Community nutrition programme IN COMMUNITY HEALTH NURSING

1. Presesnted by:
Harsh Rastogi,
M.Sc. Nursing 1st year,
King George’s Medical University,
Institute of Nursing,
Lucknow.
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3.  Large scale supplementary nutrition programmes.
 Main aim is to improve nutritional status in targeted
groups.
 And overcome specific diseases to combat
malnutrition.

4.  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
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Programme Ministry
Vitamin AProphylaxis Programme
ProphylaxisAgainst Nutritional anaemia
IDDControl Programme
Health and family welfare
SpecialNutritional Programme
Balwadi Nutritional Programme
Social welfare
ICDSScheme
Women and child
development
Mid DayMeal Programme
Mid DayMeal Scheme
HumanResource
Development

6. VITAMIN-APROPHYLAXIS
PROGRAMME
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• Initiated in 1970
• Beneficiary: agegroup 6mo - 5year
• Objective: Prevent blindness due to VAD
• Implemented by: PHCandsubcenter
• Asingle massivedose of Vitamin-A2 lac IU
(retinol palmitate 110mg) orally every 6
months above 1 year

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• Prevent respiratory infection
• Maintain GITepithelium
integrity
• Immunity
• Prevent Nutritional blindness

9. PROPHYLAXIS AGAINST
NUTRITIONAL ANAEMIA
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• Initiated in 1970
• Centrally sponsored
• Over 50%pregnant woman suffer from anemia
• CausesLBWand perinatal mortality, maternal
death
• Objectives:Assessprevalence, Givetreatment,
Giveprophylaxis, Monitoring, Education

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• Beneficiaries:
– Children aged1 to 5years
– Pregnant and nursing mother
– Femaleacceptor of terminal method offamily
planning and IUDS
• Implemented by: PHCandsubcenters

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• Dosageof 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

13. IODINE DEFICIENCY DISORDER
CONTROL PROGRAMME
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• National goiter control programme in1962
• IDDControl Programme
• Replacethe entire edible salt by iodidesalt
• Fortification of salt withiodine

15. SPECIAL NUTRITIONAL
PROGRAMME
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• Started in 1970 in urban slums, tribalareas
and backward rural areas
• Main aim is to improve nutritional statusin
– children <6years
– pregnant and lactating women
• Gradually being merged into ICDS

17. APPLIED NUTRITIONAL
PROGRAMME
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• This project wasstarted in Orissaon1963
• Later extended to TNand UP
• Objectives:
– Promoting production and of protective foodsuch
vegetables and fruits
– Ensuretheir consumption by pregnant & lactating
women and children.
• In 1973 extended to all states inINDIA

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• Major components
– Nutritional Services
– Health services
– Communication
– Monitoring andevaluation
• Later converted into ICDS

20. BALWADI NUTRITIONPROGRAMME
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• This wasstarted in 1970 by the departmentof
social welfare
• Beneficiary:
– Preschool children 3-6 years of age
• Activities
– 300 kcal and 10 g protein
– Preschool education
• Phasedout becauseuniversalization of ICDS

22. INTEGRATED CHILDDEVELOPMENT
SERVICES (ICDS) SCHEME
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• Launched on 2nd October1975
• One of the world’s largest and most unique
programmes for early childhooddevelopment
• India’s response to the challengeof
– Providing pre-school education on one handand
– Breaking the vicious cycle of malnutrition, morbidity,
reduced learning capacity and mortality, on theother
• Foremost symbol of India’s commitment to her
children

24.  Routine MCHservicesnot reachingtarget
Population
 Nutritional component not covered by
Healthservices
 Needfor communityparticipation
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• Improve the nutritional and health status of
children in the age-group 0-6years
• Foundation for proper psychological, physical and
social development of thechild
• Reduce the incidence of mortality, morbidity,
malnutrition and schooldropout
• Co-ordination of departments to promote child
development
• Nutrition and health education to the mother

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

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

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• Packageof services:
1. Supplementary nutrition
2. Immunization
3. Health check-up
4. Referral services
5. Pre-school non-formal education
6. Nutrition & healtheducation

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Services TargetGroup
Supplementary Nutrition Children below 6 years,PLW
Immunization
Children below 6 years,Pregnant
Women
Health Check-up Children below 6 years,PLW
Referral Services Children below 6 years,PLW
Pre-School Education Children 3-6 years
Nutrition & Health
Education
Women (15-45 years), Children3-6
years,PLW

31. COMPONENTS OFICDS
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• Supplementary feeding andgrowth
monitoring
• Prophylaxis against vitamin Adeficiency and
control of nutritionalanemia
• Growth Monitoring and nutrition surveillance
– children <3yearsof ageof ageare weighed oncea
month
– children 3-6 yearsof ageare weighed quarterly
• Supplementary feeding for 300 daysin ayear

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

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• Immunization of pregnant womenand
children
• Protects against tetanus and reducesmaternal
and neonatal mortality
• Protects children from sevenvaccine
preventable diseases
• Provided by the healthdepartment

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• For children <6years, antenatal care,
postnatal care of nursingmothers
• Consists of weight recording, immunisation,
management of malnutrition, treatment of
diarrhea, de-worming, simple medicines for
common illnesses

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• Sickor malnourished children, in need of
prompt medical attention, are referred tothe
Primary Health Centre or itssub-centre

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• Anganwadi – avillage courtyard
• Backbone of the ICDS
• For 3-6 year olds
• Providing anatural, joyful andstimulating
environment

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• Keyelement of the
work of theanganwadi
worker
• Thisforms part of BCC
(Behaviour Change
Communication)
strategy

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• Toelicit communitysupport
• Weigh & record eachchild
every month
• Refer cases
• Organize pre-school
activities
• Provide supplementary
nutrition
• Provide health & nutrition
education andcounseling
• Make home visits
• Coordinate with otherstaff

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• Cook& servefood
• Cleanthe Anganwadi premises
• Cleanliness of smallchildren
• Bring small children toAnganwadi

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• 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 MiniAWC

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• Practically children 3-6year
• Pregnant & Lactating notcovered
• Irregular food supplies
• Quality of Nutrition supplement?
• Poor supervision
• Lackof community ownership/ participation
• Nutrition education only onpapers
• Children come only for food

43. MID DAYMEALPROGRAMME
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• akaSchool Lunch Programme
• Objectives
– Improve school attendance
– Improve child nutrition
• Principles
– Supplement, not substitute to homediet
– 1/3rd of energy and ½of proteinrequirement/day
– low cost, easily prepared atschools
– locally available food, change menufrequently

45. MID-DAY MEALSCHEME
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• akaNational Programme of Nutritional
Support to PrimaryEducation
• Objectives:
– Universalization of primary educationby
increasing enrollment (class1 to 5)and
– Improve nutritional status of children (class1-5)
– 300 kcal and 8-12 gprotein

47.  Good for improving nutrition of the underprivileged
children
 Butit requiressustainability
 Repeatedincidenceof food poisoning in the mid daymeal
causingseriousthreat
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