Strategies that support proper nutrition education

1. Focus on nutrition of vulnerable group like the under-five children

2. Giving energy rich food from six months of age frequently; at least 4-5 feed daily

3. Discouraging the use of breast milk substitute and commercial complementary foods

4. Promoting consumption of adequate diet among school children, pregnant/lactating mothers, the sick child

5. Mobilizing and educating the community on income generating activities e.g. home gardening

6. Use of growth monitoring

7. Adequate food preparation

8. Home visit to provide supervision on food and dietary issues

Intervention strategies in the prevention and control of micronutrient deficiency

1. Supplementation of micronutrients 

2. Fortification 

3. Dietary diversification 

4. Control of parasitic infection (deworming)

CHILD NUTRITION

Infant and young child feeding (IYCF): This is the strategic approach which aims at reducing nutritional caused disease and to promote the nutritional status of infants and young children, these strategies includes:

1. Counselling to encourage breastfeeding immediately after childbirth

2. Exclusive breastfeeding for 6 months 

3. giving age appropriate complementary food 

4. Vitamin A supplements (twice annually in children 6-59 months)

5. Growth monitoring 

6. Community management of acute malnutrition using ready to use therapeutic foods

Exclusive Breast Feedind (Ebf)

EBF can be defined as feeding a child with a breast milk only from birth till six (6) month.

Breast milk contains all nutrients in adequate amount and most easily and wholly absorbed to support optimal growth for the child.

ADVANTAGES OF EBF

To the mother:

1. Prevention of postpartum haemorrhage, enhancing uterine involution.

2. Helping to establish lactation.

3. Bonding between mother and infant.

4. Sense of satisfaction

5. Natural birth spacing (lactationalamenorrhea)

To the baby:

1. Bonding between mother and baby.

2. Optimal growth.

3. Prevention of infections i.e. anti-infective properties (Immunoglobulin Oligopeptide).

4. Enhancing child survival (a component of child survival strategy).

To the home/family:

1. Cheap, pure, natural

2. Does not require preparation

3. Save cost of buying infant formula, fuel, safe clean water, etc.

4. Reduces waste (empty cans, tins, polythene)

Community management of acute malnutrition CMAM

The Community-Based Management of Acute Malnutrition (CMAM) approach enables community volunteers to identify and initiate treatment for children with acute malnutrition before they become seriously ill. Caregivers provide treatment for the majority of children with severe acute malnutrition in the home using Ready-to-Use-Therapeutic Foods (RUTF) and routine medical care. When necessary, severely malnourished children who have medical complications or lack an appetite are referred to in-patient facilities for more intensive treatment. CMAM programmes also work to integrate treatment with a variety of other longer-term interventions. These are designed to reduce the incidence of malnutrition and improve public health and food security in a sustainable manner.

Correct replenishment of nutrients like essential amino acids (protein), potassium, magnesium and zinc (among other minerals) and   Ready-to-Use Therapeutic Food (RUTF) are essential for recovery from malnutrition. This is made available to treat children with Severe Acute Malnutrition (SAM) characterized by severe wasting (W/H < 70%  Mid-Upper Arm Circumference (MUAC)

Principles of CMAM

1. Ensure the use of appropriate technology 

2. Use of ready to use food 

3. Food must be prepared under hygienic condition

4. Treatment of acute  malnutrition

COMPONENT OF CMAM

There are four key components to the CMAM approach:

1) Community Mobilisation

Build relationships and foster active participation of the community

Identify and mobilise community volunteers for CMAM

Volunteers measure Mid-Upper Arm Circumference (MUAC) of all children under 5 to identify those with acute malnutrition.

2) Supplementary Feeding Programme (SFP):

Provide take-home food rations and routine basic treatment for families of children with moderate malnutrition but no medical complications

Provide support for other groups with special nutrient requirements, including pregnant and lactating mothers

3) Outpatient Therapeutic Programme (OTP):

Provide home-based treatment and rehabilitation using RUTF for children with severe acute malnutrition but no medical complications (usually 80-85% of children)

Monitor children’s progress through regular outpatient care

Provide food rations to the whole family of each severely malnourished child

4) Stabilisation Centre/Inpatient Care:

Provide intensive in-patient medical and nutrition care to acutely malnourished children with complications such as anorexia, severe medical issues or severe oedema

Link with OTP to allow early discharge and continued treatment in the community

Common health issues that affect nutrition intake of people living with HIV

1. Lack of appetite

2. Nausea and vomiting 

3. Sore mouth (thrush)

4. Digestive problems like dyspepsia

5. Skin problems

6. Diarrhoea