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malnutrition.
IMPACT OF MALNUTRITION Pregnant and lactating women and young children less than three years are most vulnerable to malnutrition. Scientific evidence has shown that beyond the age of 2-3 years, the effects of chronic malnutrition are irreversible. This means that to break the intergenerational transmission of poverty and malnutrition, children at risk must be reached during their first two years of life. MANAGEMENT OF MALNUTRITION IN CHILDREN UNDER FIVE YEARS This section is intended mainly for practitioners and program managers. It covers management of severe malnutrition, with an in-patient outline based on WHO standards and updates from Professor Michael Golden, and an out-patient outline based mainly on the Community-based Therapeutic Care (CTC) Field Manual by the CTC Research and Development program (collaboration between ValidInternational
AFASS PRINCIPLES
AFASS means the mother/family: Accept not to breastfeed and thus use exclusive replacement feeding through Breast Milk Substitute (BMS). Consider the Breast Milk Substitute Feasible given the extended family/community but also nature of work and lifestyle of the mother/family. Can Afford to supply enough Breast Milk Substitute feeds for the duration the child needs the alternative e.g. 6INTRODUCTION
Acutely malnourished children lack growth nutrients that are required to build new tissues. These nutrients aid weight gain after illness, repair damaged tissues and help replace the rapid turn-over of cells (intestine and immune cells). Correct replenishment of nutrients like essential amino acids (protein), potassium, magnesium and zinc (among other minerals) is essential for recovery from FEEDING FORMULAS: WHAT ARE F-75 AND F-100? Home » Management of Malnutrition in Children » Management of Severe Acute Malnutrition in Children Under Five Years » Feeding formulas: What are F-75 and F-100?. Management of Severe Acute Malnutrition in Children Under Five Years. Feeding formulas: What are F-75 and F-100? F-75 is the "starter" formula used during initial management of malnutrition, beginning as soon as possible and READY-TO-USE THERAPEUTIC FOOD (RUTF) Here is a short training video on the RUTF appetite test (following the WHO guidelines). Community-based management of severe acute malnutrition: Assessing Appetite - Local production of RUTF - There are four basic ingredients in RUTF: Sugar, Dried Skimmed Milk, Oil, Vitamin and Mineral Supplement (CMV), In addition, up to 25% of a product's weight can come from oil-seeds, groundnuts or INDICATORS (BASELINE, IMPACT, OUTPUT AND PERFORMANCE Indicators should be set according to the SMART criteria: Specific to the objective; Measurable either quantitatively or qualitatively; Available at an acceptable cost; Relevant to the information needs of decision-makers; and Time-bound so that users know when to PROJECT CONCEPT NOTE ICDS-IV Project: Project Concept Note ICDS projects from 5652 in 2004-05 to 6284 projects (blocks) and that of Anganwadi Centres (AWC) from 7.44 lakh to 10.53 lakh by the end of 2006-07. CHALLENGES AND WAY FORWARD In 2005, several factors converged to make a review of the Integrated Child Development Services (ICDS) program timely. These included the launch of the Government of India's National Health Mission and a National Nutrition Mission in fiscal year 2005-2006; the decision to target improving nutrition outcomes as part of the MDGs; the findings of the Copenhagen Consensus project which identified MATERNAL, MOTHER & CHILD NUTRITION, HEALTH, MALNUTRITION Optimal maternal, infant and young child feeding and caring practices reduce underweight and stunting and set the foundations for appropriate growth. The survival of wasted children, however, depends on timely detection and management of moderate and severemalnutrition.
IMPACT OF MALNUTRITION Pregnant and lactating women and young children less than three years are most vulnerable to malnutrition. Scientific evidence has shown that beyond the age of 2-3 years, the effects of chronic malnutrition are irreversible. This means that to break the intergenerational transmission of poverty and malnutrition, children at risk must be reached during their first two years of life. MANAGEMENT OF MALNUTRITION IN CHILDREN UNDER FIVE YEARS This section is intended mainly for practitioners and program managers. It covers management of severe malnutrition, with an in-patient outline based on WHO standards and updates from Professor Michael Golden, and an out-patient outline based mainly on the Community-based Therapeutic Care (CTC) Field Manual by the CTC Research and Development program (collaboration between ValidInternational
AFASS PRINCIPLES
AFASS means the mother/family: Accept not to breastfeed and thus use exclusive replacement feeding through Breast Milk Substitute (BMS). Consider the Breast Milk Substitute Feasible given the extended family/community but also nature of work and lifestyle of the mother/family. Can Afford to supply enough Breast Milk Substitute feeds for the duration the child needs the alternative e.g. 6INTRODUCTION
Acutely malnourished children lack growth nutrients that are required to build new tissues. These nutrients aid weight gain after illness, repair damaged tissues and help replace the rapid turn-over of cells (intestine and immune cells). Correct replenishment of nutrients like essential amino acids (protein), potassium, magnesium and zinc (among other minerals) is essential for recovery from FEEDING FORMULAS: WHAT ARE F-75 AND F-100? Home » Management of Malnutrition in Children » Management of Severe Acute Malnutrition in Children Under Five Years » Feeding formulas: What are F-75 and F-100?. Management of Severe Acute Malnutrition in Children Under Five Years. Feeding formulas: What are F-75 and F-100? F-75 is the "starter" formula used during initial management of malnutrition, beginning as soon as possible and READY-TO-USE THERAPEUTIC FOOD (RUTF) Here is a short training video on the RUTF appetite test (following the WHO guidelines). Community-based management of severe acute malnutrition: Assessing Appetite - Local production of RUTF - There are four basic ingredients in RUTF: Sugar, Dried Skimmed Milk, Oil, Vitamin and Mineral Supplement (CMV), In addition, up to 25% of a product's weight can come from oil-seeds, groundnuts or INDICATORS (BASELINE, IMPACT, OUTPUT AND PERFORMANCE Indicators should be set according to the SMART criteria: Specific to the objective; Measurable either quantitatively or qualitatively; Available at an acceptable cost; Relevant to the information needs of decision-makers; and Time-bound so that users know when to PROJECT CONCEPT NOTE ICDS-IV Project: Project Concept Note ICDS projects from 5652 in 2004-05 to 6284 projects (blocks) and that of Anganwadi Centres (AWC) from 7.44 lakh to 10.53 lakh by the end of 2006-07. CHALLENGES AND WAY FORWARD In 2005, several factors converged to make a review of the Integrated Child Development Services (ICDS) program timely. These included the launch of the Government of India's National Health Mission and a National Nutrition Mission in fiscal year 2005-2006; the decision to target improving nutrition outcomes as part of the MDGs; the findings of the Copenhagen Consensus project which identified MANAGEMENT OF MALNUTRITION IN CHILDREN UNDER FIVE YEARS This section is intended mainly for practitioners and program managers. It covers management of severe malnutrition, with an in-patient outline based on WHO standards and updates from Professor Michael Golden, and an out-patient outline based mainly on the Community-based Therapeutic Care (CTC) Field Manual by the CTC Research and Development program (collaboration between ValidInternational
TEN FACTS ON NUTRITION Ten facts on Nutrition. Home » Nutrition Protection, Promotion & Support » Ten Facts on Nutrition. Nutrition is a foundation for health and development. Better nutrition means stronger immune systems, less illness and better health for people of all ages. SUPPLEMENTARY FEEDING PROGRAMS The decision to implement a Supplementary Feeding Program is usually based on raised prevalence of acute malnutrition among children under five and the presence of aggravating factors such as poor food security in the general population, disease epidemic and raised mortality (severity of a crisis). The justification for intervention, the objectives, the target groups and a viable exit strategy IN-PATIENT TREATMENT PHASE 1 Phase 1: Use only F75 Formula - Summary of key steps for Phase 1: Admitted patients should be registered and all information recorded in the Multichart including the target weight for discharge (WHO/NCHS table). Admitted patients should be provided with a systematic medical examination and given routine medicine. Children in Phase 1 should be together in a separate room or space and NOT MUAC TAPE - SCREENING FOR ACUTE MALNUTRITION - MOTHER Acute malnutrition is a result of recent (short-term) deficiency of protein, energy together with minerals and vitamins leading to loss of body fats and muscle tissues. Acute malnutrition presents with wasting (low weight-for-height) and /or presence of pitting oedema of both feet. Screening for Acute Malnutrition should be done at any contact points; children wards, immunization points PROTOCOL FOR THE MANAGEMENT OF SEVERE ACUTE MALNUTRITION ttaabbllee ooff ccoonntteenntt 3 8. phase 2 (in- and out-patients) 46 8.1 diet (f100 or rutf) 46 8.2 routine medicine 49 8.3 surveillance 50 8.4 criteria to move back from phase 2 to phase 1 50 9. failure to respond 52 10. discharge criteria 56 iinnffaannttss lleessss tthhaann 66 mmoonntthhss 57 1. infant with a female caretaker 57 1.1 admissioncriteria 57
INDICATORS (BASELINE, IMPACT, OUTPUT AND PERFORMANCE Indicators should be set according to the SMART criteria: Specific to the objective; Measurable either quantitatively or qualitatively; Available at an acceptable cost; Relevant to the information needs of decision-makers; and Time-bound so that users know when to MANAGEMENT OF SEVERE ACUTE MALNUTRITION AT HEALTH POST 11. OTP Procedures 1. Screening and Admission Step 1: Do the anthropometric measurements and check for oedema. Give priority to severely ill patients. A TOOLKIT FOR ADDRESSING NUTRITION IN EMERGENCY SITUATIONS Nutrition Cluster . A Toolkit for Addressing Nutrition in Emergency Situations . June 2008 . Opinions expressed in this document do not necessarily reflect those of theFACILITATOR GUIDE
ACKNOWLEDGEMENTS This Facilitator Guide is part of The Community Infant and Young Child Feeding (IYCF) Counselling Package, developed under a strategic collaboration between the United Nations Children‘s Fund (UNICEF) New York and the combined technical and graphic team of Nutrition Policy Practice (NPP) and the Center for Human Services, the not-for-profit affiliate of University Research MATERNAL, MOTHER & CHILD NUTRITION, HEALTH, MALNUTRITION Optimal maternal, infant and young child feeding and caring practices reduce underweight and stunting and set the foundations for appropriate growth. The survival of wasted children, however, depends on timely detection and management of moderate and severemalnutrition.
IMPACT OF MALNUTRITION Pregnant and lactating women and young children less than three years are most vulnerable to malnutrition. Scientific evidence has shown that beyond the age of 2-3 years, the effects of chronic malnutrition are irreversible. This means that to break the intergenerational transmission of poverty and malnutrition, children at risk must be reached during their first two years of life. MANAGEMENT OF MALNUTRITION IN CHILDREN UNDER FIVE YEARS This section is intended mainly for practitioners and program managers. It covers management of severe malnutrition, with an in-patient outline based on WHO standards and updates from Professor Michael Golden, and an out-patient outline based mainly on the Community-based Therapeutic Care (CTC) Field Manual by the CTC Research and Development program (collaboration between ValidInternational
AFASS PRINCIPLES
AFASS means the mother/family: Accept not to breastfeed and thus use exclusive replacement feeding through Breast Milk Substitute (BMS). Consider the Breast Milk Substitute Feasible given the extended family/community but also nature of work and lifestyle of the mother/family. Can Afford to supply enough Breast Milk Substitute feeds for the duration the child needs the alternative e.g. 6INTRODUCTION
Acutely malnourished children lack growth nutrients that are required to build new tissues. These nutrients aid weight gain after illness, repair damaged tissues and help replace the rapid turn-over of cells (intestine and immune cells). Correct replenishment of nutrients like essential amino acids (protein), potassium, magnesium and zinc (among other minerals) is essential for recovery from FEEDING FORMULAS: WHAT ARE F-75 AND F-100? Home » Management of Malnutrition in Children » Management of Severe Acute Malnutrition in Children Under Five Years » Feeding formulas: What are F-75 and F-100?. Management of Severe Acute Malnutrition in Children Under Five Years. Feeding formulas: What are F-75 and F-100? F-75 is the "starter" formula used during initial management of malnutrition, beginning as soon as possible and READY-TO-USE THERAPEUTIC FOOD (RUTF) Here is a short training video on the RUTF appetite test (following the WHO guidelines). Community-based management of severe acute malnutrition: Assessing Appetite - Local production of RUTF - There are four basic ingredients in RUTF: Sugar, Dried Skimmed Milk, Oil, Vitamin and Mineral Supplement (CMV), In addition, up to 25% of a product's weight can come from oil-seeds, groundnuts or INDICATORS (BASELINE, IMPACT, OUTPUT AND PERFORMANCE Indicators should be set according to the SMART criteria: Specific to the objective; Measurable either quantitatively or qualitatively; Available at an acceptable cost; Relevant to the information needs of decision-makers; and Time-bound so that users know when to PROJECT CONCEPT NOTE ICDS-IV Project: Project Concept Note ICDS projects from 5652 in 2004-05 to 6284 projects (blocks) and that of Anganwadi Centres (AWC) from 7.44 lakh to 10.53 lakh by the end of 2006-07. CHALLENGES AND WAY FORWARD In 2005, several factors converged to make a review of the Integrated Child Development Services (ICDS) program timely. These included the launch of the Government of India's National Health Mission and a National Nutrition Mission in fiscal year 2005-2006; the decision to target improving nutrition outcomes as part of the MDGs; the findings of the Copenhagen Consensus project which identified MATERNAL, MOTHER & CHILD NUTRITION, HEALTH, MALNUTRITION Optimal maternal, infant and young child feeding and caring practices reduce underweight and stunting and set the foundations for appropriate growth. The survival of wasted children, however, depends on timely detection and management of moderate and severemalnutrition.
IMPACT OF MALNUTRITION Pregnant and lactating women and young children less than three years are most vulnerable to malnutrition. Scientific evidence has shown that beyond the age of 2-3 years, the effects of chronic malnutrition are irreversible. This means that to break the intergenerational transmission of poverty and malnutrition, children at risk must be reached during their first two years of life. MANAGEMENT OF MALNUTRITION IN CHILDREN UNDER FIVE YEARS This section is intended mainly for practitioners and program managers. It covers management of severe malnutrition, with an in-patient outline based on WHO standards and updates from Professor Michael Golden, and an out-patient outline based mainly on the Community-based Therapeutic Care (CTC) Field Manual by the CTC Research and Development program (collaboration between ValidInternational
AFASS PRINCIPLES
AFASS means the mother/family: Accept not to breastfeed and thus use exclusive replacement feeding through Breast Milk Substitute (BMS). Consider the Breast Milk Substitute Feasible given the extended family/community but also nature of work and lifestyle of the mother/family. Can Afford to supply enough Breast Milk Substitute feeds for the duration the child needs the alternative e.g. 6INTRODUCTION
Acutely malnourished children lack growth nutrients that are required to build new tissues. These nutrients aid weight gain after illness, repair damaged tissues and help replace the rapid turn-over of cells (intestine and immune cells). Correct replenishment of nutrients like essential amino acids (protein), potassium, magnesium and zinc (among other minerals) is essential for recovery from FEEDING FORMULAS: WHAT ARE F-75 AND F-100? Home » Management of Malnutrition in Children » Management of Severe Acute Malnutrition in Children Under Five Years » Feeding formulas: What are F-75 and F-100?. Management of Severe Acute Malnutrition in Children Under Five Years. Feeding formulas: What are F-75 and F-100? F-75 is the "starter" formula used during initial management of malnutrition, beginning as soon as possible and READY-TO-USE THERAPEUTIC FOOD (RUTF) Here is a short training video on the RUTF appetite test (following the WHO guidelines). Community-based management of severe acute malnutrition: Assessing Appetite - Local production of RUTF - There are four basic ingredients in RUTF: Sugar, Dried Skimmed Milk, Oil, Vitamin and Mineral Supplement (CMV), In addition, up to 25% of a product's weight can come from oil-seeds, groundnuts or INDICATORS (BASELINE, IMPACT, OUTPUT AND PERFORMANCE Indicators should be set according to the SMART criteria: Specific to the objective; Measurable either quantitatively or qualitatively; Available at an acceptable cost; Relevant to the information needs of decision-makers; and Time-bound so that users know when to PROJECT CONCEPT NOTE ICDS-IV Project: Project Concept Note ICDS projects from 5652 in 2004-05 to 6284 projects (blocks) and that of Anganwadi Centres (AWC) from 7.44 lakh to 10.53 lakh by the end of 2006-07. CHALLENGES AND WAY FORWARD In 2005, several factors converged to make a review of the Integrated Child Development Services (ICDS) program timely. These included the launch of the Government of India's National Health Mission and a National Nutrition Mission in fiscal year 2005-2006; the decision to target improving nutrition outcomes as part of the MDGs; the findings of the Copenhagen Consensus project which identified MANAGEMENT OF MALNUTRITION IN CHILDREN UNDER FIVE YEARS This section is intended mainly for practitioners and program managers. It covers management of severe malnutrition, with an in-patient outline based on WHO standards and updates from Professor Michael Golden, and an out-patient outline based mainly on the Community-based Therapeutic Care (CTC) Field Manual by the CTC Research and Development program (collaboration between ValidInternational
TEN FACTS ON NUTRITION Ten facts on Nutrition. Home » Nutrition Protection, Promotion & Support » Ten Facts on Nutrition. Nutrition is a foundation for health and development. Better nutrition means stronger immune systems, less illness and better health for people of all ages. SUPPLEMENTARY FEEDING PROGRAMS The decision to implement a Supplementary Feeding Program is usually based on raised prevalence of acute malnutrition among children under five and the presence of aggravating factors such as poor food security in the general population, disease epidemic and raised mortality (severity of a crisis). The justification for intervention, the objectives, the target groups and a viable exit strategy IN-PATIENT TREATMENT PHASE 1 Phase 1: Use only F75 Formula - Summary of key steps for Phase 1: Admitted patients should be registered and all information recorded in the Multichart including the target weight for discharge (WHO/NCHS table). Admitted patients should be provided with a systematic medical examination and given routine medicine. Children in Phase 1 should be together in a separate room or space and NOT MUAC TAPE - SCREENING FOR ACUTE MALNUTRITION - MOTHER Acute malnutrition is a result of recent (short-term) deficiency of protein, energy together with minerals and vitamins leading to loss of body fats and muscle tissues. Acute malnutrition presents with wasting (low weight-for-height) and /or presence of pitting oedema of both feet. Screening for Acute Malnutrition should be done at any contact points; children wards, immunization points PROTOCOL FOR THE MANAGEMENT OF SEVERE ACUTE MALNUTRITION ttaabbllee ooff ccoonntteenntt 3 8. phase 2 (in- and out-patients) 46 8.1 diet (f100 or rutf) 46 8.2 routine medicine 49 8.3 surveillance 50 8.4 criteria to move back from phase 2 to phase 1 50 9. failure to respond 52 10. discharge criteria 56 iinnffaannttss lleessss tthhaann 66 mmoonntthhss 57 1. infant with a female caretaker 57 1.1 admissioncriteria 57
INDICATORS (BASELINE, IMPACT, OUTPUT AND PERFORMANCE Indicators should be set according to the SMART criteria: Specific to the objective; Measurable either quantitatively or qualitatively; Available at an acceptable cost; Relevant to the information needs of decision-makers; and Time-bound so that users know when to MANAGEMENT OF SEVERE ACUTE MALNUTRITION AT HEALTH POST 11. OTP Procedures 1. Screening and Admission Step 1: Do the anthropometric measurements and check for oedema. Give priority to severely ill patients. A TOOLKIT FOR ADDRESSING NUTRITION IN EMERGENCY SITUATIONS Nutrition Cluster . A Toolkit for Addressing Nutrition in Emergency Situations . June 2008 . Opinions expressed in this document do not necessarily reflect those of theFACILITATOR GUIDE
ACKNOWLEDGEMENTS This Facilitator Guide is part of The Community Infant and Young Child Feeding (IYCF) Counselling Package, developed under a strategic collaboration between the United Nations Children‘s Fund (UNICEF) New York and the combined technical and graphic team of Nutrition Policy Practice (NPP) and the Center for Human Services, the not-for-profit affiliate of University Research MATERNAL, MOTHER & CHILD NUTRITION, HEALTH, MALNUTRITION Optimal maternal, infant and young child feeding and caring practices reduce underweight and stunting and set the foundations for appropriate growth. The survival of wasted children, however, depends on timely detection and management of moderate and severemalnutrition.
IMPACT OF MALNUTRITION Pregnant and lactating women and young children less than three years are most vulnerable to malnutrition. Scientific evidence has shown that beyond the age of 2-3 years, the effects of chronic malnutrition are irreversible. This means that to break the intergenerational transmission of poverty and malnutrition, children at risk must be reached during their first two years of life. PRINCIPLES OF HEALTHY EATING Eat a variety of different foods. No one food contains all the proteins, carbohydrates, fats, vitamins and minerals you need for good health, so you have to eat a range of different foods. Eat staple foods with every meal. Staple foods should make up the largest part of a meal. These foods are relatively cheap and supply a good amount of carbohydrates and some proteins. MANAGEMENT OF MALNUTRITION IN CHILDREN UNDER FIVE YEARS This section is intended mainly for practitioners and program managers. It covers management of severe malnutrition, with an in-patient outline based on WHO standards and updates from Professor Michael Golden, and an out-patient outline based mainly on the Community-based Therapeutic Care (CTC) Field Manual by the CTC Research and Development program (collaboration between ValidInternational
FORUM - MOTHER, INFANT AND YOUNG CHILD NUTRITION Optimal maternal, infant and young child feeding and caring practices reduce underweight and stunting and set the foundations for appropriate growth. The survival of wasted children, however, depends on timely detection and management of moderate and severemalnutrition.
IN-PATIENT TREATMENT PHASE 1 Phase 1: Use only F75 Formula - Summary of key steps for Phase 1: Admitted patients should be registered and all information recorded in the Multichart including the target weight for discharge (WHO/NCHS table). Admitted patients should be provided with a systematic medical examination and given routine medicine. Children in Phase 1 should be together in a separate room or space and NOTAFASS PRINCIPLES
AFASS means the mother/family: Accept not to breastfeed and thus use exclusive replacement feeding through Breast Milk Substitute (BMS). Consider the Breast Milk Substitute Feasible given the extended family/community but also nature of work and lifestyle of the mother/family. Can Afford to supply enough Breast Milk Substitute feeds for the duration the child needs the alternative e.g. 6 MEDICAL COMPLICATIONS If there is a serious medical complication then the patient should be referred for in-patient treatment – these complications include the following: Bilateral pitting oedema Grade 3 (+++), Marasmus-Kwashiorkor (W/HDetails
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