malnutrition (icds project)

7/25/2019 Malnutrition (Icds Project)

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What is Malnutrition :

Malnutrition is a state in which prolonged lack of one or more nutrients retards

physical development or cause specific clinical disorders, e.g. iron deficiency anemia,

goiter, etc. Malnutrition can also be defined as an impairment of health resulting from

a deficiency, excess or imbalance of nutrients. In includes inter nutrition and over

nutrition kwashiorkor, a protein deficiency disease, highlights this fact since in most

cases of kwashiorkor the case is in take or poor quality protein rather than inadequate

quantity over a prolonged period of time. More recently malnutrition is defined as an

unintentional weight loss of more than 10 percent, associated with a serum albumin

level below .! g"d.

#ome characteristics of people suffering from malnutrition are dull lifeless hair,

greasy pimpled facial skin$ dull eggs, slumped posture$ fatigue and depression are

easily evident by the spiritless expression and behavior, and lack of interest in their

surroundings. #uch people may be under weight or over weight sleep may be affected,

and also the elimination hobbits constipation is a common problem.

%he problem of malnutrition cannot be taken lightly as it may sometimes provefatal. It may also cripple a person for the whole life e.g. deficiency of vitamin & is

children leads to blindness.

& disease which results from lack of a certain nutrient is known as a deficiency

disease, e.g. iron deficiency anemia, is a very common deficiency disease in women

and young girls.

Menstrual losses and increased needs in pregnancy are some of the causes of

anemia.

'ersons prone to malnutrition are infants, pre(school children, adolescents,

pregnant women and elderly people. 'regnant women are especially prone to

malnutrition if they are adolescents and not nature enough to bear children.

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Infants and pre(school children are dependent on their mother for nourishment

and if her selection of foods for them is incorrect, they may be suffering from

malnutrition. )uring the process of weaning, most poor children are a pray to faulty

nourishment since they may be fed sago kan*i +gruel as a substitute for milk and no

other foods providing good quality protein. #ago kan*i supplies carbohydrates but very

little proteins, and lack of proteins in the diet my result in severe wasting of body

tissues. %his may lead to multiple deficiencies and kwashiorkor results. %his in many

cases, is fatal or if the child on treatment does survive, it.

-eave its effect in the form of an under(developed rain hence, the period of

infancy, i.e. from birth to 1/ months is a very crucial period and thus protein qualityand quantity in the diet should be taken care of.

sually, adolescents eat often but irregularly and mostly the wrong kind of

food. #nack items such as potato wafers, popcorn, cakes, soft drinks, candies, peps

colas are their favorite foods. %hese foods not only supply very limited nutrients but

also causes a feelings of fullness. such hollow or empty calorie foods should not be a

allowed liberally. ow ever at this age what their friends eat and do is what matters

most to them. 2rash diets are also commonly seen in this age group. %he resulting

malnutrition due to wrong choice " selection of foods is evident in an adolescent either

in the form of anemia or lack of stamina and their school work is affected.

'regnancy and lactation are stress periods in a women3s life. %he women3s

appetite increases remarkably and so does the need for nutrients. %he fast growing

factors has to be continuously nourished. %his stress has to be even more carefully

managed when the mother to be is an adolescent. er own growing needs as well as

those of the fetus put a burden on her body.

%he birth weight and health of a newborn is influenced by its mother3s

nutritional well being during pregnancy. -actation also needs careful attention to food

intake and its quality. since the quality of the mothers like and the length to which she

can satisfactorily breast feed her child depends on it.

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4ld people are also malnourished many times as they may be unwell or not

properly looked after. poor eating may result in poor nutritional status in them. )ietary

restrictions due to some disorders such as diabetes, high blood pressure, etc.. may add

to this.

Malnutrition results in most of us since we do not need to our body3s

daily requirements. &s mentioned in the definition, malnutrition is evident as a

deficiency disease, c.g rickets in children due to calcium 5 vitamin ) deficiency$ &lso

malnourished people are prone to continues boots of son illness or the other which

affects their work very often. %his condition can be easily set right if we eat the right

food in the right amount daily i.e., if we consume a balanced diet every day, anddevelop good eating habits for good health.

Causes and consequences of Malnutrition in India.

Causes of severe under nutrition are6

1. &n inadequate intake a food, due either to a poor appetite or limited

availability of food, leads to a wasting syndrome with a relative loss of weight

and associated with a range of complex adaptive changes in all tissues and

organs.

!. %he presence of an underlying specific pathology, such as an in faction, or a

poor quality diet, separately and together might predispose to a reduced food

intake and in addition challenge metabolic integrity that predispose to the

formation of edema.

Malnutrition results from a combination of three key factors. Inadequate food

intake, illness and deleterious caring paucities underlying these is household

food edge of proper care. In India house hold food insecurity, inadequate

preventive and curative health #ervices and insufficient knowledge of proper.

2are In India, household insecurity stems from inadequate employment and

incomes$ seasonal migration, especially among the tribal populations$ relatively


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high food prices$ geographic and seasonal mal 5 distribution of food, poor

social organi7ation$ and large family si7e.

%he country still has a high incidence of disease, especially preventable

communicable disease, and maintains incidence of disease, especially

preventable communicable diseases, and maintains health services. In addition,

caring practices at home 5 including feeding, hygiene, home based health care,

use of available health services, and psychosocial stimulation based of children

5 are inadequate, substantially due to the lock of education, knowledge in the

socio 5 cultural and economic process that determine access to and control over

resources including information, education, assets, income, time and even howreserve allocation decisions are made in society.

& ma*or determinate of protein energy malnutrition is house hold caloric

inadequacy. &ccording to the 188(89 round of the :ational sample survey,

the most recent ma*or round available, about /0 percent of the rural population

and ;0 per cent of the urban population had caloric intakes below the !900

calories per day recommended. hile poverty largely explains the high level of malnutrition in India,

additional factors are responsible for the concentration of the problem among

women and 2hildren. hich results in women and girls getting less than their fair

share of household food and health care. &dult women comprise one third of

India3s labor force and are usually engaged in heavy manual tasks that place

additional energy demands on them. women3s heavy burden of childbearing

adds to the problem 5 India3s total fertility rate is still .? 2hildren per woman.

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-ack of information and education among women also under lies child

malnourishment. Malnutrition is directly or indirectly responsible for more than

half of the deaths of children under five years of age worldwide . while India

has successfully brought down infant mortality rate from 19@ per 1000 live

irths in 18?1 to ;! . in 188@, most of the children who survive and

malnourished. Indeed, widespread malnutrition among children and others is a

ma*or barrier of further reacudion in mortality rates. Including those amoung

pregnant women India3s maternal mortality ratio 9!0 per 100,000 live birtus in

unacceptably high. India3s accounts for approximately one low quarter of all

maternal deaths worldwide.

igh levels of anemia, low pregnancy weight gain, repeated acute infections,

ma*or chronic diseases, such as tuberadosis and inappropriate management of

deliveries are important determinates of maternal and infant deaths. & large

proportion of adults Indian women is at high risk of maternal mordacity

because their low per(pregnancy height or weight may cause obstetrical

difficulties. Moreover, a vicious intergenerational cycle commences when a

malnourished or ill mother gives birth to a low birth 5 weight female child 5

she remains shall in stature and pelvic si7e due to further malnourishment and

produces malnourished 2hildren in the next generation.

Malnourishment can also significantly lower cognitive development and

learning achievement during the preschool and school years and subsequently

results in low physical and mental performance and is exacerbated by common

worm infestations. Malnutrition not only blights the lives of individuals and

families, but also reduces the returns on the investment in education and acts as

a ma*or barriers to social and economic progress. Malnutrition reduced India3s

A)' by nearly three to nine percent in 188@, or by approximated # B 10

billion to # B !/ billion. %he higher figure is greater than the sum of India3s

current public Cxam on nutrition.

>hile mortality has declined by one 5 half and fertility by two 5 fifths,malnutrition has only came down by about one fifth in the last 90 years. %he

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inescapable conclusion is that further progress in human development in India

will be difficult to achieve unless malnutrition is tackled with greater vigor and

more rapid improvement in the future than in the post.

SOME FACTS ABOUT MA!UT"ITIO! A!# MIC"O!UT"IE!T

#EFICIE!CES

&ccording to the department of women and child development ministry of

uman resource )evelopment, 1888.

. :early one third of the world3s children suffering from malnutrition are

in India.

Incidence of micronutrient deficiencies, nutritional anemia, vitamin &

and iodine deficiencies are still very high.

Date of malnutrition is falling much too slowly 5 at only are percent per

year.

More than half of preschool children are stunted +?@.?= and nearly a

similar proportion, +98.!= are underweight. +):' survey, 188?(8@.

4ne in every six 2hildren is excessively thin +wasted.

:early 1@ percent infants less than @ months and about 9 percent

infants between six to eleven months are malnourished.

&bout 0 percent babies are low birth weight babies.

:utritional anemia affects about ?0 percent of young 2hildren

adolescent girls and women in the reproductive age group.

More than 10 percent of population, in !? districts of India is affected

with goiter 5 an iodine deficiency disorder.

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I!FA!T FEE#I!$ %"ACTICES.

4nly ?1 percent mothers exclusively rest 5 feed their babies for the

first four months.

4nly about one 5 third of 2hildren are given solid " mushy food in

addition to breast milk at the recommended age of six to nine months.

& substantial ma*ority of women squeegee the first milk containing

colostrums from the breast before breast 5 feeding their babies.

%"OTEI! & E!E"$"' MA!UTITIO! (%EM)

'rotein 5 Cnergy malnutrition +'CM is one of the largest public health

problems of our country. &s the name suggests, this condition is a deficiency

of protein and calories in the diet. #trictly speaking, it is one not disease, but a

spectrum of conditions arising from an inadequate diet. &lthough, it affects

people of all gases, ages, %he results are most drastic in child hood due to the

highest requirements in that period. In adults mild degrees of it results into

some wasting, while severe degrees are encountered in famines and wars of

long duration fortunately, both the latter have spared us during the last several

decades and therefore do not quality and a problem, ut in infants and children

'CM is a ma*or problem. %ill recently it was assumed that there was always a

primary deficiency of proteins associated with varying degrees of energy

deficiency, based upon observations in &frica.

ut in the light of extensive studies conducted mainly at the nationalinstitute of nutrition on +:I:, a different concept has emerged whereby it is a

condition, at least in India, primarily due to a deficiency of total dietary energy$

the protein deficiency being only secondary. %his condition in children

embraces at one end.

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4< the spectrum the puffed up of kwashiorkor the shriveled cases of

miasmas. &nd on the other, cases of nutritional dwarfing. In b"w these extremes

are various degrees of intermingling of the two conditions. It would not be out

of place to first look at the clinical picture of the clinical of different

manifestation.

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MA"ASMUS6

%he term derived from the Areek word meaning Eto wasteF has been in usage

in medical literature since old times. It was as common on Curope and :orth &merica

in 18thcentury as it is in India today. %his is the childhood equivalent of starvation in

adults. 2linically, the presentation is of an irritable or apathetic child who fails to

furtive is markedly emaciated and had incessant diarrhea. %he appetite may be

extreme or reduced. %here is extreme shriveling of the body with occasional

dehydration, loss of subcutaneous fat, marked wasting of muscles, and low

bodyweight and length, %he abdomen may be shrunken ir distended with gas. %here

may also be associated vitamin deficiencies like hypo vitaminosis.

*WAS+IO"*O" 6

%his term used by Aantries in and around &ccord in Ahana meant E%he

sickness the older child gets when the next body is born. It was adopted for the

medical literature by cicely >illiams in 18. %he child is apathetic, anemic, anorexic,

diarrheic and Cdematous$ sually brought to the doctor on account of same infective

condition. %hese is severe growth retardation but on account of Cdema the weight

might not be #everely subnormal. %he Cdema may be varying in degree and

distribution and associated with as cited and pleural effusions.

%he skin changes may involve any part of the body. %he more common sites

being lower limbs, buttocks and perineum. %he skin changes show characteristic areas

of desquamation and pigmentation or depigmentiation. 2racks appears at folds and

ulcers may develop at anal region and over presume points. %he muscular wasting is

extreme and may result in incapability to crawl or walk. %he hair is sparce, softer and

thinner than normal. Its colour also might change and became reddish, brown or gray.

%here are associated symptoms such as angular stomata3s, cheilosis and atrophy of the

tongue, anemia, hepatomegoly, and at times tremors like those in 'arkinsonism.

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MA"ASMIC *WAS+IO"*O" :

&s the name implies, this is a combination in varying degrees of the features of

the two conditions marasmus and kwashiorkor, and is found is places where 'CM is

prevalent. It is the superimposition of kwashiorkor on any degree of marasmus and is

the most common presentation of 'CM in India clinically some features of both

marasmus and kwashiorkor are present and the picture may be complicated further by

gastrointestinal or respiratory infections, due to which the child is usually brought to

medical attention.

,ITAMI! #EFICIE!C' 6

:ight blindness6( %his is on impairment of the vitamin & function, namely the

formation of Dhodesian in the eye. & child suffering from a deficiency of vitamin.

%he terms marasmus, kwashiorkor, miasmic 5 kwashikor, protein deficiency,

energy deficiency and protein Genergy deficiency have all been used at different times

to describe severs under nutrition with or without edema.

&n estimated /?9 million people are hungry, !0 million children under ? suffer

from severe malnutrition and around 1 million children die due to malnutrition each

year. 4ver two million people 5 more than 0= of the world3s population 5 are

anemic.

nderlying causes of malnutrition are poverty and agricultural

underdevelopment leading to food insecurity. Meeting overall energy needs and

dietary diversity is the ma*or challenge.

Infants and children suffering from severe malnutrition frequently have

moderately reduced hemoglobin 5 /0 to 100gm or reduced hematocrit 0(?=.

%he normal life of red blood cell is on an average 1!0 days but may be shorter

in severely malnourished children.

)espite low hemoglobin there is an increase in both stored and free cellular

iron, and supplementation with ion increases mortality.

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& first displays this symptom at night by bumping into ob*ects, slowly the eyes

develop it tot3s spots, which lead to dryness in the cornea and further lead to

xerophthalmia. %his is a stage of irreversible blindness. %otal blindness cannot be

curved even if large doses of vitamin & are given at this stage.

i Beri-eri6(

%his is caused due to the deficiency of thiamine, a water soluble vitamin.

%here are two types of beriberi, dry and wet. )ry eriberi is characteri7ed by

emaciation, generally, associated with deficiently such as % or dysentery. 'oly

neuropatuny occous. et beriberi involves swelling on the body, which is its characteristic.

%here is pain and tenderness in the legs and even slight movement causes

palpitation, breath lessness, which can later cause cardiac failure.

ii %ellara6(

%his is caused due to deficiency of niacin, another of the water soluble

group of vitamins. It has been found to commonly occur in corn eaters since,

corn is devoid of niacin as well as tryptophan. It is also food in people who

consume only mower as their staple. #ince, -evine, an amino acid, is found to

interfere with niacin metabolism. %his disease is characteri7ed by feeling of

unwellness. &norexia, mild gastro 5 intestinal upsets and nervousness. Dashes

appears are the skin exposed to the sun$ cheilosis, angular storatites, headache,

burning sensation in the hands and feet, hallucinations, delusions and delirium.

It untreated, it can lead to death pellagra is therefore also known as the 9)3s

disease that is diarrhea, dermatitis, dementia, and death.

iii Scurve/6(

%his disease caused due to vitamin 2 deficiency, was first noticed in sailors

who would travel for months in the sea with only salted foods as their diet. %he

diet was devoid of any fresh fruits and vegetables, which are rich in vitamin 2.

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the typical symptoms of sources are weakness, fatigue and pain in the muscles,

bones and *oints. %he skin becomes dry pinpoint name hemorrhages appears.

ounds take a long time to heal,

fractures appear spontaneously$ anemia develops, followed by convulsions

stupor$ coma and death can occur if untreated.

#eficienc/ of Minerals.

i) Anae0ia6( %he main cowses of anaemia are 6

#ietar/ iron deficienc/.

Infections diseases such as malaria, hookworm infections,

schistosomiasis, IH"&I)# tuberculosis and other chronic diseases including

almost any inflammatory illness that lasts several moths or longer and some

malignancies.

)eficiencies of their key micronutrient including foliate, vitamin 1!.

Hitamin &, protein, copper and other a minerals.

Inherited conditions that affect red blood cells, such as thalassimia.

#everal acute hemorrhage

2hronic blood losses.

%rauma.

owever, the most common type is iron deficiency, which occurs more

commonly along women then among them. Airls suffer from anemia particularly

around puberty, due to menstrual disturbances. %he blood shows low hemoglobin

levels and the cells are pale and small. %he person suffer from weakness, frequent

headdress pallor, breathlessness and dislike for work and exertion. %here is

giddiness, sleep lessens, hearth burn, palpitation, blurred vision and swelling of the

feet. %here are four key processes which contribute to anemia.

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1. "eductive ada1tation:It is the body3s adaptation to reduced food intake and

decreased metabolic activity. It is different from anemia due to chronic

disorders.

!. S1ecific nutrient: %he information of mature erythrocytes requires all the

nutrients and deficiency in any of nutrients will limit their formation and their

functional capability. esides this, nutrients like folic acid and 1! are directly

involved in the formation of hemoglobin.

. Infection:& complex interaction between and poor nutrition exists which may

elicit on inflammatory or immune response. %he availability of nutrients for red

cell formation will increase the likelihood of anemia.

9. +ae0ol/sis:Cnhanced suskeptibity to pro 5 oxidant damage will predispose

D23s to a shortened life span. Iran in the stored form can act as the focus for

pro(oxidant stress and result in cellular pathology.

?. "ic2ets: Aenerally, occurs during childhood and are a combination of

deficiencies of calcium phosphorous, vitamin ) and vitamin 2. %he child

suffers from growth retardation$ bones became fragile and bent. >ith the short

bones being affected more. nock 5 kness and bowed legs are the

characteristic.

Iron deficiency accounts for approximately half of the amaemia in developing

countries, while the other being proposed as due to a lock of copper, 7ine, foliate

or vitamins &, !,1! or c.

%he overriding principle of any intervention must be first do not harm.

The usual nutritional su11le0ent doses are.

0(@0 mg iron for a ;0 kg adult.

Maximum of 1!0 mg iron during pregnancy.

!mg iron 1kg for children.

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#ide effects of iron are not usually seen after oral intakes of 0(@0mg.


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CU""E!T !UT"ITIO! %"O$"AMMES I! I!#IA

Ma*or nutritional problems in India are protein energy malnutrition, iodine

deficiency disorders, vitamin & deficiency and anemia, esides, flourosis is also

prevalent, and liturgist is locali7ed to certain regions. %he nutrition cell in the

)irectorate general of ealth services provides technical advice on all the matters

related to nutrition. #tate nutrition divisions, sct up in 1; states and union

%erritories, assess the diet and nutritional states in various groups of population

conduct nutrition education campaigns, and supervise supplementary feeding

programmed and other ameliorative measures. #urveys conducted by state

nutrition divisions and :ational :utrition Monitoring ureau under MD revealthat malnutrition and other deficiency disorders are found more is young children,

and pregnant and lactating mothers.

2hildren in difficult circumstances continue to face greater deprivation and

neglect. It is estimated that there are 1;./ million working children, five million

street children and 9,00,000 child prostitutes the country. &lso one in every ten

child suffers from one form of disability or the order and incidence of crime

against children are on the increase.

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Sche0es and 1rore00es :

%he Aovernment of India is implementing more than 1!0 schemes and

programmes for the welfare and development of women and children through more

than 1 Aovernment Ministries and )epartment.

!ational %olicies and action 1lans

18;9 :ational 'olicy for children

18/ :ational ealth 'olicy

18/@ :ational 'olicy an Cducation

18/; :ational 'olicy an child labour

188 :ational :utrition policy

188@ 2ommunication strategyfor 2hild )evelopment

1881(!000 :ational 'lan of &ction for 2hildren

188! :ational 'lan of &ction for 2hildren

188? :ational 'lan of &ction on :utrition

I01ortant #a/s

1?thMay International )ay of orld Cnvironment )ay

1st(;th&ugust >orld reast 5 eek

1@


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#eptember

/th#eptember International -iteracy )ay

1@th4ctober >orld


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+18//(80

'revalence of goiter!1.=

+18/80=+188/ 10=

Incidence of low birth

weight babies

0=

+18880

'ear +ihlihts

188 Dationing introduced in ombay for the first time in the.

18@? %he :ational 2o(operative 2onsumer3s


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188;


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Interated Child #evelo10ent Services (IC#S) %rora00e :

%he integrated child development services programme of the )epartment of

women and 2hild )evelopment was started in 18;? and has emerged as the world3s

most unique and largest early childhood development progreamme, I2)#, which

started as a social experiment with pro*ects, has emerged as a social experience to

reach the unreached. It is a visible vehicle for achieving.

It provides a package of services to control nutritional and health problems.

%he )epartment of >omen 2hild >elfare and )eveloped a Management Information

system for monitoring and implementing the I2)# pro*ects. %he department

generated L'D# which were regularly analy7ed for delivery of services to

beneficiaries under the scheme. %he states were also regularly being advised to take

necessary corrective actions based on the analysis. y 188?, 80/ I2)# pro*ect had

been sanctioned in the county of which !9! are operational selection of community

is done on the basis of proportional distribution of rural population living below

poverty line with first preference being given to the community development block

having the highest concentration of scheduled caste population.

In order to improve the quality of service in the I2)# an extremely

comprehensive training programme called )I#& has been devised. It is seen as an

important element in empowering child(care workers. 'arents and communities for a

continuous process of assessment, analysis and informed action to promote to

fulfillment of children3s rights in the communities in which children live, grow and

develop.

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O-8ectives of IC#S %rora00e :

%he main ob*ectives of the I2)# programme are to

-ay the fardation for the proper psychological , physical and social

development of the child.

Improve the nutritional and health status of children below the age of six years.

Deduce the incidence of mortality, morbidity, malnutrition and school dropouts.

&chieve effective coordination of policy and implementation among various

department to promote child development.

Cnhance the capability of the mother to look after the normal health and

nutritional needs of the child through proper health and nutritional education.

%he I2)#, fewer than 10 percent of 9!00 prograne blocks also includes

schemes for adolescent girls nutrition, health awareness, and skill development$ in

some areas it has been linked with women3s income generating programmes. &ll

trained village woman who is assisted periodically in the health tasks by an

&uxiliary :urse Midwife from the health sub(center.

owever, evaluations of children below three years of age those at greatest risk

of malnutrition, and women and children living in hamlets.

Inadequate coverage of children below three years of age, those at greatest risk

of malnutrition, and women and children living is hamlets.

Irregular food supply, irregular feeding and inadequate rations.

Mothers and families are not educated regarding nutrition which might

encourage improved feeding practices at home and other relevant behavioral

changes.

&nganwadi worker is over loaded and in a weak position, non(supportive

supervision to &>>s results in the neglect of crucial nutrition related tasks.

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%o prevent blindness among children due to Hitamin & deficiency, a

concentrated dose of Hitamin & is given orally to children along with their

immuni7ation, similarly to prevent nutritional anemia among women and children,

tablets of iron and folic acid are distributed through health centers. & pilot

programme against micronutrient malnutrition has been initiated in five districts in

%ripura, ihar, 4rissa, west engal and &ssam to asses and improve micronutrient

status in school children. %he national institute of :utrition and all India institute

of ygiene and public health, olkatha are the principal organi7ations for nutrition

research and treating.

Food su-sid/ 1rora00es :

%u-lic #istri-ution S/ste0 (%#S) :

>hile the ')# has been an important buffer against local food shortages in

many respects it his fallen short of providing food security to the poor. It has been in

adequately targeted. Many of the poorer states do not obtain the require to cover their

needy populations. %hey take less than their share of supplies from the ')# mainly

because of a weak administrative capacity and the inability to move the food stocks.

%here are serious leakages in the programme with supplies often finding their way to

the open market.

%he ')# is a high cost operation relative to the caloric support it provides. It

costs about three times as much for the ')# to provide a given number of calories to a

house hold, compared with the I2)#. Most important, as late as 188;. %he poor man3s

access to the ')# proved extremely limited, particularly in the most poverty 5

stricken states.

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Tareted %u-lic #istri-ution S/ste0 (T%#S) :

In early 188; the 2entral Aovernment introduced the targeted ')# to ensure

better coverage of households below the poverty line. nder the %')#. '-

households are given a special identity card to obtain up to 10 kg of rice or wheat per

month at the assure price. %he 2entral Aovernment will allot adequate stocks per

month at cover the requirement. %he %')# guide lines imply that the second non(

targeted channel will be phased out gradually.

>hile the %')# is designed to improve food supplies in the poorest

households. It has not gone fat enough in number of ways. %he quantity of subsidi7ed

gain provided amounts to a marginal supplement of 100 calories per person per day,

much less than the estimated gap of poor people to noon(poor households, although

this food could be targeted to needy children and mother for examples.

India3s food grain production has continued in increase fairly steadily, although

population growth has eroded these gains somewhat. 'er capita availability of food

grains was /9 kg in 18@0.

%o ensure proper nutrition, adequate quantities for pulses or other protein(rich

foods such as milk, eggs, or meat which are also short supply, unless the prices of

these commodities are reduced substantially, through vastly increased availability,

they will remain out of reach of the poor.

%here is little independent corroboration of the extent to which the employment

programmes have supplemented the incomes and food available to the poor, although

intended for this purpose. %he efforts of the employment programmes to provide

household food support by part payment in grain been have poorly implemented and

times. #uch as ensuring that 0= of beneficiaries are women, or raising participant

families above the poverty line.

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!ational Midda/ Meal %rora00e (!MM#) :

%he Midday Meal scheme was launched by the ministry of uman Desource

)evelopment during 188?(8@ for the benefit of students in primary schools.


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!ational iodine #eficienc/ #isorders control 1rora00e :

Iodine is an essential and is required at a level of 100(1?0 micrograms daily for

normal human growth and development. )eficiency of iodine in the daily diet may

cause goiter and other iodine deficiency disorders. Cndemic goiter has been

recogni7ed as a ma*or health problem. In india results of some surveys ;1 million of

prevalence I)) is above 10 percent. It is estimated that is India more than ;1 million

people are suffering from various iodine disorders.

%he Aovernment launched fully centrally assisted :ational Aoiter 2ontrol

'rogramme in 18@! with focus on provision of iodi7ed salt to identified endemic

areas. In 18?. %he Aovernment decided to iodise the entire edible salt in the 2ountry

by 188! in a phased manner. %o day the production to iodi7ed salt is 9! lakhs metric

ton per annum. 4nly about ?! of the ;80 private manufactures licensed by the salt

commissioner have commenced production of iodi7ed salt. %he :A2' has been re(

designated the importance of all the I))3s, &s per the directions of the centre !8

state " nion %erritories completely banned the use of salt other than iodi7ed salt for

edible purpose. ence, non(iodi7ed salt is now made freely available.

%his programme has some problems which need to be tackled in order to

achieve success. Iodi7ed salt is fortified with potassium iodated which is heat sensitive

and con benefit the consumer if used at table and preferably not during cooking. &lso

excessive iodine intake may cause toxicity in a population which does not needed

iodine supplementation. ence, it would be advisable to provide iodi7ed salt only to

the goiter 5 prone population.

malnutrition (icds project)

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