Professional Documents
Culture Documents
Adulteration
Food Fortification
WHO The process whereby nutrients are
added to foods (in relatively small
quantities) to maintain or improve the
quality of the diet of a group , a community
or a population.
Micronutrients
Iron, Iodine
Iron, Folic Acid, Calcium,
Zinc
Iron, Folic Acid, Calcium, Zinc
Vit. A & D
Vitamin D, A Iron, Folic Acid,
Calcium, Omega-3,6 Fatty
Acids
Iron, Folic Acid, Calcium, Zinc
Vitamin A
8
Advantages
Providing certain nutrients simultaneously
in the same food improves the utilization
of certain
Vitamins and minerals, e.g. vitamin C
enhances the absorption of iron
Providing nutrients through the regular
food supply and distribution system
reduces costs.
11
Food adulteration
The process of lowering the nutritive
value of food either by removing a
vital component or by adding
substances of inferior quality, is
called food adulteration.
FSSA - Adulterant
Common Adulterants
n
1
Material
Milk
Coffee
& Water
Date husk, Tamarind husk, Chicory
powder
Mustard
4
5
6
7
seeds
Butter
Honey
Rice, wheat
Black
Oleo, margarine
Fructose syrup /cane sugar
Mud grits , Soapstone bits
Dried seeds of papaya
19
Food Standards
1. Codex Alimentarius :
Collection of international food standards
recommended by FAO and WHO.
2. PFA-Standards :
Its purpose is to obtain a minimum level of
quality of food stuffs attainable under Indian
conditions.
3. Agmark Standards:
Gives the consumer an assurance of quality in
accordance with standards laid down
Programmes
Ministry
Health and
family
Welfare
Social
welfare
ICDS Program
Mid Day Meal Program
Education
Vitamin A Prophylaxis
Programme
Initiated in 1970
Age group 1-5 year
Priority to VAD geographical area
Objective
Prevent blindness due to VAD
Organization
PHC and subcenter
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
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JLNH&RC
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JLNH&RC
Beneficiary group
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
JLNH&RC
Major components
Nutritional Services
Health services
Communication
Monitoring and evaluation
Later it is converted as ICDS
1/18/16
JLNH&RC
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 provided with pre school education
Balawadis are being phased out because
universalization of ICDS
1/18/16
JLNH&RC
Integrated Child
Development Services
(ICDS) Scheme
1/18/16
JLNH&RC
ICDS
Launched on 2nd October 1975.
ICDS Scheme represents one of the worlds
largest and most unique programmes for
early childhood development.
Indias 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.
JLNH&RC
1/18/16
JLNH&RC
Objectives:
1. To improve the nutritional and health status of children in
the age-group 0-6 years;
2. To lay the foundation for proper psychological, physical and
social development of the child;
3. To reduce the incidence of mortality, morbidity, malnutrition
and school dropout;
4. To achieve effective co-ordination of policy and
implementation amongst the various departments to
promote child development; and
5. 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.
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JLNH&RC
Services:
The above objectives are sought to be
achieved through a package of services
comprising:
1. Supplementary nutrition,
2. Immunization
3. Health check-up
4. Referral services
5. Pre-school non-formal education and
6. Nutrition & health education.
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JLNH&RC
Beneficiaries of ICDS
Adolescent Girls
Pregnant Woman
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Lactating women
Women in Reproductive
age group
JLNH&RC(15-44)
Target Group
Supplementary
Nutrition
Immunization*
Service Provided by
Anganwadi Worker and
Anganwadi Helper
ANM/MO
Pregnant Women
Health Check-up*
ANM/MO/AWW
AWW/ANM/MO
AWW
AWW/ANM/MO
JLNH&RC
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
JLNH&RC
Immunization:
Immunization of pregnant
women and infants
protects children from six
vaccine preventable
diseases-poliomyelitis,
diphtheria, pertusis,
tetanus, tuberculosis and
measles.
Immunization of pregnant
women against tetanus
also reduces maternal
and neonatal mortality
1/18/16
JLNH&RC
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.
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JLNH&RC
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
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JLNH&RC
JLNH&RC
JLNH&RC
JLNH&RC
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
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JLNH&RC
Role of AWW
Make home visits
Assist PHC staff
Guide ASHA
Assist in implementation of Kishori
Shakti Yojana (KSY)
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JLNH&RC
Role of AW Helper
Cook & serve food
Clean the Anganwadi premises
Cleanliness of small children
Bring small children to Anganwadi
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JLNH&RC
Role of ASHA
Awareness generation
Counsel women
Community mobilization
Work with VHSC
Escort/accompany pregnant women &
children requiring treatment
Provide primary medical care
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JLNH&RC
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
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JLNH&RC
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JLNH&RC
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
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JLNH&RC
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JLNH&RC
Pre-revised
Revised
w.e.f. Feb.
2009
Calories Protein
(KCal)
(G)
Calorie Protein
s (KCal) (Gm)
Children (6-72
months)
300
8-10
500 12-15
Severely
malnourished
children (6-72
months)
600
20
800 20-25
500
15-20
600 18-20
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JLNH&RC
PreRevised w.e.f
revised June 2010
Children (6-72
Rs. 2.00 Rs.4.84
months)
Severely
Rs. 2.70 Rs.5.82
malnourished children
(6-72 months)
Pregnant & Lactating Rs. 2.30 Rs.6.00
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JLNH&RC
International Partners
United Nations International Children
Emergency Fund (UNICEF)
Cooperative for Assistance and Relief
Everywhere (CARE)
World Food Programme (WFP)
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JLNH&RC
Major Initiatives
Revision in Population norms
Universalization and 3rd 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
1/18/16
JLNH&RC
Monitoring System
Central level
State level
Block level
Village level (Anganwadi level)
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JLNH&RC
Failures
Practically children 3-6 Yrs and
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
1/18/16
JLNH&RC
JLNH&RC
1/18/16
JLNH&RC
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
1/18/16
JLNH&RC
Keep visiting
dnbpaediatrics.blogspot.in
THANK
YOU
1/18/16
JLNH&RC
PROGRAM OUTLINE
Started by the Government of India in
1975, the
Integrated Child Development Scheme (IC
DS)
has been instrumental in improving the
health and wellbeing of mothers and
children under 6 by providing health and
nutrition education, health services,
supplementary food, and pre-school
education.
The ICDS national development program is
one of the largest in the world. It reaches
more than 34 million children aged 0-6
Lesson Objectives
To know the extent of malnutrition
To know about the goals. objectives
target groups, service components
and coverage of ICDS program
To know about the impact of the
Program
(6 months)
Achievement: 46%
ICDS OBJECTIVES
To improve the nutritional status of
preschool children 0-6 years of age
group.
To lay the foundation of proper
psychological development of the child
To reduce the incidence of mortality,
morbidity malnutrition and school drop
out
To achieve effective coordination of
policy and implementation in various
departments to promote child
development
To enhance the capability of the mother
to look after the normal health and
nutritional needs of of the child through
Pregnant women
Nursing Mothers
SERVICES
COMPONENTS
Health Check-ups.
Immunization.
Growth Promotion and
Supplementary Feeding.
Referral Services.
Early Childhood Care and Pre-school
Education.
Nutrition and Health Education.
Supplementary nutrition
Each child upto 6 years of age to get
300 calories and 8-10 grams of
protein
Each adolescent girl to get 500
calories and 20-25grams of protein
Each pregnant women and lactating
mother to get 500 calories and 20-25
gms of protein
Each malnourished child to get 600
calories and 16-20 grams of protein
Immunization
Immunization of pregnant women and
infants protects children from six vaccine
preventable diseases-poliomyelitis,
diphtheria, pertussis, tetanus, tuberculosis
and measles.
These are major preventable causes of
child mortality, disability, morbidity and
related malnutrition. Immunization of
pregnant women against tetanus also
reduces maternal and neonatal mortality
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.
The anganwadi worker has also been
oriented to detect disabilities in young
children. She enlists all such cases in a
special register and refers them to the
medical officer of the Primary Health
Centre/ Sub-centre
Contd.
Its program for the three-to six years old children
in the anganwadi is directed towards providing
and ensuring a natural, joyful and stimulating
environment, with emphasis on necessary inputs
for optimal growth and development.
The early learning component of the ICDS is a
significant input for providing a sound foundation
for cumulative lifelong learning and development.
It also contributes to the universalization of
primary education, by providing to the child the
necessary preparation for primary schooling and
offering substitute care to younger siblings, thus
freeing the older ones especially girls to
attend school.
Health check-ups
Record of weight and height of children
at periodical intervals
Watch over milestones
Immunization
General check up for detection of
disease
Treatment of diseases like diarrhea,
ARI
Deworming
Prophylaxis against vitamin A
deficiency and anemia
Referral of serious cases
Anganwadi Centre
Anganwadi is the Focal Point for
Delivery of ICDS Services.
Located in a Village/Slum.
Anganwadi is run by an AWW,
supported by a Helper.
AWW is the 1st Point of Contact for
Families Experiencing
Nutrition and Health Problems.
No. of Blocks
No. of AWW
Children (0 - 6 years)
Sanctioned
Functioning
Gap
5652
4545
19.6%
608,066
546,434
11.2%
35.39 million
6.38 million
Training Infrastructure
There is a countrywide infrastructure for
the
training of ICDS functionaries, viz.
Anganwadi Workers Training Centres
(AWTCs) for the training of Anganwadi
Workers and Helpers.
Middle Level Training Centres (MLTCs) for
the training of Supervisors and Trainers
of AWTCs;
National Institute of Public Cooperation
and Child Development (NIPCCD) and its
Regional Centres for training of
CDPOs/ACDPOs and Trainers of MLTCs.
NIPCCD also conducts several skill
development training programmes
PROGRAM MONITORING
CENTRAL LEVEL
(i) Supplementary Nutrition : No. of
Beneficiaries (Children 6 months to 6 years and
pregnant & lactating mothers) for
supplementary nutrition;
(ii) Pre-School Education : No. of Beneficiaries
(Children 3-6 years) attending pre-school
education;
(iii) Immunization, Health Check-up and
Referral services : Ministry of Health and Family
Welfare is responsible for monitoring on health
indicators relating to immunization, health
check-up and referrals services under the
Contd.
The survey data reveal that more than 45 per cent
Anganwadis have no toilet facility and 40 per cent
have reported the availability of only urinal;
Of the 39 per cent Anganwadis reporting
availability of hand pumps, half of the hand pumps
were provided by the Gram Panchayat and 12 per
cent provided by the ICDS;
More than 90 per cent Centers provided
supplementary food, 90 per cent provided preschool education and 76 per cent weighed children
for growth monitoring;
Only 50 per cent Anganwadis reported providing
referral services, 65 per cent health check-up of
children, 53 per cent for health check-up of women
and more than 75 for nutrition and health
education;
Contd.
Average number of days in a month in
which services are provided at the
Anganwadi centers are 24 for
supplementary food, 28 for pre-school
education and 13 for Nutrition and health
education;
More than 57 per cent of Anganwadi
centers reported availability of ready-toeat food and 46 per cent availability of
uncooked food at the Anganwadi centers;
Nearly three-fourth of the Anganwadis
have reported the availability of medical
kits and baby weighing scale. On the other
hand adult weighing scale has been
reported only by 49 per cent of the
Contd.
v) 36.5 per cent mothers did not
report weighing of new born children;
vi) 29 per cent children were born
with a low weight which was below
normal (less than 2500 gm);
vii) 37 per cent AWWs reported nonavailability of materials/aids for
Nutrition and Health Education
(NHED).
Concerned
Departments
WEST BENGAL
2012-13
2013-14
Primary
Central State
Upper Primary
Total
Central State
Total
*Remarks
2.17
1.00
3.17
3.25
1.08
4.33
Upto June-12
2.33
1.00
3.33
3.49
1.16
4.65
From July-12
2.50
1.00
3.50
3.75
1.25
5.00
Proposed
WEST BENGAL
1.
2.
3.
4.
5.
Items
Food-grains
(Rice)
Pulse
Vegetables (leafy
also)
Oil & Fat
Salt &
Condiments
150gms
20gms
30gms
50gms
75gms
5.0gms
7.5gms
As per need
As per need
WEST BENGAL