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COMMON NUTRITION PROBLEMS IN INDIA

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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COMMON NUTRITION PROBLEMS IN INDIA

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  1. COMMON NUTRITION PROBLEMS IN INDIA Dr. K.VIJAYARAGHAVAN DIRECTOR – RESEARCH, SHARE INDIA (MEDICITI INSTITUTION) & Sr. Dy. Director, NIN (Retd) <drk.vijayaraghavan@gmail.com>

  2. 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

  3. NUTRITION PROBLEMS IN INDIA WHO IS AT RISK?? PREGNANT WOMEN LACTATING WOMEN INFANTS PRESCHOOL CHILDREN ADOLESCENT GIRLS ELDERLY SOCIALLY DEPRIVED (SC & ST Communities) . Vijayaraghavan

  4. 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

  5. PREVALENCE OF LBW IN S.E ASIAN COUNTRIES Vijayaraghavan

  6. 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

  7. Source : Shanti Ghosh Source: Shanti Ghosh et al, 1978

  8. Source: Leela Iyengar & Apte, S,V.,1970

  9. Source: Leela Raman & Rajalakshmi,1974

  10. NUTRITIONAL DISORDERS IN CHILDREN • PROTEIN ENERGY MALNUTRITION (PEM) . CLINICAL FORMS . SUBCLINICAL UNDERNUTRITION • MICRONUTRIENT DEFICIENCIES Vijayaraghavan

  11. CLINCAL FORMS of PEM KWASHIORKOR • OEDEMA+ • IRRITABILITY+ • GROWTH FAILURE+ • DISCOLOURED HAIR+ Vijayaraghavan

  12. CLINCAL FORMS of PEM MARASMUS EXTREME WASTING “SKIN AND BONES” MONKEY/OLD MAN FACIES Vijayaraghavan

  13. SUB-CLINICAL FORMS OF PEM Vijayaraghavan

  14. UNDERNUTRITION IN INDIA ADULTS (Females) PRESCHOOL CHILDREN Based on NCHS weight for age Based on BMI Vijayaraghavan

  15. VIJAY’00

  16. DISTRIBUTION WEIGHT FOR AGE – IAPGujarat Gr. II Gr. I Gr. III Gr. IV Normal

  17. WEIGHT FOR AGE– SD CLASSIFICATION - GUJARAT

  18. VITAMIN A DEFICIENCY

  19. KERATOMALACIA BITOT SPOT V A D BILATERAL BLINDNESS Vijayaraghavan

  20. 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

  21. VITAMIN A DEFICIENCY (%) IN INDIA * 24-71 MONTHS Vijayaraghavan

  22. 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

  23. NUTRITIONAL DEFICIENCY SIGNS IN PRESCHOOL CHILDREN Vijayaraghavan

  24. Vijayaraghavan

  25. ANAEMIA

  26. Vijayaraghavan

  27. PREVALENCE OF ANAEMIA -ADOLESCENT GIRLS

  28. 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

  29. IODINE DEFICIENCY DISORDERS

  30. IODINE DEFICIENCY DISORDERS GOITRE+ 239 OF 282 DTs. SURVEYED – ENDEMIC 167 millions AT RISK ?

  31. PREVALENCE OF GOITRE IN 6-12 Yr CHILDREN - Gujarat

  32. DIETARY INTAKES

  33. HOUSEHOLD NUTRIENT INTAKES IN DIFFERENT AREAS VIJAY’00

  34. HOUSEHOLD NUTRIENT INTAKES IN DIFFERENT AREAS

  35. NUTRIENT INTAKES AMONG INDIAN WOMEN Source: NNMB, 2000

  36. NUTRIENT INTAKES IN PREGNANT WOMEN % RDI Source: NNMB,2000

  37. NUTRIENT INTAKES (per day) IN CHILDREN • NNMB, 2000 Vijayaraghavan

  38. 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

  39. 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

  40. 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

  41. THANKS & NAMASKAR

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