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COMMON NUTRITION PROBLEMS IN INDIA

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COMMON NUTRITION PROBLEMS IN INDIA. Dr. K.VIJAYARAGHAVAN DIRECTOR – RESEARCH, SHARE INDIA (MEDICITI INSTITUTION) & Sr. Dy. Director, NIN (Retd). < drk.vijayaraghavan@gmail.com >. MOTHER AND CHILD SURVIVAL. MMR 407/100,000 live births IMR* 58/1000 live births

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slide1

COMMON NUTRITION PROBLEMS

IN INDIA

Dr. K.VIJAYARAGHAVAN

DIRECTOR – RESEARCH,

SHARE INDIA (MEDICITI INSTITUTION)

&

Sr. Dy. Director, NIN (Retd)

<drk.vijayaraghavan@gmail.com>

mother and child survival
MOTHER AND CHILD SURVIVAL

MMR 407/100,000live births

IMR* 58/1000 live births

Child Mortality 19.5/1000Children

Rate(1-4 years)

*Gujarat 53

Vijayaraghavan

slide3

NUTRITION PROBLEMS IN INDIA

WHO IS AT RISK??

PREGNANT WOMEN

LACTATING WOMEN

INFANTS

PRESCHOOL CHILDREN

ADOLESCENT GIRLS

ELDERLY

SOCIALLY DEPRIVED

(SC & ST Communities)

.

Vijayaraghavan

slide4

NUTRITION PROBLEMS IN INDIA

WHAT ARE THE COMMON PROBLEMS?

  • WOMEN
  • • POOR WT. GAIN
  • DURING PREGNANCY
  • CED
  • MICRONUTRIENT DEFICIENCIES
  • CHILDREN
  • LOW BIRTH WEIGHT
  • GROWTH FALTERING
  • PEM
  • MICRONUTRIENT DEFICIENCIES
  • FLUOROSIS, LATHYRISM
  • DIET RELATED CHRONIC DISEASES
  • OBESITY, CARDIOVASCULAR
  • DISEASES, DIABETES

Vijayaraghavan

slide6

FACTORS MODIFYING PREVALENCE OF LBW

  • % INSTITUTIONAL DELIVERIES
  • # ANCs (Minimum: >5)
  • QUALITY OF ANC
  • Includes:
  • No.of ANCs, TT, Weight, BP, Examination of Blood, Examination of Urine
slide7

Source : Shanti Ghosh

Source: Shanti Ghosh et al, 1978

nutritional disorders in children
NUTRITIONAL DISORDERS IN CHILDREN
  • PROTEIN ENERGY MALNUTRITION (PEM)

. CLINICAL FORMS

. SUBCLINICAL UNDERNUTRITION

  • MICRONUTRIENT DEFICIENCIES

Vijayaraghavan

clincal forms of pem
CLINCAL FORMS of PEM

KWASHIORKOR

  • OEDEMA+
  • IRRITABILITY+
  • GROWTH FAILURE+
  • DISCOLOURED HAIR+

Vijayaraghavan

clincal forms of pem1
CLINCAL FORMS of PEM

MARASMUS

EXTREME WASTING

“SKIN AND BONES”

MONKEY/OLD MAN FACIES

Vijayaraghavan

undernutrition in india
UNDERNUTRITION IN INDIA

ADULTS (Females)

PRESCHOOL CHILDREN

Based on NCHS weight for age

Based on BMI

Vijayaraghavan

distribution weight for age iap gujarat
DISTRIBUTION WEIGHT FOR AGE – IAPGujarat

Gr. II

Gr. I

Gr. III

Gr. IV

Normal

slide19

KERATOMALACIA

BITOT SPOT

V

A

D

BILATERAL BLINDNESS

Vijayaraghavan

who criteria for public health significance vad
WHO Criteria for Public Health Significance- VAD

Minimum Prevalence (%) in children <6 yrs

  • BITOT SPOTS 0.5
  • NIGHT BLINDNESS 1.0
  • CORNEAL LESIONS 0.01
  • CORNEAL SCARS 0.05
  • Serum Retinol <10 g/l 5.0

Vijayaraghavan

slide21

VITAMIN A DEFICIENCY (%) IN INDIA

* 24-71 MONTHS

Vijayaraghavan

slide22

No VAD

VAD

VITAMIN A DEFICIENCY

Districts(%) with X1B >0.5%

Average prevalence (%)

2.1

Based on surveys in 126 Dts.

by NIN and NNMB

Vijayaraghavan

anaemia in females
ANAEMIA IN FEMALES
  • PREVALENCE OF ANAEMIA IS VERY HIGH IN BOTH THE GROUPS
  • NO CHANGE NOTICED OVER TIME IN THE PREVALENCE

Pregnant Women

Adolescent girls

Vijayaraghavan

slide30

IODINE DEFICIENCY DISORDERS

GOITRE+

239 OF 282 DTs. SURVEYED –

ENDEMIC

167 millions AT RISK ?

slide38

DETERMINANTS OF MALNUTRITION

MATERNAL MALNUTRITION

START WITH A HANDICAP(LBW)

FAULTY CHILDFEEDING PRACTICES

DIETARY INADEQUACY

FREQUENT INFECTIONS

LOW PURCHASING POWER

LARGE FAMILIES

HIGH FEMALE ILLITERACY

TABOOS AND SUPERSTITIONS

slide39

Factors Affecting Nutritional Status

High illiteracy Unemployment/

Underemployment

Large families

Low purchasing power

Ignorance High dependence rate

False food beliefs Inadequate intakes

Low Procurement

of foods Poor PDS High cost

Low availability of foods

Low production Reduced work Malnutrition

of foodgrains output

Poor environment Morbidity Absorption of nutrients

Low Appetite

Poor utilization of services poor coverage of immunization

Improper health services

poor infrastructure

Lack of resources

slide40

INTERVENTIONS IN OPERATION

  • DIRECT
  • CONVERGENCE OF SERVICES (RCH)
  • INTEGRATED CHILD DEVELOPMENT SERVICES
  • IRON AND FOLIC ACID DISTRIBUTION
  • MASSIVE DOSE VITAMIN A PROGRAMME
  • PRIMARY HEALTH CARE PROGRAMME
  • HEALTH AND NUTRITION EDUCATION
  • INDIRECT
  • POVERTY ALLEVIATION PROGRAMMES
  • ENVIRONMENTAL SANITATION
  • PROTECTED WATER SUPPLY
  • LITERACY PROGRAMME
slide41

THANKS &

NAMASKAR