1. T
Towards
Optimum
Nutrition
How nutrition takes baby steps in Akanksha schools
Akanksha Nutrition Assessment Program (A.N.A.P)
Malnutrition Eradication Rehabilitation Activity (M.E.RA)
Journey from February, 2013
.

2. From thought to action.....
Introduction session with Social work team, Pune. Keen understanding of Nutrition ,
made team move ahead to work for our children.
Holistic Programs – ANAP & MERA.Field Visits– Field Trainings of
Anthropometry,Mock Sessions on Nutrition.Pilot studies - Anthropometry &
Energy Dense Food. One Day Workshops – SMC training& Mumbai Team
Training.
Recommended Material – WHO Growth Charts, SAM Guidelines Prof. Michael
Golden, UNICEF &RajmataJijauNutrtion Mission training Material.
Key Messages – Responsive feeding, Family care approach, 5 times meal, Baal
kopra, Regular parent sessions.
Master Trainers evolved for entire nutrition program & community mobilization.
All from Non-medical background with a credential role in Anthropometric
malnutrition screening.
Helper’s trained for Anthropometry Examinations hand holding Social workers.
Severe Underweight children (-3 to -4 SD) from 3 Schools involved in MERA for
Energy dense food treatments with significant weight gain in this course.
Nutrition Sessions both Expert In house&Trained teams stimulating parents for a
sound approach to a basic need called “FOOD”.
SMC members including centralized SMC trained in one day workshop, a pool
of trainers made available to exsiting team for different nutrition activities like 24
Hour dietary recall.
Students screened in entire ANAP program with a strong self-sustainable
machinery & skilled people to identify Malnutrition by simple WHO
standards.
2
7
14
60
3
5
44
85
1200+
+
1

3. 100
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0
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2 5 5 3 6 3 1 5 2 6 2 2 1
Weightgain(ingrams)
Number of students showing weight gain
21 21
1
7
0
5
10
15
20
25
100 to 500 600 to 1200 1300 to 1800 No Change
Numberofstudents
Weight Gain (in grams)
• The average weight gain in the above program for 43 children was 15.46 Grams
/day.
(The program was conducted for 40 days and the weight gain of these 40 days was
coretaled to find out weight gain for one day.)

4. About entire Nutrition program –
The Malnutrition eradication Rehabilitation Activity (MERA) is one of the ambitious program to cater
underweight or nutritionally deprived children, their families through community approach. The entire
exercise begins with assessment of malnutrition status from a entire spectrum of Underweight &
Wasting. These children are identified from universal standards of World Health Organisation through
its growth graphs.
Key objective of MERA –
1. Develop awareness about health & nutrition.
2. Capacity building of mother & maternal empowerment for healthy food approaches.
3. Developing a family care approach to child.
4. Improve personal health & hygiene to reduce disease frequency burden & facilitate by reducing
school absenteeism.
5. Develop a health seeking attitude in early childhood.
Basic principle of MERA –
Behavioral Change Communication & Family involvement in nutrition support.
Flow of entire exercise –
1. Assessment of weight, height & date of birth.
2. Identification of Wasting & Underweight children in categories of severe & moderate.
3. Separating severe (-3 to -4 SD) children & including them under 40 days program.
4. Three Interventions focused – Energy Dense Food (ladoo), Fruits & Complimentary proteins in
tiffin & Family empowerment session.
Strengths of activity –
1. Since last two years’ parents getting sensitized to healthier choices in food.
2. Weight gain in children to boost parents with a change.
3. SMC, Teachers, Helpers, School leaders getting actively participated.
4. Entire program running on in house skilled social work team trained.
5. Parents actively involved in entire activity.
6. Community as whole getting benefitted.
7. Perhaps no other school in India has application based Nutritional Intervention Model as per
WHO guidelines.