Nutritional Assessment and AnalysisDay: 3 Time: 90 mins

Objectives: • NGO partners understand the concept of various degree of malnutrition.

• NGO partners are able to recognize the micro nutrient deficiencies among children.

• NGO partners are proactive to reduce malnutrition among children

A family (or country) may be food secure, yet have many individuals who are nutritionally insecure.

Food security is therefore often a necessary but not sufficient condition for nutrition security.

FOOD SECURITY AND NUTRITION SECURITY

NUTRITION SECURITY

• Nutrition security is an outcome of • –good health, • –a healthy environment, • –and good caring practices in addition to

household-level food security

For example, a mother may have reliable access to the components of a healthy diet, but because of poor health or improper care, ignorance, gender, or personal preferences, she may not be able to or may choose not to use the food in a nutritionally sound manner, thereby becoming nutritionally insecure

FOOD SECURITY AND NUTRITION SECURITY

•It arises from either excessive deficiency of food or•Excessive consumption of food leading to overweight and impaired physiological functions or•Consumption of the wrong type of food in wrong proportions

MALNUTRITION

UNDERNUTRITION

•It arises primarily because of inadequate food intake

•The total quantity of food intake is less than the required quantity

•As a result, there is primarily energy deficiency followed by protein deficiency and other micronutrient deficiencies

Measurement of Malnutrition

Detection of Bilateral Oedema

•Apply moderate thumb pressure bilaterally to lower extremities (just above the ankle or on the tops of the feet) and count to 3 seconds.

•If a pit remains after the thumbs are removed, the person has oedema

Bilateral Oedema

•Independent indicator of severe malnutrition

•Only individuals with bilateral lower limb oedema are classified as having nutritional oedema

Nutrition (Anthropometric) Surveys•help to quantify the severity of the nutritional situation at one point in time–which is essential to help plan and initiate an appropriate response.

•The prevalence of malnutrition in the 6-59 month age group is used as an indicator for nutritional status of the entire population:–this sub-group is more sensitive to nutritional stress–interventions are usually targeted to this group

Objectives of Anthropometric Assessment•Measure degrees of acute and chronic malnutrition among individuals

•Identify individuals at risk of death

•Select individuals to be enrolled in a feeding programme.

•Follow-up individuals enrolled in a feeding programme.

•Monitor individuals’ growth

•Assess the prevalence of malnutrition in a population

Measuring Nutrition (Anthropometric Measurements)

•weight•height (or length)•mid-upper arm circumference (MUAC)•bilateral oedema •Age and sex should be recorded to allow interpretation of indices

Measuring Weight•Most sensitive indicator for changes in nutrition

•Children:SalterScale,25kg hanging scale graduated by100g

•Child weighed with minimum clothing

•Read the scale at eye level

•Infants: Infant weighing scale with10g precision

•Adults: Mechanical Beam scale or bathroom scale

Measuring Length/Height Length for children < 85 cmHeight for children >85 cm

Body Mass Index (BMI)•Body Mass Index = Weight (in kg) Height squared (in m)

•assess nutritional status of adolescents & adults

•used in both emergency and stable contexts

EXERCISE

Severe wasting

MARASMUS

Old man’s face

Thin, flaccid skin hanging in folds

Hair -thinner and lighter

Moon face

No appetite

Oedema (symmetrical oedema involving at least the feet)

Skin lesions

KWASHIORKOR

GROUP WORK

Key Learning:

• Able to identify Protein Calorie Malnutrition, Micro Nutrient deficiency,

• How to conduct growth monitoring for Under 5 Years (tools are weighing scales and growth card).

• Role of NGO and PVO in analyzing SAM and MAM