Community Nutrition

COMMUNITY NUTRITION 3 (1+2)

Lesson 14 : Nutrition programme in India

National nutrition programmes

1. National Vitamin A Prophylaxis Programme
   Nutritional blindness caused by vitamin A deficiency is one of the major nutritional problems affecting children. Dietary improvements to provide adequate amounts of vitamin A is the logical approach for prevention and control of this condition and there are relatively inexpensive sources of vitamin A precursor (carotenes) such as green leafy vegetables and fruits. Achieving this however, involves intensive nutrition education which is a long term approach. A short term measure of providing synthetic vitamin A periodically to pre-schoolers was launched in 1971 by the Ministry of Health and Family Welfare. A massive oral dose of 200,000 I.U. of vitamin A is given once in every six months to children between 1-5 years. Supplies of vitamin A for this programme are made available by the ministry of Health to State Family Welfare Departments implementing the programme through the network of Primary Health centres and sub-centres. ANMs and other paramedical workers administer vitamin A by home visits to all the children between 1-5 years. The acceptability of this approach and administrative feasibility and efficacy of the programme are well established.


2. National anaemia control programme
   Iron deficiency is the major causative factor for anaemia in India, although folate deficiency is also responsible to some extent. High rates of prenatal mortality and premature births are some sequelae of anaemia. As a preventive measure, the Ministry of Health has undertaken a national programme of distribution of iron and folic acid tablets to pregnant women during last trimester of pregnancy and to preschool children. The existing network of Primary Health and Maternity and Child Health Centres is used for this programme. Evaluation studies revealed that the programme could be effective in raising the haemoglobin status of the beneficiaries, though not achieved anticipated success.


3. National Iodine deficiency disorders (IDD) control Programme
   India has one of the most severely endemic areas of goiter. It occurs all along the sub-Himalayan regions and several new foci of endemic goiter has been discovered in recent years in the country. Of the 120 million people living in the endemic region, nearly 1/3rd are estimated to be suffering from goiter. Prevention and control of this condition through distribution of Iodised salt is well known. The ministry of health and family welfare launched a National Goitre Control Programme towards the end of the Second Five Year Plan. The programme was renamed in 1992 as National Iodine deficiency disorders control programme. Identification of pockets of goiter and supply of iodised salt to the population at risk are done under this programme. Salt is iodised with potassium iodate and distributed in endemic areas at the same prices as common salt. Iodised salt is made accessible to below poverty line population through PDS in several states of India. Various administrative and managerial bottlenecks at the implementation level appear to have contributed to the poor impact of this programme.