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Consultation cum Review Meeting of Available Schemes and Services for Malnourished and Stunted Children in High Prevalent Districts in NE.

    


Date:22nd March, 2019
Venue: Sakus Mission College in Dimapur

Organised by National Commission for Protection of Child Rights & State Commission for Protection of Child Rights
in joint collaboration with
Intellectual Forum of North East (IFNE) 
 
 
One day district level workshop and seminar on the issue of Malnourished Children and Stunted Children was held in Dimapur on 21st January, 2020. This workshop was organized by National Commission for Child Rights in joint collaboration of Intellectual Forum of Northeast at Sakus Mission College in Dimapur. 
 
 
In the inaugural session, the opening remarks was delivered by the Deputy Commissioner Sir of Dimapur, Shri Anoop Khinchi. During his speech, he emphasized that malnutrition should not be considered as something simple, in fact this should be taken seriously starting from the phase of the pregnancy of a mother. If the health of the mother is not in good position and if she is not taking the proper nutrition, then it might influence the health of the child. Not taking proper nutrition during the time of pregnancy might result in some complexities during the birth of the child which affects the whole life of the child. He stressed on the fact that not only nutrition before birth of a child, proper nutrition after birth such as breast feedings should be followed wisely, so that the child remains healthy.
 
He appealed to all the parents to take care of the proper nutrition of their child and also avoid providing excessive food which also have a severe impact on the child’s health. Proper Nutrition helps the child to lead a healthy life. He talked about nutrition as something which is not simply about eating pizzas or fast foods, instead it is about taking food in balanced way. Pizzas or fast food may fill our stomach but not necessarily bring nutrition to us and so there is a need to take a balanced diet. The honorable deputy commissioner also talked about the aspects of providing employment which can indirectly help in ensuring proper nutrition for child. He mentioned about several schemes like rural employment guarantee schemes which provides employment to people and assists in ensuring the proper nutrition. To provide a child the proper nutrition’s, income of parents is crucial and so there is a need to introduce several schemes which will ensure the minimum income for the parents. At the end, he stressed about using the currently available schemes in the best possible way to combat this malnutrition issue and also appealed to explore other policies which can help us in combating malnutrition both at state and national level. 
 
The second speaker on the board who turned to speak at the event was the honorable police commissioner of Dimapur. He mentioned about the choices of the food which influence our health. He stressed that everyone instead of consuming tasty food, we need to switch towards the consumption of healthy food to bring proper nutrition and health for our child. He mentioned that apart from being underweight, the issue of overweight also needs to be taken seriously. He appealed the medical departments to look into this aspect in order to ensure proper health for the child. He also ensured about providing all legal and administrative support in implementing the schemes which will bring welfare for the child’s. 
 
The third speaker was the state chairman of NCPCR. She started her speech by defining the meaning of malnutrition which is a case when the children is not getting the adequate food which is required for the physical and overall development of child. She also mentioned that malnutrition reduces the ability to learn and makes a child less productive in future. During her speech, she highlighted the fact of ministry of health which says the malnutrition has adverse effect on the productivity of population and eventually leads to increase in the mortality rate in the nation. She mentioned the fact that according to UNICEF, India stands at 10th position in terms of children who are underweight. According to national family health survey, 9 out of 11 states has been unable to reduce the infant mortality rate even by 2 percent annually. She emphasized that in order to combat this issue of malnutrition, various schemes like National Health Mission, National Food Security Mission, Mid-Day Meal and many others has been introduced. However, this issue of malnutrition still exists in our nation despite of all these efforts. To make more feasible efforts in this direction, the National Nutrition Strategy has been introduced which aims to reduce all forms of malnutrition by 2030. This policy identify itself the part of the goal to achieve sustainable development including nutrition and health. 
 
The technical session started with the opening remarks of Dr. Arbik of District Hospital on the issue of dealing with malnutrition in Dimapur and state of Nagaland. He initiated his speech by talking about the definition of malnutrition given by world health organization which refers it as the deficiencies, imbalances in the intake of energy and nutrients in human body. It includes both undernutrition and over nutrition. However, he mentioned that malnutrition is often seen as a case of undernutrition 
 
 
He mentioned about the several groups of undernutrition as follows:
 
1. Underweight children: These children’s have low weight as per their age. 
 
2. Stunting: It denotes low height and the height is lower than two standard deviations. It usually indicates the chronic form of undernutrition. 
 
3. Wasting: It means the low weight for height. It refers to low weight for his or her height is less than minus two standard deviations. It usually indicates the acute form of undernutrition. 
 
He mentioned the fact underlined by National Family Health Survey for 2015-16, 36% of the Indian children under the age of 5 are underweight. 38% are stunted, 21% are wasted. In the state of Nagaland, as per the National Family Health Survey, 36.4% of the children are stunted. 17% are wasted, 6.2% children are severely stunted and 29.89% children are underweight. 
 
He also talked about the consequences of malnutrition which includes higher risks of infection and mortality usually associated with 35% child deaths who are under the age of 5.  It also brings a shorter adult height which result in reduced economic productivity. For women’s, they usually witness low birth weight. Low birth weight and undernutrition in childhood are important risk factors for hypertensions and diabetes in adulthood. 
 
He mentioned the three determinants which includes:
 
1. Low birth weight where the babies who are born with this often remain undernourished and 20% of childhood nutrition are attributed to feudal growth restrictions. 
 
2. Infections where 25% childhood under nutrition is attributed to Daria, pneumonia and other infections. 
 
3. Low food intake, inadequate breast feeding, delayed complementary feeding beyond 6 months of age and insufficient food intake. This underlies 25% of childhood undernutrition.
 
Talking about the preventive steps for undernutrition, he stressed o the need to take action at the individual and societal level. The health and well-being of girl and child must be ensured. He also mentioned the need to deal with factors like illiteracy, poverty and social discrimination to combat this issue. Along with this, the convergence of health programs requires to be done at a large scale.  He mentioned that at individual level, the mother should take care of the adolescent girl and the child birth should take place only after 20years of age. One must also consider enough spacing of pregnancy for at least 2 year and more than 2 children policy should not be encouraged. He told that imitation of breast feeding within 1 hour is very crucial and exclusive breast feeding for the first 6 months is compulsory. There is also a need to provide special support for low birthweight babies in their breast feeding along with optimum intake of food and good quality balanced food. He stressed that one also need to ensure proper hygiene and hand washing which prove beneficial in preventing from diseases. The proper growth monitoring and regular health checkups must be ensured for children in order to combat the issue of malnutrition. 
  
He mentioned the need like providing the safe drinking water and proper sanitation facilities along with good nutrition should be ensured at our societal level. The efficient promotion of breastfeeding at workplace can be done at societal level along with ensuring proper education for both men and women. 
 
During his presentation, he outlined the numerous policies which are available in India to deal with the issue of malnutrition which are as follows:
 
1. The national nutrition policy of 1993 
 
2. National Health mission which introduced several measures like promotion of efficient young and infant child feeding practices. 
 
Apart from all these, he said that there are several other schemes like mid-day meal schemes and which works towards ensuring the proper nutrition for Childs. 
 
In department of social welfare Dimapur, we have district head which is headed by district welfare officer which is assisted by 6 child development welfare officer based in Dimapur urban, Dimapur Rural and in several other parts. Apart from this we also have ICDS scheme which is a package of 6 services and is a flagship program of India which was implemented in 1975. We also have supplementary programs which are provided from Anganbadi centers along with health checkup in collaboration with health and family. Nutrition and health education is also provided by social welfare department. The total population covered by ICDS Dimapur as of 2019, we have 129 centers in urban areas which covers a population of 1 lakh 48 thousand and in rural part, there are 123 centers. In total, we have 524 Anganbadi centers which covers a total population of 3 lakhs 35 thousands. The number of beneficiaries of ICDS are significant who belong to several age groups. There is a provision where severely malnourished Childs are given double rations in quantity. We also provide medical kits to Anganbadi workers in order to ensure proper medication. In addition to that, we have a scheme called Pradhanmantri Madhu Bandana Yojna which is a direct benefit transfer scheme where the beneficiary receives the cash incentives of Rs 5000 through the umbrella of ICDS to pregnant mothers for their first living child. This scheme is implemented by the Anganbadi centers which ensures that proper checkups and immunization is done to improve the health prospects of pregnant women’s.
 
Apart from this, schemes like Poshan Abhiyan are also working in a mission mode to ensure proper nutrition to all children and mother in a specified time frame. The ICDS application for mobile has been introduced for the Anganbadi workers where anyone can upload their data and get real time results over the internet and there are incentives for using this app which facilitates in reducing the registers. We also have started the use of devices for measuring the growth of a child such as infant meter which takes the length and height of the child. 
 
The fourth speaker during the event was the coordinator of MDM stressed on the fact that how government of India has introduced the mid-day meal program under the umbrella of national program for nutrition support to primary education. She mentioned about the series of steps which are being undertaken to improve the scenario of malnutrition and presented several photographs of equipment’s which are provided to beneficiaries under MDM.
 
The final lecture on technical session was delivered by dietician of Indian medical center. She voiced about the need to provide nutrition education to mothers with the audio visual equipment’s which will help in changing food habits. There is also a need to define the food which needs to be provided to child in accordance to the need which will support the nutrition of child.  She also emphasized on the need to maintain the hygiene among mothers which includes washing hands properly before feeding food to the child. Not washing hands properly may result in bacterial infections among child.  She also said that breastfeeding should be give more importance because mother’s milk contain certain type of proteins which is not available in any other forms of milks. Apart from this, she mentioned about how over nourishment of child also influence the health of child in a negative way and so there is a need to balance the nourishment diet. She ended her speech by appealing all to encourage tradition style of food which would be efficient for the nourishment of a child. 
 
The entire event ended with the open house session where the Anganbadi workers and their queries associated to nutrition was answered by the experts which helped these workers to gain insight on this issue. 
 
CONCLUSION:
 
The overall conclusion from this entire event was that there is a need to implement the available laws to combat malnutrition with more grounded approach.  Apart from this, awareness about hygiene and good food habits including the promotion of breast-feeding practices also requires to be undertaken. All these aspects need to be followed in state as well as at national level by incorporating these aspects individually and also at societal level.
 
 
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Consultation cum Review Meeting of Available Schemes and Services for Malnourished and Stunted Children in High Prevalent Districts in NE.

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