water-borne diseases. it is said to have the ability to combat antimicrobial drug effect which is essential in the cure. Some cases of the same were reported in kalahandi which suffered the most in 2008 of the same outbreak. Government however was slow on response to vaccination in rayagadas which witnessed a major out break in 2007. Out break of chikungunya fever in 2005 on the islands of Indian ocean and later spread to AP in February 2006 and Tamil nadu in April 2006,then Karnataka and Kerala in may of the same year. However the disease was first experienced in India in 1963-1964 in Karnataka and 1965 in Chennai Pneumonia plague in northern India was experienced in 2002 with 16 cases reported who lived in hamlet in Himalayas. One of the victims claimed to have gone hunting where he killed and skinned a sick cat in shimla district which is suspected to have caused the disease. Analysis cont’d According to census of India 1991,88.2% of the households had access to drinking water through tap

16. Unicefs ’ latest report Child mothers:the report stated that 22% of the women in india between the age of 20-24years gave birth to their first child before they turned 18. 45 among every thousands births are born to mothers in the 15-19 age bracket. 57% male adolescents(15-19yrs) and 53% female thought it is okay for husbands were justified to beat their wives under certain circumstances. 35% male and 19% female adolescent had comprehensive knowledge on HIV. conclusion Ecology plays an important role nutrition status of a community hence alot attention should be given to it Sanitation is the major determinant of communicable diseases and if not controlled, efforts to supply food will remain insignificant as malnutrition will remain significant at all life styles. Western culture were consumption of fast foods is considered prestigious is a major cause of obesity and CVD ,diabetes etc Nutrition education will lower the prevalence of malnutrition so should be included in formal curriculum. Child mothers should be avoided as it increases the risk of malnutrition among children and mothers some cultural values need to be revised

17. references www.charitywater.org/blog/category/countries/countries_india /?guind=c1717rif-LMcfu576woodf35AOQ Ganges river at varanasi2008.jpeg available at en.wikipedia.org/wiki/file:ganges-river-at-varanasi_2008.jpeg.,accessed on 23/11/2012. Kounteya Sinha,TNN , March, 1.2012, hthe time of india,State of the world childrens ’ report.WHO,UNICEF available at www.indiatimes.com/2012-03-01/india/31113013-1-child marriage- unicef -child-brides. accessed on22/11/2012