NEW DELHI: To combat malnutrition in children in the country, the Centre on Tuesday launched the first ever national protocol under which severe acute malnourished (SAM) children without medical complication will be managed at anganwadi centers instead of nutrition rehabilitation centers (NRC).
The standardised national protocol, which was launched by Women and Child development Minister Smriti Irani, is a comprehensive guide to identify and provide extensive care and management of malnourished children.
The protocol will also help in identifying severity of malnutrition among anganwadi children at an early stage and chart out a functional institutionalised course of treatment in a time-bound manner. Now, according to the ‘Protocol for Management of Malnutrition in Children,’ severely malnourished children with medical complications will be enrolled in the NRCs.
It introduces new initiatives like appetite testing and ‘buddy mother’, which is an arrangement between the mother of a healthy child and the mother of a malnourished child for joint supervision and exchange of guidance with respect to the health of the malnourished child.
The protocol lists that children who suffer from bilateral pitting oedema and failed appetite test will be enrolled in the NRCs. Bilateral pitting oedema is swelling in both legs characterised by an indentation, or ‘pit’ that remains when pressure is applied to the swollen area.
The NRC is a unit in a health facility where children with severe acute malnutrition were admitted and managed. Severe Acute Malnourishment is a condition in which a child has a very low weight in relation to the height, as per WHO growth standards. Earlier, all SAM children were to be admitted in the NRCs.
The new rules also included counselling of parents and follow-up care. It also ascertains accountability from the level of anganwadi workers to the district magistrate, who will be the nodal point in the district for monitoring nutritional status and quality standards.
The protocol lays emphasis on a community-based approach, which involves timely detection and screening of children with SAM, management for those without medical complications with wholesome, local nutritious foods at home and supportive medical care. So far, majority of NRCs were managing SAM children aged 6-59 months, but they will now extend services to infants aged 1-6 months with severe malnutrition or nutritional risk.
Nutrition indicators improve