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Nutrition status

Arvind Patel
Retired Demonstration officer
FNB
Govt.Of India
9428352270

8/14/2018 1
Introduction
 In order to achieve an overall sustainable
development and improve global health the
United Nations adopted the Millennium
Development Goals (MDGs) at the Millennium
summit held in New York city, September, 2000.

 It comprises of 8 Goals, 18 Targets and 48


Indicators of progress to be achieved by the year
2015.

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The Millennium Development Goals:
Goal 1: Eradicate extreme poverty and hunger.
Goal 2: Achieve universal primary education.
Goal 3: Promote gender equality and empower women.
Goal 4: Reduce child mortality.
Goal 5: Improve maternal health.
Goal 6: Combat HIV/AIDS, Malaria and other diseases.
Goal 7: Ensure environmental sustainability.
Goal 8: Develop a global partnership for development.

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Major Health related Millennium
Development Goals:
 Goal 4: Reduce Child Mortality

 Goal 5: Improve Maternal Health

 Goal 6: Combat HIV/AIDS, Malaria and other diseases

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MDG Goal
1990-2015
NFHS III ‘10 ‘15
‘06

Target 2 Halve Prevalence of underweight 45% 35% 24%


Indicator 4 children under five years of age

Target 4 Two third reduction in Under 61/ 50 35


Indicator 13 five mortality 1000
child.
Target 4 Two third reduction in Infant 50/1000 30 23
Indicator 14 mortality LB
Target 6 Three quarter reduction in 172/100,0 <100
Indicator 16 Maternal mortality ratio 00 LB

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Maternal Mortality in Gujarat

500

400 389
Maternal Dealth

300
202 CRS
200 172 132
100 100
Target
0
1989 1999-01 2001-03 2010

SRS 1997-2003

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ANEMIA PREVALENCE RATE- GUJARAT
90
80.1
80 74.5
70
60.8
60 55.5
50 46.3 47.4

40

30

20

10

0
Children (6-35m) Ever married woman(15-45yrs) Pregnant women

NFHS II NFHS III


Vegetarianism, wheat cereal based diet and very low intake of
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green leafy vegetables 7
Malnutrition Map of Gujarat

Banaskantha

Patan
Mehsana Sabarkantha

Kutch Gandhinagar
Panchmahals
Ahmedabad
Kheda Dahod
Surendranagar
Anand
Jamnagar
Vadodara
Rajkot

Porbandar Bharuch Narmada


Bhavnagar
Amreli Surat
Junagadh
≥ 50 %
40-49 % Navsari
30-39% Dangs
20-29%
Valsad

8/14/2018 Source : National Family Health Survey-III 05-068


NUTRITION SERVICE NETWORK (HEALTH & FW)

State Nutrition cell

Tertiary Nutrition
Rehabilitation centers

Child Development and Nutrition


centers

District nutrition units

MAMTA Abhiyan
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MAMTA ABHIYAN
 Mamta divas
(Health and Nutrition day)
 Mamta Mulakat
(Postnatal care visit)
 Mamta sandarbh
(Referral service)
 Mamta Nondh
(Record & register)

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Steps Adopted for Malnutrition Management

 Monitoring for Malnutrition ( Children & Mothers ) through Mamta


day
 Growth monitoring of children 0-3 years on Mamta Divas
 Weighing of Antenatal mothers
 Convergence with ICDS
 Development of statewide nutrition support network:
 Programme Associate Nutrition for each district
 Child Development & Nutrition Centers – A Nirogi Bal Varsha initiative
 Piloted in 2 blocks each of 7 tribal districts
 Nutrition Counselling & Rehabilitation Centers – A Nirogi Bal Varsha
initiative
 Set up in paediatric departments of government medical college hospitals

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NIROGI BAL VARSH

Health

Adolescent Pregnancy

School New born

Pre
Infant
school

Rural/Tribal/Urban
development
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Interventions for Micronutrient Malnutrition by Health Department
In Gujarat State
Various Programmes

 Vitamin A Supplementation Programme

 Anaemia Control Programme

 Iodine Deficiency Disorder Control Programme

 National Nutrition Monitoring Bureau- Diet Survey

 Calcium Supplementation

 Fluorosis Control Programme

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Interventions for Micronutrient Malnutrition

Vitamin A supplementation Programme

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Interventions for Micronutrient Malnutrition

Vitamin A Supplementation Programme for Children

Dose & Beneficiaries

9 months to 1 year 1-5 year children


One mega Dose One mega Dose
Once Twice a year
12,90,900 Children 51,63,600 Children
( Equal to Measles target ) (Measles target X 4 )

To obtain the mortality-reducing effect of Vitamin A supplementation, at least 85%


of children of 1 to 5 Years need to receive Two doses of vitamin A per year , six
months apart.
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Interventions for Micronutrient Malnutrition

Iodized salt distribution to AN women and PN mothers

1.5 kg Iodized salt /month 1.5 kg Iodized salt /month


to to
Ante Natal Women Ante Natal Women

15,92,171 14,47,281
Total beneficiaries Total beneficiaries

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Interventions for Micronutrient Malnutrition

Calcium Supplementation

Antenatal women
 Supplementation of Calcium to meet out growing demand of fetus for
bone development and to replenish mother Calcium stores.
 Calcium tablet 500 mg per day for 3 months

 During 7th, 8th and 9th month of pregnancy

 2008-09 Expected beneficiaries: 15,92,171

Postnatal women
Calcium tablet 500 mg per day for 3 months

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Interventions for Micronutrient Malnutrition

Fluorosis Control Programme

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Interventions for Micronutrient Malnutrition

Fluorosis is a crippling disorder/condition


known to occur due to entry of fluoride to the body.

Fluoride ,when ingested beyond the limit of tolerance of the human body
may cause
three types of Fluorosis:
Dental Fluorosis ( Affecting Teeth )
Non Skeleton Fluorosis ( Affecting Soft Tissues )
Skeleton Fluorosis ( Affecting Bones )

Fluorosis is considered ,to be caused only by drinking fluoride contaminated water. It is now evident that Fluorosis is
also caused by consuming fluoride contaminated food,drugs ,using cosmetics and also by inhaling fluoride
contaminated dust and fumes from industry.
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Interventions for Micronutrient Malnutrition

Prevalence of Fluorosis • Fluorosis is Public


Health problem in 22
other countries around
the globe.
•In India out of 35 states
and Uts 20 are endemic
for Fluorosis.
• Gujarat is one of the
high endemic state for
Fluorosis, where out of
25 districts some parts
of 24 districts are
affected.
Endemic states : 20 Endemic Districts : 200
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Interventions for Micronutrient Malnutrition

Out of 24 Fluorosis affected districts in Gujarat:


• Amreli
• Mehsana
• Sabarkanthha
• Panchmahal
• Kachha
• Banaskanthha
are the districts with High Fluoride level in Drinking water.

Fluoride detected in drinking water in India 1.1 – 48.0 mg/L

Fluoride detected in drinking water in Gujarat 1.5 – 13.8 mg/L

Permissible limit in drinking water is 1.0 mg/L, less the better


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Interventions for Micronutrient Malnutrition

Activities under Fluorosis Control Programme

• Sensitization Workshop : 6 Sensitization workshop at Medical Colleges


organized
• Development of Diagnostic Facility:
• Ion meter were supplied to Biochemistry depts. of all Govt.Med.College
Hospitals
• Mapping of Fluorosis affected Villages
• Training
• Asstt.Prof. Biochem. Department from all Med.College were trained .
• Training of Lab.Tech.at Biochem.dept. of Medical College
• IEC
• Supplementation of Calcium & Vitamin C along with diet Counseling

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Status: Child Development & Nutrition Centres ( CDNC)

 establishment of 14 CDNC 7 Tribal districts (1 each in 2


identified Blocks) on pilot basis
 Guidelines for Functioning of CDNC is available with
concerned districts
 Nutrition Assistant placed with respective CDNC

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Thank You..

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