Maternal malnutrition

brief information about maternal malnutrition and its intervention to deal with this problem

1. Dept. of Public Health,
Gurugram University,
Gurugram
NUTRITION ASSIGNMENT
Submitted by :-
Mahesh Drall
Roll no. 20100160010
MPH 2nd Semester
Submitted to:-
Dr. Vandana Mohan

2. Maternal
malnutrition
•The term "maternal nutrition" focuses attention on women as
mothers, on their nutritional status as it relates to the bearing &
nurturing of children. At the same time, women also play vital,
if often unacknowledged role in their families, communities &
societies.
•Lack of sufficientfood or the deficiencyof a specificnutrient,
such as iron,folic acid, etc. isclearly implicated
incontemporarymaternal malnutrition. Often,a heavy work-
loadmade yet more difficult by limited access tobasic
resources(e.g.water & fuel), pushes a women withmarginally
adequate food intakeinto a state of undernutrition.
•When a womenbeginslife as anundernourished infant, with
illness & poornutrition during childhood, she arrivesat
maturity in a lessthan optionalstate to undertake pregnancy &
lactation. Astheconditionsthatproducemalnutrition
continueto affecther, bothshe & her offspring, as well as
thelarger community, are further disadvantaged through a
viciousintergenerational cycle ofpoverty & undernutrition.

4. PROBLEMS
•The needs during pregnancy for such nutrients as calcium, vit. A, thiamine, niacin, riboflavin,
ascorbic acid, vit. D, vit. B12, folate, iron, protein & energy have been assessed by various
FAD/WHO experts groups. The requirement for energy & protein are in the process of being
re-examined.
•The primarymaternalnutritional deficiencies foundinpopulationcan be summarized as :
a.Energy deficiency-primarily occasioned by poor availability of food but also conditioned
by anorexia & stress of infections plus the high requirements of physical labour.
b.Iron deficiency anaemia-coupled with folate deficiency in some areas. Again the main
cause is too low an intake of foods containing iron/folate, exacerbated by the increased
needs of pregnancy. In hostile environments there is the added burden of reduced
absorption, defective haemopoesis&increased blood loss
c.Vit. A deficiency-occasioned by low intake. As carotene is the main source for third
world mothers, vegetables consumption habits & seasonal availability are crucial. The
most striking adverse effects are usually seen in the offspring of deficient mothers after
the infants are weaned.
d.Iodine deficiency–leading to endemic goitreoccurs in areas where the iodine content of
the soil, water & plants is low, especially in the presence of goitrogens & where foods
from outside the area are not consumed. Adverse effects on the mental performance of
the offspring is a main concern.
e.Deficiency of other micro-nutrients, such as thiamine, niacin and zinc may still occur in
certain geographic areas.

5. INTERVENTIONS
A.Long term interventions
•Legislative action–with legislation it is important to recognize two aspects; the
development of legislation per se & the infrastructure to enforce these laws.
E.g.
a)Equal rights and opportunities
b)Marriage & family laws
c)Child labourlaws
d)Conditions of work & employment for women
e)Family planning
f)Social toxicants.
•Education–women who receive even a minimal basic education are generally
more aware than those who are illiterate of the need to utilize available
resources for the improvement of the health of themselves and their families.
Young girls to be enrolled into compulsory primary school education.
•Food availability–national agricultural policy should ensure a sufficiency of
food production & an efficient system of storage & distribution. Inflationary
trends tend to erode the purchasing power of the poorer families. Measures are
therefore especially necessary to ensure that the poorer families are able to
obtain their basic food requirements.

6. Long term
intervention
continued...
•Appropriate technology to reduce material work-load-poor access to
water, fuel & other basic household necessities encroach on the
mothers energy, time & health. Employment of traditional & modern
appropriate technology should be implemented to reduce
women'senergy expenditure & release time for self-improvement,
child case & community participation.
•Health services-implementationof
internationallyadvocatedapproaches to ensure the accessibility of
healthcare throughthe primaryhealth care approachwill have
amajorimpact on the nutrition & healthstatus of the mother. The
nutritionaleducation & prima trainingof the traditionalbirth
attendant& primaryhealth-care workers. Provision of environmental
sanitation to reduce someof the endemicdiseases. Access to
MCHservices to ensurea longinterbirth interval.

7. B. Short term
intervention
•Adequacy of the energy supply-to date, food supplementation for pregnant &
lactating women, outside of experimental settings has not achieved the objectives
of increasing infant birth weight & lactation performance. Short term efforts should
be made to increase their intake by the following means:-
a)Encouraging redistribution of available food within the family. The feasibility of
such efforts will vary from culture to culture & depends greatly on the
effectiveness of the health or other social workers in the community's setting as
will overcoming negative attitudes & practices that lead to food restriction.
b)Making it a prime national & local policy objective to ensure that the poorest in
any community have the ability to obtain an adequate entitlement of foods.
c)Introducing appropriate technology to reduce the mother's workload &
investigating whether this might be more feasible than increasing her intake.
•Anaemia-nutrition education should emphasize the maximum utilization of
food that prevent anaemia& primary health care services should provide simple
protection or treatment of other causes of anaemiasuch as hookworm.
Provision of iron & folate preparations is effective in preventive & treating the
deficiencies but requires an efficient, well utilized service & long treatment
periods.

8. Short term
intervention
continued...
•Vitamin A deficiency-vitamin A levels in breast milk can be improved by
the postpartum administration of a single massive oral dose of vitamin A
that can be given by the traditional birth attendant. Where goitre&
cretinism are prevalent, every effort must be made to introduce the
iodization of salt. In areas where it is feasible, encouraging the growth of
leafy vegetables in kitchen & community gardens will provide a source of
carotene-rich foods.
•Other vitamins & mineral deficiencies-in certaingeographicareas beri-
beri, rickets, osteomalacia, or otherdeficienciesstill afflictwomen. While
an improved& varied dietwill remove these hazardsin shortterm. Where
food fortificationis impractical, it may be necessaryto resort to the
provisionof supplements through the health service,
particularlyduringpregnancyand lactation.

9. THANK YOU