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MATERNAL AND CHILD MALNUTRITION: CAUSES, NUTRITIONAL IMPLICATIONS AND INTERVENTIONS

MATERNAL AND CHILD MALNUTRITION: CAUSES, NUTRITIONAL IMPLICATIONS AND INTERVENTIONS. Diwa Pandey Assistant Dietician Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow. FOOD AVAILABILITY. MORTALITY RATE. Source: UNICEF website. PEM: Kwashiorkor. PEM: MARASMUS. UNICEF.

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MATERNAL AND CHILD MALNUTRITION: CAUSES, NUTRITIONAL IMPLICATIONS AND INTERVENTIONS

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  1. MATERNAL AND CHILD MALNUTRITION: CAUSES, NUTRITIONAL IMPLICATIONS AND INTERVENTIONS Diwa Pandey Assistant Dietician Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow

  2. FOOD AVAILABILITY

  3. MORTALITY RATE Source: UNICEF website

  4. PEM: Kwashiorkor

  5. PEM: MARASMUS

  6. UNICEF 1998-2004 LBW 30% Anaemia Under 3 74 % Adolescent 90 % Women 50 % 1996-2004 Under 3 years Stunting 46 % Wasted 16 % Underweight Moderately 47 % Severely 18 % Highest: Madhya Pradesh 55 % Lowest: Kerela 27 %

  7. MALNUTRITION UP: 2nd 3rd

  8. MALNUTRITION: CLASSIFICATION Type: Under nutrition/ over nutrition Cause: Endogenous/ exogenous Degree: Mild/ moderate/ severe Outcome: Reversible/ irreversible Nutrient: Single/ multiple Duration:Acute/ chronic

  9. ANTOPOMETRY: REFERENCE Traditional reference:- Gomez, Waterlow Recent:- Stunting: Height for age Wasting: Weight for height Type Normal Mild Moderate Severe Stunting(%) 90-120 80-89 70-79 <70 Wasting(%) 95-110 90-94 70-79 <85 Range+2 to –1 SD-1 to –2 SD-2 to –3 SD-3/more SD

  10. GOOD NUTRITION • Promotes good health • Allows for growth and development • Protects against disease • Provides for socially essential and desirable activity • Leads to quick recovery from illness with fewer complications MALNUTRITION Impedes development Motor Sensory Social Emotional Malnourished adults easy susceptibility to disease early death

  11. ASSESSMENT OF NUTRITIONAL STATUS WHO 1963

  12. CAUSES OF MALNUTRITION SocialEconomical Illiteracy Poverty Poor personal hygiene Unemployment Inadequate weaning Inaccessible health and diet care Ecological Unfertile land/drought Poor sanitation Poor food distribution/famine Interaction of social, economical and ecological variables leading to malnutrition. (Underwood 1992)

  13. FOOD AVAILABILITY Food security: World Bank (1986) Access by all people at all times to enough food for an active and healthy life. EVALUATION OF FOOD SECURITY Population level Household level Individual level Food production Food diversity Diet recall Per capita availability Diet record Import-export data Screen out potential nutritional deficiency Identify population at risk Implement appropriate intervention

  14. BALANCED DIET Purchasing power Local availability Religious affiliations

  15. DIETARY DIVERSITY • Cereals • Pulses • Roots and tubers • Milk • Sugar • Oils and fats • Fruits • Leafy Vegetables • Flesh foods and eggs • Divided into different food group • depending upon their nutritional • Significance • Used to cross check major • nutritional deficiencies • Form a basis to implement • intensive nutritional screening • and appropriate intervention

  16. MICRO-NUTRIENTS Vitamins, minerals and trace elements: Required in minute amounts but are essential for normal metabolic processes and their inadequacy leads to various deficiency diseases. Vitamin A Iron Calcium Iodine

  17. HYGIENE AND SANITATION Worm infestation Loss of appetite Effect on gut mucosa Reduced nutrient intake Malnutrition Less able to procure food Loss of energy More malnutrition Increases susceptibility to infection Latham 1991

  18. APPROPRIATE CHILD CARE PRACTICES Promotion of breast milk Timely and appropriate weaning MAXIMISING NUTRITIVE VALUE OF FOODS • Freshly consumed • Cooking and cleaning losses • Complementing foods • Natural fortification • Promote use of nutritious locally and/ or seasonally available foods

  19. SPECIFIC INTERVENTION MEASURES • Health and nutrition surveys: especially for high risk population • Food availability and selection: priority • Use of various forms of media: individual, community or • organization level • Training of field workers • Implement environmental hygiene programs

  20. THANK YOU

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