A new standardised Protocol for Management of Malnutrition in Children (Protocol) was launched yesterday by Union Minister of Women and Child Development, Smt Smriti Zubin Irani, in the presence of Minister of State for WCD and Ayush, Dr Munjapara Mahendrabhai, Secretary, Women and Child Development, Shri Indevar Pandey, UNICEF Representative to India, Ms Cynthia Mc Caffrey, UN Women Country Representative, Ms  Susan Ferguson, Deputy Country Head, WHO, Ms Payden,  and Joint Secretary, Ministry of Health and Family Welfare, Sh Rajiv Manjhi.

The Protocol for Management of Malnutrition in Children has been jointly prepared by the Ministry of Women and Child Development and the Ministry of Health and Family Welfare, Govt of India.

The launch event at Vigyan Bhawan was also attended by dignitaries and experts from key organisations such as Indian Medical Association (IMA), International Paediatric Association, and Indian Academy of Paediatrics, World Bank, Bill & Melinda Gates Foundation etc. Besides this, Senior Officers from WCD and Health Departments from across the country participated in the event. The event was also attended by frontline functionaries including, CDPOs, Lady Supervisors, Anganwadi Workers and ASHA workers from across the country.

Secretary, WCD, Shri Indevar Pandey gave the opening remarks and addressed the gathering on various key efforts being undertaken to support better nutrition for children. Secretary, WCD highlighted the role played by the ICT application Poshan Tracker in aiding and monitoring key delivery of nutrition and health management and services. Special emphasis was laid on the achievement of measuring and capturing the nutritional status of over 7 crore children in the month of September 2023. Secretary, WCD while addressing the audience, stated that “The protocol will be a core component of the efforts by MoWCD to reduce malnutrition through Mission Saksham Anganwadi and Nutrition 2.0. The protocol clearly describes the process of assessing and caring for malnourished children through the Anganwadi and medical ecosystem.”  

Dr Praveen Kumar, Pediatrician and Deputy Lead of the National Centre of Excellence- Severe Acute Malnutrition in Lady Hardinge College delivered a presentation on ‘Upgradation of NRCs’ for better nutrition outcomes and Community Management of malnutrition. Dr Praveen Kumar expressed great hope that the launch of Standardised Protocol will go a long way in helping States/UTs across the country to manage and address malnutrition at a community level, in cases where there are no medical complications.

The gathering was also addressed by Dr Naveen Thacker, President International Paediatric Association. Dr Thacker spoke about how the new protocol will help in mentoring mothers and community in addressing malnutrition challenges. Dr Thacker also said that the new Standardised Protocol is a momentous document that should be shared across the world.

During the event, Anganwadi Workers and ASHA workers from different States/UTs, who have shown exemplary dedication and commitment to management of malnutrition among children, were felicitated by the  Union Minister.

The UNICEF Country Representative, Ms Cynthia Mc Caffrey, WHO Deputy Country Head, Ms Payden, Joint Secretary, Indian Medical Association, Dr Munish Prabhakar and Country Head, UN Women, Ms Susan Ferguson congratulated the Ministry on the initiative and hailed the newly launched Protocol in their remarks.

Dr Munjapara Mahendrabhai, Minister of State, stated that the launch of the Protocol for Management of Malnourished Children marks a significant step forward. This framework is designed to take a holistic approach to health and wellness, outlining clear steps to tackle malnutrition. It places particular emphasis on critical periods of nutritional vulnerability and opens the way for opportunities for enhancing human development potential.

MoS highlighted that the Protocol will ensure that SAM/MAM children can be supported across the country in a timely and effective manner. It provides clarity and guidance to all stakeholders involved, from the Anganwadi Workers and ASHA workers, Lady Supervisors, Child Development Project Officers and every functionary responsible for implementation on the ground.

Smt. Smriti Zubin Irani, Union Minister for Women and Child Development in her keynote address highlighted that Poshan Abhiyan is a reflection of the unprecedented collaboration and convergence between 18 Ministries and State Governments in tackling the problem of malnutrition.

The Minister spoke about the achievements of the Poshan Abhiyan since 2019, which include issuance of the Streamlined Guidelines on Quality Assurance, Roles and Responsibilities of Duty Holders, etc., for transparency and efficiency and to strengthen the systems at the grassroots.

The Union Minister highlighted that the Poshan Tracker application devised and made during the lockdown in Covid Pandemic has emerged as a game-changer with the on-boarding of more than 13 lakh AWCs within three months of launch. She emphasised that results captured in the Poshan Tracker show substantially lower malnutrition (wasting) levels in comparison to NFHS-5 findings. Data captured of more than 7 crore children shows, 1.98% children 0-5 years to be SAM and 4.2% MAM against 19.3% wasting as per NFHS-5 (2019-21) for children 0-5 years

The Union Minister stated that keeping in view the requirements of the States, the Ministry has made provisions for enhancement in the cost of construction of toilets from Rs. 12,000/ to Rs.36000/- and the cost for providing drinking water facilities from Rs.10, 000/- to 17000/.  Further, provisions have been made to upgrade more than 40,000 AWCs in Aspirational Districts and Blocks into Saksham Anganwadis, equipped with LED screens, smart audio-visual teaching aids etc. Besides Anganwadi Centers are envisaged in border villages in Sikkim, Ladakh and Arunachal Pradesh.

Further, the Minister for Women and Child Development stated that provisions have also been made for upgradation of current handheld sets of all the Anganwadi workers to 5G enabled mobile phones for which cost norms have been suitably revised. Besides, a policy has been formulated for the replacement of mobile phones every four years.

The Union Minister mentioned that the migration facility in the Poshan Tracker has ensured that beneficiaries moving from one village to another or from one State to another continue to receive their benefits under the Anganwadi Services Scheme. Since May 2022 ,more than 1 lakh beneficiaries have been served through this facility.

The Union Minister stated that the new Protocol which is hailed by paediatricians and experts alike would strengthen the on-going efforts and commitment to address the challenges of malnutrition. Initiatives taken by MWCD to include millets in the Supplementary Nutrition Programme and the intensification of Jan Andolan activities in Poshan Maah 2023 which included around 35 crore activities were highlighted. Reference was made by the Union  Minister of 1 crore activities conducted on promotion of millet consumption and popularization of millet-based recipes in Poshan Pakhwada in March 2023. The Minister took the opportunity to thank all the frontline functionaries, Anganwadi workers and ASHA workers for their unwavering commitment and exemplary work.

The newly launched protocol for identification and management of malnourished children provides detailed steps for identification and management of malnourished children at the Anganwadi level, including decision making regarding referral, nutritional management and follow-up care. The key steps, explained in the protocol, include, Growth Monitoring & Screening, Appetite Test for SAM children, Medical Assessment, Decision making regarding level of care, Nutritional Management, Medical Management, Nutrition, Health Education & counselling including WASH practices, Home Visit by AWW and Referral, Duration of Monitoring and Follow-up Care.

***

SS/AKS