Nutrition monitoring is the measurement of the changes in the nutritional status of a population or a specific group of individuals over time
The paucity of reliable and comparable data from all parts of the country is a definite obstacle towards a realistic and disaggregated problem definition. This calls for a nation-wide monitoring system. To achieve this, it is necessary to restructure and strengthen the existing National Nutrition Monitoring Bureau (NNMB) and to develop a mechanism for generating nationwide disaggregated data.
National Nutrition Policy, Govt. of India, 1993
Undernutrition continues to be a widespread problem in India, despite quantum increase in food production during the last five decades. The National and State governments have been implementing a number of poverty alleviation programmes for the overall socioeconomic development of the community and several nutrition interventions to mitigate the problem of undernutrition. The Government of India's National Nutrition Policy, apart from setting nutrition goals to control and prevent malnutrition in the country, recommended that a National Nutrition Surveillance System should be developed. For the purpose of formulation of policies and strategies to control and prevent malnutrition, it is essential to assess continuously the nutritional problems in the country.
Monitoring of the nutritional status of population, therefore, becomes an important aspect of any nutrition intervention programme to assess the impact of these massive inputs and to determine the direction in which the community's nutrition is progressing, so as to initiate appropriate corrective actions. The Indian Council of Medical Research (ICMR), established National Nutrition Monitoring Bureau (NNMB) in the year 1972, with a Central Reference Laboratory at the National Institute of Nutrition, Hyderabad, in the States of Andhra Pradesh, Gujarat, Karnataka, Kerala, Madhya Pradesh, Maharashtra, Orissa, Tamil Nadu, Uttar Pradesh and West Bengal.
Separate teams of research investigators, who are either Medical graduates or postgraduates in Nutrition/ Sociology, collect information on diet and nutritional status of population. All the members of the team are given intensive training in the methods of data collection, analysis and interpretation. Each state has also been provided with a vehicle for field survey.
Collaboration with State Governments
The NNMB activity was envisaged, as a collaborative exercise between the Indian Council of Medical Research and the respective State governments. The Bureau was therefore, put under the administrative control of the State Nutrition Officer, so that the NNMB team gets necessary help and cooperation from the local administration staff for execution of field surveys. In the States of Andhra Pradesh, Madhya Pradesh, Orissa and Uttar Pradesh, the NNMB units are however functioning to the ICMR Institutes/Regional Centers.
In each of the above States, the NNMB team collects information on dietary intakes and nutritional status of population in rural areas on a representative sample, by adopting prescribed standard procedures and using accurate equipment.
The study design and Sampling procedure
Survey methodology, development, pre-testing and finalization of survey instruments are worked out at Central Reference Laboratory (CRL), National Institute of Nutrition, Hyderabad. The investigators of the NNMB units are trained and standardized at NNMB-CRL. In addition, re-orientation training of the staff is carried out every year.The data collected, using standardized pre-tested questionnaires, includes:
- Household demographic and socioeconomic status,
- Dietary intake of individuals and households
- Nutritional anthropometry on all the available members of the households,
- Village level information on population, agricultural production, nutrition and other developmental programmes.
- Measurement of diet related chronic diseases such as obesity and hypertension.
Unique Features of NNMB
- Carry out repeat surveys in the same villages in all the States that were surveyed during 1975-79, to assess time
trends in diet and nutritional situation.
- Generate data periodically on diet and nutritional status of socially vulnerable groups of population such as tribal
communities living in the Integrated Tribal Development Agency (ITDA) areas, and special group of population 'at-risk' such as 'elderly' and 'adolescents, pregnant women, etc.
- The only organization involved in continuous collection of data on actual dietary intakes of households as a
whole,as well as by individuals belonging to different age and physiological groups, in different states
- This is made possible by availability of strong contingent of multidisciplinary experts in NIN to plan and execute the community-based surveys and to carry out detailed analysis and interpretation of the data.