Mumbai’s teeming slums have at least 50,259 moderately underweight and 3,190 severely underweight children, latest data gathered by the Integrated Child Development Services (ICDS) shows. The count of undernourished children is 17 per cent of the total children weighed by anganwadis across the city till March this year. The figures reiterate that malnutrition is not just a rural phenomenon and needs to be tackled differently in urban slums as well.
The ICDS, a central government programme under the Women and Child Development department, is responsible for addressing growth needs of children aged below six years. The ICDS, along with NGOs, also provides nutritional support, reduces child mortality and provides health information for both mothers and children. The ICDS data compiled until March 2016 shows that of 3.12 lakh children weighed in Mumbai, 2.59 lakh weighed normal according to their individual heights, 50,259 children were moderately undernourished and 3,190 were severely undernourished.
At least eight children, suffering from malnutrition, died in 2015-2016. Of them, five were below one-year-old and three were aged between three to six years. The children who were reported dead lived in slum pockets of Kanjurmarg, Santacruz (East), Jogeshwari, Ghatkopar, Bhandup (East), Dharavi and Mankhurd.
“The major problem we face is with migrants. Migrant population accounts for 33 per cent population in Mumbai. Hundreds come and leave the city on a regular basis. Tracking them becomes an issue,” said Vanessa D’souza, CEO of Sneha, an NGO working on malnutrition. The NGO is attached with over 350 anganwadis in the city. According to D’souza, even when an underweight baby is born and stabilised in slums, his condition trickles back into severely acute malnutrition (SAM) and moderately acute malnutrition (MAM) category if the family moves back to native village for few months”
“The illiteracy amongst migrants puts health on back seat. Malnutrition is not considered a medical condition until the health worsens and child requires hospitalisation. These mothers are thin and young, so for them giving birth to children who are also thin is normal,” a field worker attached with ICDS said.
The city has 5,130 anganwadis, each with a teacher and a helper. NGOs with ICDS provide their field volunteers who conduct door-to-door survey to examine undernourished kids and provide them nutritional support.
“Once we find a SAM or MAM child, we admit them in hospital until their condition stabilises. Then monthly visit is done to ensure their weight is increasing,” said Dr GT Ambe, CEO with NGO Committed Communities Development Trust (CCDT) that works in Khar and Santacruz area with undernourished children. The area still has a lower migrant population which makes follow-up easier, Ambe said. While Santacruz and Khar East have 122 children categorised as SAM and MAM, Santacruz West has 69.
Mankhurd, however, has the highest SAM and MAM cases in Mumbai at 347 followed by Dharavi where 214 children have been diagnosed undernourished by ICDS. Mahim follows with 183 cases, Borivli 173 and Goregaon East with 153 such cases.
Of the 553 government run programs under ICDS on child health, 104 are devoted to urban slums. Mumbai alone, according to ICDS,has 4.47 lakh children aged less than six years. With just 5,130 anganwadis in slums, that leaves one teacher and one helper to look after 87 kids on average in each anganwadi every day.
Experts, however, point that only 20-25 children visit a single anganwadi and coverage needs to be increase. “For a single anganwadi worker, there is not just malnutrition to tackle. They are burdened with health surveys, ground reporting and various other government programs which forces child’s health to suffer,” Shubha Shamim, general secretary of Anganwadi Karmchari Sangathna, said.
Even National Family Health Survey (NFHS) points to a dismal figure across Maharashtra. In the last decade, severe wasting— children underweight as per their height— rose from 5.2 per cent to 9.4 per cent since 2005-2006.
In Maharashtra, the NFHS also pointed out that only 6.5 per cent children aged less than two years receive adequate diet, including both in urban and rural pocket. “There is no separate policy to tackle migrant population. We are making attempts to bring down malnutrition count in Mumbai through nutritional support,” said Bapurao Bhavane, Child Development Project Officer (ICDS) in Mumbai.