PRESENTED BYDR N C DE

DR S K MISHRA

PICTURE OF MALNUTRITION

0

10

20

30

40

50

60

70

80

NFHS-2(98-99)NFHS-3(05-06)

Wasted Stunted Under weight Anemia

51 45

20 23

43 40

74 79

Comparison of under-nourished Children Under 3 years of age

10 Million under 5 die in the world,

2.2 million in India

More than 50% of them contributed by Mal nutrition

PREVALENCE OF MALNUTRITIONState IMR Under nutrition

India 57 43

W. B 48 39

Orissa 65 41

Kerala 15 23

Not by Food alone

FOOD/ENERGY HEALH CARELOVE & CARE

The pot remains empty.

Recurrent infections drain Nutrition.

Nutrition

Malnourished Child

Low Birth Weight <2.5 Kg Adolescent

Malnourished adult woman

Early MarriageEarly Marriage

Improper Feeding & Infection

Nutrition intervention

What goes wrong…What goes wrong…

•Non Exclusive Breastfeeding

•Improper complementary food

•Poor hygiene, sanitation and immunization

•Too-many too soon

•Inadequate care & Support by family/community

I. Pregnancy

II. Birth – 2 Yrs.

III. Adolescents

Growth Spurt / Empowerment

Birth

Care in PregnancyCare in PregnancyHealth and Nutrition – (Antenatal Care)Safe Delivery Post Natal CareGood Referral System ( Emergency Obstetric

service & care of sick new born)

Care of the Infant.Care of the Infant.Care of the New Born at Birth.Exclusive Breast-feedingAppropriate complementary feeding with Continued breast-feeding.( IYCF)

Immunization Growth Monitoring Referral

Adolescent CareAdolescent CareHealth, Nutrition & EducationFamily life education.Capacity Building (Self Esteem)

Prepare for useful member of the family and the society

Who will do & How ?Who will do & How ?Existing Government Departments/Systems –

ICDS (AWW), NRHM (ANM, ASHA )NGOsCBO/PRI (VHC)Community Participation and ownership-

accountability/sharing responsibility.

Who & How (contd.)

Early detection & referral.Prompt and effective quality service.Follow-up and prevention of relapse.Treatment of Severe Acute Malnutrition

(SAM) with complications at Hospital /NRC.Community/Home based management for

those without complications.

Training NeedTraining NeedUp-gradation of Knowledge , Skill &

MotivationBehavior Change Communication (BCC)Practical Hands on TrainingStress on IMNCI.

SIMPLE INEXPENSIVE NUTRITION INPUTS

Exclusive Breastfeeding-Six monthsHome-made complementary Food along with

continued Breastfeeding.Hygiene&Sanitation, Immunization and

removing superstitions of all kinds.Growth Monitoring and Promotion.Early Childhood Stimulations, love and Care.

Positive Deviance Approach.Positive Deviance Approach.

Some children grow better in spite of same adverse socio-economical environment as that of their counterpart due to improved feeding and caring practices. The process is called Positive Deviance Approach.

It encourages community participation, learning by doing, self reliance and sustainability.

Challenges to be met.Challenges to be met.• Community empowerment, sharing responsibility

and accountability for development of a true Child and Woman Friendly Community (CWFC).

• Provision of quality health services and delivery of integrated nutrition package (true convergence).

• Development of communication skill at every level for bringing in behavior change.

Concluding paragraph.Concluding paragraph.

“Ultimately, there is nothing as important as informed public discussion

and the participation of the people in pressing for changes that can protect our lives and liberties. The public has to see itself not merely as a patient, but also as

an agent of change. The penalty of inaction and apathy can be illness & death.”--Concluding remark by

Amartya Sen in “Health in Development” Keynote address to fifty Second World Health Assembly, Geneva, May 1999 {Bulletin of the WHO, 1999(77)}

Accountability Accountability and sharing responsibility.and sharing responsibility.

Thank youThank you