NUTRITION – THE FOUNDATION FOR LIFE

1. NUTRITION – THE FOUNDATION FOR LIFE Dr.M.S.Tara Regional Director NIPCCD, SRC, Bangalore

2. Wisdom of the Body Three Entities Three entities are always interacting and dependent on each other To wards this function- Nutrition plays an important role The other Organs Brain Intestinal Micro flora

3. SURVIVAL NUTRITION DEVELOPMENT GROWTH Nutrition is a basic human need & A Pre-requisite for a Healthy Life. Health Physical/mental/emotional/social &not merely absence of disease.

4. Basic Foods for Nutritional Attainment

5. Major nutrition-related public health problems • Chronic energy deficiency and undernutrition • Micro-nutrient deficiencies • Anaemia due to iron and folate deficiency • Vitamin A deficiency • Iodine Deficiency Disorders • Chronic energy excess and obesity

6. NUTRITION FOR growth&DEVELOPMENT

7. Nutrition & Development - Critical Link 7

8. Major health problems among school children • Anemia • Vitamin A deficiency • Oedema • Worms • Diarrohea • Dental caries • Skin infection

9. POVERTY MALNUTRITION and INFECTION LOW WORK OUTPUT ILLITERACY UNHYGIENE INFECTIONS AND INFESTATIONS SUPERSTITIONS FOOD TABOOS II-HEALTH OR SICKNESS MAL NUTRITION

10. MULTI DIMENSIONAL Restricted Access To Health Services Household Food Insecurity Low Attendance at School and Low Cognition Low Income Low Food Consumption Low Productivity Low School Performance Malnutrition Poor access to safe water &poor Sanitation Low Work Output Poverty Poor Caring Poor Returns on Investment in Education

11. Malnutrition and Productivity Reduced work capacity and work output Household food Insecurity Malnutrition in childhood and adolescence

12. NUTRITION PROBLEMS IN INDIA WHO ARE AT RISK? pregnant women lactating women infants preschool children adolescent girls elderly socially deprived Communities .

13. Consequences of Malnutrition • Mortality due to infection/Malnutrition (IMR,CMR) crippled for the rest of lives either blinded, congenitally deformed or physically and mentally retarded • Suffer from various degrees of malnutrition- contribution to the society and the state is greatly reduced • adds to the health costs of the nation • A drain in National human resource • Malnutrition negatively impacts the GDP as it reduces physical/ cognitive growth, reduces productivity and earnings of individuals, and results in economic loss to the nation. 3% of GDP is lost on account of malnutrition

14. Scenario in Andhra Pradesh

15. Distribution(%) of Adult men & women≥18 years & Children 10-17 yrs according to BMI (NNMB Rural Survey:2005-06)

16. Nutrition Programmes in AP for women &children… • ICDS – 387 Projects & 91307 AWCs • NDCCs - 4,200 NDCCs across Andhra Pradesh, • INDIRAMMA AMRUTHAHASTHAM(IAH) – 102 ICDS high risk projects) • Girl Child Protection Scheme • MID DAY MEAL SCHEME • KISHORI SHAKTI YOJANA • SABLA

17. Some challenges • Access to Food • Access to quality nutrition • Access to health services • Access to potable drinking water • Sanitary conditions • Access to Toilet facilities • Access to PUBLIC NUTRION PROGRAMS

18. Current Eating Practices in Urban area • Fast food: • Foods rapidly prepared & quickly served esp. in a packaged take away… • Vada, noodles, battura , paties, fries, samosa.. • Instant Foods: Specially processed to dissolve & serve with low cooking time – soup powder, noodles • Junk Food: Energy dense high fat/sugar/ salt with low nutrient values of protein, fiber, micronutrients • Burger, pathiri, chips, Lays, Colas • Street Food: Ready to eat foods & drinks prepared by vendors • Kappa meencurry, cool drinks, thattu dosa

20. Nutrition – Information Gap? Innovations -Advocacy Strategies

22. Campaign as a key technique AREA- ANGANWADI CENTRES OF ICDS PROJECTS KARNATAKA

23. Objectives of the campaign • Reaching out to families, pregnant, lactating mothers ,adolescents ,teachers ,PRI& community • To create an understanding on causes and consequences of malnutrition • to sensitize the community on lifecycle issues and approach for breaking the intergenerational cycle of malnutrition. • To promote home level care and behaviour-IYCF • create an enabling environment for smooth implementation and integration of support services for optimal nutritional attainment. • To support every individual towards advocating the cause in his/her own capacity

24. Need assessment to Address the gaps -Compiled a comprehensive data base of the nutrition support and health facilities in and around the area -Sensitization -need for nutrition as foundation of life. -Identification of stake holders -Capacity development of stake holders -Mobilizing resources -Reforms and policies -Will-political and administrative -simulation exercises to tighten the response

25. How Advocacy? • Listed a set of targeted actions directed at decision makers in support of specific cause A)child malnutrition issues B)Nutrition-the foundation of life. • Defined the promotion of a cause for influencing the different stake holders - devised a campaign technique for aiming at change in attitudes ,actions, by influencing people and organizations ,system, structure at different levels for betterment of people and more so women and children.

26. contd • advocacy involved ,making in favour of nutrition attainment for young children. Key issues( Early registration/EDD/JSY/ Health Checkups/IYCF/IMMUNISATION • A planned communication management, skillful persuasion and /strategic action for promoting nutrition to young children. • Existing tools like Mother Child Protection card used intensely .calendar/,and the IEC materials of MWCD on pro-bono services of celebrity- standing malnutrition • Consistent Advocacy actively supported the cause, and tried to get others to support it as well .

27. Why advocacy was needed? - being a critical component for ensuring optimal program out reach and services -Envisaged a safe and reassuring environment for vulnerable population to access services -enabled in seeking information that empowered mothers with necessary skills to cope up with challenges.

28. Who were the advocates? • Women and child development functionaries • Health functionaries • Civil society organizations • Women ,men. ,youth/adolescents children • SHG members ,opinion leaders/ persons who influenced others to support the idea,/ issue, • All others who could lobby with-for Policy issues Programmatic issues People /community

29. What did Advocacy Involve? • Analyzing the environment- availability/access • Defining the agenda or cause • Identifying the partners • Lobbying the support of decision makers • Forming allies and rallying support • Establishing Networks • Mobilizing public opinion • Enlisting the support of beneficiaries • Addressing the concerns of adversaries

30. Skills that helped for Advocacy • Positive attitude and patience • Thinking skills; social skills and negotiation skills • Credibility of the person, like a role model

31. What worked? Some of the basic conduct like- • Being gracious-to receive lot of criticism, • Being professional-not spoke negative • Being focused- clear about the support from expected stakeholders. • Needed to do a prior home work, and prepared rationality. • Needed to Consider oneself as an information source • Telling the truth helped-had to avoid false/misleading information …contd…

32. contd.... for well coordinated advocacy- effort was needed to Know who else was more helpful . • the opposition had to be Known • The campaigners were not afraid to admit their lacunae. • Curtailed giving too many messages but were specific • Followed up for positive response. • Updated /informed on -latest developments • Allowed the channel of communication open for future.

33. OUTCOME? • CREATED A DEMAND FOR PUBLIC NUTRITION SERVICES • ENABLED FUNCTIONARIES TO MOBILISE COMMUNITY • BUILT THE CONFIDENCE OF THE COMMUNITY ON THE PROGRAMS • INITIATIVE WAS A PUSH FACTOR FOR CONVERGENCE OF SERVICES • VISIBILITY TO THE ISSUES GENERATED SUPPORT WITHIN THE FAMILY • EMPOWERD WOMEN INDEED HAVE BECOME TRUE ADVOCATES THAT BEFITTED THE PURPOSE OF THE CAMPAIGN • .

34. THANK YOU