1. What are NRC ?

status of child undernutrition in i ndia undernutrition is one of the most concerning health and development issues in india as in other parts of the world. undernutrition encompasses stunting (chronic malnutrition), wasting (acute malnutrition) and deficiencies of micronutrients (essential vitamins and minerals). the high mortality and disease burden resulting from undernutrition call for urgent implementation of interventions to reduce their occurrence and consequences and this would include determined action on the social determinents of undernutrition. nFHS 3 shows that the proportion of children who are stunted or underweight increases rapidly with the child’s age from birth to age 20-23 months; peaking at age 20 months. even during the first six months of life, when most infants are breastfed, 20-30 percent of children are underweight. it is notable that by age 18-23 months, when many children are being weaned from breast milk, 30 percent of children are severely stunted and one-fifth are severely underweight. the levels of child undernutrition is unacceptably high in almost all states, even though some states like Goa, Kerala, Manipur, Mizoram, Punjab and Sikkim have lower levels.

2.addressing undernutrition in children under five years

addressing undernutrition in children under five years undernutrition is associated with high rates of mortality and morbidity and is an underlying factor in almost one-third to half of all children under five years who die each year of preventable causes. Strong evidence exists on synergism between undernutrition and child mortality due to common childhood illnesses including diarrhoea, acute respiratory infections, malaria and measles. to

3. What are the types of undernutrition?

The three indices - weight-for-age, height/length-forage, weight-for- height/length are used to identify three nutrition conditions: underweight, stunting and wasting, respectively. Each of the three nutrition indicators is expressed in standard deviation units (Z-scores) from the median of the reference population based on which undernutrition may be further classified as moderate or severe. Underweight: Underweight, based on weightfor- age, is a composite measure of stunting and wasting and is recommended as the indicator to assess changes in the magnitude of malnutrition over time. This condition can result from either chronic or acute malnutrition, or both. Underweight is often used as a basic indicator of the status of a population’s health as weight is easy to measure. Evidence has shown that the mortality risk of children who are even mildly underweight is increased, and severely underweight children are at even greater. An underweight child has a weight-for-age Z-score that is at least two standard deviations (-2SD) below the median in the World Health Organization (WHO) Child Growth Standards. Stunting: Failure to achieve expected height/length as compared to healthy, well-nourished children of the same age is a sign of stunting. Stunting is an indicator of linear growth retardation that results from failure to receive adequate nutrition over a long period or recurrent infections. It may be exacerbated by recurrent and chronic illness. It is an indicator of past growth failure. It is associated with a number of long-term factors including chronic insufficient nutrient intake, frequent infection, sustained inappropriate feeding practices and poverty. Stunting often results in delayed psycho-social and cognitive development and poor school performance. This in turn affects economic productivity at national level. A stunted child has a height-for-age Z-score that is at least two standard deviations (-2SD) below the median for the WHO Child Growth Standards.

4.  Facility based management of severe acute malnutrition How can undernutrition be measured?

3 Facility based management of severe acute malnutrition How can undernutrition be measured? in children, undernutrition is synonymous with growth failure - undernourished children are shorter and lighter than they should be for their age/height. to get a measure of malnutrition in a population, young children are weighed and/or their height is measured and the results compared to those of a 'reference population' known to have grown well. Measuring weight and height is the most common way of assessing malnutrition in a given population. Such use of measurements of dimensions of the human body is known as anthropometry. Anthropometry is a widely used, inexpensive and non-invasive measure of the general nutritional status of an individual or a population group. the three commonly used anthropometric indices are: Weight-For-Age (WFA). length-For-Age or Height-For-Age (HFA). Weight-For- length or Weight-For-Height (WFH).