India: Childhood Malnutrition Eradication Program
Malnutrition Eradication Outreach and Innovation
May 12, 2014
By Michael Matheke-Fischer, Santosh Pal & Amit Purohit
Summary of Activities
RMF’s new program focuses screenings on targeted populations of mothers and families with children under 5 years old in 3 district settings:
- Cluster Screenings that target mothers in a small setting, usually 4-6 mothers, in their houses during the day.
- Evening Screenings that target larger groups of 10-15 families and are screened when male family members can attend to increase their awareness of nutrition and health issues.
- Mangal Diwas Screenings on Tuesdays at the Anganwadi Centre for ration distribution. By adding video screening at the Anganwadi center on Mangal Diwas, RMF aims to both increase participation in ration distribution and also target at-risk families with health information.
Produced 12 Videos
Conducted a total of 502 screenings in 50 villages, reaching 4,391 households. Recorded 108 unique practice adoptions directly resulting from our videos.
Identified 415 children suffering from severe malnutrition. Identified 674 new children with moderate malnutrition. Conducted 15,188 family counseling sessions.
Working checking on families saw an improvement in 567 children with severe malnutrition 1,315 children with moderate malnutrition.
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.
Nutrition Educators Work Hard
The Steady Fight Against Malnutrition – RMF Community Nutrition Educators Work to Improve Health Outcomes
Convincing people to adopt healthier behaviors can be a difficult job. In Southwestern Madhya Pradesh, where RMF’s Community Nutrition Educators (CNEs) work in 600 villages across 5 districts every day, targeted health education is crucial to combating malnutrition.
For four years, each CNE has patiently worked in communities, identifying children and families in need of counseling, referring serious cases to treatment, and building crucial bonds with the community. Since 2010, our program has reached over 400,000 people with targeted health and nutrition messages.
While not flashy or particularly glamorous, RMF’s boots-on-the-ground, or more accurately, chappals-on-the-ground, have been a steady and formidable force fighting malnutrition and increasing ownership of nutrition outcomes in some of the most difficult communities in the world. Each CNE’s relationship with her communities is crucial to improving nutrition and health related knowledge. These relationships are priceless, and earned through tireless efforts over four years of extremely hot summers and monsoon seasons of flooded and washed out roads.
The CNE’s task is not an easy one. According to the National Institute of Nutrition (NIN) 2011 survey, in Barwani District an estimated 34.8% of children suffer from acute malnutrition. In the same district, there are alarmingly poor indicators of health and sanitation behaviors. Only 13% of mothers reported washing their hands before feeding their child, 53% reported washing their or their child’s hands after defecation, and only 5.8% use sanitary latrines. In addition, at the age of 5 months, only 41.2% of children were exclusively breastfed, and only 68% were breastfed within three hours of birth.
Mothers Attend Screenings in Khandwa
In four months, we have directly observed 179 adoptions of behaviors recommended in our videos, and are working on verifying the longer term effects of our videos, such as the increase in awareness of practices promoted in the videos. Our goal is to see 6,500 households practicing behaviors outlined in the movies after a year of screenings across the 90 targeted villages in Khandwa.
RMF’s CNEs are now armed with three distinct tools:
Any one of these is needed in the fight against malnutrition, but when combined they go a long way towards liberating human potential and eradicating malnutrition.