Objective="To promote child survival and to reduce under five child mortality and morbidity"
Details for Reform Option "Sishu Sanraksan Maah, Chattisgarh"
A national workshop on micronutrients was organized by the Indian Council of Medical Research (ICMR) in November, 2003. It recommended that the biannual child health and nutrition promotion months be held six months apart which would offer a package of child health and nutrition services with Vitamin A supplementation to target children as an integral part. The recommendation is in line with the globally used REACH (Regular Events to Advanced Child Health) strategy which focuses on providing contact points for delivery of child friendly health services to pre-school children.According to the National Family Health Survey III, only 12.7% children (of age 12-35 months) in Chattisgarh received a dose of Vitamin A in the last 6 months, 81% children (6-35 months) are anaemic and 52.1% (under 3 years of age) are underweight in the state. As per the Coverage Evaluation Survey, 2005, the immunization coverage of BCG, DPT 3, OPV 3, measles and fully immunized children (12-23 months) was 89.2%, 65.5%, 46.4%, 72.0% and 44.4% respectively. In order to promote better child survival and reduce under five morbidity and mortality rate, the Government of Chattisgarh announced October and April as the health and nutrition promotion months in the name of “Sishu Sanraksan Maah (Child Protection Month)” in all the district of the state. The first “Sishu Sanraksan Maah” was celebrated in October, 2006 (on all Tuesdays and Fridays of the month excluding holidays).This inter-sectoral initiative is a collaborative effort of the state Department of Health and Family Welfare, Department of Women and Child Development (DWCD), State Health Resource Centre, Micronutrient Initiative, Child in Need Institute and Unicef.
The Sishu Sanraksan month involves delivery of service package on health, nutrition and immunization days. It includes: (i) Administration of Vitamin A doses to eligible children (aged 9 months to 3 years) who have not received Vitamin A in the past 6 months.
(ii) Administration of vaccines to eligible beneficiaries- focussing on never or partially vaccinated.
(iii) De-worming of children (aged 1 to 5 years) having signs or symptoms of worm infestation.
(iv) Weighing of all children upto 3 years of age and referral of children with severe malnutrition.
(v) Salt testing at the household of pregnant women, school (mid day meal) and anganwari centre (spotfeeding) for iodine content.
It is a new initiative and so far only one ‘Sishu Sanraksan Maah’ in October, 2006 has been celebrated. The impact of this initiative is yet to be studied.
The initiative received financial support of INR 26.5 lakhs from the Micronutrient Initiative and UNICEF for activities like IEC, training of health workers, mobility and accommodation support, printing and supply of recording and reporting formats.
All the districts of Chattisgarh.
Enhances child survival: The focussed approach on child health, nutrition and immunization will have a positive and promotional impact on child survival.
Inter sectoral Coordination: Inter-sectoral coordination among various departments, NGOs, private and public sector institutions will yield high dividends in terms of improved visibility and coverage.
Leadership and commitment: Strong leadership and administrative commitment at district levels are critical to the success of the initiative. Involvement of DWCD needs to be enhanced.
Delay in submission of reports: There was a delayed submission of concurrent evaluation report from the districts to the state.
Difficulty in identifying children with worm infestation: It was observed that the health workers were finding difficulty in identification of children with worm infestation. The guidelines need revision for the April, 2007 round.
Vaccine, nutrition and supply requirements.
Identification, categorization and prioritization of villages and urban units in the area.
Identification and mobilizing of left-out/drop-out children
IEC and social mobilization plan.
Who needs to be consulted
State Health Directorate
Chief Medical Officer
Panchayat Body Members
The coordination and cooperation among the collaborative partners requires persistence.
Chances of Replication
The initiative can be replicated in similar settings. The operational plan is based on the routine immunization area microplan; already in practice.
Dr. Anil Bhola, Research Consultant, National Institute of Medical Statistics, New Delhi, January, 2007