Key Actions to Combat Undernutrition

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Policy:
  • Setting of State Nutrition Missions /Councils
    Various States have either launched or initiated the process for setting up of Nutrition Mission/Council. To facilitate inter-sectoral coordination and convergence and action plans on Nutrition.

  • Universalisation of the ICDS Scheme
    The ICDS has been universalized to cover all habitations with increased focus on SC/ST and minority habitations. Several measures for augmenting and improving service delivery have been taken.

  • Adoption of New WHO Growth Standards and Joint Mother and Child Protection Card
    New standards have been adopted in 2008-09 for assessment of growth of children under the ICDS Scheme. Family based card has been jointly introduced by NRHM and ICDS for monitoring health and nutrition status of pregnant women and children.

  • Village Health Sanitation and Nutrition Committees (VHSNC)
    These committees are intended to function as a village level institutions comprising of key stakeholders including members of PRI, ASHA, AWW and ANM, and include representatives from women's groups (including from Self Help Groups) and marginalized communities. There are about five lakh VHSNC, which are the key mechanism to address health, water and sanitation, nutrition issues. In 2011 decision to include nutrition as a component in these committees has been taken.

  • Establishment Nutrition Resource PlaHorm {NRP) - A Knowledge Exchange Facility
    Ministry of Women and Child Development has established single e-platform for sharing knowledge related to nutrition by different stake holders and sectors. NAP accordingly, will have three domains:
            i) a Digital/physical Library, which would provide access to resource materials electronically or other wise;
            ii) a web-based knowledge management e-forum for discussion and exchange of ideas;
            iii} a package of services for end-users through mobile telephony services, which offers outbound dialling based services such as pre-recorded voice message blast supported by Interactive Voice Recording System (IVRS}. This resource can be accessed at Website: www.akshayaposhan.gov.in or www.poshan.nic.in

Preventitive and Programmatic:
  • Two new schemes launched from ICDS platform to focus on lifecycle approach
            - Rajiv Gandhi Scheme for Empowerment of Adolescent Girls {SABLA}, with pilots underway in 200 districts. {2010-11)
            - lndira Gandhi Matritva Sahyog Yojana - A Conditional Maternity Benefit Scheme with pilot projects operational in 52 districts {2010-11)

  • Control of Anaemia, Vitamin A deficiency and Iodine Deficiency
            - To manage the widespread prevalence of micronutrient deficiencies like anaemia, iodine and vitamin A amongst infants, children, adolescent girls, pregnant and lactating mothers. The following programmes are being implemented
            - To prevent Vitamin A deficiency: Vitamin A supplementation is provided for infants 9-11 months {1 lakh I.U.) and children 1-5 years {2 lakh I.U. every 6 months). A child receives 9 doses of Vitamin A by 5th birthday.
            - To prevent Iron deficiency, Anemia: Iron and Folic acid supplements are provided through the health systems. 100 days of supplementation is provided to children, pregnant and lactating women and weekly supplementation for adolescents.
            - To prevention of Iodine deficiency: Promotion of consumption edible salt fortified with iodine is ongoing. Decision to use Double Fortified Salt i.e fortified with both iron and iodine, in Government feeding programs like ICDS and Mid -Day meal Programme has been taken in 2011.

  • Promotion of Infant and young child feeding
            There is renewed focus on informing and educating mothers on initiation of breastfeeding, exclusive breastfeeding and age appropriate complementary feeding during home visits, at Village Health and Nutrition Days and Antenatal Check-ups through NRHM and ICDS. {Please refer to National guidelines on infant and young child feeding, 2006)

  • Supplementary Nutrition/ Meal under ICDS and Mid-day Meal programme
                In order to bridge the 'food gap', one of the approaches adopted is to provide the supplementary nutrition/meal through the targeted schemes/programmes such as Integrated Child Development Services Scheme {ICDS), Rajiv Gandhi Scheme for Empowerment of Adolescent Girls {RGSEAG), i.e. SABLA, and Mid-day Meal {MDM).

  • Schemes for Child Survival and prevention of early onset of under-nutrition
            - Janani Suraksha Yojana (JSY) launched in 2005 is being implemented with the objective of reducing maternal and neonatal mortality. It is a 100% centrally sponsored scheme and it integrates cash assistance with delivery and post-delivery care for both mother and child. The scheme has helped to increase institutional delivery among the poor families and ensures a healthy start to life.
            - Janani Shishu Suraksha Yojana (JSSK) was launched on 1 June 2011. Under the scheme pregnant women and new-barns are given free and cash less services during the first 30 days of life, at all Government health Institutions both rural and urban. Some of the free entitlements include cash less delivery, free treatment of sick new born, free provision for blood and free transport etc.
            - Sick New Born Care Units (SNCU) established has established units in several states to take care of low-birth-weight children and sick new-barns.
            - Integrated Management of Neonatal and Childhood Illness (IMNCI) encompasses a range of interventions to prevent and manage the major childhood illness such as diarrhoea and acute respiratory infection which are major cause of under-nutrition.
            - Immunization programme The Universal Immunization Programme has been expanded to include immunization for Hepatitis B. Currently second dose of measles is being administered to children. Introduction of Pentavalent vaccine has been piloted in two States and will be extended to another six States.

  • Actions for Care and Treatment for Under-nutrition
            - At the Anganwadi Centre: The Anganwadi worker through routine growth monitoring identifies moderate and severe underweight children. She counsels their care givers on proper feeding and care practices and follows them up. For those who are severely underweight she provides double ration of supplementary nutrition and counsels care givers and those cases with medical complications are referred to health facilities in consultation with ANM.
            - At Health Facility: Children who are severely underweight and have medical complications are treated at special units called Nutrition Rehabilitation Canters (NRCs) or Malnutrition Treatment Canters (MTCs) set up at District hospitals or Primary health centres. Such units have been set up in several States and inpatient treatment is provided for 14 days along with counselling for mothers on feeding and care practices.
            - Innovative Approaches: Initiatives such as Positive Deviance in West Bengal, Dular in Bihar and Jharkhand and Village Child Development Canters operational in Maharashtra have been successful in reducing under-nutrition amongst children through provision of integrated package of services and community participation.



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  • Indian Academny of Pediatrics
  • HealthPhone
  • Vodafone India
  • Ministry of Women and Child Development
  • UNICEF India

About IAP HealthPhone

An initiative of HealthPhone™, conducted under the aegis of Indian Academy of Pediatrics, in partnership with the Ministry of Women and Child Development, UNICEF, Aamir Khan and with support from Vodafone.

The objective of this nationwide campaign against malnutrition is to address issues of status of women, the care of pregnant mothers and children under two, breastfeeding and the importance of balanced nutrition and health. The focus is on women between 13 and 35 years of age and their family members.


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