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METHODS IN NUTRITION PROGRAMS IN INDIA AND ASSESTMENT OF EXISTING PROGRAM . National Prohylaxis Programme for Prevention of Blindness due to vitamin A deficiency. National anaemia control programme , and National iodine deficiency disorder (IDD) control programme .
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National ProhylaxisProgramme for Prevention of Blindness due to vitamin A deficiency.
Vitamin A deficiency recognizes to be a major controllable public health and nutritional problem.
According to WHO>0.5% prevalence of Bitot spot in preschool children in indicative of public health significance.
The national prophylaxis programme for the prevention of nutritional blindness due to vitamin A deficiency aims at protecting children 6 months- 5 years at risk from vitamin A deficiency.
Prevention of vitamin A deficiency : The programme comprises a long term and a short term strategy. While the short term intervention focuses on administration of mega dose of vitamin A on periodic basis.
Regular dietary intake of vitamin A rich foods by pregnant and lactating mothers and by children under 5 years of age must be promoted.
Feeding of locally B-carotene (precursor of vitamin A) rich food such as green leafy vegetables and yellow and orange vegetables and fruits like pumpkin, carrots, papaya, mango, oranges etc. along with cereals and pulse to a weaning child must be promoted widely.
Under the massive dose programme, every infant between 6-11 months of age and every child between 1-5 years is to be administered vitamin A every 6 months.
Pregnant Women: One big (adult) tablet per day for 100 days (each tablet containing 60 mg/ 100 mg of elemental iron and 500 ug folic acid). These tablets to be provided to women after the first trimester of pregnancy.
Surveillance of iron deficiency involves an ongoing process of recording and assessing iron status in an individual or a community.
One common practice in assessing whether or not anemia is due to iron deficiency involves monitoring the response in hemoglobin or haematocrit levels after 1 or 2 months of oral supplementation with iron.
Determine the magnitude, severity, and distribution of iron deficiency and anemia, and preferably its main causes.
Elimination of Iodine Deficiency Disorders (IDD) is a most important healthand social goal.
There are three major components of sustainable programme to eliminate IDD:
Monitoring of any health intervention is essential, to check that it is functioning as planned and to provide the information needed to take.
Assessment of the situation requires baseline IDD prevalence surveys, including measurement of urinary iodine levels and an analysis of the salt situation.
Monitoring and evaluation require the establishment of an efficient system for the collection of relevant scientific data on salt iodine content and urinary iodine levels.
It is necessary to provide adequate dietary iodine to prevent brain damage in the fetus and in the young infant when the brain is growing rapidly.
External monitoring systems by governments-This system are based upon the establishment of a law which mandates that all salt for human and - in most countries, animal - consumption is iodized.
The NIDDCP is executed by a multiplicity of agencies comprising the Health, Industry and railway ministries of the central government.
The salt commissioner, in consultation with the ministry of railways, arranges for the movement of iodized salt from the production centre to the states.
Clinical examination assess levels of health of individuals or of population groups in relation to the food they consume.
Variations in the intake of different nutrients present in the diet are reflected by changes in the concentration of the corresponding nutrients or metabolites influenced by the nutrients, in blood, tissue and in urine.
The accuracy of biochemical tests depend upon the standards of collection, methods of transport and storage, including possible exposure to ultraviolet light, heat and shaking as well as the actual technique used.
The important biochemical methods useful in the detection of nutritional deficiency states are classified under 2 heads:
Measurement of nutrients, metabolites or other products in blood or urine.
Serum albumin: albumin counts for 50% of total serum proteins. It helps maintain fluid and electrolyte balance and transport many nutrients, hormones, drugs and other compounds. Albumin conc. reflects protein status of blood and internal organs.
Total lymphocyte count: TLC is reduced in protein malnutrition. So it is a useful index in nutrition assessment .WBC volume and red blood cell counts are routinely measured through which TLC can be easily calculated.
Creatinine in urine: skeletal muscle is depleted during protein deficiency. Muscle mass is related to the excretion of creatinine in urine. Studies show that excretion of creatinine in urine in 24 hrs expressed per cm. body height is a good index of muscle mass in children.
Iron: iron deficiency is the most widespread mineral deficiency. Although other tests are more specific in detecting early deficiency, Hb and Heamatocrit are commonly available tests.