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Micronutrient Malnutrition Control for Better Productivity & Economic Growth

Micronutrient Malnutrition Control for Better Productivity & Economic Growth. Dr. Saraswati Bulusu National Program Manager, India The Micronutrient Initiative April 24, 2006. Overview.

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Micronutrient Malnutrition Control for Better Productivity & Economic Growth

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  1. Micronutrient Malnutrition Control for Better Productivity & Economic Growth Dr. Saraswati Bulusu National Program Manager, India The Micronutrient Initiative April 24, 2006

  2. Overview • Micronutrient deficiencies is a major public health problem in India affecting productivity and overall economic development. Minimal loss to GDP due to VMDs per year: Rs 27,720 crores • ICDS is the largest program in the world for integrated child nutrition with a network of 5,68,888 AWC’s across the country. • ICDS is targeted to reach the most vulnerable segments like <2 children, 2-6 yrs and PLW, who suffer more from these micronutrient deficiencies. • ICDS offers a scope for innovations to reach micronutrients to the at risk groups, leveraging the ICDS infrastructure. • The fortification programs could be piggy backed to the supplementary nutrition component of ICDS.

  3. Proven Opportunities to Control Micronutrient Deficiencies through ICDS • Supplementation (Since 1970’s): • Strengthening Bi-annual Supplementation of Vit A for Children 9m-59ms • IFA tablets to P&LW, Adolescent Girls and children. • Fortification : • Nutri Candies • Fortified ‘khichdi’ • Fortified RTE Foods • Fortified Wheat Flour ( ICDS & TPDS) • Multiple Micronutrient Sachets (Anuka)

  4. Fortified Candy Anuka Khichdi & RTE Wheat Flour Fortifcation VAS Salt Initiatives MI India – Summary of Interventions

  5. Nutri-candies: 5 Million Beneficiaries Covered Per Day

  6. Advantages of Nutri-candies • Simple distribution & compliance is nearly 100% • Targeted delivery • Centrally processed – qty. of mns ensured, • Packed attractively and hygienically • Cost effective (Rs.55 to 60 per ben. per year with 4 micronutrients inclusive of indirect costs) • Drawn the attention of policy makers • Proven : Sensory (IHE); Stability (NPIL); Effectiveness (CINI) & Efficacy (AIIMS)

  7. Effect of candies on attendance of pre-school children at AWCs - West Bengal (Udaynarayanpur Block, Howrah dist)

  8. Efficacy Trials on Anemia Prevalence in Pre-school Children Prevalenceof Anemia %

  9. ‘Vita Shakti’ to Fortify ‘Khichdi’-- An Innovative Approach • Khichdi -- Locally cooked at AWC with rice, lentil, oil & salt. (Presently reaching 1.2 million) • Vita Shakti -- premix with iron(7mg), vit A(500iu) & folic acid(50mcg) • Packaging -- 1 kg pouch that can cater to 4000 beneficiaries • Mode of addition -- A small spoon measuring 1.25 gms of the premix to be used for 5 beneficiaries, costing 3p per beneficiary per day. • Training - Dilution, Mixing, Storage : temp & light • Efficacy Study by Tufts University & CINI

  10. 40 0 Weeks 36 32.6 12 Weeks 32 24 Weeks 28 24 20.7 19.1 20 16 Mean Prevalence Anemia 13.3 12 9.8 8 4.1 4 0 NFK FK Treatment Group Prevalence of Anemia for Non-Fortified Khichdi (NFK) and Fortified Khichdi (FK) groups at 0, 12, and 24 weeks.

  11. 40 38 0 Weeks µ 35.48 36 24 Weeks 34 32 30 28 Mean SF Concentration (µg/L) 25.7 26 25.12 24 22.91 22 20 FK NFK Treatment Group Serum Ferritin Conc.in Non-Fortified Khichdi (NFK) and Fortified Khichdi (FK) groups at 0 and 24 weeks.

  12. ANUKA

  13. Wheat Flour Fortification for Control of IDA & VAD • Pilot project in DarjeelingSadar Subdivision in West Bengal through TPDS – reaching 0.6 million • Scaled up in Kalimpong & Kurseong through TPDS - today reaching 1.8 million • Launched in Haryana, Punjab & Chandigarh in 2005 through open market - today reaching 2.5 million (Jan 05) • Govt. Of AP initiated flour fortification through PDS (Nov 05) • Govt of Gujarat Model – Public Private Partnership for WFF (Jan 06) • Advocacy meetings at West Bengal & Orissa last week • Commitment of GOI at the national level – Policy Change??

  14. Iodized Salt & Double Fortified Salt • Use of adequately iodized salt in ICDS • Salt fortified with iron & iodine (DFS) is presently available – NIN and MI formula. • TNSC is presently manufacturing DFS which is being used in Mid Day Meal Program in Tamilnadu with support from MI • Efforts to scale up in ICDS/MDM/PDS

  15. Thank You

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