Integrated Programme FOR NUTRITION IMPROVEMENT


Background

Nutrition is the science that interprets the interaction of nutrients and other substances in food, in relation to maintenance, growth, reproduction, health and disease of a person. Nutritional status is influenced by three broad factors: food, health and care. Optimal nutritional status results when children have access to affordable, diverse, nutrient-rich food; appropriate maternal and child-care practices; adequate health services; and a healthy environment including safe water, sanitation and good hygiene practices. These factors directly influence nutrient intake and the presence of disease.From a life-cycle perspective, the most crucial timeto meet a child’s nutritional requirements isin the 1,000 days including the period of pregnancy and ending with the child’s second birthday.

Is not there any need to work on Malnutrition in Delhi? When

  • 26.1 % of underweight children <5
  • 42.2 % of stunted children <5
  • 15.4 % of wasted children <5
  • 57 percent children in Delhi are anemic
  • 34.5 percent children age 0-5 months exclusively breastfed
  • 38.3 percent mothers consumed IFA for 90 days or more when they were pregnant with their last child
  • 65.1 percent Births assisted by a doctor/nurse/LHV/ANM other personnel
  • 50.4 percent Mothers received postnatal care from a doctor/nurse/LHV/ANM/ other health personnel within 2 days of delivery for their last birth
  • Under reporting of malnutrition and poor growth monitoring within the ICDS system
  • Linkages between ICDS and Health is a biggest concern due to lack of clarity within the government systemto address the issue of child malnutrition
  • No mission mode strategy at state level involving multiple stakeholders to address the issue of malnutrition
    (Source: National Family Health Survey 3 -2005-06, various government reports and field experiences of NGOs)

About Integrated Programme for Nutrition Improvement

The programme builds on life cycle approach to prevent, reduce and promote curative care of malnourished children through community participation. It focuses on children below six years (particularly children aged less than 3 year), adolescent girls and pregnant women and lactating mothers.

Key objectives

  • To work with pregnant women and lactating mothers on child health and nutrition
  • To work with adolescent girls toward their health and nutrition behavior
  • Identification of children with malnutrition for prevention in early stages of childhood
  • To strengthen the capacity of individuals, families and communities through community meetings, awareness and campaign
  • Creating a chain of ‘Nutrition Champions’ preferably mothers or primary care givers who deviates positively toward child development
  • To establish coordination between ICDS and Health to improve the nutritional and health status of children
  • To influence the policy in order to address the issue of malnutrition through advocacy and research

Core Components of the programme

1. Community Outreach
  • Assessment and evaluation of health and nutrition status of children through regular growth monitoring and developing ‘individual nutrition care plan’
  • Early identification of malnourished children before onset of serious complications
  • Community mobilization and awareness on malnutrition through participatory learning method
  • To work toward development of positive knowledge, attitude and practices among the community on malnutrition
  • Follow-up and home visits in complicated cases of malnutrition to promote curative care
2. Strengthening Delivery Mechanism
  • That regular assessment of a child being done through anthropometry measurements (weight for age concept) in anganwadis
  • Ensuring proper linkages of malnourished child with primary urban health centre through ASHA/ANM
  • That proper curative care is being given to a child with severe acute malnutrition as per government norms
  • Home-based care of a child through dietary counseling, feeding practices, linkages, etc.
3. Research and Advocacy
  • To strengthen ICDS and NRHM and its key components to address urban malnutrition
  • To strengthen other delivery mechanisms within the system

Approach

  • A proper management information system has been createdfor all children aged below six years, pregnant women, lactating mothersand adolescent girls in intervention areas
  • Regular growth monitoring of all children below six years is being taken on weight for age norms (WHO standard adopted by Anganwadi Centers)
  • Periodic assessment of growth pattern of a child through regular home visits
  • Health and nutrition counseling of mothers to promote positive behavior, knowledge and practices toward child health and nutrition
  • Community mobilization and awareness on issues of child health and nutrition
  • To make Anganwadis, ASHA workers, ANM, Supervisor, CDPO and Medical Officer sensitive toward child health and nutrition issues
  • Research and advocacy on issues of child health and nutrition