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Insights into Editorial: A vital cog in Bongaigaon’s response to malnutrition

 

 

Context:

Project Sampoorna which was successfully implemented in Bongaigaon district of Assam is a model that can be easily implemented anywhere in reducing child malnutrition

This is in line with the UN SDG goals and Kuposhan Mukta Bharat initiative of India. The project has resulted in the reduction of malnutrition in children using near zero economic investment.

Initiatives like these are needed to tackle the vicious cycle of malnutrition.

 

Addressing child nutrition:

The highest risk factor for high risk pregnancy is anaemia which is usually nutritional.

The vicious cycle of a malnourished child:

Growing into an unhealthy adolescent, and then further into an anaemic pregnant young woman giving birth to an asphyxiated low birth weight baby;

This baby then facing possible developmental delays, only to grow into a malnourished child; and

This child who struggles further for nutrition and appropriate care while the world around her barely makes ends meet is the one that sucks in all possibilities of a healthy society.

This portrays the worst-case scenarios, but truth is indeed stranger than fiction.

In order to break out of this vicious cycle, the low-hanging fruit had to be targeted: children’s nutrition.

 

About Project Sampoorna:

Sampoorna is in tandem with the United Nations’ Sustainable Development Goals and those set by the UN Secretary General in the Food Systems Summit (September 2021) including the need to have food systems and social protection that support resilience and food security.

PM Modi also had identified health and nutrition as priority areas and reiterated the need for a ‘Kuposhan mukt Bharat’ (Malnutrition Free India) while launching the Prime Minister’s Overarching Scheme for Holistic Nourishment (POSHAN Abhiyaan) (National Nutrition Mission) in 2017-18.

 

Acting as an interlink:

  1. The project has resulted in the reduction of malnutrition in children using near zero economic investment.
  2. It was during Poshan Maah (Nutrition Month) in September 2020 that 2,416 children were identified to be malnourished in the lush green Brahmaputra valley district of Bongaigaon.
  3. The National Family Health Survey (NHFS)-5) has documented that the number of children under five who are stunted, wasted, underweight and the number of anaemic women and children in the district are higher than the national average — anaemia being a major determinant of maternal and child health.
  4. These were corroborated by Project Saubhagya that was designed to reduce the maternal mortality rate and infant mortality rate of the district.
  5. A real time data sheet is updated by field-level doctors as and when a high risk pregnancy is identified, which is then followed up till safe delivery.

 

Case study: Malnutrition, patriarchy:

Bongaigaon has 1,116 Anganwadis with a total of 63,041 children below five.

  1. The massive exercise of plotting their weights and heights in World Health Organization growth charts revealed a total of 2,416 malnourished children; 246 cases of Severe Acute Malnutrition (SAM) and 2,170 instances of Moderate Acute Malnutrition (MAM).
  2. District Nutritional Rehabilitation Centres, or NRCs, usually have up to 20 beds; and a monthly intake of 200 SAM children is not practical.

 

  1. Based on the success of the community-based COVID-19 management model (Project Mili Juli), we launched Project Sampoorna targeting the mothers of SAM/MAM children, the tagline being ‘Empowered Mothers, Healthy Children’.
  2. In addition, we identified the mother of a healthy child of the same Anganwadi Centre (AWC) and paired her with the target mother; they would be ‘Buddy Mothers’ (2,416 pairs).
  3. They were usually neighbours and shared similar socio-economic backgrounds. The pairs were given diet charts to indicate the daily food intake of their children; they would have discussions about this on all Tuesdays at the AWC. Local practices related to nutrition would also be discussed.
  4. The major hindrance to the project was patriarchy. Mothers had to be empowered financially for sustained results.
  5. Therefore, they were enrolled in Self Help Groups (SHGs) under the National Rural Livelihoods Mission (NRLM).
  6. By the end of three months, 74.3% of mothers were enrolled in SHGs; by the end of six months, enrollment went up to 75.6% and by the end of a year, it was 90%.
  7. Meanwhile, local government arranged for 100 millilitres of milk and an egg on alternate days for all 2,416 children for the first three months, giving time for their mothers to stabilise themselves in the newly found jobs.
  8. The large-hearted people of Bongaigaon adopted Anganwadis and filled the tiny stomachs with the much needed proteins and their hearts with love.

 

New guidelines of POSHAN 2.0:

  1. POSHAN scheme focuses on the 1,000 days between a mother’s pregnancy and her child’s second birthday.
  2. Prioritizing women and girls, and addressing their nutritional deficiencies through fortification and provision of take-home rations.
  3. The introduction of community-based programmes for tackling severe acute malnutrition.
  4. The guidelines now place accountability at the district level with nutrition indicators included in the KPIs (key performance indicators) of DN/DC.
  5. POSHAN tracker: The Ministry of Women and Child Development has developed a new software tool called the POSHAN Tracker.
  6. The aim is to streamline the supply side of the scheme. This will replace the earlier ICDS CAS, because the data generated by it was not usable.

 

Conclusion:

Project Sampoorna had prevented at least 1,200 children from becoming malnourished over the last year.

The National Nutrition Mission and the State government recognised our project in the ‘Innovation Category’.

The Chief Minister of Assam, has written an encouraging message for the project report which will be released soon.

The model can easily be implemented anywhere in the world. We believe children everywhere have the right to stay healthy, and hope that the vicious cycle is broken sooner rather than later.

‘Let food be thy medicine and medicine be thy food’. This statement is often attributed to Hippocrates, the Father of Medicine, and quite literally sums up Project Sampoorna which was conceptualised and successfully implemented in Bongaigaon district of Assam.