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FoodFortifcation &
Adulteration
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FoodFortifcation
WHO The process whereby nutrients areadded to foods (in relatively smallquantities) to maintain or improve thequality of the diet of a group a community
or a population!"
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History o Food Fortifcation
#odised $alt was used in the %nited$tates before World War ##
&itamin ' was added to margarine in'enmar in early *+s
&itamin , - ' were added to &anaspati(hydrogenated &egetable Oil) in #ndiasince ./0
1
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Fortifcation o ood under thegovernment supported
programmes 2orti3cation of ICDS supplementarycooed food
2orti3cation of food for theMid DayMeal
2orti3cation of factory producedReadyto!at "R#!$ oods
2orti3cation of wheat 4our suppliedthrough #argeted %ulicDistriution System"#%DS$
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cominations omicronutrients
'ehicles Micronutrients
5dible common salt #ron #odine
Whole wheat 4our -6aida
#ron 2olic ,cid 7alcium8inc
9ice #ron 2olic ,cid 7alcium 8inc
&egetable oils &it! , - '
6il and 'airyproducts
&itamin ' , #ron 2olic ,cid7alcium Omega:1; 2atty,cids
#7'$ supplementaryfoods
#ron 2olic ,cid 7alcium 8inc
$ugar &itamin ,
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Criteria or Fortifcation
=utrient de3ciency should be widespread!
The vehicle food must be consumed by thetarget group
The high consumption of forti3ed food will
not lead to to>icity ,ddition of micronutrient should not change
the taste colour 4avour te>ture and shelf:life of the food item
The item of food should be centrallycontrolled and monitored
The cost of forti3cation should be a?ordable
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Advantages
@roviding certain nutrients simultaneouslyin the same food improves the utiliAationof certain
&itamins and minerals e!g! vitamin 7enhances the absorption of iron
@roviding nutrients through the regularfood supply and distribution system
reduces costs!
..
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Food adulteration
The process of lowering the nutritivevalue of food either by removing a
vital component or by addingsubstances of inferior quality iscalled food adulteration!
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FSSA Adulterant
,ny material which is or could be employed
for maing the food unsafe or sub:standardor mis:branded or containing e>traneousmatter
Misranded)
2alse claims on label B ad #mitation B substitute
2alse statement design or device
regarding the ingredients 2alse 6anufacturer details or
#mproper label : arti3cial 4avouringcolouring or chemical preservative
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Common Food Adulterants
S*
n
Food
Material
Common Adulterants
. 6il 5>traction of fat ,ddition of starch
- Water
C 7o?ee
powder
'ate hus Tamarind hus 7hicory
1 6ustard
seeds
$eeds of pricly poppy:argemone
0 Dutter Oleo margarine
Honey 2ructose syrup Bcane sugar
; 9ice wheat 6ud grits $oapstone bits
E Dlac 'ried seeds of papaya ./
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Health Ha+ards o Adulteration
Dreaing of teeth
7ause F#T disturbances lie diarrhea,inections !
$tomach or intestinal Cancer*
To>icity due to to>ic sweeteners additivescolours etc!
-athrysim due to consumption of Gesari
dal !!pidemic Dropsy due to consumption of,rgemone oil mi>ed mustard oil!
&arious abnormalities of bone eyes sin
and lungs! C*
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Food Standards
.* Code/ Alimentarius
7ollection of international food standards
recommended by 2,O and WHO!
0* %FAStandards
#ts purpose is to obtain a minimum level ofquality of food stu?s attainable under #ndianconditions!
1* Agmar2 Standards
Fives the consumer an assurance of quality inaccordance with standards laid down
3* 4ureau 5 Indian Standards
The #$# mar on any article of food is a guarantee
of good quality
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%revention o Food Adulteration Act "%FA$.673
5nacted in ./0 and amended in ./;1 ./;/and./
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7ommunity =utritional @rogrammes
Iarge scale supplementaryprogrammes
6ain aim is to improve nutritionalstatus in targeted groups
To overcome speci3c diseasesthrough various ministries to
combat malnutrition
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%rogrammes Ministry
&itamin , @rophyla>is @rogram Health andfamilyWelfare@rophyla>is ,gainst =utritional
anaemia
#''s 7ontrol @rogram
$pecial =utritional @rogram $ocialwelfare
Dalwadi =utritional @rogram
#7'$ @rogram
6id 'ay 6eal @rogram 5ducation
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#nitiated in ./E*
,ge group .: year
@riority to &,' geographical area
ObJective
@revent blindness due to &,'
OrganiAation @H7 and subcenter
'itamin A %rophyla/is%rogramme
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&itamin , @rophyla>is@rogramme
Dene3ciary group
preschool children(; months to years)
a single massive dose of oily preparation of&itamin , C***** #% (retinol palmitate..*mg) orally every ; months for everypreschool child above . year
half the amount in K than . year children
.B.
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@regnant woman K.. gmBdl
=on pregnant woman K.CgmBdl
#nitiated in ./E* 7entrally sponsored
Over *Mpregnant woman su?erfrom anemia
C*M of maternal death
7auses IDW and perinatal mortality
%rophyla/is Against 9utritionalAnaemia
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9ational Iodine Defciency
Disorder Control %rogramme =ational goiter control programme
in ./;C
#'' 7ontrol @rogramme
9eplace the entire edible salt by
iodide salt
.B.
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Special 9utritional %rogramme
$tarted in ./E* is in operation in urbanslums tribal areas and bacward ruralareas!
Iaunched under minimum need programme
6ain aim is to improve nutritional status intargeted group
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Dene3ciary group 7hildren below ; years @regnant and lactating women
child 1**cal and .*:.Cgm protein pregnant **cal and C gm protein
Total of 1** days in a yearThis programme is gradually being merged
into ICDS
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Applied 9utritional %rogramme
This proJect was started in Orissa on ./;1
Iater e>tended to T= and %@
ObJectives
@romoting production and of protective food such&egetables and fruits
5nsure their consumption by pregnant - lactatingwomen and children!
./E1 it is e>tended to all states in #='#, 6ainly through nutritional education
=utrition worth C paisa for children and * paisa forpregnant and lactating women for C days in a year
.B.
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6aJor components
=utritional $ervices
Health services
7ommunication 6onitoring and evaluation
Iater it is converted as #7'$
.B.
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Dalwadi =utrition@rogramme
This was started in ./E*under the departmentof social welfare
Dene3ciary group
preschool children 1:;years of age 1**cal and .*gm protein
,lso provided with pre school education
Dalawadisare being phased out becauseuniversaliAation of #7'$
.B.
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%rinciples o Mid Day Mealprogramme
The meal should be supplement and not asubstitute to home diet!
$upply at least one third of the total
energy requirement and half of theprotein needed
7ost of meal should be reasonably low
@repared easily in schools nocomplicating cooing procedures involved
Iocally available foods should be used
The menu should be frequently changed
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=ational @rophyla>is @rogramme against=utritional Dlindness due to &itamin , 'e3ciency
#nitiated in ./E* with the speci3c aimof preventing nutritional blindness
due to &it! , #nitially age group of eligible children
was restricted to / to 1; months of
age #n C**; revised as ;:/ months
#mplemented through the e>isting
networ of primary health centres
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Integrated Child
Development Services"ICDS$ Scheme
.B.
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ICDS Iaunched on CndOctober ./E! #7'$ $cheme represents one of the world+s
largest and most unique programmes forearly childhood development!
#ndia+s response to the challenge of @roviding pre:school education on one hand and
Dreaing the vicious cycle of malnutrition
morbidity reduced learning capacity andmortality on the other!
#7'$ is the foremost symbol of #ndia+scommitment to her children!
.B.
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%urpose or Initiation
Routine MCH services not reaching target
Population
Nutritional component not covered by
Health services
Need for community participation
.B.
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5:ectives)
.! To improve the nutritional and health status of children in
the age:group *:; yearsN
C! To lay the foundation for proper psychological physical and
social development of the childN
1! To reduce the incidence of mortality morbidity malnutrition
and school dropoutN
0! To achieve e?ective co:ordination of policy and
implementation amongst the various departments to
promote child developmentN and
! To enhance the capability of the mother to loo after the
normal health and nutritional needs of the child through
proper nutrition and health education!
.B.
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Services
The above obJectives are sought to beachieved through a pacage of servicescomprising
.! $upplementary nutritionC! #mmuniAation
1! Health chec:up
0! 9eferral services! @re:school non:formal education and
;! =utrition - health education!
.B.
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4enefciaries o ICDSChildren < 6 years
.B.
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$ervices and bene3ciariesServices arget Group Service Provided !"
Supplementar"
#utrition
$%ildren !elow & "ears'
Pregnant Lactating ot%er (PL)
Anganwadi Wor*er and
Anganwadi +elper
,mmuniation. $%ildren !elow & "ears'
Pregnant Women
A#/0
+ealt% $%ec*-up. $%ildren !elow & "ears'
Pregnant Lactating ot%er (PL)
A#/0/AWW
Reerral Services $%ildren !elow & "ears'
Pregnant Lactating ot%er (PL)
AWW/A#/0
Pre-Sc%ool 2ducation $%ildren 3-& "ears AWW
#utrition +ealt%
2ducation
Women (15-45 "ears) $%ildren 3-&
"ears
Pregnant Lactating ot%er (PL)
AWW/A#/0
.B.
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Supplementary 9utrition
This includes supplementary feeding and growthmonitoringN and prophyla>is against vitamin ,de3ciency and control of nutritional anaemia!
Frowth 6onitoring and nutrition surveillance aretwo important activities that are undertaen! 7hildren K1 years of age of age are weighed once a
month
children 1:; years of age are weighed quarterly
They avail of supplementary feeding support for1** days in a year!
.B.
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Immuni+ation)
#mmuniAation of pregnantwomen and infantsprotects children from si>vaccine preventablediseases:poliomyelitisdiphtheria pertusistetanus tuberculosis andmeasles!
#mmuniAation of pregnant
women against tetanusalso reduces maternaland neonatal mortality
.B.
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Health Chec2ups
This includes health care of childrenless than si> years of age antenatalcare of e>pectant mothers and
postnatal care of nursing mothers recording of weight immuniAation
management of malnutrition
treatment of diarrhoea de:wormingand distribution of simple medicinesetc!
.B.
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Reerral Services)
'uring health chec:ups and growthmonitoring sic or malnourishedchildren in need of prompt medical
attention are referred to the @rimaryHealth 7entre or its sub:centre
.B.
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9onormal %reSchool !ducation"%S!$
anganwadi a villagecourtyard
@$5 is considered the
bacbone of the #7'$programme!
#ts for the three:to si>years old children andis directed towards
providing and ensuringa natural Joyful andstimulatingenvironment
.B.
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9utrition and Health !ducation
#t is a eyelement of thewor of the
anganwadiworer!
This forms partof D77(Dehaviour7hange
7ommunication).B.
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#H! ICDS #!AM
The #7'$ team comprises
,nganwadi Worers
,nganwadi Helpers
$upervisors
7hild 'evelopment @roJect Ocers
(7'@Os) and 'istrict @rogramme Ocers ('@Os)!
.B.
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Role o A;;
o elicit community supportParticipation in running the program
!eigh " record each child every month
Refer cases
#rgani$e non%formal pre%school activities
Provide supplementary nutrition
Provide health " nutrition education and
counseling
.B.
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Role o A;;
Ma&e home visits
'ssist PHC staff
(uide ')H'
'ssist in implementation of *ishori
)ha&ti +o,ana -*)+.
.B.
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Role o A; Helper
Coo& " serve food
Clean the 'ngan/adi premises
Cleanliness of small children
0ring small children to 'ngan/adi
.B.
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Role o ASHA
'/areness generationCounsel /omen
Community mobili$ation
!or& /ith 1H)C
2scort3accompany pregnant /omen "
children re4uiring treatment
Provide primary medical care
.B.
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Role o A9M
Hold /ee&ly 3 fortnightly meeting /ith ')H'Participate " guide in organi$ing the Health
5ays at '!C
tili$e ')H' in motivating the pregnant
/omen and married couples
(uide ')H' in motivating pregnant /omen
for full 'NC
2ducate ')H' on danger signs of pregnancyand labor
.B.
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Role o Health Department
Health Chec&%ups
Handling Referral
7mmuni$ationNutrition " Health 2ducation
Monitoring of Health components
.B.
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Angan(adi Centre
Population Norms8
9or Rural3rban Pro,ects
:;;%;; % = '!C
;;%=6;; % > '!Cs=6;;%>:;; % ? '!Cs
hereafter in multiples of ;; = '!C
9or Mini%'!C=@;%:;; %= Mini '!C
.B.
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9or ribal 3Riverine35esertA Hilly and otherdifficult areas3 Pro,ects
?;;%;; % = '!C
9or Mini% '!C=@;%?;; = Mini '!C
't present there are 5&5 7C5) pro,ectsB
.B.
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Supplementary 9utrition per Day
.B.; 6;; =%>;
R i d f i l d
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Revised fnancial norms or oodsupplement
$ategor" Pre-revised
Revised w7e7;une 9:1:
Children -6%>months.
RsB >B;; RsB:B:
)everelymalnourished children
-6%> months.
RsB >B; RsB@B>
Pregnant " Dactating RsB >B?; RsB6B;;
.B.
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International %artners
nited Nations 7nternational ChildrenE
2mergency 9und -N7C29.
Cooperative for 'ssistance and Relief2very/here -C'R2.
!orld 9ood Programme -!9P.
.B.
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Ma:or Initiatives
Revision in Population norms
niversali$ation and ?rdphase of
eFpansion of the )cheme of 7C5)
7ncrement in 0udgetary allocation for7C5) )cheme
7ntroduction of cost sharing bet/een
Centre " )tates
Revision in financial norms of
supplementary nutrition
.B.
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Monitoring System
Central level
)tate level
0loc& level1illage level -'ngan/adi level.
.B.
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Failures
Practically children ?%6 +rs and
Pregnant " Dactating not covered
7rregular food suppliesGuality of Nutrition supplement
Poor supervision
Dac& of community o/nership3 participation
Nutrition education only on papers
Children come only for food
.B.
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Mid Day Meal %rogramme
6aJor ObJective improve the $chool attendance
reduce school drop outsbene3cial impact on 7hilds nutrition
@rinciples.!supplement not substitute to home diet
C!.B1 total energy requirementBday andP total protein requirement Bday!
1! reasonably low cost0!easily prepared at schools
!as for as possible locally available food ;!change menu frequently
.B.
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6id:day meal scheme
=ational programme of nutritional support toprimary education
ObJective
%niversaliAation of primary education by
increasing enrollment (class . to ) and
#mprove nutritional status of children!
1* to ** cal and
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'rawbacs
@rogramme is good as for asimproving nutrition of the
underprivileged children Dut it requires sustainability for thisrequires political will communityparticipation monitoring andevaluation
9epeated incidence of food poisoningin the mid day meal causing serious
threat to e>istence of this.B.
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#HA9
Geep visitingdnbpaediatrics!blogspot!in
.B.
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I9#!?RA#!D CHI-D D!'!-5%M!9#S!R'IC!S
"ICDS$
'9! G,=%@9#Q, 7H,T%9&5'#
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@9OF9,6 O%TI#=5
$tarted by the Fovernment of #ndia in./E the#ntegrated 7hild 'evelopment $cheme (#7'$)
has been instrumental in improving thehealth and wellbeing of mothers andchildren under ; by providing health andnutrition education health services
supplementary food and pre:schooleducation!
The #7'$ national development program isone of the largest in the world! #t reaches
more than 10 million children aged *:;
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Iesson ObJectives
To now the e>tent of malnutrition
To now about the goals! obJectivestarget groups service componentsand coverage of #7'$ program
To now about the impact of the@rogram
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$O%975 =2H$:1 C**:;
%nder nutrition in 7hildren under ,ge 1
,nemia among 7hildren ,ge ; 1
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$O%975N =2H$ :1 C**:;
,nemia among 7hildren ,ge ;:16onths
9ecommended and ,ctual
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$O%975 =2H$:1 C**:;
9ecommended and ,ctualDreastfeeding @ractices
?oal) Initiation o reasteeding(ithin. hour o irth
Achievement) 07@
?oal) 9o prelacteal eeding Achievement) 31@
?oal) !/clusive reasteeding
" months$ Achievement) 3@
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!very fth young child in the
(orld lives in India
!very second young child in Indiis malnourished
#hree out o our young
children in India areanaemic
!very second ne(orn inIndia isat ris2 o reduced learning
capacitydue to iodine defciencyMalnutrition limitsdevelopment potential andactive learning capacity o
the child
#7'$ ODL57T#&5$
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#7'$ ODL57T#&5$
To improve the nutritional status of
preschool children *:; years of agegroup!
To lay the foundation of properpsychological development of the child
To reduce the incidence of mortalitymorbidity malnutrition and school dropout
To achieve e?ective coordination ofpolicy and implementation in variousdepartments to promote childdevelopment
To enhance the capability of the motherto loo after the normal health and
nutritional needs of of the child through
TH5 T,9F5T F9O%@$
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TH5 T,9F5T F9O%@$
@regnant women
=ursing 6others
7hildren less than 1 years
7hildren between 1:;
years
,dolescent girls( ..:. years old children
in the anganwadi is directed towards providingand ensuring a natural Joyful and stimulatingenvironment with emphasis on necessary inputsfor optimal growth and development*
The early learning component of the #7'$ is asigni3cant input for providing a sound foundationfor cumulative lifelong learning and development!
#t also contributes to the universaliAation ofprimary education by providing to the child the
necessary preparation for primary schooling ando?ering substitute care to younger siblings thusfreeing the older ones especially girls toattend school!
H lth h
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Health chec:ups
9ecord of weight and height of childrenat periodical intervals
Watch over milestones #mmuniAation Feneral chec up for detection of
disease Treatment of diseases lie diarrhea
,9#
'eworming @rophyla>is against vitamin ,
de3ciency and anemia 9eferral of serious cases
,dolescent girls scheme
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,dolescent girls scheme( Gishori shati yoJna)
Feneral health chec ups
#mmuniAation
Treatment of minor ailments 'eworming
@rophylactic measures againstanemia #'' vitamin de3ciency
9eferral
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,nganwadi 7entre
,nganwadi is the 2ocal @oint for'elivery of #7'$ $ervices!
Iocated in a &illageB$lum!
,nganwadi is run by an ,WWsupported by a Helper!
,WW is the .st @oint of 7ontact for2amilies 5>periencing
=utrition and Health @roblems!
#ntegrated 7hild 'evelopment
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#ntegrated 7hild 'evelopment$cheme (#7'$) in #ndia
Sanctioned 8unctioning Gap
#o7 o 6loc*s 5&59 4545 17&
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