India: Childhood Malnutrition Eradication Program

First Quarter 2014 Malnutrition Eradication Program Report

July 30, 2014
By Michael Matheke-Fischer, Santosh Pal & Amit Purohit


Summary of Activities

Our team of 60 Community Nutrition Educators (CNEs) and 6 District Coordinators is covering enormous ground every week across 5 districts and 600 villages in Madhya Pradesh. Our strategy continues to be closing the gap between the resources available and the families who need them by focusing on the basics of malnutrition awareness, identification, treatment, and prevention and inserting simple, but innovative technologies and practices.

  • Continue to identify new SAM and MAM cases, refer complicated cases to the NRC and provide home-based counseling for all malnourished children
  • Review all program data and make necessary changes in program reporting system
  • Refer 1,000 SAM children to government centers for treatment with a 50% success rate
  • Conduct 2,500 Community Nutrition Meetings
  • Conduct 9,000 Individual Family Counseling Sessions
  • Send CNEs to Nutrition Rehabilitation Centers (NRCs) to help counsel families present
  • Continue to develop linkages with government health and nutrition services
  • Continue pilot with Digital Green trust to produce and screen nutrition and health based videos in Khandwa, Madhya Pradesh
  • Strengthen institutional capacity with support from World Bank’s India Development Marketplace Award.


RMF red arrow icon
Return to Top

Results &

Accomplishments

  • RMF and Digital Green partnership

    Community Based Video Screening Parternship with Digital Green

    100 Villages reached

    After successful trainings of the CNEs in Khandwa District in September, RMF began full operations with videos in October, producing four videos per month and screening in 50 villages. From January through March, RMF’s team completed more video production and also expanded operations to full program coverage to 100 villages

  • CNE measuring MUAC on child

    Severe Acute Malnutrition

    Identified 358 children suffering from SAM

    Identified children suffering from SAM and gave counseling to the caregivers of each of these children. Saw an improvement from SAM to MAM in 486 children and ensured the 14-day treatment of 129 of the most serious cases at local Nutrition Rehabilitation Centers

  • Checking MUAC measurement in India

    Moderate Acute Malnutrition

    Identified 1,067 children suffering from MAM

    Identified children with MAM and provided one-on-one counseling to the caregivers of these children. Saw an improvement from MAM to normal in 1,254 children

  • CNE's gathered

    Group Training Sessions

    Village and Family Nutrition Training

    Conducted 2,066 village nutrition training sessions, with over 15,610 people in attendance. Conducted 14,323 family counseling sessions

RMF red arrow icon
Return to Top

Background

& Objectives

Background

This project empowers communities through health literacy and connects rural communities with the government health and nutrition services available. This project aims to prove that a holistic, decentralized, community-based approach to malnutrition eradication will have better health outcomes, be more inclusive for children under 5, and will be more cost-effective in the long-run than centralized approaches, especially for rural, marginalized tribal communities. Our team of up to 75 Community Nutrition Educators (CNEs) and 6 District Coordinators has covered enormous ground across 5 districts and 600 villages in Madhya Pradesh.


Objectives
  • To reduce the prevalence of underweight children under 5 years old and to reduce child mortality from malnutrition by strengthening communities and village level government facilities’ capacity to identify, treat, and prevent malnutrition.
  • Continue to identify new SAM and MAM cases, refer complicated cases to the NRC and provide home-based counseling for all malnourished children
  • Refer 1,000 SAM children to government centers for treatment with a 50% success rate Quarterly
  • Conduct 2,500 Community Nutrition Meetings Quarterly
  • Conduct 9,000 Individual Family Counseling Sessions Quarterly
  • Send CNEs to Nutrition Rehabilitation Centers (NRCs) to help counsel families present
  • Continue to develop linkages with government health and nutrition services
  • Strengthen institutional capacity with support from World Bank’s India Development Marketplace Award.
RMF red arrow icon
Return to Top

More

Photos

Click to Enlarge
RMF red arrow icon
Return to Top

Numbers

Served

During this quarter the Malnutrition Eradication program

• Identified 358 children suffering from SAM and gave counseling to the caregivers of each of these children
• Saw an improvement from SAM to MAM in 486 children
• Identified 1,067 new children with MAM and provided one-on-one counseling to the caregivers of these children
• Saw an improvement from MAM to normal in 1,254 children
• Successfully ensured the 14-day treatment of 129 of the most serious cases at local Nutrition Rehabilitation Centers
• Conducted 2,066 village nutrition training sessions, with over 15,610 people in attendance
• Conducted 14,323 family counseling sessions

RMF red arrow icon
Return to Top

Success

Stories

Vanshika’s family sees a new dawn

Vanshika’s family sees a new dawn

Silawad, a small hamlet with a population of 8,000 is located at a distance of about 21 kilometers from Barwani district headquarters. For the health service provisions, there are 6 Anganwadi centers and one community health center with an almost adequate number of staff in place.

Pawan, an unemployed 27-year-old man, lives in one of the Harijan (lower caste) faliyas with his mother, father and wife Renuka of 23 years of age. The couple has a 7-month-old beautiful, but malnourished girl child, named Vanshika. Pawan’s father is a government schoolteacher. As Pawan is unemployed, his father has to take care of all household expenses.

On June 25th, 2013, Nasreen Patel, one of the RMF CNEs of Silawad and Durga Badole, and an Anganwadi worker together were visiting their area as part of their routine field visit. During the course of this visit, the Anganwadi worker spoke with Nasreen about the severity of Vanshika’s malnutrition and requested Nasreen to visit her house. Together, they visited Vanshika’s house and counseled Vanshika’s mother, Renuka, who was counseled on the continuity of breastfeeding and the timely introduction of supplementary feeding. They were surprised to find that Renuka was pregnant for 4 months and could not breastfeed Vanshika properly, one of the factors leading to the severity of malnutrition of Vanshika. Seeing the repeat of pregnancy and the physical conditions of the mother and daughter, the duo counseled Vanshika’s mother on supplementary feeding for improving the condition of Vanshika. At the same time, Vanshika’s pregnant mother was guided on taking care of nutritional precautions, especially keeping her own pregnancy in mind. Vanshika’s mother was also educated to consume iron folic acid tablets and take 3 Tetanus Toxoid injections while she was pregnant. Both the CNE and AWW shared with her information about services of the Anganwadi center and encouraged her to avail the services of the AWC.

The MUAC measurement conducted on Vanshika revealed that she suffered from SAM. Nasreen’s counseling to Vanshika’s mother also included the side effects of malnutrition on the future wellbeing of her child. Further, both the community based cadre of service providers talked about the services at the Nutritional Rehabilitation Centre, where medical treatment is provided for SAM, but in the wake of the 4-month pregnancy of Vanshika’s mother, the family refused to take Vanshika to the NRC.

After having understood the internal complexities of Vanshika’s family leading to the failure of the NRC referral, Nasreen, RMF’s CNE spoke with Vanshika’s mother at length on ways and means by which she could improve the nutritional status of both herself and her child. The aspects that Nasreen counseled Vanshika’s mother on included: preparation of nutrition rich food at home, keeping the precautions of health & hygiene, maintain the immunization calendar of the child, seeking the services of AWC and ANM’s sub-center, regular visits to Anganwadi centers for collection of supplementary food, etc.

The first follow-up visit conducted by the same CNE after a month revealed that both mother and child were improving on almost all aspects of their health and wellbeing. The child showed a visible improvement of MUAC reading of 11.5 from the last month’s base line of 11.0. Vanshika’s mother showed significant signs of improvement as far as her own anemia was concerned. The CNE maintained the consistency of her follow up and regularly visited the family to track the condition of mother & child. In the subsequent visits that the CNE conducted for tracking the case of Vanshika, her nutritional status had improved substantially. From 11.0 cms, Vanshika had reached the MUAC reading of 12.9 cms. In the meantime, in November 2013, Vanshika’s mother gave birth to a healthy baby boy in the hospital. Through the programmatic consistency that RMF’s CNE demonstrated and maintained for a period of one year, the health of a village woman and her severely malnourished child could be transformed, and Vanshika’s whole family saw a new dawn.

RMF red arrow icon
Return to Top
  More Reports on:
Childhood Malnutrition Eradication Program
        Country Page: India
        Initiative Page: Childhood Malnutrition Eradication Program
        Facebook: #RMFindia