Centre launches nationwide ‘Protocol for Management of Malnourished Children’

Appetite testing of children under five, their growth and medical assessment and assigning ‘buddy mothers’ — where mothers with healthy children guide mothers of malnourished children — are some of the steps detailed in the Centre’s new protocol for management of acute malnourishment. 

The Protocol for Management of Malnutrition in India was unveiled by the ministry on Tuesday, with WCD minister Smriti Irani calling the initiative first of its kind.

“The efforts of 18 ministries and state governments go into the success of Poshan 2.0,” Irani said.  

The protocol states that anganwadi workers should look for signs of malnutrition in children in the rural healthcare centres. If a child shows symptoms of malnourishment, then an appetite testing should be carried out.

Children who are acutely malnourished, should be shifted to a Nutritional Rehabilitation Centre (NRC) for medical attention. The protocol also encourages diet diversity, and has recommended micronutrients in food. 

The ministry has been screening the health of children in anganwadis through the POSHAN Tracker ICT system, and the protocol will signal an end to the physical collection of data.

WCD Secretary Indevar Pandey said that in the last four months, 7 crore children have been screened. Data from the government’s POSHAN Tracker dashboard for September shows that 18 per cent of the 8.35 crore children under the age of 5 in anganwadis that it screened are underweight. 

The WCD ministry said that in India, its screening data from anganwadis show that 1.98 per cent children under 5 suffer from severe acute malnourishment, and 4.62 per cent suffer from moderate acute malnourishment. NFHS data shows that 19.3 per cent of children across the country suffer from SAM and MAM. 

Rajiv Manjhi, joint secretary from the health ministry, said that the number of NRCs across the country (1112) have risen 40 per cent since 2014, and that the admission of SAM children with medical complications went up in the same period by 80 per cent.

“32.1 per cent of children under 5 are underweight, 35.5 per cent are stunted and 19.3 per cent are wasted; only 7.7 per cent children in India are severely malnourished,” Manjhi said. 

The WCD ministry measures malnutrition as per three anthropometric indices based on a comparison of the height and weight of the child as per the standards laid out by the World Health Organization.

The weight of the child as per their age, height, and weight-for-height are used to measure nutritional status, with anything below -2 being considered underweight, and under -3 being severe acute malnutrition. 

APPETITE TEST 

In the appetite test, children should be offered food according to body weight – 15 grams to those that weight below 5 kg, 30 grams to those weighing between 5 to 9 kg and 45 gms to those above 10 kg. If the child does not consume three-fourths of the food, they should be transferred to a NRC.