NATIINAL NUTRITION PROGRAMME

Introduction:- it the time of our political independence about 50years ago. India
was a veritable museum of the most florid clinical forms of malnutrition, classical,
kwashiorkor, keratomalacia, beriberi and pellagra were wide spread as major public
health problem.
The green revolution has helped the country in overcoming families. The food grain
production which was 50- 82 million tones during 1950- 51 has risen to 198.96
million tones in 1996-97. The country is now carrying a suffer stock of about 36
million tones.
The major national nutrition supplementation programme in India are-
1. National nutritional anaemia control programme.
2. National programme for prevention of blindness due to vitamins A deficiency.
3. National iodine deficiency disorders control programme.
4. Integrated child development service schemes ( ICDS)
5. Special nutrition programme.
6. Wheat based nutrition programme.
7. Applied nutrition programme.
8. Balwadi nutrition programme.
9. Mid day meal programme.

1. NATIONAL NUTRITIONAL ANEMIA CONTROL

PROGRAMME (NACP)
The national nutritional anaemia prophylaxis was launched in 1970. The programme
was renamed as NACP in 1991, it is totally a centrally sponsored scheme.
Objectives:-
1. To assess in baseline prevalence of nutrition anaemia in mothers and young
children through estimation of haemoglobin level.
2. To put the mothers and children with low Hb levels that is less than 11mg/dl and
less than 8mg/dl respectively on anti anaemia treatment.
3. To put the mothers Hb level more than 11gm/dl and children with Hb level more
than 8 mg/dl on prophylaxis programme.
4. To monitor continuously the quality distribution and consumption of iron folvite
tablets.
5. To motivate the mothers to consume the tablet through relevant nutrition
education.

Beneficiaries:- The programmes beneficiaries are children 1-5 years of age and
pregnant and nursing mothers female acceptors of terminal method of family
planning and intra uterine device.
The target beneficiaries of the scheme are 50% of total pregnant and nursing
mother and 25% of total women acceptors of terminal methods and IUDS.
Activities and services:-
The programme focuses on the following activities.
1. Promotion of regular consumption of foods rich in irons.
2. Provision of iron and folate supplements in the form of tablets to the target
groups.
3. Identification and treatment severe anemia cause.
Prophylaxis treatment of iron deficiency anemia:-
Adult women 100 mg elemental iron.( equivalent to 300 mgg ferrous
sulphate) + 500 mg folic acid.
Children 1-5 year:- 20 mg elemental iron.( equivalent to 60 mg ferrous
sulphate) + 100 mg folic acid.
Treatment for iron deficiency anemia:-
1. Administration of 21FA tablets daily for 100days starting from the second
trimester of pregnancy.
2. Women with syptmos and sign of anemia are required to be given 3 tablets
daily. Other activities.
a. Promotion of consumption of balanced and adequate diet.
b. Treatment of hookworm infection.
c. Birth spacing by at least 3 years among the women.
Recent initiatives:-
A national consultation on control of nutritional anemia in India was held in
October 1998 which made the following recommendations to strength on NACP

2.NATIONAL PROGRAMME FOR PREVENTION OF BLINDNESS DUE TO

VITAMIN A DEFICIENCY
It was launched in 1971 and presently 30 million beneficiaries. The programme
comprise a long term and short term strategy. A short terms intervention focuses
administration of mega dose of vitamin A on periodic basis while long term
emphasis on dietary intervention to increased the intake of food which are rich in
vitamins A.
Objectives:-
The specific objective of the programme to reduce the disease and present
blindness due to vitamin A deficiency.
Beneficiaries:-
Through the programme tolerance to all children between 6 months to 5 years of
age, the children below3 years are given priority for coverage.
6-11 months : once dose of 100000IU
1-5 years : 200000 IU
Regular consumption of vitamin A rich food such dark green leafy vegetable,
yellow vegetable and fruits dairy products and the promotion of breast feeding.
 3.NATIONAL IODINE DEFICIENCY DISORDERS CONTROL
PROGRAMME (NIDDCP)
Realizing the magnitude of the problem of the problem the government of India
launched a 100% centrally assisted national goiter control programme in 192 with
the following objectives:
1. Initially survey to assess the magnitude of the iodine deficiency disorders.
2. Supply of iodized salt in place of common salt.
3. Resurvey to assess the impact of iodized salt 1992 the national Goiter
programme (NGCP) was renamed as national iodine deficiency disorder control
programme (NIDDCP).
Beneficiaries:-
All people residing in endemic and non endemic area for IDD. The
endemic area is given priority.
Activities and service : The following activities are organised under the NIDDCP.
1. Production and distribution of iodine salt:- On the recommendation of central
council of health in 1984 the government decided to iodine the entire edible salt
in the country by 1992. This policy decision was implemented April 1968 in a
phased manner.
2. Establishment of goiter cell”- For effective and proper implementation of
NIDDCP all the state and UTs have been advised to establish IOD control cell in
the state health directorate.

4.INTEGRATED CHILD DEVELOPMENT SERVICE SCHEMES

(ICDSS)
The most important scheme in the field of child welfare is the ICDS scheme. It was
initiated by the govt of India in the ministry of social and women's welfare in 1975.
The ICDS programme was initiated for the welfare of the children development of
human resources is designed for both preventive development effort through a
integrated package service.
The beneficiaries of the programme are children up to 6 years
pregnant women, nursing mother and women of 15 to 45 years. ICDs schemes is
working at village level in rural area and also in urban and tribal areas.
In 1975 number of ICDs projects was only 33 which was stared experimental basis.
At present the ICDs projection are functioning in 5320 blocks all special
intervention over the country.
For children less than 3 years
 Supplementation
 Immunization
 Health check-up
 Referral service.
For children in age group 3 to 36 years.
 Supplementation nutrition
  Immunization
 Health check-up
 Referral service.
 Non formal preschool education.
For pregnant women
 Supplementation nutrition
 Immunization against
 Health check-up
 Referral service.
For nursing mothers
 Supplementation nutrition
 Health check-up
 Referral service.
Other women of 15 to 45 years.
OBJECTIVES:
1. To improve the nutritional health status of children in the age group 0-6
years.
2. Proper psychological, physical and social development of the child.
3. To reduce mortality and morbidity, malnutrition and school drop out.
4. To achieve an effective coordination of policy and implementation among the
various departments working for the promotion of child development.
5. Nutritional needs of the mother and nutritional needs of the child through
proper nutrition and health education.

DELIVERY OF SERVICES:
The service are declared by the Anganbadi workers at the ICDs centres for
about by 1000 population she is assisted by a local women who is usually
uneducated and unskilled person.

1.Supplementary Nutrition:
it is given to children below 6 years and expectant mother. The aim is to
supplement nutritional intake by about 200 cal and 8-10 grams of protein for
children below 1 year about 300 cal and 15 grams of protein for children between 1-
6 year about 500 cal and 25 gram of protein for pregnant mother.
2. Nutrition and health education:
Nutrition education and health education is given to all women in the age
group 15-45 years.
3. immunization:
Immunization of children against 6 vaccine preventable diseases is being
done, while for expectant mothers immunization against tetanus is recommended.
4. Health check up:
the health care of children under 6 years of age consist of:
1. record of weight and height of children at periodical intervals.
2. Watch over mile stones
3. Immunization.
 4. check up every 3-6 months to detect diseases, malnutrition etc
5. treatment for disease like diarrhoea, dysentery, respiratory tract infection etc
6. deforming
7. prophylaxis against vitamin A deficiency and anaemia.

5. non formal pre school education:

children between the ages 3-6 years are imparted non formal pre school
education in an anganwadi in each village with about 1000 population . The
objective is to provide opportunities to develop desirable attitudes, values and
behaviour pattern among children.

6.SPECIAL NUTRITION A PROGRAMME

The special nutrition programme was launched in 1970-71by the
ministry of social welfare. Government of India. It was initially launched as a central
to the state sector during the 5th five year plans , steps were taken to convert the SNP
centres on the pattern of ICDs scheme by strengthening them with health and other
inputs.
Objectives:
The objectives of the programme is to improve the nutritional status of
preschool children pregnant and lactating mothers of poor socioeconomic groups in
urban slums, tribal areas and drought prone rural areas.
It activities include-
To provide supplementary nutrition.
To provide health care service including supply of vitamins A solution and
iron and folic acid tablets.
The supplementary nutrition is provided in
6 months- 72months: 300 cal+10g protein/ child/ day.
The severe by malnourished children are provided :600cal+20g protein/day
Pregnant and lactating mothers received 500 cal an 20g protein/ day iron and folic
acid tablets are also provide.

7.WHEAL BASED SUPPLEMENT NUTRITION PROGRAMME

(WNP)
It is a centrally sponsored scheme started in 1986. Scheme was initiated to
enlarge the scope of existing nutrition programme by covering additional
beneficiaries to the children and antenatal and nursing mother. But form 1990 only
the beneficiaries of the central sector ICDs project are provided supplementary
nutrition under this scheme.
At present 16 states and 3 union territories are implementing this
scheme with a target of 3lakh beneficiaries.
8.APPLIED NUTRITION PROGRAMME ( ANP)
IT WAS 1ST IMPLEMENTED IN ORISSA AND Andhra Pradesh in 1962 by
the year 1973 the whole country was covered by the scheme . the programme was
initiated as a centrally sponsored scheme but now is being implemented by the states.
Objectives:-
To make people conscious of their nutritional needs.
To increase production of nutrition food and its consumptions.
To provide supplementary nutrition to vulnerable group through local
production of food.
Beneficiaries:
Children between3-6 years.
Pregnant and lactating mothers.

9.BALVADI NUTRITION PROGRAMME(BNP)

It is being implemented since 1970-71 through 5 national level voluntary
organization namely the central social welfare broad. India council for child welfare,
Harijan sevak singh, Kasturba Ghandi national memorial trust.
The grant in aid under this programme is given to voluntary organization towards
the Bal sevikas/ helpers and supplementary feeding of children about the 5 national
level voluntary organization to implement the programme.
Aims:-
1. To supply about 3 of the calorie and ½ of of the protein requirement of the
preschool child as a measure improve nutritional status.
2. To supplement the gap between the nutritional requirement actual availability of
nutrients to the child.
3. Beneficiaries:- pre school children between the age of 3 to 5 years.

10. MID DAY MEAL PROGRAMME ( MDM)

It is also known as school lunch programme. It has
been in operation since 1961 throughout the country. The major objectives of the
programme is to attract more children for admission to schools . and retain then so
that literacy improvement of children could be brought about.
Principles are:-
1. The meal should be supplement and not a substitute to the home diet.
2. The meal should supply at least 1/3 of the total energy requirement and half of
the protein need.
3. The cost of the meal should be reasonably low.
4. The meal school be such that it can be prepared easily in schools. no
complicated cooking process should be involved.
5. Locally available foods should be used. this will reduce the cost of the meal.
6. The menu should be frequently changed to avoid monotony.

Mid day requirement

 # Food Gm/day/child
1 Cereal and millets :: 75
2. Pulses :: 30
3. Oils and fats :: 68
4. Leafy vegetables :: 30
5. Non leafy vegetable :: 36
Till recently in many states CARE. CARE support has been with drawn from the
state but the programme is continuous with state government funds. Target
beneficiaries and number of feeding days in an ear varies from state to state.

BIBLIOGRAPHY
1. Dr. Agarwal “ Textbook of paediatric and Neonatology” 2001 1st edition
modern published page no. 92-95.
2. Parul Datta “ Textbook of Paediatric Nursing” 1st edition 2007 published by
Jaypee brothers privatelimited page no. 521-522.
3. K. Park “ Preventive and Social Medicine” 2002 17th edition published by
M/S Banarsidas Bharat Publishers, page no. 320-321.
4. Assuma Beevi T.M. “ Textbook of paediatric Nursing” 1st edition
2010published by Elsevier page no. 230-232