A five-year programme of two NGOs, together with the government, in slums of Mumbai has shown malnutrition can be tackled with the right approach. From 2011 till 2016, wasting (low weight-for-height among children) reduced from 18 to 12 per cent in Kurla, Govandi and Mankhurd slums (M East and L ward) that house a large population of undernourished kids.
Wasting is a condition that arises when a child’s weight does not increase as per his height. In most cases, it arises out of starvation and affects growth parameters. The National Family Health Survey (NFHS)-IV reported 20 per cent of under-five-year-olds in Mumbai suffered from wasting.
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The five-year programme ended in March 2016, and the report was published this year. It covered 35,000 slum children of which 6,000 were in severely acute malnourished (SAM) and moderately acute malnourished (MAM) category. With the aid of Integrated Child Development System (ICDS) and Brihanmumbai Municipal Corporation (BMC), social workers started individual counselling of mothers, scaled up immunisation programmes in these slums and conducted a monthly measurement of weight and height of children to monitor their growth. In addition, home visits were made more frequent and pregnant women were made aware of nutritional importance.
By the end of the programme in March 2016, the coverage of immunisation against various diseases increased from 66 to 73 per cent in all the three slums in five years. “The monthly check-up helped us know which child is slipping into malnutrition. Those already in SAM and MAM were encouraged to eat well,” said Vanessa D’Souza, CEO of Sneha, NGO that partnered with Child Relief and You (CRY) for the study.
What pushed down wasting was extra manpower induced by NGOs with anganwadi workers in these slums, a factor that continues to lack in rural anganwadis.
Both the NGOs propagated family planning, institutional births, and child immunization. From 2011, when 34 per cent women practised family planning, the figure jumped to 54 per cent in 2016 in Kurla, Govandi and Mankhurd. While adolescent pregnancies reduced from 17 to 4 per cent. Data with ICDS until September last year showed that Mankhurd has 1,946, Kurla 1,167 and Govandi 1,709 malnourished children.
“It is the need of the hour to monitor wasting levels in children through ICDS, and government should immediately take measures to combat wasting,” said Kreeanne Rabadi, regional director of CRY. She added that stakeholders need to converge to address the issue of urban malnutrition.
In Dharavi, along with ICDS, another programme called Aahar is run in 300 anganwadis where early screening, growth monitoring and home-based care for 31,057 children as well as 6,475 pregnant women has been focused for four years by Sneha. According to field workers, early diagnosis and continued treatment is the only means to control malnourishment problem.
In India, the prevalence of wasting is pegged over 15 per cent by the World Health Organisation.