Tackling malnutrition is a tough challenge

Grave Concerns

Tackling malnutrition is a tough challenge
A major political, commercial and cultural City – our very own ‘Dilli’ is grappling with a problem that takes the sheen off its status as the national Capital---malnutrition among children. 

Almost 36 per cent of the City’s infants are malnourished, says a survey by the NGO Child Rights and You (CRY) conducted in December 2013. 

Deplorable condition of the Integrated Child Development Services (ICDS), poor workforce in Anganwadi Centres (AWCs), lack of equipments for growth monitoring and gender discrimination has turned out to be major factors behind the problem.

Based on the survey which covered 3,650 children (1,863 boys, 1,787 girls) under 0-6 years in urban slum areas of Delhi (NCT), 36 per cent were found malnourished.

 Secondly, overall malnutrition among girl children (38 per cent) was higher than the boys (34 per cent). 

Ironically, out of total malnourished children, 33 per cent children are in Severely Acute Malnutrition (SAM) category. Rest, 67 per cent were found to be moderately malnourished (MAM). 

Overall malnutrition is higher in north-west district whereas there is high percentage of SAM children in south-west district.

Attributing poor condition of ICDS as one of the reason behind malnourishment, Subhendu Bhattacharjee, general manager, Development Support, CRY says, “In terms of coverage ICDS is catering to just approximately 30 per cent of the total 0-6 yrs population of children in Delhi. Though 11 Nutritional Rehabilitation Centers have been operational, functioning of these NRCs are very dismal as severely acute malnourished (SAM) children are hardly availing referral services for their immediate care 
and treatment.”

Notably, as per the report, there are 95 operational ICDS Projects in Delhi. 

Despite 36 years of existence, ICDS is catering to just 30 per cent of the total 0-6 yrs of population of children in Delhi. 

“Out of the six major functions attributed to AWC, we strongly feel that except for nutrition/supplementary nutrition and immunisation (both of which are reinforced because of community awareness and demand) rest four (health check-up, referral services, pre-school non-formal education and nutrition and health education) needs to be overhauled for maximum and effective utilisation of resources,” says Subhendu. 
 
He points towards another worrying fact. According to the report, though every child under six years of age should be covered within ICDS, only 9,11,783 children were found as registered beneficiaries of ICDS services. 

As per Census 2011, there are more than 19 lakh children aged below six years in Delhi out of which 10 lakh children are out of the purview of ICDS services! 
 
More so, the Growth Monitoring Process is being compromised. Taking a cue from the National Commission for Protection of Child Rights (NCPCR) Delhi Visit Report, Subhendu says, “Centres have non-availability of weighing machines, sharing of the weighing machines between 3-4 AWCs, faulty machines and non-availability of new growth chart booklets.”
 
Not just services, but poor infrastructure facilities are another reason behind malnourishment. 

Poor infrastructural facilities in AWC such as shortage of space, difficult approachability, ill-ventilated, suffocating rooms, cramped unhygienic places, no space for outdoor activities hamper the quality of service delivery.
 
Other factors like lack of awareness, gender discrimination, working parents in low income/marginalised groups, young children left behind at home and not being properly looked after plus susceptibility to water-borne diseases, are playing their own role in 
malnourishment and affecting mortality.  

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