Union Minister Smriti Zubin Irani, Ministry of Women and Child Development (MoWCD) launched a new standardised Protocol for Management of Malnutrition in Children (Protocol) during a national event “Suposhit Bharat – Sashakt Bharat” at Vigyan Bhawan, Delhi, to fight malnutrition in children in India.
- It is the first-ever national protocol for the Management of Malnutrition in Children.
- The Protocol has been jointly prepared by the MoWCD and the Ministry of Health and Family Welfare (MoHFW).
- This is a part of the efforts of MoWCD to reduce malnutrition through Mission Saksham Anganwadi and Nutrition 2.0.
i.Dr. Munjpara Mahendrabhai Kalubhai, Minister of State (MoS) for MoWCD; Cynthia McCaffrey, United Nations Children’s Fund (UNICEF) Representative to India; Susan Ferguson, the United Nations(UN) Women Representative for India; and Payden, Deputy World Health Organisation (WHO) Representative to India were also present at the event.
ii.Dignitaries and experts form Indian Medical Association (IMA); International Paediatric Association (IPA) and Indian Academy of Paediatrics (IAP), World Bank, Bill & Melinda Gates Foundation (BMGF) also attended the event.
- Frontline functionaries including, Child Development Project Officers (CDPOs), Lady Supervisors, Anganwadi Workers (AWW), and Accredited Social Health Activist (ASHA) workers across India also participated in the event.
About the Protocol:
i.The protocol aims to streamline the care of Severe Acute Malnourished (SAM) and Moderate Acute Malnutrition (MAM) children, particularly those without medical complications.
- Instead of traditional Nutrition Rehabilitation Centers (NRCs), SAM children will be managed at Anganwadi Centers (AWC).
ii.It provides comprehensive guidelines to address malnutrition at the Anganwadi level, including decision-making regarding referral, nutritional management, and follow-up care.
iii.The protocol clearly describes the process of assessing and caring for malnourished children through the Anganwadi and medical ecosystem.
Note: 1.98% children 0-5 years to be SAM and 4.2% MAM against 19.3% wasting as per National Family Health Survey (NFHS)-5 (2019-21) for children 0-5 years.
Key Steps for Assessment of the Protocol:
- Growth Monitoring & Screening;
- Appetite Test for SAM children;
- Medical Assessment;
- Decide the level of care;
- Nutritional Management;
- Medical Management;
- Nutrition, Health Education & counseling including Water, Sanitation & Hygiene (WASH) practices;
- Home Visit by AWW and Referral;
- Duration of Monitoring; and
- Follow-up Care.
Analysis of the Protocol:
i.The protocol mandates the screening of SAM (who pass the appetite test) and Severely Underweight (SUW) children by the medical officer of primary health centers within 3 to 5 days of testing.
- SAM is defined as very low weight-for-height/length.
- SUW is defined as very low weight-for-age.
ii.The protocol lists that children who suffer from Bilateral Pitting Oedema and failed appetite tests will be enrolled in the NRCs.
- Bilateral Pitting Oedema is swelling in both legs characterised by an indentation, or ‘pit’ that remains when pressure is applied to the swollen area.
iii.The protocol stipulates that infants under 6 months old showing visible signs of being wasted, oedematous, or too weak to breastfeed require immediate referral to the nearest health facility.
- For SUW infants under 6 months, direct referral to NRCs is recommended in accordance with WHO guidelines.
Note: Wasting indicates current or acute malnutrition resulting from failure to gain weight or actual weight loss.
Millets in Nutrition:
The MWCD has initiated efforts to include millets in the Supplementary Nutrition Programme.
- Millets are rich in nutrients and can play a vital role in addressing malnutrition.
Recent related News:
The MWCD discontinued its two autonomous bodies, Rashtriya Mahila Kosh (RMK) and Central Social Welfare Board (CSWB), as well as its internal division namely the Food and Nutrition Board (FNB).
About Ministry of Health and Family Welfare (MoHFW):
Union Minister– Mansukh Mandaviya (Rajya Sabha Gujarat)
MoS– Dr. Bharati Pravin Pawar (Constituency- Dindori, Maharashtra)