This article presents the concept of community participation as a strategy for achieving development. Community assessment, awareness, involvement, participation, and empowerment need to be to ensured before community participation can become a self-dynamic process. From the Integrated Nutrition Health Programme (INHP) in India came the following features that highlighted the community participation process, including: (a) women group formation and/or strengthening, (b) a participatory rural appraisal (PRA) exercise, (c) sub-center level team formation, (d) mother meetings, and (e) service providers with women's groups (WGs). The strategies of the INHP integrate several developmental sectors so as to bring about lasting positive health and nutrition related behavioral changes among the targeted beneficiaries. The Convergent Community Action (CCA) approach, introduced by the Panchayat government, is an updated social action strategy enhancing the capability of the family and the community to meet the needs of children and women.

This is a case study of a lactating grandmother. Thini Bai, married for 34-36 years and living in the village of Pantaniya, had been through menopause 3-4 years prior to her condition. A grandson named Bantu, whose mother had died of malaria two days after his birth, was left under her care. She related that she had let Bantu suckle at her breast to pacify him. After a while she noticed changes in her breast size and fullness, in the color spread of the areolae, and in nipple consistency. Eventually, milk was being secreted. She continued to breast-feed 8-10 times a day as she had done when she was a mother. An increase in weight of 75 g in the child was subsequently noted. At the time of investigation, Bantu's age was 6 months and his weight was 6.5 kg. This is a unique case of a postmenopausal grandmother lactating after a minimum of 16 years since last lactation.

Integrated Child Development Services (ICDS) scheme is the largest national programme for the promotion of the mother and child health and their development in the world. The beneficiaries include children below 6 years, pregnant and lactating mothers, and other women in the age group of 15 to 44 years. The package of services provided by the ICDS scheme includes supplementary nutrition, immunization, health check-up, referral services, nutrition and health education, and pre-school education. The distribution of iron and folic acid tablets and megadose of vitamin A is also undertaken, to prevent iron deficiency anaemia and xerophthalmia respectively. The scheme services are rendered essentially through the Anganwadi worker (AWW) at a village centre called "Anganwadi". The ICDS had led to (i) reduction in prevalence of severe grades of malnutrition and (ii) better utilization of services of national nutritional anaemia prophylaxis programme and the national programme for prevention of nutritional blindness due to vitamin A deficiency by ICDS beneficiaries. The ICDS scheme is being modified continuously to strengthen the programme.

A total of 653 women in third trimester of pregnancy were examined for the presence of anaemia in Kanksha and Ausgram II blocks of Burdwan. 80% of them were found anaemic (haemoglobin level < 11 gm%). 67% of the pregnant women took iron folates till varied periods. Iron deficiency was the commonest cause for the anaemia.

To study the trends of beneficiary coverage (pregnant and lactating women and children less than two years of age) for utilization of supplementary nutrition and health services in a rural block before and after the launch of a strategy to converge Health & Integrated Child Development Services (ICDS) on a single day christened "Nutrition and Health Day" (NHD). It is a before and after intervention design in rural ICDS block Amarwada in district Chhindwada. As a part of intervention, NHD were organised on which convergent services of Health & ICDS were made available to the beneficiaries. On the weekly NHDs, uncooked supplementary nutrition for the week was distributed to pregnant and lactating mothers and children under two. The Health worker visited the Anganwadi Centre (AWC) and immunized children and pregnant women, distributed IFA, Vitamin A and provided health and nutrition education. The study assessed the impact of these interventions on the coverage rates of the services. Study was conducted between May 97 and March 98. The routine monitoring reports of the ICDS and Health System of the state government were used as study tools. The study sample comprised of AWC beneficiaries in the project area. The total population of the block was 89,476. Participation in the supplementary nutrition program (SNP) increased two to three folds in all categories of the target population. Immunization and Vitamin A coverage levels for children also showed an increase of about 3 and 5-8 times from baseline status respectively in a year's time. Among pregnant women, Tetanus Toxoid (TT) and Iron and Folic Acid (IFA) utilization rates have also shown two and five fold increase respectively.

A total of 479 children aged 6-60 months (male/female, 240/239) were studies during 1991 to 1992. Weight for age, height for age (mean +/- SD) were 72 +/- 11%, 90 +/- 7 and 87 +/- 10% of NCHS median respectively. According to Gomez classification, 96% of children had varying degrees of protein energy malnutrition (PEM) (28.4% mild, 58.2% moderate and 9.2% severe). According to Waterlow classification 84% were stunted(36% mild, 33% moderate and 15% severe) and 67% were wasted (47% mild, 18% moderate and 2% severe). Of all children 368 (77%) received BCG and 439 (82%) received partial or full dose of DPT and Polio vaccines. Among children aged 13-60 months 75% received Measles vaccine. Weaning food was started at (mean +/- SD) 8 +/- 4 months. Low household income, parental illiteracy, small family size (< or = 6), early or late weaning and absence of BCG vaccination were significantly associated with severe PEM. Timely weaning, education and promotion of essential vaccination may reduce childhood malnutrition especially severe PEM.

Success of Universal Salt Iodization (USI) programme depends on availability of iodised salt to consumers, which should be reflected in their body iodine status. From a monitoring study in Calcutta, it was found that all packed salts were iodised and most of them (98.1% at household level and 93.6% at retailers' outlets) had iodine at a level of > or = 15 ppm. Of the loose salts, 34.6% at household level and 19.9% at retailers' outlet had iodine level < 15 ppm. A few number (0.5% at household level and 1.0% at retailers' outlets) of salts had no iodine. To ascertain the impact of consumption of iodised salt iodine excreted in urine (UIE) was measured in school children of age between 8-12 years of south, east, west, north and central parts of Calcutta. 22.95% of male children and 31.81% of female children had urinary iodine level less than 50 micrograms/l, which is cut off figure of public health concern. Children from poor slum areas were found to be at greater risk.

Pavement dwelling is likely to aggravate malnutrition among its residents due to extreme poverty, lack of dwelling and access to food and their exposure to polluted environment. Paucity of information about nutritional status of street children compared to that among urban slum dwellers, squatters or rural/tribal population is quite evident. The present study revealed the magnitude of Protein Energy Malnutrition (PEM) and few associated factors among a sample of 435 underfives belonging to pavement dweller families and selected randomly from clusters of such families, from each of the five geographical sectors of Calcutta city. Overall prevalence of PEM was found almost similar (about 70%) to that among other 'urban poor' children viz. slum dwellers etc., but about 16% of them were found severely undernourished (Grade III & V of IAP classification of PEM). About 35% and 70% of street dweller children had wasting and stunting respectively. Severe PEM (Grade III & IV) was more prevalent among 12-23 months old, girl child, those belonged to illiterate parents and housewife mothers rather than wage earners. It also did increase with increase of birth rate of decrease of birth interval.