Nutritional Problems and Community Nutrition: Malnutrition and Intervention Programmes
Defining and measuring malnutrition
Undernutrition is assessed by anthropometric indices: weight-for-age (underweight), height-for-age (stunting, chronic), weight-for-height (wasting, acute), plus mid-upper arm circumference and bilateral pedal oedema for severe acute malnutrition. Overnutrition - obesity and diet-related chronic disease - coexists in the same communities, the double burden.
Major public health problems
Protein-energy malnutrition, iron-deficiency anaemia, iodine deficiency disorders, vitamin A deficiency, vitamin D deficiency and obesity. Assessment uses the ABCD approach: anthropometry, biochemical tests, clinical examination and dietary survey, supported by vital statistics.
National programmes
- ICDS (1975) - supplementary nutrition, growth monitoring, immunisation, health check-ups and pre-school education through anganwadis.
- Mid-Day Meal (1995), renamed PM POSHAN (2021) - hot cooked school meal.
- National Programme for Prevention of Blindness due to Vitamin A Deficiency (1970) and National Nutritional Anaemia Prophylaxis Programme (1970).
- National Goitre Control Programme (1962), renamed NIDDCP (1992) - iodised salt.
- Poshan Abhiyaan (2018), Anaemia Mukt Bharat, Eat Right India, food fortification, and the National Food Security Act 2013 with PDS and Antyodaya Anna Yojana.
Worked example
A 3-year-old has height-for-age −2.8 SD and weight-for-height −1.0 SD. Reasoning: the low height-for-age index identifies stunting from long-standing undernutrition, while the near-normal weight-for-height shows he is not currently wasted - so the priority is dietary improvement and growth monitoring rather than emergency management of severe acute malnutrition.
Traps that cost marks
Do not swap stunting and wasting. ICDS is more than supplementary feeding. Anaemia is not exclusively iron deficiency. Fortification and supplementation are not the same strategy.