PRESENTERS: ANJAN KHADKA(62023)GITA KHAKUREL(62024)

INTRODUCTIONNutrition: may be defined as the science of food and

its relationship to health.

Nutritional survey of a community:

is the sum of the nutritional status of individuals that form the community.

Nutritional statusThe state of the human body resulting from the balance

between intake of food and expenditure of energy is known as the nutritional status.

• Clinical examination

• Anthropometry

• Biochemical evaluation

• Functional assessment

• Assessment of dietary intake

• Vital and health statistics

• Ecological studies

National programme on nutritionobjectives:

• Control of protein energy malnutrition.• Control of vitamin A deficiency disorders.• Control of anemia.• Control of iodine deficiency disorders.• Control low birth weight.• Protection and promotion of breastfeeding.• Reduce the infestation of intestinal worms.

Targets• Reduce severe and moderate malnutrition

among under 5 children at 40% by the year 2017.

• Reduce iron deficiency in pregnant women to 43% by the year 2015.

• Reduce sub clinical vitamin deficiency among children under 5 years of age to 7% by preventive measures by the year 2015.

• Reduce nutritional blindness caused by vitamin A deficiency among pregnant women to 1% by the year 2015.

OBJECTIVES OF NUTRITIONAL SURVEY

• To evaluate the nutritional status of the community.

• Identification of the nutritional

problems prevalent in the area.

• To give proper health education so as to improve the health status.

METHODOLOGY:

• Place of study: Kathmandu-34, Jagritinagar• No. of families visited: 23• Type: household survey• Method: Oral questionnaire method• Procedure: The families were visited for three

consecutive days and questioned about the food consumed by them during those three days.

• Calculation: The energy consumed, the values of the micro and macro nutrients consumed, were then calculated by referring with the standard tables provided.

COMMON FOOD ITEMS USED IN THE COMMUNITY:

RICE PULSES

POTATOESLEAFY VEGETABLESFLESH FOODS

0

50

100

150

200

250

pro. Fat Fe Nia. Rio.

Reqirement

Actual Consumption

REQUIREMENT & ACTUAL CONSUMPTION OF VARIOUS NUTRIENTS IN THE COMMUNITY:

0

2000

4000

6000

8000

10000

12000

Cal. Ca VitA VitB VitC

requirement

Actual Consumption

Nutrition statistics

0

5

10

15

20

25

energy prt. ca Fe vit A vit B1

deficiencyexcess

Per Capita calorie:

Total calories taken by family per day

No. of family members

Mean Per capita calorie of community =

1724.80 Kcal

CONSUMPTION UNIT REQUIREMENTCU= Total Calories taken by family per day

Family coefficient

MET7%

NOT MET93%

MET

NOT MET

Frequency of the deficiencies observeds.n. energy protein iron vit.A vit.b1 vit.b2 fat vit.c ca niac in percapita

1 1252 116.7 8828.2 1.99 1.4 805.9 14.4 20952 48.5 5246.8 0.32 1.2 27.1 421.8 26863 38.8 0.5 77.8 35974 112 8525 0.8 1.3 800 12 25005 52.7 7596 0.79 1.8 45.6 284 13.5 25186 50 0.3 300 11 24147 2223 45 32 23 13508 27.64 61 4754 1.5 1.9 21.2 657.4 14.5 42479 1305 58.6 53.8 4441.6 42.6 69.4 858 24.9 2167

10 1714 758.6 44.3 3282.4 1.1 1.7 26.3 10.5 249.6 15.5 125711 30.6 0.04 126 262112 71.8 7883.5 0.2 1.5 7.8 285113 4578 102.6 68.8 6998 2.5 1.9 105.8 398.2 24.7 873.914 618 66.5 5545 0.7 1.9 186 286 9.5 222315 3990 52.8 87.4 8687.6 2.6 1.3 25 657.4 30.6 129216 4799 163.8 10533 81.6 1531 26.7 154317 490.5 44.4 5295.2 0.4 1.6 535.2 7.3 219618 6098 115.7 121.2 11387 3.57 4.6 67.9 108.1 1664 42.3 104519 302.5 80.2 8483.5 2.2 1.8 20 24 1010 8.6 231120 24.7 8810.8 1292 150621 4905 44.4 5295.2 0.4 1.6 535.2 7.3 219622 1252 116.7 8828.2 1.99 1.4 805.9 14.4 209523 4578 102.6 68.8 6998 2.5 1.9 105.8 398.2 24.7 873.9

Energy

Protein

Ca

Iron Vit. A

NO

OF

FAMILIES

FREQUENCIES OF THE DEFICIENCIES AND EXCESS

0

5

10

15

20

25 Deficiency

Excess

NUTRITIONAL DEFICIENCIES OBSERVED :

• Iron Deficiency• Vitamin A Deficiency• Vitamin B Deficiency• Protein Deficiency• Calcium Deficiency• Energy Deficiency

Few to many deficiencies were observedin all the 23 families surveyed.Scrutinizing the deficiency, the community is at

the risk of following disease:-☻ Protein energy malnutrition☻ Stomatitis☻ Iron deficiency anemia☻ Rickets and Osteomalacia☻ Night blindness and xerophtalmia☻ Beriberi

OTHER DISEASES AT RISK: • ACUTE RESPIRATORY INFECTION.• ACUTE GASTROENTERITIS.• OTHER WATER BORNE DISEASES

LIKE TYPHOID, HEPATITIS A.• DEPRESSION, ANXIETY,

BEHAVIOURAL DISORDERS, DRUG ADDICTION.

BODY MASS INDEX:

• B.M.I.=WEIGHT(Kg)

HEIGHT (m2)

• NORMALVALUE=18.5-24.9 Kg/m2

• B.M.I values are age independent and same for both the sexes.

B.M.I. in under 5 children

60%27%

13%

normal

subnormal

obese

B.M.I. in 6-18 yrs. population

33%

63%

4%

normal

subnormal

obese

66%

12%

22%

normal

subnormal

obese

BMI distribution in adults

B.M.I. distribution in population

54%31%

15%

normal

subnormal

obese

MEAN NUTRITIONAL DEFICIENCIES IN THE FAMILY

Mean energy deficiency per family= 1463.06Kcal

Mean protein deficiency per family=60.10gm

Mean calcium deficiency per family=592.02mg

Mean iron deficiency per family=60.97mg

Mean Vit.A (carotene) deficiency per family=5974.7 mcg

ConclusionOverall nutritional status of the community

is NOT SATISFACTORY.

It may be due to:

Low socio-economic status.

Lack of knowledge regarding,

a.Hygiene and environmental sanitation

b. Balanced diet in family

RECOMMENDATIONS

Balanced diet should be consumed, which includes:

1. Vitamin A rich foods-egg, yellow fruits such as carrots, green leafy vegetables.

2. Iron rich foods – liver of goat, meat, cereals

3. Calcium rich foods - milk and milk products, eggs and fish.

To drink boiled or purified water & proper storage of foods.

Improvement of housing condition and maintenance of hygiene.

Recommendation contd..

Health education should be emphasized on increasing public awareness on

• Importance of nutritious diet pattern •Hygienic health behaviors and health care

services by using information and tools appropriate across various ages, literacy, and cultural contexts.

Change attitudes & obtain new knowledge & skills which they can use to improve the variety & the amounts of food according to the needs of every family member.

Acknowledgement

• Special thanks to Prof.Dr. I. DUDANI, Head of Department of Community Medicine.

• Dr. SUNIL KUMAR JOSHI • Dr. AVINAV VAIDYA• Dr. ARUN SIGDEL• SAKUL DAI• Cordial thanks to the family members for

invaluable support without which this survey would not have been possible

• Thanks to all of the classmates specially group A pals

• Special thanks to Prof.Dr. I. DUDANI, Head of Department of Community Medicine.

• Dr. SUNIL KUMAR JOSHI • Dr. AVINAV VAIDYA• Dr. ARUN SIGDEL• SAKUL DAI• Cordial thanks to the family members for

invaluable support without which this survey would not have been possible

• Thanks to all of the classmates specially group A pals

References:

ANNUAL REPORT 063\064, DOHS, NEPAL

PARK’S TEXTBOOKPARK’S TEXTBOOK OF OF PREVENTIVE AND SOCIAL PREVENTIVE AND SOCIAL MEDICINE, MEDICINE, 18TH EDITION,18TH EDITION, BY K. PARKBY K. PARK

CHILD NUTRITION AND HEALTH,CHILD NUTRITION AND HEALTH, 3RD EDITION, BY RAMESH K. ADHIKARI & 3RD EDITION, BY RAMESH K. ADHIKARI & Ms. MIRIAM E. KRANTZMs. MIRIAM E. KRANTZ

KATHMANDU MEDICAL

KATHMANDU MEDICAL

COLLEGE TEACHING

COLLEGE TEACHING

HOSPITALHOSPITAL

HAVE A N

ICE

DAY

WE ARE WHAT WE EAT