Community Nutritional Programmes and ICDS

Community Nutritional Programmes: 

Community Nutritional Programmes Dr.Bayapa Reddy N Assistant Professor Dept. of Community Medicine Chennai Medical College Hospital Research Centre 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Community Nutritional Programmes: 

Community Nutritional Programmes Large scale supplementary programmes Main aim is to improve nutritional status in targeted groups To overcome specific diseases through various ministries to combat malnutrition 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Programmes Ministry : 

Programmes Ministry Mid Day Meal Scheme Human Resource Development 20 January 2012 Dr N.B.R Comm Med CMCH&RC Vitamin A Prophylaxis Programme. Prophylaxis Against Nutritional anaemia . IDDs Control Programme . Health and family welfare Special Nutritional Programme Balwadi Nutritional Programme ICDS Programme Social welfare Mid Day Meal Programme Education

Vitamin A Prophylaxis Programme: 

Vitamin A Prophylaxis Programme Beneficiary group preschool children(6 months to 5 years) a single massive dose of oily preparation of Vitamin A 200,000 IU ( retinol palmitate 110mg) orally every 6 months for every preschool child above 1 year half the amount in < than 1 year children 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Prophylaxis Against Nutritional Anaemia: 

Prophylaxis Against Nutritional Anaemia Iron and folic acid to pregnant women, Pregnant women : 100 mg Fe & 0.5mg folic acid children covering in this programme is between 1 to 12 years. Screening test for aneamia done at 6 months,1 and 2 years of age. Children 6 to 60 months : 20mg Fe & 0.1 mg folic acid Children 6 to 10 years : 30mg Fe & 0.25 mg folic acid Should be given 100 days Adolescent girls : 100 mg Fe & 0.5mg folic acid b. Iron fortification in salt 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Iodine Deficency Disorder Control Programme: 

Iodine Deficency Disorder Control Programme National goiter control programme in 1962 IDD Control Programme Replace the entire edible salt by iodide salt Double fortification of salt iodine and iron (40ppm and 1000ppm) 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Special Nutritional Programme: 

Special Nutritional Programme This was started in 1970 is in operation in urban slums, tribal areas and backward rural areas. It was launched under minimum need programme Main aim is to improve nutritional status in targeted group. Beneficiary group children below 6 years pregnant and lactating women child : 300kcal and 10-12gm protein pregnant :500kcal and 25 gm protein Total of 300 days in a year this programme is gradually being merged into ICDS 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Applied Nutritional Programme: 

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. 1973 its extended to all states in INDIA Mainly through nutritional education Nutrition worth 25 paise for children and 50 paise for pregnant and lactating women for 52 days in ayear 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Tamilnadu Integrated Nutritional Programme: 

Tamilnadu Integrated Nutritional Programme This project was started in 1980 Targeting the 6-36 months children, pregnant and lactating women Objectives To reduce malnutrition up to 50% in under 4 children To reduce IMR by 25% To reduce vit A deficiency from 27% to 5% in <5 childs To reduce aneamia in pregnant and nursing women from 55% to 20% 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Major components: 

Major components Nutritional Services Health services Communication Monitoring and evaluation Later it converted as ICDS 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Balwadi Nutrition Programme: 

Balwadi Nutrition Programme This was started in 1970 under the department of social welfare Beneficiary group preschool children 3-6years of age 300kcal and 10gm protein Also provide with pre school education Balawadis are being phased out because universalization of ICDS 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Integrated Child Development Services (ICDS) Scheme : 

Integrated Child Development Services (ICDS) Scheme 20 January 2012 Dr N.B.R Comm Med CMCH&RC

ICDS: 

ICDS Launched on 2 nd October 1975. ICDS Scheme represents one of the world’s largest and most unique programmes for early childhood development. India’s response to the challenge of Providing pre-school education on one hand and Breaking the vicious cycle of malnutrition, morbidity, reduced learning capacity and mortality, on the other. ICDS is the foremost symbol of India’s commitment to her children. 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Purpose for Initiation: 

Purpose for Initiation Routine MCH services not reaching target Population Nutritional component not covered by Health services Need for community participation 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Objectives:: 

Objectives: To improve the nutritional and health status of children in the age-group 0-6 years; To lay the foundation for proper psychological, physical and social development of the child; To reduce the incidence of mortality, morbidity, malnutrition and school dropout; To achieve effective co-ordination of policy and implementation amongst the various departments to promote child development; and To enhance the capability of the mother to look after the normal health and nutritional needs of the child through proper nutrition and health education. 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Services:: 

Services : The above objectives are sought to be achieved through a package of services comprising: Supplementary nutrition , Immunization Health check-up Referral services Pre-school non-formal education and Nutrition & health education. 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Beneficiaries of ICDS: 

Beneficiaries of ICDS Children < 6 years 20 January 2012 Dr N.B.R Comm Med CMCH&RC Pregnant Woman Lactating women Adolescent Girls Women in Reproductive age group (15-44)

Services and beneficiaries: 

Services and beneficiaries Services Target Group Service Provided by Supplementary Nutrition Children below 6 years: Pregnant & Lactating Mother (P&LM) Anganwadi Worker and Anganwadi Helper Immunization* Children below 6 years: Pregnant Women ANM/MO Health Check-up* Children below 6 years: Pregnant & Lactating Mother (P&LM) ANM/MO/AWW Referral Services Children below 6 years: Pregnant & Lactating Mother (P&LM) AWW/ANM/MO Pre-School Education Children 3-6 years AWW Nutrition & Health Education Women (15-45 years ), Children 3-6 years Pregnant & Lactating Mother (P&LM) AWW/ANM/MO 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Supplementary Nutrition: 

Supplementary Nutrition This includes supplementary feeding and growth monitoring; and prophylaxis against vitamin A deficiency and control of nutritional anaemia. Growth Monitoring and nutrition surveillance are two important activities that are undertaken. Children <3 years of age of age are weighed once a month children 3-6 years of age are weighed quarterly They avail of supplementary feeding support for 300 days in a year. 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Immunization:: 

Immunization: Immunization of pregnant women and infants protects children from six vaccine preventable diseases-poliomyelitis, diphtheria, pertussis , tetanus, tuberculosis and measles. Immunization of pregnant women against tetanus also reduces maternal and neonatal mortality 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Health Check-ups: 

Health Check-ups This includes health care of children less than six years of age, antenatal care of expectant mothers and postnatal care of nursing mothers recording of weight, immunization, management of malnutrition, treatment of diarrhoea, de-worming and distribution of simple medicines etc. 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Referral Services: : 

Referral Services: During health check-ups and growth monitoring, sick or malnourished children, in need of prompt medical attention, are referred to the Primary Health Centre or its sub-centre 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Non-formal Pre-School Education (PSE): 

Non-formal Pre-School Education (PSE) anganwadi – a village courtyard PSE is considered the backbone of the ICDS programme. Its for the three-to six years old children is directed towards providing and ensuring a natural, joyful and stimulating environment 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Nutrition and Health Education: 

Nutrition and Health Education It is a key element of the work of the anganwadi worker. This forms part of BCC (Behaviour Change Communication) strategy 20 January 2012 Dr N.B.R Comm Med CMCH&RC

THE ICDS TEAM: : 

THE ICDS TEAM : The ICDS team comprises Anganwadi Workers, Anganwadi Helpers, Supervisors, Child Development Project Officers (CDPOs) and District Programme Officers (DPOs). 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Role of AWW: 

Role of AWW To elicit community support Participation in running the program Weigh & record each child every month Refer cases Organize non-formal pre-school activities Provide supplementary nutrition Provide health & nutrition education and counseling 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Role of AWW: 

Role of AWW Make home visits Assist PHC staff Guide ASHA Assist in implementation of Kishori Shakti Yojana (KSY) 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Role of AW Helper: 

Role of AW Helper Cook & serve food Clean the Anganwadi premises Cleanliness of small children Bring small children to Anganwadi 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Role of ASHA: 

Role of ASHA Awareness generation Counsel women Community mobilization Work with VHSC Escort/accompany pregnant women & children requiring treatment Provide primary medical care 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Role of ANM : 

Role of ANM Hold weekly / fortnightly meeting with ASHA Participate & guide in organizing the Health Days at AWC Utilize ASHA in motivating the pregnant women and married couples Guide ASHA in motivating pregnant women for full ANC Educate ASHA on danger signs of pregnancy and labor 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Role of Health Department: 

Role of Health Department Health Check-ups Handling Referral Immunization Nutrition & Health Education Monitoring of Health components 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Anganwadi Centre : 

Anganwadi Centre Population Norms: For Rural/Urban Projects 400-800 - 1 AWC 800-1600 - 2 AWCs 1600-2400 - 3 AWCs Thereafter in multiples of 800 1 AWC For Mini-AWC 150-400 -1 Mini AWC 20 January 2012 Dr N.B.R Comm Med CMCH&RC

PowerPoint Presentation: 

For Tribal / Riverine /Desert, Hilly and other difficult areas/ Projects 300-800 - 1 AWC For Mini- AWC 150-300 1 Mini AWC At present there are 5659 ICDS projects. 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Supplementary Nutrition per Day: 

Supplementary Nutrition per Day Beneficiary Pre-revised Revised w.e.f. Feb. 2009 Calories ( KCal ) Protein (G) Calories ( KCal ) Protein (Gm) Children (6-72 months) 300 8-10 500 12-15 Severely malnourished children (6-72 months) 600 20 800 20-25 Pregnant & Lactating 500 15-20 600 18-20 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Revised financial norms for food supplement: 

Revised financial norms for food supplement Category Pre-revised Revised w.e.f June 2010 Children (6-72 months) Rs. 2.00 Rs.4.84 Severely malnourished children (6-72 months) Rs. 2.70 Rs.5.82 Pregnant & Lactating Rs. 2.30 Rs.6.00 20 January 2012 Dr N.B.R Comm Med CMCH&RC

International Partners: 

International Partners United Nations International Children’ Emergency Fund (UNICEF) Cooperative for Assistance and Relief Everywhere (CARE) World Food Programme (WFP) 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Major Initiatives: 

Major Initiatives Revision in Population norms Universalization and 3 rd phase of expansion of the Scheme of ICDS Increment in Budgetary allocation for ICDS Scheme Introduction of cost sharing between Centre & States Revision in financial norms of supplementary nutrition 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Monitoring System: 

Monitoring System Central level State level Block level Village level (Anganwadi level) 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Failures: 

Failures Practically children 3-6 Yrs. 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 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Mid Day Meal Programme : 

Mid Day Meal Programme Major Objective: improve the School attendance reduce school drop outs beneficial impact on Childs nutrition Principles 1.supplement, not substitute to home diet 2.1/3 total energy requirement/day and ½ total protein requirement /day. 3. reasonably low cost 4.easily prepared at schools 5.as for as possible locally available food 6.change menu frequently 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Mid-day meal scheme : 

Mid-day meal scheme National programme of nutritional support to primary education Objective Universalization of primary education by increasing enrollment (class 1 to 5) and Improve nutritional status of children . 350 to 500 kcal and 8-12gm protein 20 January 2012 Dr N.B.R Comm Med CMCH&RC

Drawbacks: 

Drawbacks Programme is good as for as improving nutrition of the underprivileged children But it requires sustainability for this requires political will, community participation, monitoring and evaluation Repeated incidence of food poisoning in the mid day meal causing serious threat to existence of this programme. 20 January 2012 Dr N.B.R Comm Med CMCH&RC

PowerPoint Presentation: 

THANK YOU 20 January 2012 Dr N.B.R Comm Med CMCH&RC