Making a difference
Manish Gupta elaborates how nutritional intervention has led to healthy babies in poor households.
Fourteen-month-old Ayush smiles as he plays in his mother's lap at the anganwadi centre in Bhandaria village in Uttar Pradesh. Eight months ago he was a severely undernourished and underweight child born to a frail mother. It has been quite a journey for the sickly child to transform into a healthy baby, thanks to an intervention by UNICEF.
"Ayush was a very weak child, used to defecate frequently and always cried. Now he is a happy child," said his mother Sudha who soon left for home to look after her two-month-old daughter. "It was a compulsion," she said without elaborating when asked why she had a second child soon after the first.
State health workers identified Ayush as one of the severely underweight children during Weight Divas in November 2017 when all children up to five years of age were weighed. Ayush was enlisted for a 10-day Bal Poshan Satra (Child Nutrition Session) a month later.
"It was difficult convincing parents. Most are unwilling to accept that they do not know what to feed their own child. It took several visits to Ayush's home and interactions with family members before they agreed to join," said anganwadi worker Bimla and ASHA worker Aarti Devi.
Parents were surprised to see how much their child could eat. The session had milk, suji halwa, omelette, banana, moong dal and khichdi with a mix of vegetables and soya bean. It was a major shift from the tea and chappati Ayush used to have as his first meal at noon. The frequency of meals also jumped from 2-3 times to 5-6 times.
Mothers were made to cook to learn nutritious recipes at the session and were told about breastfeeding. The session added half-a kilo to Ayush, but at 5.5 kg he was still in the red zone. At six months, a child is severely underweight if below 5.6 kg, moderately underwieght between 5.6 kg and 5.8 kg, and normal between 5.8 kg and 7.3 kg.
Ayush and his mother then spent 14 days at the Nutritional Rehabilitation Centre (NRC) at the district headquarter in Bareilly, 23 km away from their village, in December 2017. At the end of the stay at NRC, Ayush came back to the care of ASHA and anganwadi workers in the village with a normal weight of 6.3 kg.
Ayush's grandfather Ghanshyam, who finally convinced Sudha to accept the interventions under the State Nutrition Mission, said he has now stopped giving Ayush snacks like chips from his shop and that he is happy that the baby no longer sleeps on an empty stomach.
The journey from 5 kg to 6.3 kg and his current weight of 8.2 kg could not have been possible without the timely support of Gram Pradhan Amit Patel and the focus provided by Bareilly Chief Development Officer Satyendra Kumar by adopting the village.
Bhandaria village, like other villages in the country's most populous state of 220 million people, had stopped getting the supplementary food consisting of premix laddu, sweet and salted daliya for children between six months and three years between January and April this year due to some problem with the tendering process.
Gram Pradhan Amit Patel made arrangements for the continuous supply of supplementary food from his own pocket and even added milk, egg, and banana during the 10-day Bal Poshan Satra.
"Most families have the necessary food items in their kitchen but do not know how and when to feed their children. At the end of the session, all kids gained at least 200 gms," said 25-year-old Patel.
Helping the state health workers achieve the objectives of State Nutrition Mission is UNICEF in collaboration with the IKEA Foundation, the philanthropic arm of Sweden's IKEA group. UNICEF has deployed experts at various levels to help motivate villagers, counsel them, provide training to health workers, share best practices and inform about nutritious diets.
"Every small achievement takes a lot of effort. There is a huge challenge still left. Healthy children would go a long way to build a strong nation," said UNICEF State Consultant (Uttar Pradesh) Mustafa Kamal.
While Ayush made it out of the red zone and so did Bhandaria village but there are 632 children like Ayush in 175 Aganwadi centres across Bithari block, one of the 16 blocks in Bareilly district.
Bithari block Child Development Project Officer in-charge Poonam Sharma said, "The supply of supplementary food is always less than what is required. During shortages, two categories of children get priority -- those who have Aadhaar card and those who are in red or yellow zones."
(The views expressed are strictly personal)