The document discusses malnutrition and nutritional assessment. It defines nutrition security and explains that while a family may be food secure, individuals can still be nutritionally insecure. It also outlines different types of malnutrition including undernutrition which arises from inadequate food intake and marasmus and kwashiorkor which are protein-calorie malnutrition conditions. The document describes how to measure malnutrition through anthropometric measurements like weight, height, mid-upper arm circumference and edema. It explains the objectives of anthropometric assessments including identifying those at risk of death and selecting individuals for feeding programs.

2. NGO partners are able to recognize the micro nutrient deficiencies among children.

4. NUTRITION SECURITY Nutrition security is an outcome of –good health, –a healthy environment, –and good caring practices in addition to household-level food security

5. FOOD SECURITY AND NUTRITION SECURITY For example, a mother may have reliable access to the components of a healthy diet, but because of poor health or improper care, ignorance, gender, or personal preferences, she may not be able to or may choose not to use the food in a nutritionally sound manner, thereby becoming nutritionally insecure

6. MALNUTRITION •It arises from either excessive deficiency of food or •Excessive consumption of food leading to overweight and impaired physiological functions or •Consumption of the wrong type of food in wrong proportions

7. UNDERNUTRITION •It arises primarily because of inadequate food intake •The total quantity of food intake is less than the required quantity •As a result, there is primarily energy deficiency followed by protein deficiency and other micronutrient deficiencies

8. Measurement of Malnutrition

11. Bilateral Oedema •Independent indicator of severe malnutrition •Only individuals with bilateral lower limb oedema are classified as having nutritional oedema Detection of Bilateral Oedema •Apply moderate thumb pressure bilaterally to lower extremities (just above the ankle or on the tops of the feet) and count to 3 seconds. •If a pit remains after the thumbs are removed, the person has oedema

14. Nutrition (Anthropometric) Surveys •help to quantify the severity of the nutritional situation at one point in time –which is essential to help plan and initiate an appropriate response. •The prevalence of malnutrition in the 6-59 month age group is used as an indicator for nutritional status of the entire population: –this sub-group is more sensitive to nutritional stress –interventions are usually targeted to this group

15. Objectives of Anthropometric Assessment •Measure degrees of acute and chronic malnutrition among individuals •Identify individuals at risk of death •Select individuals to be enrolled in a feeding programme. •Follow-up individuals enrolled in a feeding programme. •Monitor individuals’ growth •Assess the prevalence of malnutrition in a population

16. Measuring Nutrition (Anthropometric Measurements) •weight •height (or length) •mid-upper arm circumference (MUAC) •bilateral oedema •Age and sex should be recorded to allow interpretation of indices

17. Measuring Weight •Most sensitive indicator for changes in nutrition •Children:SalterScale,25kg hanging scale graduated by100g •Child weighed with minimum clothing •Read the scale at eye level •Infants: Infant weighing scale with10g precision •Adults: Mechanical Beam scale or bathroom scale

18. Measuring Length/Height Length for children < 85 cm Height for children >85 cm

22. Body Mass Index (BMI) •Body Mass Index = Weight (in kg) Height squared (in m) •assess nutritional status of adolescents & adults •used in both emergency and stable contexts

24. EXERCISE

25. Old man’s face Thin, flaccid skin hanging in folds Severe wasting MARASMUS

26. Hair -thinner and lighter Moon face No appetite Oedema (symmetrical oedema involving at least the feet) Skin lesions KWASHIORKOR

29. GROUP WORK

34. How to conduct growth monitoring for Under 5 Years (tools are weighing scales and growth card).