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

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

Programme Ministry Vitamin A Prophylaxis Programme Prophylaxis Against Nutritional anaemia IDD Control Programme Health and family welfare Special Nutritional Programme Balwadi Nutritional Programme Social welfare ICDS Scheme Women and child development Mid Day Meal Programme Mid Day Meal Scheme Human Resource Development

VITAMIN-A PROPHYLAXIS PROGRAMME

Initiated in 1970 Beneficiary: age group 6mo - 5 year Objective: Prevent blindness due to VAD Implemented by: PHCand subcenter Asingle massive dose of Vitamin-A2 lac IU (retinol palmitate 110mg) orally every 6 months above 1 year

Prevent respiratory infection Maintain GITepithelium integrity Immunity Prevent Nutritional blindness

PROPHYLAXIS AGAINST NUTRITIONAL ANAEMIA

Initiated in 1970 Centrally sponsored Over 50%pregnant woman suffer from anemia Causes LBWand perinatal mortality, maternal death Objectives: Assess prevalence, Give treatment, Give prophylaxis, Monitoring, Education

Implemented by: PHC and subcenters 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

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

IODINE DEFICIENCY DISORDER CONTROL PROGRAMME

National goiter control programme in1962 IDD Control Programme Replace the entire edible salt by iodidesalt Fortification of salt with iodine

SPECIAL NUTRITIONAL PROGRAMME

Started in 1970 in urban slums, tribal areas and backward rural areas Main aim is to improve nutritional statusin children <6 years pregnant and lactating women Gradual y being merged into ICDS

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

Later converted into ICDS Major components Nutritional Services Health services Communication Monitoring and evaluation Later converted into ICDS

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

INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS) SCHEME

India’s response to the chal engeof Launched on 2nd October1975 One of the world’s largest and most unique programmes for early childhooddevelopment India’s response to the chal engeof Providing pre-school education on one hand and Breaking the vicious cycle of malnutrition, morbidity, reduced learning capacity and mortality, on theother Foremost symbol of India’s commitment to her children

Routine MCHservices not reaching target Population Nutritional component not covered by Health services Need for communityparticipation

Improve. the. nutritional. and. health. status Improve the nutritional and health status of children in the age-group 0-6years Foundation for proper psychological, physical and social development of the child Reduce the incidence of mortality, morbidity, malnutrition and school dropout Co-ordination of departments to promote child development Nutrition and health education to the mother

Pregnant women Nursing Mothers Children less than 3 years Children between 3-6 years Adolescent girls( 11-18 years)

District Programme Officer (DPO) Child Development Project Officer (CDPO) Supervisor (Mukhyasevika) Anganwadi Workers (AWW) Anganwadi Helpers (AWH)

Package of services: Supplementary nutrition Immunization Health check-up Referral services Pre-school non-formal education Nutrition & healtheducation

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

COMPONENTS OF ICDS 31

Supplementary feeding and growth monitoring Prophylaxis against vitamin Adeficiency 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 ayear 32

Severely malnourished children (6-72 months) 800 20-25 Beneficiary Calorie Protein Children (6-72 months) 500 12-15 Severely malnourished children (6-72 months) 800 20-25 Pregnant & Lactatingwomen 600 18-20 33

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

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 il nesses 35

Sick or malnourished children, in need of prompt medical attention, are referred tothe Primary Health Centre or its sub-centre 36

Anganwadi – a village courtyard Backbone of the ICDS For 3-6 year olds Providing a natural, joyful and stimulating environment 37

Key element of the work of the anganwadi worker This forms part of BCC (Behaviour Change Communication) strategy 38

Toelicit communitysupport Weigh & record eachchild every month Refer cases Organize pre-school activities Provide supplementary nutrition Provide health & nutrition education and counseling Make home visits Coordinate with other staff 39

Clean the Anganwadi premises Cleanliness of smal children Cook & serve food Clean the Anganwadi premises Cleanliness of smal children Bring smal children to Anganwadi 40

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

Practical y 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 42

MID DAY MEAL PROGRAMME 43

School Lunch Programme Objectives Improve school attendance Improve child nutrition Principles Supplement, not substitute to homediet 1/3rd of energy and ½ of protein requirement/day low cost, easily prepared at schools locally available food, change menu frequently 44

MID-DAY MEAL SCHEME 45

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 (class1-5) 300 kcal and 8-12 g protein 46

 Good for improving nutrition of the underprivileged children But it requiressustainability Repeated incidence of food poisoning in the mid day meal causing seriousthreat 47

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