NUTRITIONAL PROGRAMMES

The Government of India have initiated several large scale supplementary feeding programs aimed at overcoming
specific deficiency diseases through various ministries to combat malnutrition. The various programs are shown as
below:

1. ICDS:(INTEGRATED CHILD DEVELOPMENT SERVICE) SCHEME:

Integrated child development services programme was started in 1975 .In the pursuance of the national policy for
children, there is strong nutrition component in the programme in the form of supplementary nutrition vitamin A
prophylaxis and iron and folic acid distribution. The state and Union territories are encouraged to undertake the
additional ICDS projects on the central pattern to cover more beneficiaries.
The workers at the village level who deliver the services are called anganwadi workers. Each anganwadi unit covers
a population of about 1000. A network of Mahila Mandals has been built in ICDS project areas to help anganwadi
workers in providing health and nutritional services. The work of anganwadis is supervised by mukhysevikas.Field
supervision is done by the child development project officer.

 Integrated Child Development Service (ICDS) scheme was launched on 2nd October, 1975 (5th Five year Plan) in
pursuance of the National Policy for Children in 33 experimental blocks. Success of the scheme led to its expansion
to 2996 projects by the end of March 1994. Now the goal is to universalization of ICDS throughout the country.
 The primary responsibility for the implementation of the programme is with the Department of Women and Child
Development, Ministry of Human Resources Development at the Centre and the nodal departments at the state
which may be Social Welfare, Rural Development, Tribal Welfare, Health & Family Welfare or Women and Child
Development.

 Beneficiaries:
1. Children below 6 years
2. Pregnant and lactating women
3. Women in the age group of 15-44 years
4. Adolescent girls in selected blocks
The Ninth Five Year Plan aim to universalize the ICDs, i.e. coverage to the whole country.

 Objectives:
1. Improve the nutrition and health status of children in the age group of 0-6 years;
2. Lay the foundation for proper psychological, physical and social development of the child;
3. Effective coordination and implementation of policy among the various departments; and
4. Enhance the capability of the mother to look after the normal health and nutrition needs through proper nutrition
and health education.
 The Package of services provided by ICDs:

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 1. Supplementary nutrition, Vit-A, Iron and Folic Acid,
2. Immunization,
3. Health check-ups,
4. Referral services,
5. Treatment of minor illnesses;
6. Nutrition and health education to women;
7. Pre-school education of children in the age group of 3-6 years, and
8. Convergence of other supportive services like water supply, sanitation, etc.

 Scheme for Adolescent Girls (Kishori Shakti Yojna):

There was a gap in between women and child age group which was not covered by any health and social welfare
programme whereas girls in this crucial group need special attention. On one side they need appropriate nutrition,
education, health education, training for adulthood, training for acquiring skills as the base for earning an
independent livelihood, training for motherhood, etc. Similarly on the other side their potential to be a good
community leader has to be realized. A scheme for adolescent girls in ICDs was launched by the Department of
Women and Child Development, Ministry of Human Resource Development in 1991.

 Common Services:
All adolescent girls in the age group of 11-18 years (70%) received the following:
-common services:
1. Watch over menarche,
2. Immunization,
3. General health check-ups once in every six-months,
4. Training for minor ailments,
5. Deworming,
6. Prophylactic measures against anemia, goiter, vitamin deficiency, etc., and
7. Referal to PHC.District hospital in case of acute need.

2.VITAMIN A PROPHYLAXIS PROGRAMME:

The programme was launched in 1970 with the objective of reducing the disease and preventing blindness due to
Vitamin A deficiency. It was initially started in 7 states with severe problems. Later it was extended to the entire
country.
-This programme was launched by the Ministry of Health and Family Welfare in 1970, on the basis of technology
developed at the National Institute of Nutrition, Hyderabad.
Vitamin-A deficiency is considered a public health problem in India. The nationwide survey of blindness conducted
during 1986-89 included the prevention of Vitamin A deficiency in children. One of the component of national
programme for control of blindness is to be administered a massive single dose of an oily preparation of vitamin A

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 containing 200000IU orally, all preschool children in community every 6 months through peripheral workers .
Recommended daily intake of vitamin A is 600 micrograms for adults, for the infant 350 micrograms.

-Under the programme, children aged 6 months to 6 years were to be administered a mega dose of vitamin A at 6
monthly intervals. To prioritize Vitamin A administration, the programme was revised to give 5 mega doses at 6
months intervals to children 9 months to 3 years of age. In view of adequate supplies of Vitamin A, the target group
has been revised to cover children 9 months- 5 years, since 2007.

 Objectives: to decrease the prevalence of Vitamin A deficiency from current 0.6% to less than 0.5%.

 Strategy:
 Health and nutrition education to encourage colostrum feeding, exclusive breast feeding for the first six months,
introduction of complementary feeding thereafter and adequate intake of Vitamin A rich foods.
 Early detection and proper treatment of infections
 Prophylactic Vitamin A as per the following dosage schedule:
100000 IU at 9 months with measles immunization.
200000 IU at 16-18 months, with DPT booster
200000 IU every 6 months, up to the age of 5 years.
Thus a total of 9 mega doses are to be given from 9 months of age up to 5 years.

 Sick Children:
 All children with xerophthalmia are to be treated at health facilities.
 All children having measles, to be given 1 dose of Vitamin A if they have not received it in the previous month.
 All cases of severe malnutrition to be given one additional dose of Vitamin A.
 Prevalence of mild vitamin A deficiency in the world ranges between 20-40 million cases at any one time, nearly a
half of which is in India. Other sources (Ministry of Health and Family Welfare, undated) report a 5-7% prevalence
of “eye-signs” of vitamin A deficiency among children in India, while NNMB (NIN 1991) (which covered eight
states in the country) reports a 0.7% incidence of Bitot’s spots among children in 1988-90, the figures being 1.0%
for Andhra Pradesh and 0.6% for Tamil Nadu. WHO’S cut-off for identifying a public health problem is 0.5% thus
identifying both states as vitamin A deficient.
 The Government of India has initiated a two-pronged approach to combat vitamin A deficiency in India:
i) Fortification of vegetable oils. It is mandatory by law for all vegetable oils marketed in India for human
consumption, to be fortified to the level of 25 IU retinol per gram of oil. 60% of the vitamin A utilized in the country
is used for fortification of vegetable oils or animal feeds. However, in view of the low level of consumption of
vegetable oils by poorer/vulnerable sections, much of this fortification benefits the less vulnerable sections of the
population.

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 ii) The National Prophylaxis Programme for Prevention of Blindness due to Vitamin A Deficiency. This was
initiated by the government in 1970, to target children 1-5 years of age. A recent review of the situation in 1989 has
led to the inclusion of 6-12 month old children with a single dose of 100,000 IU of retinol, linked with the Universal
Immunization Programme (UIP). The prophylaxis programme comprises a long-term and a short-term strategy.
While the short-term strategy focuses on administration of prophylactic mega-doses of vitamin A periodically, the
long-term strategy aims to improve dietary intakes as the ultimate solution to the problem. The four major thrusts of
the programme are:
- Promotion of regular consumption of dark-green leafy vegetables or yellow fruits and vegetables;
- Promotion of breast-feeding and colostrum to protect against vitamin A deficiency;
- Oral prophylactic doses of vitamin A as follows: one dose of 100,000 IU to infants 6-11 months, and six-monthly
doses of 200,000 IU to children 6-60 months;
- Treatment of vitamin A-deficient cases by administrating: a single oral dose of 200,000 IU of vitamin A
immediately at diagnosis, and a follow-up dose of 200,000 IU 1-4 weeks later.

 By the fifth year, each child is expected to have received a total of nine oral mega doses of vitamin A under the
national programme (although in frequent situations of limited availability of vitamin A, the unstated policy has
been to preferentially target the 6-36 month child, and treat deficiencies in the older prescool children). For infants,
it is proposed to use the 9-12 month contact for measles vaccine as the point for administration of the vitamin A
supplement of 100,000 IU. This link with the UIP has been promoted by WHO as part of it’s official policy.
 The prophylaxis programme is implemented through Primary Health Centres and sub-centres. Prophylactic doses of
vitamin A, (supplemented with nutrition advocacy) are administered by para-medical staff manning the PHC. In
areas where the ICDS is in operation, vitamin A administration is conducted under the auspices of the ICDS.
Records of administration of doses are kept in registers/weight cards/health cards maintained by ICDS functionaries.
In Tamil Nadu, vitamin A prophylaxis (and nutrition education) is implemented through the ICDS and the TINP in
areas where these programmes are operational. There has been a successful health education component of TINP
directed to vitamin A prophylaxis.
 Assessments by the Ministry of Health and Family Welfare (1988) claim that 85% of the target for vitamin A
prophylaxis was met in 1987-88. However, these estimates of programme performance seem unrealistically
optimistic especially in view of the limitations in supply and logistics of delivery of the prophylactic dose. Further,
none of the assessments pertain to information/education/communication efforts. One programme review found a
“low” level of awareness of the prophylaxis programme and it’s benefits among health workers and the general
public.
 In Tamil Nadu, coverage in 1987-88 is reported at 0.32 million children for the first dose and 0.37 million children
for the second bi-annual prophylactic dose (UNICEF, 1990). In Andhra Pradesh, coverage was reported at 0.37
million children in 1985 (Rao et al, 1988). More recent data (Govt of Andhra Pradesh 1992), estimate coverage in
Andhra Pradesh at 1.14 million children i.e. about 14% of the total preschool population in the state.

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 3.PROPHYLAXIS AGAINST NUTRITIONAL ANEMIA:
A programme for the prevention of anemia was launched by Government of India during Fourth Five Year plan.
Available studies on prevalence of nutritional anemia in India show that 65% infant and toddlers, 60% 1-6 years of
age, 88% adolescent girls (3.3% has hemoglobin <7 gm./dl; severe anemia) and 85% pregnant women (9.9% having
severe anemia. The prevalence of anemia was marginally higher in lactating women as compared to pregnancy. The
commonest is iron deficiency anemia.

 The programme was launched in 1970 to prevent nutritional anemia in mothers and children. Under this programme,
the expected and nursing mothers as well as acceptors of family planning are given one tablet of iron and folic acid
containing 60 mg elementary iron which was raised to 100 mg elementary iron, however folic acid content remained
same (0.5 mg of folic acid) and children in the age group of 1-5 years are given one tablet of iron containing 20 mg
elementary iron (60 mg of ferrous sulphate and 0.1 mg of folic acid) daily for a period of 100 days. This programme
is being taken up by Maternal and Child Health (MCH) Division of Ministry of Health and Family Welfare. Now it
is part of RCH programme.
 At present, the National nutritional Anaemia Prophylaxis Programme is operated as part of the RCH programme.
under the revised policy, the target group has been expanded to include infants 6-12 months, school children 6-10
years and adolescents 11-18 years of age, clinically found to be anemic. For infants and children, liquid formulation
having 20 mg elemental iron and 100 ug folic acid per ml, will be made available. Dosage schedule for various age
groups is given below:
 Children 6-60 months: 2o mg elemental iron + 100 ug folic acid(one tablet of pediatric IFA or 5 ml of IFA syrup or
1 ml of IFA drops) for a total of 100 days if the child is clinically found to be anaemic.
 School children 6-10 years: 30 mg elemental iron + 250 ug folic acid for 100 days.
 Adolescent’s 11-18 years: 100 mg elemental iron + 500 ug folic acid for 100 days. Adolescent girls to be given
greater priority in the programme.
 Pregnant women: one tablet of 100 mg elemental iron + 500 ug folic acid prophylactically daily and if clinically
anaemic, 2 such tablets to be given daily for 100 days.
 Nursing mothers and acceptors of family planning: one tablet containing 100 mg elemental iron + 500 ug folic acid
daily for 100 days.
 The programme strategy also includes health and nutrition education to improve overall dietary intakes and promote
consumption of iron and folate rich foods as well as food items that promote iron absorption.
 The Ministry of Health and Family Welfare has revised the guidelines on IFA supplementation related to the
National Nutritional anaemia Prophylaxis programme.
 This is the outcome of a long process, initiated with different consultations on anaemia in adolescent girls, the
National Consultation on Micronutrients in end 2003 with ICMR/MHFW, work with the committee (chaired by DG
ICMR) constituted subsequently and work with NRHM and different groups on the 11 the plan. Highlights of the
same include the following

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1. The infants between 6-12 months should also be included in the programme as there is sufficient evidence that iron
deficiency affects this age also.
2. Children between 6 months to 60 months should be given 20mg elemental iron and 100 mcg folic acid per day per
child as this regimen is considered safe and effective.
3. National IMNCI guidelines for this supplementation to be followed.
4. For children (6-60 months), ferrous sulphate and folic acid should be provided in a liquid formulation containing 20
mg elemental iron and 100mcg folic acid per ml of the liquid formulation. For safety reason, the liquid formulation
should be dispensed in bottles so designed that only 1 ml cab be dispensed each time.
5. Dispersible tablets have an advantage over liquid formulations in programmatic conditions. These have been used
effectively in other parts of the world and in large scale Indian studies. The logistics of introducing dispersible
formulation of Iron and Folic Acid should be expedited under the programme.
6. The current programme recommendations for pregnant and lactating women should be continued.
7. School children, 6-10 year old, and adolescents, 11-18 year olds, should also be included in the National Nutritional
Anaemia Prophylaxis Programme (NNAPP).
8. Children 6-10 year old will be provided 30 mg elemental iron and 250 mcg folic acid per child per day for 100 days
in a year.
9. Adolescents, 11-18 years will be supplemented at the same doses and duration as adults. The adolescent girls will be
given priority.
10. Multiple channels and strategies are required to address the problem of iron deficiency anemia. The newer products
such as double fortified salts / sprinkles/ ultra-rice and other micro nutrient candidates or fortified candidates should
be explored as an adjunct or alternate supplementation strategy.

4.CONTROL OF IODINE DEFICIENCY DISORDER:

Iodine is an essential micro nutrient. It is required at 100-150 micrograms daily for normal human growth and
development. The disorders caused due to deficiency of nutritional iodine in the food/diet are called iodine
deficiency disorders (IDDs). Iodine is an essential nutrient. If a pregnant woman is starved of iodine, the fetus
cannot produce enough thyroxine with consequent retardation of physical and mental growth. Hypothyroid .fetuses
often perishes in the womb and many affected infants die within a week of birth. Hypothyroid children are
intellectually subnormal and may also suffer physical impairment. Studies have documented that in areas with an
incidence of mild to moderate 100, IQs of school children are, on an average, 13 points below those of children
living in areas where there is no iodine deficiency(2).
Iodine Deficiency Disorders are a worldwide major public health problem. These affect a large segment of
populations in all continents of our planet and have been with us from generation. As per information available,
more than 1.5 billion people all over the world are at risk of IDD.

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  Objective:
The important objectives and components of National Iodine Deficiency Disorders Control Iodine Deficiency
Disorders Control Programme (NIDDCP) are as follows:-
 Surveys to assess the magnitude of the Iodine Deficiency Disorders.
 Supply of iodated salt in place of common salt.
 Resurvey after every 5 years to assess the extent of Iodine Deficiency Disorders and the impact of lodated salt.
 Laboratory monitoring of iodated salt and urinary iodine excretion.
 Health education & Publicity.

Rationale:
The National Iodine Deficiency Disorders Control Programme (NIDDCP) started in our state since Dec'1989. It is a 100%
Central Plan Scheme. Iodine Deficiency Disorders are a group of diseases starting from a visible goitre in the neck to
many physical and mental disorder like dwarf. Cretin, squint, abortion, stillbirths and impaired mental functions due to low
intake of Iodine in food.

Objectives :
 The aim of the programme is to prevent Iodine Deficiency Disorders like the incidence of Goitre: Physical & Mental
disorders cretinism & deaf mutism etc. in the State.
 To conduct the I.D.D Surveillance through Medical Colleges/Research Institutions in endemic districts as per guide line of
Govt. of India.

Strategies:
 Assess the magnitude& distribution of I.D.D Prevalence.
 Identify high-risk population.
 Monitoring progress towards achieving long-range goals to create awareness among the people through I.E.C activities
regarding use and benefits of lodised Salt.
 Evaluation of Control Programmes.

Activities:
 Health Education & Publicity
 IEC through observation of Global 100 Prevention Day on 21st October.
 IEC through Electronic media.
 IEC through Sensitisation Seminars
 Public awareness Camp on IDD
 IDD/GOITRE Survey
 IDD/Goitre Survey work to be under taken in remaining un-surveyed 20 districts as per Guideline of Govt. of India in phased

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 manner taking help of 3 Medical Colleges of the State. So, 20 districts have got to be surveyed within a period of 5 years.
 Establishment of IDD Monitoring Laboratory
 As per Govt. of India Guideline - for analysis of Salt Samples and Urine samples, an IDD Monitoring Laboratory.

5.SPECIAL NUTRITIONAL PROGRAMME:
The programme was launched in the country in 1970-71. It provides supplementary feeding of about 300 calories and 10
grams of protein to preschool children and about 500 calories and 25 grams of protein to expectant and nursing mothers for
six days a week. This programme was operated under Minimum Need Programme. The programme was taken up in rural
areas inhibited predominantly by lower socio-economic groups in tribal and urban slums. Fund for nutrition component of
ICDs programme is taken from the SNP budget.
 Special Nutrition Program was introduced in 1970 to improve the nutritional status of specific target groups
 -The target groups are:
 children under 6 years
 pregnant and lactating mothers
 -The program is operated in the following locations:
 urban slums
 tribal areas
 backward rural areas
 -Supplementary nutrition is provided for 300 days every year
 -Children under 6 years – 300kcal, 10-12g protein
 -Pregnant and lactating women – 500kcal, 25g protein
 -Initially the program was under the Central Government
 -The responsibility was later shifted to the state government under the Minimum Needs Program
 -Now the special nutrition program is integrated with the ICDS (Integrated Child Development Services)

6.SPECIAL SUPPLEMENTARY NUTRITIONAL PROGRAMME FOR -WOMEN,INFANT AND CHILDREN:
 WIC is a program that provides the following services to pregnant women, new mothers, infants, and children up to age 5.
 Nutrition counseling and education
 Breastfeeding resources and support.
 Nutrient-rich foods (Foods provided by the program supply calcium, protein, iron, and Vitamins A, D, and C.).
 Immunization assessment and screening.
 Referrals to health and social service providers.
 For women and children over 1 year old, WIC also provides fresh fruits and vegetables (May – November) through
the Farmers’ Market Nutrition Program.
 All this at no cost to the participants!

 -Who can participate in WIC?

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 You can participate in WIC if you:
 Are pregnant or breastfeeding, a new mother, an infant, or a child up to age 5
 Live in DC (You do not have to show proof of U.S. citizenship to participate.).
 Meet income guidelines or medical risk for your family as listed below or are participating in Medicaid, DC Healthy
Families, School Lunch Program, Temporary Assistance for Needy Families (TANF), or the Food Stamp Program;
and/or Have a nutritional or medical risk (determined by a nutritionist or other health professional).
 Fill out the WIC Prescreening Tool to find out if you might be eligible for WIC.

-WIC makes a difference:

 -Women have access to nutritious foods and have healthier babies.
 -Infants show improved growth and development.
 -Children develop strong minds and bodies.
-Research shows that WIC:
 -Increases enrollment in prenatal care in the first trimester of pregnancy.
 -Increases infant birth weight.
 -Increases intake of iron and vitamin C during infancy.
 -Increases intake of nutrient-dense foods.
 -Decreases medical costs. WIC saves the taxpayers up to $4.21 in Medicaid expenses for every $1 spent on pregnant women.
-Summary:
 -WIC reduces fetal deaths and infant mortality.
 -WIC reduces low birth weight rates and increases the duration of pregnancy.
 -WIC improves the growth of nutritionally at-risk infants and children.
 -WIC decreases the incidence of iron deficiency anemia in children.
 -WIC improves the dietary intake of pregnant and postpartum women and improves weight gain in pregnant women.
 -Pregnant women participating in WIC receive prenatal care earlier.
 -Children enrolled in WIC are more likely to have a regular source of medical care and have more up to date immunizations.
 -WIC helps get children ready to start school: children who receive WIC benefits demonstrate improved intellectual
development.
 -WIC significantly improves children’s diets.

 7.BALWADI NUTRITION PROGRAMME:
 Bal (children) wadi (home or center) Nutrition Programme is a contemporary of SNP and is being implemented since 1970-
71 by the Central Social Welfare Board and national level nongovernmental voluntary organizations, namely, Indian Council
for Child Welfare, Harijan (Scheduled Castes) Sevak (Service) Sangh (Board), Bhartiya (Indian) Adimjati (Scheduled Tribe)
Sevak Sangh and Kasturba (wife of Mahatma Gandhi) National Memorial Trust. This segment of nutrition programme is thus
implemented essentially by non-governmental organizations. The Central Social Welfare Board, which is a semi-government

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 umbrella organization in the field of social work, gives in turn, grants-in-aid to voluntary organizations to actually run the
programme and so do the other four national level voluntary organizations, which also extend assistance to various voluntary
organizations beside running some centres directly.

 The beneficiaries of SNP are basically from the disadvantaged section of the society like tribal/scheduled caste people, urban
slum dwellers and also migrant labourers. The in-charge of the Balwadi Centre is an honorary worker, like Anganwadi
worker of ICDS, and is paid an honorarium which is Rs. 200 per month for trained and Rs. 150 for untrained. She is assisted
by a helper who is also an honorary worker. The Balwadis not only provide supplemental nutrition but also look after the
social and emotional development of children attending these Balwadis.

 A total number of 5641 Balwadi centres are presently being run by the five organisations. About 229 thousand children in the
age group 3-5 years are covered under the programme. The budget for the SNP during 1993-94 stood at Rs. 100 million.
 It is under the overall charge of the department of social welfare .Four national levels of organization including the Indian
council for child welfare are given grants to implement the programme. Voluntary Organizations which receives the fund are
actively involved in the day to day management. This programme is implemented through Balwadis which also provide pre-
primary education to these children. The food supplement also provides, 300 kcal and 10 gms of protein per child per day.
Balwadis are being phased out because of universalization of ICDS.

8. APPLIED NUTRITION PROGRAMME:

The Applied Nutrition Programme (ANP) was introduced as a pilot scheme in Orissa in 1963 which later on extended to
Tamil Nadu and Uttar Pradesh .
-Objectives :
a) promoting production of protective food such as vegetables and fruits and
b) ensure their consumption by pregnant and nursing mothers and children.
During 1973, it was extended to all the state of the country. The nutritional Education was the main focus and efforts
were directed to teach rural communities through demonstration how to produce food for their consumption through their
own efforts. The beneficiaries are children between 2-6 eyars and pregnant and lactating mothers. Nutrition worth of 25
paise per child per day and 50 paise per woman per day are provided for 52 days in a year. No definite nutrient content
has been specified. The idea is to provide better seeds and encourage kitchen gardens, poultry farming, beehive keeping,
etc., but this programme does not produced any impact. The community kitchens and school gardens could not function
properly due to lack of suitable land, irrigation facilities, and low financial investment.

9.MID DAY MEAL PROGRAMME:

The mid-day meal programme is also known as school lunch programme. This programme has been in operation since 1961
throughout the country .The major objective of this programme to attract more children for admission to schools and retain
them so that literacy improvement of children could be brought about.

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In formulating mid-day meals for school children, the following broad principles should be kept in mind:
1. The meal should be a supplement and not to substitute to a home diet.
2. The meal should supply at least one-third of the total energy requirement and half of protein need.
3. The cost of meal should be reasonable low.
4. The meal should be such that it can be prepared easily in the schools , no complicated cooking process should be involved.
5. As far as possible, locally available foods should be used , this will reduce the cost of meal.
6. The menu should be changed frequently to avoid monotony.

A mid-day school meal

Food for mid-day meal Quantity
-Cereals and millets 75
-Pulses 30
-Oils and fats 8
-Leafy vegetables 30
-Non leafy vegetables 30

The National institute of Hyderabad has prepared model recipes for the preparation of school meals suitable for North and
South Indians. Copies of these publications can be had gratis on request. The national institute of nutrition is of the view that
the minimum number of feeding days in a year should be 250 to have the desired impact on children.
School feeding should not be considered as end ii itself. The important goals to be accomplished are:
-Reorientation of eating habits.
-incorporating nutrition education into curriculum.
--encouraging the use of local commodities.
-improving school attendance as well as educational performance of all the pupils.
The mid-day meal programme became a part of minimum needs programme in the fifth five year plan.

10.MID-DAY MEAL SCHEME:

With a view to enhancing enrolment, retention and attendance and simultaneously improving nutritional levels among
children, the National Programme of Nutritional Support to Primary Education (NP-NSPE) was launched as a Centrally
Sponsored Scheme on 15th August 1995.
In 2001 MDMS became a cooked Mid Day Meal Scheme under which every child in every Government and Government
aided primary school was to be served a prepared Mid Day Meal with a minimum content of 300 calories of energy and 8-12
gram protein per day for a minimum of 200 days. The Scheme was further extended in 2002 to cover not only children
studying in Government, Government aided and local body schools, but also children studying in Education Guarantee
Scheme (EGS) and Alternative & Innovative Education (AIE) centres.
In September 2004 the Scheme was revised to provide for Central Assistance for Cooking cost @ Re 1 per child per school

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 day to cover cost of pulses, vegetables cooking oil, condiments, fuel and wages and remuneration payable to personnel or
amount payable to agency responsible for cooking. Transport subsidy was also raised from the earlier maximum of Rs 50 per
quintal to Rs. 100 per quintal for special category states and Rs 75 per quintal for other states. Central assistance was
provided for the first time for management, monitoring and evaluation of the scheme @ 2% of the cost of foodgrains,
transport subsidy and cooking assistance. A provision for serving mid day meal during summer vacation in drought affected
areas was also made.
In July 2006 the Scheme was further revised to enhance the cooking cost to Rs 1.80 per child/school day for States in the
North Eastern Region and Rs 1.50 per child / school day for other States and UTs. The nutritional norm was revised to 450
Calories and 12 gram of protein. In order to facilitate construction of kitchen-cum-store and procurement of kitchen devices
in schools provision for Central assistance @ Rs. 60,000 per unit and @ Rs. 5,000 per school in phased manner were made.
In October 2007, the Scheme was extended to cover children of upper primary classes (i.e. class VI to VIII) studying in 3,479
Educationally Backwards Blocks (EBBs) and the name of the Scheme was changed from ‘National Programme of Nutritional
Support to Primary Education’ to ‘National Programme of Mid Day Meal in Schools’. The nutritional norm for upper
primary stage was fixed at 700 Calories and 20 grams of protein. The Scheme was extended to all areas across the country
from 1.4.2008.
The main objectives of the scheme (as per the 2006 revision) are to:
 Improve the nutritional status of children in classes one through five in government schools and government aided schools
 To encourage children from disadvantaged backgrounds to attend school regularly and help them concentrate in school
activities.
 As well as provide nutritional support to students in drought- ridden areas throughout summer vacation.
Mid-day meal scheme is also known as National Programme of Nutritional Support to Primary Education. It was launched as
a centrally sponsored scheme on 15 august 1995 and revised in 2004.Its objectives being universalization of primary
education by increasing enrollment, retention and attendance and simultaneously impacting on nutrition of primary classes. It
was implemented in 2,408 blocks in the first year and covered the whole country in a phased manner by 1997-98.The
programme originally covered the children of primary stage (class 1 to 5 th) in the government, local body and government
aided schools and was extended in October 2002, to cover children studying in Education Guarantee Scheme and Alternative
and Innovative Education Centers also.
The central assistance provided to states under the programme is by free supply of food grain from nearest Food Corporation
of India go down at the rate of 100 g. per student per day and subsidy for the transport of food grain. To achieve the
objective, a cooked mid –day meal with minimum 300 calories and 8 to 12 grams of proteins content will be provided to all
children in the class 1 to 5th.
Some suggestions for the preparation of nutritious and economical mid-day meal as under:
-Food grains must be stored in a place away from moisture, in air tight containers or bins to avoid infestation.
-Use whole wheat or broken wheat (Dalia) for preparing mid-day meal.
-Rice should preferably be parboiled or unpolished.
-‘Single dish meals’ using broken wheat or rice and incorporating some amount of pulse or soybean, a seasonal vegetable ,
green leafy vegetable and some amount of edible oil will save both time and fuel besides being nutritious. Broken wheat,

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pulses, dal, green leafy vegetables are examples of single dish meal.
-Cereals pulses combination is necessary to have good quality protein.
-Sprouted pulses have more nutrients and should be incorporated into single dish meal.
-Leafy vegetables when added to any preparation should be thoroughly washed before cutting and should not be subjected to
wash after cutting.
-Soaking of rice, dal Bengal gram etc. reduces the cooking time. Wash the grains thoroughly and soak in just sufficient
amount of water required for cooking.
-Rice water if left after cooking should be mixed with dal. If these are cooked separately and should never be thrown away.
-Fermentation improves nutritive value. Preparation of idli , dosa , dhokla etc. may be encouraged.
-Cooking must be done with lid on to avoid loss of nutrients.
-Over cooking should be avoided.
-Reheating of oil used for frying is harmful and should be avoided.
-Leafy tops of carrot, radish, turnips etc. should not be thrown but utilized in preparing mid –day meals.
-Only iodized salt should be used for cooking mid-day meals.

11 WORLD FOOD PROGRAMME:

World Food programme is the world’s largest international food aid organization, serving in 84 countries
working with the goal of achieving “A world in which every man, woman and child has access at all times to
the food needed for an active and healthy life. Without food, there can be no sustainable peace, no democracy
and no development”. Founded in 1963 as the food aid arm of the United Nation. After the Rome Declaration
on World Food Security in 1996, WFP is committed to achieve the goal of halving the number who are
without adequate access to food by 2015.

12.TAMILNADU INTEGRATED NUTRITION PROGRAMME:

The Tamil Nadu Integrated Nutrition Project was started in 1980 targeting at 6-36 months old children, and pregnant
and lactating women.
 TIMP aimed for:
-To reduced malnutrition upto 50% among children under 4 years of age.
-To reduce infant mortality by 25%;
-To reduce Vit-A deficiency in the under 5 year from about 27% to 5%; and
-To reduce ammonia in pregnant and nursing women from about 55% to about 20%.
-This project has four major components:
1. Nutrition services,
2. Health services,
3. Communication, and
4. Monitoring and evaluation.

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TINP-II was designed to cover in a phased manner. 316 of the total 385 rural blocks in Tamil Nadu. The Goals of
the programme were
1) To increase the proportion of children classified as “nutritionally normal” by 50% in new and 35% in TINP-II
areas;
2) To reduce the infant mortality to 55% per 1000 live births; and
3) To 50% reduction in incidence of low birth weight.
The projects are assisted by World Bank and with the goal of universalization of ICDs all the TINP blocks will be
converted to ICDs blocks.

13.WORLD FOOD PROGRAMME:

World Food programme is the world’s largest international food aid organization, serving in 84 countries working
with the goal of achieving “A world in which every man, woman and child has access at all times to the food needed
for an active and healthy life. Without food, there can be no sustainable peace, no democracy and no development”.
Founded in 1963 as the food aid arm of the United Nation. After the Rome Declaration on World Food Security in
1996, WFP is committed to achieve the goal of halving the number who are without adequate access to food by
2015.

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