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Journalism of Courage
Written by Yogesh Chowdhary and Anuj Ghosh
Nutrition is one of the most fundamental building blocks of good health. It impacts development during childhood and adolescence, and can have long-term effects on productivity, cognitive ability, and quality of life. Still, many children and adolescents do not have access to adequate nutrition in regions across India even today. As a result, levels of acute malnutrition, anaemia and other similar disorders continue to be highly prevalent.
Gujarat has a high burden of malnutrition, which necessitates swift action to prevent millions of children and adolescents from suffering the consequences of poor diets. Here, the lack of nutrition often stems from poor nutrient diversity rather than low access to food. Varied diets are an important contributor to protecting children from illness and fatality related to malnutrition. Often, traditional diets lack diversity, making it important to educate families about the need to incorporate foods that contain adequate protein, vitamins, iron and folic acid and other key micro-nutrients that aid growth.
In Bharuch, government programmes have taken a comprehensive approach to safeguarding reproductive health and child health, as these are complementary. Once the health and nutrition of the mother is ensured, the child is more likely to be born healthy and grow up within adequate health and nutrition parameters. The government machinery actively reaches out to women and girls at multiple stages of their development to safeguard their health.
The cycle starts with adolescent girls, with whom outreach is conducted at Anganwadi Centres and by ASHAs. We try to reach pregnant women as early as possible via Ante-Natal Care (ANC) centres, register them, and follow-up on their progress to ensure they receive complete medical check-up, nutrition supplementation and care as required.
After birth, neonatal care is provided immediately, and between six months and six years, growth monitoring is conducted to ensure healthy development in children. Nutrition supplementation is also provided. While this takes place primarily through schools, Anganwadi Centres cater to those children who are not enrolled in school. Integrated Child Development Services (ICDS), Education, and Health departments target one or the other aspect of health and nutrition.
In Bharuch’s Hansot block, a series of innovative, community-centric approaches have been introduced to address more specific issues. These targeted interventions aim to create an enabling ecosystem for parents, teachers, community members, and health care providers to safeguard child and adolescent nutrition. Collaborating with diverse partners, government departments in the block strengthened existing programmes in the block and rolled out new ones to engage these various stakeholders.
Data from implementation projects in the region show that building health worker capacity and increasing awareness of and accountability within existing schemes and programmes can make a marked difference in the nutritional status of children. Home visits to the families of children suffering from acute malnutrition has significantly improved nutrition outcomes. The sharing of guidance on feeding practices, such as highlighting the importance of consuming Take-Home Ration (THR) provided by the Anganwadi Centres, ensuring a balanced diet, and seeking timely and specialized treatment, has made an enormous impact.
Hansot was the first block in the district to restart routine health screenings in schools and Anganwadi Centres, ensuring that children aged six months to eighteen years receive free medical services. All schools in the block and all Anganwadi Centres have been equipped to administer Weekly Iron and Folic Acid Supplementation (WIFS), in the form of syrups to infants and tablets to older children, in the presence of schoolteachers, to prevent anaemia. Anganwadi Centres also hold routine recipe demonstrations that have resulted in the improved consumption of Take-Home Rations in making healthy meals that suit local tastes.
To further strengthen early childhood nutrition and development, SMART Anganwadi Centres have been introduced in the block recently. These centers are equipped with safe and hygienic food storage and cooking equipment to provide daily meals to children between six months and five years old. These centers also cater to adolescent girls and mothers, and by teaching them about nutrition, conducting routine check-ups, and distributing supplements and fortified food, we hope to disrupt the inter-generational cycle of malnutrition.
Since healthy adolescents grow up to be healthy mothers who bear healthy children, it is critical that we adopt and scale up best practices to prevent malnutrition. By not only strengthening health systems but also creating bridges between providers and the communities they serve, we can build a health future where no child or young person is left behind.
Chowdhary is District Development Officer (DDO), Bharuch, Gujarat; Ghosh is Senior Director, Global Health Strategies Institute. Both have been working in Hansot, Bharuch, to strengthen health and nutrition for children and adolescent as part of a project titled Strengthen Access and Awareness of Health Services (SAAHAS).