India: Childhood Malnutrition Eradication Program

India: Stories from the field, Pooja in Devigarh

April 17, 2013

Michael Matheke-Fischer

In August 2012, RMF CNE Santosh Pall found Pooja, a 9 month old girl, in Devigarh village, with a MUAC of 7.9. Picture the circumference of your thumb: that was the size of her upper arm.

Pooja was immediately rushed to the closest Nutritional Rehabilitation Centre (NRC) in the Thandla Hospital. There, she received the care that was required, and slowly began gaining weight. After 16 days in the NRC, she was released for home feeding.
In Jhabua district, up to 70% of the families migrate for work during the dry season, starting in October. Unfortunately, although she had gained weight, Pooja and her family left their village for work for 9 months. They are expected to return in June to prepare their fields for the upcoming monsoon and cultivating season.

One advantage that Pooja has is that her family took her with them on their migration. Often, families leave weak or sick children in their homes in the care of other relatives. However, since she has migrated with her family, Pooja will have access to breast milk and complementary feeding with her mother, who has been thoroughly counseled by both RMF and the NRC staff.
While we wait for her return in June, Santosh can take pride in the fighting chance she gave Pooja, who would not have been admitted to the NRC without RMF’s intervention.


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.


  • 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.