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Dear Reader,

 

Greetings!

We are happy to bring you the 15th issue of nutrition partners e-news bulletin WeConnect - a quarterly dose of recent news, views, events, and stories from the nutrition space.


About this Issue:


The current issue brings you an expert column by Dr Suneela Garg from IAPSM on strengthening MIYCN in medical community, innovation from Bihar on energy dense food, strengthening maternal nutrition in ANC from Jharkhand, success stories on identifying and treating SAM children and growth monitoring activities in communities from Uttar Pradesh and Bihar during POSHAN Pakhwada. The issue also includes key events from the last quarter. Lastly, we are pleased to share a compendium of learnings from Anemia Mukt Bharat implementation in four states of India!


Wish you an enjoyable read!


Expert Column

Strengthening MIYCN by enhancing knowledge and skills of medical practitioners


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Author:

Dr Suneela Garg

Dr Garg is Professor of Excellence (Community Medicine), National President OMAG, National President IAPSM 2021 (immediate past), CO Project Lead Addressing Smokeless Tobacco ASIA (ASTRA). Chair, Programme Advisory Committee, NIHFW. Member, Multi-disciplinary Research Unit, Department of Health Research, ICMR.

India contributes to around one-third of the global burden of child undernutrition. Results from fifth round of the National Family Health Survey (NFHS-5), revealed a mixed landscape for nutrition in India. The results mark significant progress in the uptake of services and positive trends when it comes to child nutrition, feeding practices and mortality rates. Though the percentage of wasted children below five decreased in five years — to 19.3 per cent (NFHS-5) from 21 per cent NFHS-4), the percentage of those under five and severely wasted increased from 7.5 percent in NFHS-4 to 7.7percent in NFHS-5. Anemia among children within the age-group of 6-59 months has increased by 14.51 percent as compared to NFHS-4. Government of India has prioritized maternal and child nutrition since the last few years and launched National Nutrition Mission in early 2018, under the Ministry of Women and Child Development. The current focus of NNM is on increasing the coverage of key MIYCN (Maternal Infant and Young Child Nutrition) interventions. Over the years, there has been a monumental shift in the way nutrition interventions have got prioritized with a higher government ownership and greater visibility to undernutrition as a big national priority. 

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Innovative Solution to tackle undernutrition

Energy Dense Nutritive Food (EDNF) for Children in Bihar

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COVID 19 pandemic has led to the closure of all Anganwadi Centres (AWCs) from March 2020 to October 2021. This closure brought unprecedented challenges for the ICDS Directorate in providing supplementary nutrition to the beneficiaries for 300 days in a year without hinderance. Adhering to the 300 days mandate set by the National Food Security Act 2013 during the COVID-19 lockdown led to undertaking of alternative provisions such as doorstep delivery of food packets for the beneficiaries according to the entitlement given under the Take Home Ration (THR) and Hot Cooked Meal (HCM). The FLWs whole heartedly extended their service to visit homes of the beneficiaries and do the needful. Despite following the prescribed COVID-19 protocols for hygiene and cleanliness, there were risks of the Frontline Workers being exposed to the infection. Hence, the doorstep delivery had to be discontinued after two months of service (April and May 2020).

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Stories of Hope

Saving lives from the grip of malnutrition through counselling and support

Meet Rani Devi from Prem Nagar, Sitamarhi, mother of three children. She has borne her first child at the age of 17 and her third child on 30 September 2021, through normal delivery. At birth, the child weighed 3 kg. However, over the weeks the child started to lose weight.

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Improving maternal nutrition by integrating it in the health system

Integrating maternal nutrition component in Ante-Natal care in Jharkhand

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Jharkhand recorded the lowest maternal mortality ratio (MMR) in eastern India and the fifth lowest in the country, according to a special bulletin released by the office of the Registrar General of India recently. There has been a reduction in Maternal Mortality Ratio (MMR) of 371 (SRS 2003) to 71 (SRS 2018) which is much lower than the national estimate of 113. But there are multiple barriers such as socio-economic factors, economic constraints, quality of health care services, professional relationships between staff and behaviour of health personnel that act as major obstacles in promotion and utilization of health care services. The identified barriers can lead to non-utilization of antenatal care services by pregnant women (including high risk women) and contribute to rise in incidence of maternal mortality. According to NFHS 5, 68% mothers had antenatal check-up in first trimester but only 38.6 % mother had at least 4 antenatal visits. 56.8% pregnant women aged 15-49 years are anemic whereas only 15% has consumed 180 IFA tablets during their pregnancy. According to the body mass index, 26% of pregnant women are thin and 11.9 % are obese. 69% mother received post-natal care within 2 days of delivery. Hence, it is evident that there is a need to increase the coverage, follow ups and quality of antenatal and post-natal care to improve overall maternal health in Jharkhand.

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POSHAN Pakhwada (21 March - 4 April 2022)

Engaging PRI members for mobilizing community for regular growth monitoring in AWCs

Sheelu, an Anganwadi Worker (AWWs) from Basia Jagat, Jarwal, Bahraich in Uttar Pradesh was worried for few days since she was unable to mobilise the beneficiaries and care givers for growth monitoring and promotion (GMP) including regular recording of a child's weight and height. Majority of the people in the village were reluctant to bring their children to the AWC to get their weight checked. She made several home visits to pursue and encourage the care givers to bring their children for GMP. In this endeavour, she along with her supervisor reached out to the Gram Pradhan (GP)- the elected PRI member in the village seeking his support. Read more...

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Nutrition Champion from Bahraich: Anganwadi Worker Poonam

Sheelu, an Anganwadi Worker (AWWs) from Basia Jagat, Jarwal, Bahraich in Uttar Pradesh was worried for few days since she was unable to mobilise the beneficiaries and care givers for growth monitoring and promotion (GMP) including regular recording of a child's weight and height. Majority of the people in the village were reluctant to bring their children to the AWC to get their weight checked. She made several home visits to pursue and encourage the care givers to bring their children for GMP. In this endeavour, she along with her supervisor reached out to the Gram Pradhan (GP)- the elected PRI member in the village seeking his support.

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Key Events

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National webinar on identifying key priorities for improving Infant Young Child Feeding (IYCF) with special focus on Early Initiation of Breast Feeding in Caesarean section delivery and Complementary Feeding organized by Indian Academy of Pediatrics- IYCF chapter on 27 February 2022, attended by over 100 participants including medical practitioners, development partners and agencies. For more info, click here: IYCF Practices: Are we going in right directions?

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A panel discussion on Integrating MIYCN in Health care professional’s Undergraduate Curriculum and Continued Medical Education with MIYCN Working Group of IAPSM during the annual National conference on 5 March 2022, involving speakers from Undergraduate Medical Education Board (UGMEB) of Medical Council of India (MCI), IAPSM, IAP, Federation of Gynecological and Obstetric Societies of India (FOGSI), Trained Nurses Association of India (TNAI) and A&T. The webinar was attended by 200+ delegates. For more info, click here: IAPSM | Indian Association of Preventive and Social Medicine

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Knowledge Products

Compendium on Learnings from Anemia Mukt Bharat Implementation:


Government of India launched the Anemia Mukt Bharat (AMB) Program in 2018 as a part of the POSHAN Abhiyaan to intensify its efforts for tackling anemia prevalence in the country. The program adopts a system strengthening approach and aims to provide a multi-pronged strategy with lucid operational guidelines to reduce anemia.


Implementation of AMB in various Indian states based on a systems approach has generated some interesting insights and practices that hold significance for charting the future course of action and cross-learning. The compendium presents learnings captured from Chhattisgarh, Jharkhand, Madhya Pradesh, and Uttar Pradesh on components of MIS & Reporting, Nutrition Financing, Supply Chain Strengthening, Governance and Demand Generation respectively in the form of five practice insights. In addition to these, the compendium includes an innovative case study based on normative approaches from Odisha and a synthesis document that presents the essence of captured learnings. 

 

To download the compendium, click here: Compendium of Learnings from AMB Implementation

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NFHS-5 Nutrition relevant data analysis by IFPRI-POSHAN

 

The National Family Health Survey-5 (NFHS-5) factsheets and reports for 36 states & UTs were released in December 2020 and November 2021, in two phases. More recently their full reports became available as well. Last year, the POSHAN team conducted a preliminary analysis using factsheet data to examine changes in nutrition outcomes and continues to explore the available information from the fact sheets and reports. IFPRI-POSHAN is conducting a series of webinars to share nutrition-relevant analyses of NFHS-5 data with a wider audience with an aim to encourage cross learning and strengthen data interpretations to inform policy and program directions. Click on the link below to watch the recording and the presentation and access the #NFHS-5 state & district level knowledge products: TOWARDS PROGRESS ON NUTRITION IN INDIA: INSIGHTS FROM NATIONAL FAMILY HEALTH SURVEY 5 (ifpri.info)

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