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Nutrition Rehabilitation Centres, Chattisgarh
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Subject Area="Inter-sectoral links." Objective="Controlling severe malnutrition among the children."
Details for Reform Option "Nutrition Rehabilitation Centres, Chattisgarh"
Summary

Background: Acute malnutrition is an extremely common condition associated with the high rates of mortality and requires specialized treatment and prevention interventions. As per the National Family Health Survey III, the prevalence of malnutrition in Chattisgarh is 52.1 percent and of stunting is 45.4 percent. Thus, almost every second child in the state is chronically malnourished. Anganwadi centres lack specialised care that is needed for treating severe malnutrition. They only provide spot feeding, monitor weight and nutritional status of the children and refer severely malnourished (Grade III and IV) children. Activities:The (NRC) initiative is a program for severely malnourished (Grade III and IV) children of the age 1 to 5 years. It is presently organized in a tent on raised platform in Dhornapal area of Dantewada district. The Unicef- Raipur branch office provides technical assistance in terms of knowledge sharing and facilitation. The department of women and child development (DWCD) has purchased utensils for cooking and serving. The cooking is done by aanganwari workers and their helpers (from the Integrated Child Development Scheme). Medical Officer from the nearby primary health centre evaluate every child and follows up the children requiring critical care. Auxiliary Nurse Mid-wife (ANM) and community volunteers of CARE organization facilitate maximum attendance of the children and their mothers at the nutritional rehabilitation centre. Nutrition Rehabilitation Centres are providing: (i) Medical Care (ii) Timely, adequate and appropriate feeding to the children (iii) Training on preparation of low cost nutritious diet from locally available stuffs (iv) Enhancement of mothers’ skills on child care and feeding (v) Special diets (prepared by cooks) for severely malnourished children according to their age and condition (vi) Monitoring of the health and nutritional status of the child during the stay at the nutrition rehabilitation centre (vii) At the time of discharge, the parents or care-takers are given a follow-up card, through which a child is followed up four times up to six months Results:The NRC is in its initial phase and the results are not yet very evident. However, its feeding services are being implemented properly

Cost Establishment cost: Tent Supply INR 34000 Utensils: INR 10000 (provided by DWCD) Technical Support: INR 18000 (provided by UNICEF). Recurring Cost: Fuel cost varies on day to day basis Approximately INR 24 per day and per child enrolled.
Place Dhornapal area of Dantewada district in Chattisgarh
Time Frame One week
Advantages

Specialized focus care: severely malnourished children get proper medical and nutritional care. Greater Sensitization: mothers and caregivers will be more sensitized towards nutritional needs, balanced diets and safe feeding practices. Inter-sectoral involvement: the close coordination of the welfare department and community increases the effectiveness and utility of the initiative.

Challanges

Coordination and cooperation: maintaining a continuous commitment from the DWCD is a huge challenge. Erratic food supply: Food supply often is erratic. Its streamlining is a challenge.

Prerequisites

Baseline data, need assessment, supportive environment, and advocacy. Government or private building near to the district hospital or block community health centre. Minimum 20 bedded ward with latrine-bathroom at district level and a 10 bedded ward at block level. Kitchen with enough space for feeding demonstration and child friendly environment. Essential Staff: one paediatrician or any doctor trained by a paediatrician, one feeding demonstrator, one cook, three nurses, three care takers and one cleaner.

Who needs to be consulted

State government. Department of women and child development. Health and family welfare department. UNICEF. Health professionals working in the field of paediatrics. Anganwari workers and health workers. NGOs working in the field of child care

Risks

Sustainability

Project can be sustained through persistent coordination and cooperation among the collaborative partners

Chances of Replication

The initiative can be replicated in similar settings. Unicef is planning eight nutritional rehabilitation centres in the year 2007 in collaboration with department of health and family welfare and department of women and child development; in blocks with high malnutrition.

Comments

It is a good initiative involving collaboration among health, woman and child welfare, NGOs and social sectors.

Contact

Submitted By

Dr. Anil Bhola, Research Consultant, National Institute of Medical Statistics, New Delhi, December, 2006.

Status Active
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