ABSTRACT
Objective: To describe the nutritional outcomes of children with severe acute malnutrition(SAM) in a village-level intervention. Methods: This observational longitudinal study on 179children aged <3 years was conducted in seven tribal blocks of Central and Eastern India withSAM managed in a comprehensive day care program. Results: 76% children with SAMshowed improvement over a 4-6 months period, with 37% shifting to normal anthrometricstatus. There was a significant shift in Z scores. Conclusion: This community-basedintervention showed fair results for management of children with SAM at village level.
ABSTRACT
Nationwide Rapid Survey on Children (RSoC), conducted by the Ministry of Women and Child Development and UNICEF in 2013-14 showed a marked improvement in the status of the child malnutrition over the third National Family Health Survey (NFHS-3) that was conducted in 2005-06. Despite some impressive gains in the anthropometric indicators of malnutrition, the absolute levels remain high, and of concern. Despite these gains, the feeding indicators remain stagnant. The programmatic responses need to adopt a multi-sectoral comprehensive approach with regular and comprehensive nutrition surveillance and recognize the epidemiological diversity.
ABSTRACT
Programming platforms need to recognize the diversity of malnutrition epidemiology in India and choose appropriate implementation designs. With severe chronic malnutrition as the dominant epidemiologic entity, the net needs to be cast wide, focusing on: food security, health care, agriculture, water and sanitation, livelihoods and women’s empowerment. Community-based malnutrition treatment and prevention programs need to collaborate to complement treatment with socioeconomic and preventive interventions. Expansion of nutrition rehabilitation centers should be limited to areas/districts with high wasting. Pediatric services with nested nutrition services (including counseling) requires urgent strengthening. Continuum of Care is a weak link and requires strengthening to make both hospital and community-based models meaningful.
ABSTRACT
Anthropometric data from our survey of 1,879 children in Madhya Pradesh revealed low sensitivity (17.5%) and positive predictive value (30.4%) of Mid-Upper Arm Circumference (MUAC) at the recommended cut-off of 115 mm for identifying Severe Acute Malnutrition (SAM). This led us to question the reliability of MUAC as a screening tool to identify SAM at the community level, especially in the context of very high levels of stunting.