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Mission nutrition

Aarti Dhar
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Bringing results:A malnutrition rehabilitation centre in Mumbai.Photo: AP
Bringing results:A malnutrition rehabilitation centre in Mumbai.Photo: AP

Maharashtra has managed to improve the health of its children as significantly lesser number of children under the age of two years is stunted, a latest UNICEF report has said.

The first-ever State-wide nutrition survey done in 2012 to assess the progress and identify areas for future action to improve the health of the children indicated that prevalence of stunting in children under two years was 23 per cent — a decrease of 16 percentage points over a seven-year period.

Results of this Comprehensive Nutrition Survey in Maharashtra suggested progress was associated with improvements in how children were fed, the care they and their mothers received, and the environments in which they lived.

From 2005-2006 to 2012, the percentage of children, aged 6 to 23 months old, who were fed a required minimum number of times per day increased from 34 to 77 and the proportion of mothers who benefited from at least three antenatal visits during pregnancy increased from 75 to 90 per cent.

More than 60 million children under 5 years are stunted in India, comprising almost half the children in this age group. They represent an estimated one-third of stunted children worldwide.

In Maharashtra, 39 per cent of children under the age of two years were stunted in 2005-2006. But by 2012, according to a State-wide nutrition survey, the prevalence of stunting had dropped to 23 per cent. The State’s determined actions and focus on service delivery contributed to this dramatic decline, said the UNICEF report ‘Improving Child Nutrition: The achievable imperative for global progress’.

In 2005, in response to reports of child deaths from under-nutrition in a number of districts, the State launched the Rajmata Jijau Mother-Child Health & Nutrition Mission. It was initially focused on five primarily tribal districts with the highest incidence of child under-nutrition (Amravati, Gadchiroli, Nandurbar, Nasik and Thane). But after the National Family Health Survey of 2005–2006, the Mission’s mandate was expanded to coordinate efforts to reduce child under-nutrition throughout the State. The Mission was extended to 10 additional districts with a substantial concentration of tribal populations in 2006–2007 and finally to the remaining districts in 2008–2009.

The State Nutrition Mission began by working to improve the effectiveness of service delivery through the Integrated Child Development Services and the National Rural Health Mission, the national flagship programmes for child nutrition, health and development. Their focus was on filling vacancies in key personnel, particularly front-line workers and supervisors, and on improving their motivation and skills to deliver timely, high-quality services in communities.

In the second five-year phase, beginning in 2011, more emphasis was placed on improving the nutrition of children under two years and their mothers. This shift was made in response to global evidence about the critical 1,000-day window to prevent under-nutrition in children.

The provisional results of the Maharashtra survey showed that in spite of more frequent meals, only 7 per cent of children 6–23 months old received a minimal acceptable diet in 2012. Too few children are being fed an adequately diverse diet rich in essential nutrients with the appropriate frequency to ensure their optimal physical growth and cognitive development. A State-wide strategy to improve the quality of complementary foods and feeding and hygiene practices is essential to further reduce stunting levels.

Maharashtra’s efforts to check under-nutrition among children has paid off, says a new UNICEF report

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