gujarat state nutrition mission (gsnm)

GUJARAT STATE NUTRITION MISSION

(GSNM)

Departments of H&FW and WCDDepartments of H&FW and WCD

Presentation to Hon’ble Chief Minister

Agenda of the Meeting 1. Overview of the nutrition status in Gujarat-High

incidence of undernutrition in Gujarat2. Nodal Departments for Gujarat State Nutrition

Mission- HFWD & DWCD.3. To decide the Roles, Responsibilities and Structure of

Nutrition Mission4. To evolve Concept and Approach to achieve the

objective :- 3 –Tier Approach.5. Human and Financial resources for the Mission6. Maharashtra & Other Models – successful case study.7. Any other agenda items from the Chair

Apr 21, 2023 2Health & FW

National Family Health Survey-3, 2005 – 06,Gujarat

INDIA

Gujarat

Nutrition Situation of various States of India

38

37

37.625

22.929.8

32.5

39.9

44.6

25.6

42.4

60

39.6

24.9

26.1

36.5

56.5

40.747.1

48.855.936.4

19.7

22.1

39.619.9

32.5

25.2

38.7

45 % Children (<5 Yrs) of Gujarat are underweight.

3

DLHS-2, 2002-04

• 45% U5 underweight• 50% Breastfed in 1st hr ***• 45% Exclusively breastfed **• 56% Initiate Complementary feeding - 6-9 months ***• 24% Get adequate Proteins & Calories*• 80% Anaemic (6-35 m)• 56% HHs use Iodized salt• 56% Vit A supplement**

NFHS 2005-2006* NNMB (ICMR)** DLHS – 2008***CES, Unicef - 2009 4

Nutrition Situation in Gujarat

Types of Malnutrition

• Underweight- A composite measure – Low Weight for Age

• Stunting- An indicator of past growth failure – Low Height for Age

• Wasting- Current or Acute malnutrition – Low Weight for Height

• Micronutrient deficiencies- Iron(Anaemia), Iodine (Hypothyroidism, Cretinism-Mental retardation), Vit-A (Night Blindness)

Weight for Age criteria Weight for Height criteria

Normal %[Green]

Severe Under Weight % (Red)

Moderate Under Weight % [Yellow]

Nutrition Status in Gujarat

Normal %

Moderate Acute

Malnutrition (MAM) %

Severe Acute Malnutrition

(SAM) %

44.6%

Underweight (%)

55.4%

28.3%

16.3% 5.8%

12.9%

55.4%

18.7%

Wasting (%)

Source:- NFHS- 3 (2005-06)

25.9%

SUW/ MUW

Weight for Age criteria Weight for Height criteria

Normal %[Green]

Severe Underweight %

(Red)

Moderate Under weight % [Yellow]

Nutrition Status (Hungama Report- 2011)

Normal %

Moderate Acute

Malnutrition (MAM) %

Severe Acute Malnutrition

(SAM) %

42.3%

Underweight (%)

57.7%

25.9%

16.4% 3.3%

8.1%

57.7%

11.4%

Wasting (%)

As per the data of 100 focus districts of six states Bihar, Jharkhand, Madhya Pradesh, Orissa, Rajasthan and Uttar Pradesh

30.9%

SUW/ MUW

Distribution (%) of 1-3 yrs children according to daily intake of Food stuffs as percent RDISource:- NNMB Tribal Survey

Percent of RDI

(>=70%) Kerala TN KarnatakaAndhra Pradesh Maharashtra Gujarat MP Orissa

West Bengal

Cereals & Millets 36.1 52 48.9 65.5 59.5 81.5 60.7 76 69.6

Pulses & Legumes 5.7 18 9 32.4 47.9 42.5 20.1 19.2 3.7

GLV 4.3 6.3 6.4 3.4 2 2.5 12.9 43.7 33.5

OV 22.2 32 28.7 28 19.2 39.6 24.4 36.6 34.6

R &T 56.1 43 35.1 48.8 24.2 53.5 38.4 50.1 70.2

M & MP 1.3 1.5 2.1 2.4 2.5 1.5 0.2 0.3 1

Fats & Oil 0.4 0 0.5 3.1 2.7 0.7 0.5 0 1

Sugar & Jaggery 0.4 0.9 13.8 6.1 15.2 1.5 4.3 0.3 1

Key Points:- The daily intake of food stuff for children age group 1-3 is higher than the average in case of Cereals &Millets , Pulses & Legumes , Other Vegetables and Roots &Tubers but less in case of Fats &Oils , Milk & Milk Products, Green Leafy Vegetables and Sugar & Jaggery . When compared to other States like Andhra Pradesh, Maharashtra and Orissa..

Distribution (%) of 4-6yrs children according to daily intake of Food stuffs as percent RDI Source:- NNMB Tribal Survey

Percent of RDI (>=70)

Kerala TN Karna AP Maha Gujarat MP Orissa WB

Cereals & Millets >=70

27.4 55.6 43.3 78.4 67.9 71.2 58 84.2 86.8

Pulses 27 42.3 14.3 45.7 68.6 62.4 37.5 28.8 9.3

GLV 6.5 7.3 3.8 6.1 4.2 3 13.3 47.1 38.8

OV 29.1 51.6 41 34.5 21.1 35.2 29 39.2 35.3

R &T 52.6 26.2 31 43 21.3 49.4 46.7 43.8 74.8

M & MP 1.7 0.8 0.5 1.8 0.4 2.1 0.2 0 1.6

Fats & Oil0 2 1 4.6 5.5 2.7 1 0.8 1.6

Sugar & Jaggery

0.4 0 8.1 6.1 16.5 0.3 0.4 0.3 0.8

Key Points:- The daily intake of food stuff for children age group 4-6 is higher than the average in case of C&M, P& L, OV and R&T but less in case of F &O, M & MP, GLV and S&J. when compared to other States like Andhra Pradesh, Maharashtra and Orissa.

Focus Areas •Keeping in view insignificant improvement in SAM and MAM category of children, 3- tier approach seems to be necessary and desirable.

• Focus needs to be on adolescents, pregnant and lactating mothers.

•Need to strengthen micronutrient supplementation program .

•Special focus on Infant Young Child Feeding Practices (Especially Initiation of Breastfeeding within one hour , Exclusive Breastfeeding up to 6 months & Initiation of Complementary Feeding after 6 month ).

•Effective communication strategies to improve dietary practices and Life style .

•Emphasize on deworming of children, adolescent girls and Pregnant Women to improve absorption of nutrients.

Acute Malnutrition - SAM/MAM

Children with Severe Acute Malnutrition (SAM) have nine times higher risk of death.

Severe Acute Malnutrition (SAM) if :

W/H-L < -3SD &/or MUAC** <11.5cm &/or Bilateral pitting oedema

Severe Acute Malnutrition (SAM) if :

W/H-L < -3SD &/or MUAC** <11.5cm &/or Bilateral pitting oedema

Moderate Acute Malnutrition (MAM) if : W/H-L between <-2

and -3 SD &/or MUAC between 11.5 to <12.5 cm

Moderate Acute Malnutrition (MAM) if : W/H-L between <-2

and -3 SD &/or MUAC between 11.5 to <12.5 cm

SOURCE:- WHO & IAP ProtocolsSOURCE:- WHO & IAP Protocols

**MUAC=Mid Upper Arm Circumference- an age independent screening tool

Underweight - SUW/MUW

Severe Under Weight (SUW) if :• Weight for Age < -3SD

Severe Under Weight (SUW) if :• Weight for Age < -3SD

Moderate Under Weight (MUW) if :• Weight for Age < -2SD to -3SD

Moderate Under Weight (MUW) if :• Weight for Age < -2SD to -3SD

SOURCE:- New WHO Growth StandardsSOURCE:- New WHO Growth Standards

Ongoing Nutrition Interventions of H&FWD to tackle Malnutrition


Mamta Abhiyan- Health and Nutrition service delivery strategy i.e. Mamta Diwas

Micronutrient Supplementations – IFA supplements, Vitamin A supplements & Iodized salt

Conditional Cash Transfer Scheme- “Kasturba Poshan Sahay Yojana” implemented from 29-2-2012.

Facility based management of malnutrition- (a) Child Development and Nutrition Centers (CDNC)

(No of Centers – 76 in 20 districts)- at CHCs and District Hospitals.(b) Nutrition Counseling and Rehabilitation Centers. ( No of Centers – 6 )- at Medical College Hospitals.c)Bal Gram Parivar Yojana (pilot), A community based

malnutrition management program in three villages – Positive Deviance model .

Ongoing Nutrition Interventions of DWCD to tackle Malnutrition


Growth Monitoring Supplementary Nutrition Program in the AWC for 6 month to 6 yrs

old:a) Energy dense Bal Bhog (3.5kg)/ month to 6 month to 3 yrs

age.b) Hot cooked food to 3 yrs to 6 yrs.c) Energy dense Take Home Ration (THR) for severe

underweight children 6m-3y – Bal Bhog (5kg)/monthd) Energy dense Take Home Ration (THR) for severe

underweight children 3-6y – Bal Bhog (2kg)/month Fruits to children 3- 6 yrs, twice a week Doodh Sanjeevani Yojana 10 Blocks of 6 Tribal districts, to children 3-

6 years, twice a week. Mobile Anganwadi scheme for NREGA/Migrants population. Nutri-Candy with micronutrients (Iron, Folic acid, Vitamin A and

Vitamin C) for age group of 3 to 6 years Conditional Cash Transfer Scheme- “Indira Gandhi Matratva Sahay

Yojana (IGMSY) ” implemented in Bharuch and Patan.

Gujarat State Nutrition MissionConcept and Approach


Gujarat State Nutrition Mission Structure

Autonomous and independent structure of the Mission• An independent structure with autonomy in decision

making and planning-in the form of Society /Trust ?• Three Tier Approach• Mission Director/Director General – a dedicated senior

official of the level of a Principal Secretary / Secretary & not on additional charge.

• Joint responsibility of HFWD & DWCD• Convergence with other line departments – Education,

Food & Civil Supplies, Water Supply, Panchayat and Rural Development, Urban Development etc.

Apr 21, 2023 .17Health & FW


The operational structure of the Mission should include A.State Level –12 persons - Mission Director/Director

General (IAS), Deputy Directors-3, Consultants and Project Officers -4, M&E Asst.-1, Data Entry Operators-2, Finance Asst.-1, Office Asst-1. Aim is to have specialists on board.

B. District Level- 3 persons – District Nutrition Officer, Dist. M&E Asst., Data entry operator, reporting to both CDHO and PO- ICDS to ensure convergence.

C. Taluka Level- 2 persons – Taluka Nutrition Assistant, Date Entry Operator reporting to Taluka Health Officer and designate Taluka CDPO .Apr 21, 2023 18Health & FW


D. Urban Level –(1) Corporation level- 3 persons – Corporation Nutrition

Officer, Corporation M&E Asst & Data entry operator, reporting to both MO- Urban Health and PO- Urban ICDS to ensure convergence.

(2) Zonal Level- 2 persons – Zonal Nutrition Assistant and Date Entry Operator reporting to Corporation Nutrition Officer.


Apr 21, 2023 Health & FW 20

Gujarat State Nutrition Mission Organogram (State Level Team)

Mission Director/ Director General (IAS) (1)

Mission Director/ Director General (IAS) (1)

Deputy Dir (Nutrition)

(1)

Deputy Dir (Nutrition)

(1)

Deputy Dir (Health)(1)

Deputy Dir (Health)(1)

Deputy Dir (Mon)(1)

Deputy Dir (Mon)(1)

Consultants/POs (Community Nutrition, Monitoring, IEC and Capacity building) -4

Consultants/POs (Community Nutrition, Monitoring, IEC and Capacity building) -4

Monitoring and Evaluation Asst

(1)

Monitoring and Evaluation Asst

(1)

Data Entry Operators

(1)

Data Entry Operators

(1)

Finance Asst(1)

Finance Asst(1) Office Asst

(1)Office Asst

(1)

State Level(12 members) State Level

(12 members)

HFWDHFWD DWCDDWCD


Gujarat State Nutrition Mission Organogram (District & Taluka level Team)

District Nutrition Officer (1)

District Nutrition Officer (1)

District M& E Asst (1)

District M& E Asst (1)

Data Entry Operator (1)Data Entry

Operator (1)

Taluka Nutrition Assistant (1)

Taluka Nutrition Assistant (1)


Operator (1)

Chief District Health Officer (Health)

Chief District Health Officer (Health)

District Program Officer (WCD)

District Program Officer (WCD)

District Level(3 members)

Taluka Level

(2 members)

DDODDO


Gujarat State Nutrition Mission Organogram (Urban)

Corporation Nutrition Officer (1)

Corporation Nutrition Officer (1)

Corporation M& E Asst (1)

Corporation M& E Asst (1)

Corporation Data Entry Operator

(1)

Corporation Data Entry Operator

(1)

Zonal Nutrition Assistant (1)

Zonal Nutrition Assistant (1)


Operator (1)

Medical Officer (Urban Health)

Medical Officer (Urban Health)

Municipal Commissioner /DMC

Zonal level(2 members)

Corporation level (3 members)

CDPO

Focus of the Mission

• To strengthen growth monitoring and evaluation system and bringing in subject specialist.

• Ensuring growth monitoring and promotion by improving– Survey efficiency– Weighing efficiency– Plotting of weights on growth charts, and– Identification of undernourished children and detection of

growth faltering and stagnation and focusing on the most vulnerable- SAM, MAM, SUW and MUW

• Improving Infant and Young Child Feeding (IYCF) practices to reduce malnutrition.

• Mass awareness (IEC) on nutrition related issues including IYCF and healthy food habits through a community based approach.


Malnutrition Screening Tools & Equipments


Digital Weighing Scale : Cost Rs 4000/- Spring Scale Rs 800 - 1500/-Digital Weighing Scale : Cost Rs 4000/- Spring Scale Rs 800 - 1500/-

Weight for HeightSAM if W/H <-3SD

MAM if W/H <-2SD to -3SD

Weight for HeightSAM if W/H <-3SD

MAM if W/H <-2SD to -3SD

Indigenous Board:- Rs 1000/-Indigenous Board:- Rs 1000/-

Malnutrition Screening Tools & Equipments


Mid Upper Arm Circumference (MUAC)

SAM if MUAC <11.5cmMAM if MUAC 11.5 to 12.5 cm

Mid Upper Arm Circumference (MUAC)

SAM if MUAC <11.5cmMAM if MUAC 11.5 to 12.5 cm

MUAC Tape - Low Cost Tool (Rs 3/-)MUAC Tape - Low Cost Tool (Rs 3/-)

Plan of the MissionManagement of SAM and MAM Children (WASTED) through 3 - tier approach1. To adopt and follow SAM and MAM Identification Criteria as per WHO Standards.

2. To establish demand based facilities at all levels•Village - Village Child Nutrition Centres (VCNCs) at AWCs. Duration of Program will be for 30 days. Cost approx Rs 40/child/day•PHC/CHC/SDH - Child Malnutrition Treatment Centres (CMTCs). Duration of Program will be for 21 days. Costs approx Rs 200/ child/ day (current CDNCs will function as CMTCs)•District Hospital/Medical College - Nutrition Rehabilitation Centers (NRCs). Duration of Program will be for 25 days. Costs approx Rs 250/ child/ day.

PApr 21, 2023202 26Health & FW

Hierarchy of 3- tier approach

Children admitted with defined SAM criteria with severe

Medical Complications/

Oedema

Children admitted with defined SAM criteria with severe

Medical Complications/

Oedema

Children admitted with defined SAM

criteria with Medical Complications

Children admitted with defined SAM

criteria with Medical Complications

Children admitted with defined SAM &

MAM criteria without Medical

Complications

Children admitted with defined SAM &

MAM criteria without Medical

Complications

Roles of HFWD and DWCD in the 3-Tier Approach

Village Child Nutrition Centre (VCNC)

• Target Group:- Both SAM and MAM children• At Village level, at Anganwadi Centers managed by

AWW, AWH & ASHA.• Incentive to AWW, AWH & ASHA.• Nutritional Supplements as per standard protocols• Stay will be for 30 days• Daily visit by an ANM• An expenditure of Rs 40/- per child/day: Rs 20 for Diet

(Dynamic as per region) , Rs 10/- for Medicines and Rs.10/- for Incentives.

• Follow a camp approach.Apr 21, 2023 29Health & FW

Child Malnutrition Treatment Centre (CMTC)

• Target Group:- SAM Children with medical complication• At PHC / CHC / SDH level• Treatment as per standard protocols• Daily visit by a Trained Doctor.• Follow a camp approach for 21 days • Expenditure of Rs. 200 per child per day• Mother/guardian accompany and stay with the child

throughout and compensated Rs 100 per day for wage loss.

• Rs. 100 is expended on diet and medicines per day/ child (Diet- Rs 60 and medicines Rs 40 per child/ day).


Nutritional Rehabilitation Center (NRC)

• Target Group:- SAM Children with severe medical complication

• At District Hospital and Medical Colleges level• Treatment as per WHO standard protocols• Daily visit by a Trained Doctor.• Expenditure of Rs. 250 per child per day• Mother/guardian accompany and stay with the child


• Rs. 150 is for diet and medicines per day/ child (Diet- Rs 60 and medicines Rs 90 per child/day).


Financial Resources available for Mission Objectives

• State Budget 12-13:- Rs.60 Crores for Nutrition Mission which includes –

a) Mission Structure.b) Conditional Cash Transfer – Kasturba Poshan Sahay

Yojana (GR already issued on 29-02-2012).c) Anemia Management Package.d) Innovative interventions.• Gujarat Integrated Nutrition Project – Out of 60 crores

allocated as one time Central Assistance from GOI- Rs. 54 Crores is available ( Received in March 2010).

• NRHM- Rs. 40.09 Crores proposed for 2012-13.

04/21/23 Health & FW 32

Roles and Responsibilities of GSNM

• To set-up the structure of the VCNC,CMTC,NRC through HFWD and DWCD

• Organize trainings/orientation workshops for the staff

• Review through meetings and workshops• Strengthen MIS, Data collation , analysis and regular

feedback• Set-Up committees at State, District and Taluka level

for effective monitoring and implementation of the Mission objectives.


1. State Level Gujarat State Nutrition Mission will have:a) Steering Committee under Hon’ble Chief Ministerb) Monitoring Committee to be Chaired & Co-chaired by

Hon’ble Ministers – HFWD and DWCD as per seniorityc) Governing Body, under Chief Secretaryd) Executive Committee- Chaired and Co-chaired by PS

(PH&FW)/ PS DWCD as per seniority.

2. District level Committee under Dist. Collector and DDO as Chairman & Co-chairman respectively.

3. Taluka Level Nutrition Committee -Prant Officer (ATVT)Apr 21, 2023 34Health & FW

Committees At Various Levels

Leveraging Partnerships (Jan-Bhagidari)

• Implement Positive Deviance approach by involving parents to share positive infant and young child feeding practices for making malnutrition-free village.

• Build strong Jan-Bhagidari through Village Health, Sanitation and Nutrition Committees (VHSNC) and Pani Samities.

• VHSNC/ RKS (Rogi Kalyan Samities) to be permitted to accept assistance by cheque/kind from public for this cause.

• Social Audit and Monitoring through Samities.• Malnutrition-free village campaigns through Samities• Partnership with Home Science Institutions for advocacy,

capacity building, monitoring and evaluation.


Assumptions/ Basis for estimates- - Target Group:- 0 to 6 yrs

- SAM Children:- 5%- MAM Children:- 10%- Total (SAM and MAM) Children:- 15%-VCNC workload: (80% of SAM + 100% of MAM)-Expenditure per child at VCNC= Rs 40/day x 30= Rs 1200-CMTC workload: (15% of SAM with Medical Complications)-Expenditure per child in CMTC = Rs 200/day x21 day= Rs 4200-NRC workload (5% of SAM with Medical Complications) Expenditure per child in NRC= Rs 250/ day x 25 days= Rs 6250


MAM(10%)

SAM(5%)

NOR-MAL(65%)

15%

SUW/MUW(20%)


Budget Estimates for different coverage scenarios

(a) Scenario 1All 41 backward talukas + 1 taluka each from remaining 10 districts = 51 talukas Anticipated Children:- 165431; Budget Required:- Rs 23.7 Crores

(b) Scenario 2All 43 Vanbandhu talukas + 1 taluka each from remaining 14 districts = 57 talukasAnticipated Children:- 202417; Budget Required:- Rs 29.0 Crores

(c ) Scenario 3Entire StateAnticipated Children:- 1086905; Budget Required:- Rs 155.8 Crores


•Population covered under one AWC = 1000•Population of (0-6) years Children @ 12% of total pop=120•SAM+MAM@15%= 18 children•SAM @ 5 % = 6 children•MAM @ 10%=12 children•Estimated Children /VCNC /(AWC)= SAM +MAM=6+12=18• Initially cover all targeted children of age group 6 months- 6 years with gradual reduction leading to closure of VCNC (Camp Approach)•Also target entire population for nutrition awareness so that parents start correct feeding on their own so as to prevent onset of malnutrition.

Estimated Workload SAM/MAM per Anganwadi Center(AWC)

Role of ASHA

1) To create awareness about nutrition in the community.2) To counsel on Infant and Young Child Feeding (IYCF)

practices. 3) To mobilize the community to access health and nutrition

services.4) To escort mothers with their SAM/ MAM children for

treatment to nearest VCNC / CMTC / NRC & to motivate mothers to stay for desired duration at CMTC/ NRCs.

5) To ensure that children are followed up at AWC /VCNC CMTC/ NRCs

Incentives to be paid under NRHM.



Malnutrition Management Programs of other states

State Programs for Under

Weight Children Programs for SAM/ MAM

ChildrenRemark

Maharashtra ICDS at AWC

(a) Total VCDC conducted ( At Village level):- 18454 (b) Total CTC completed ( At Block level):- 301 (c ) NRC :- ( At Medical College/ Super speciality)

3- tier approach for management of SAM/ MAM

Madhya Pradesh ICDS at AWC

NRC- 263 at District & Blocks for Management of SAM children

Community Based Mngt Program on SAM/ MAM in process for 2 districts

Management of SAM at District & Block level Health facilities

Jharkhand

ICDS at AWC

+

Dular Strategy implemented in 24 districts

(At Village level)

NRC at DH/Sub DH/CHC/PHC- (81)

Community based management program ( CBMP) at Village/ AWC/ Community level to strengthen ICDS system

Malnutrition Management Programs of other states


State Programs for Under Weight Children

Programs for SAM/ MAM Children

Remark

UP

ICDS at AWC +

IYCF Counseling through Mother Support Groups in

one district

NRC at DH/Sub DH/CHC/PHC- (19)

West Bengal

ICDS at AWC +

Positive Deviance (PD) approach (9 districts )

Positive Deviance (PD) approach (9 districts ) NRC at PHC/ CHC/ SDH/DH-

(11)

People recognize and practice positive early childhood care in feeding, home health seeking, hygiene and psychosocial care .

Bihar

ICDS at AWC +

Dular Strategy implemented in 24

districts (At Village level)

NRC at DH/CHC- (34)

Community based management program ( CBMP) at Village/ AWC/ Community level to strengthen ICDS system

Andhra Pradesh ICDS at AWC NRC - 2 Karnataka ICDS at AWC NRC - 2

Chhattisgarh ICDS at AWC NRC - 25

Rajmata Jijau Mother –Child Health and Nutrition (RJMCHN) Mission,

Maharashtra-Case Study


Operational Facets (Maharashtra)

• Independent and autonomous Mission Structure. • Neither Society nor Trust, steering by CM• Headed by a very senior IAS Officer of PS/Secretary level on

full time basis as Director-General of the Mission• Committed Officers (3 to 4) identified and posted in the

Mission to assist the Director -General. • Champions (people willing to contribute) identified in all

Depts.• Nodal Department is DWCD.• Funding from multiple sources like DWCD, NRHM, TSP, SCSP,

District Planning Boards, etc.


Organogram (Maharashtra)


Director General (IAS,Senior) (1)Director General (IAS,Senior) (1)

Deputy Director (Diet)

(1)

Deputy Director (Diet)

(1)

Deputy Director

(Health) (1)

Deputy Director

(Health) (1)

Deputy Director

(Monitoring) (1)

Deputy Director

(Monitoring) (1)

Director (MVS Cadre) (1)

Director (MVS Cadre) (1)

Coordinator (Training) (1) Coordinator

(Training) (1) Manager (MIS)

(1) Manager (MIS)

(1) Supplementary

Staff (2)Supplementary

Staff (2)Accounts

Manager (2)Accounts

Manager (2)

State Level(11 members) State Level

(11 members)

Levels of Intervention (Maharashtra)

Three tier approach adopted in Maharashtra:1. Village Child Development Centres / Camps (VCDC) at

AWCs- 30 days camp2. Child Treatment Centres / Camps (CTC) – at PHC/ Sub-

district/ district hospitals- 21 days camp on residential basis

3. Nutrition Rehabilitation Centres (NRC)- Medical College / super specialty hospitals- as per need.


Committee Structure (Maharashtra)

There are three committees :-

1. Mission Steering Committee : Headed by Hon. Chief Minister of Maharashtra

2. Mission Monitoring Committee : Headed by Hon. Minister, DWCD

3. Mission Advisory Committee : Headed by Hon. ACS (Health)


Village Child Development Camps /Centre (Maharashtra)

• Both SAM and MAM children• At Village level, at Anganwadi Centres managed by

AWW and Helper• Nutritional Supplements as per protocols• Incentive to AWW and AWH• Stay is for full 30 days• Daily visit by a Dr and an ANM• An expenditure of Rs 32/- per child/day: Rs 16 for diet

(Dynamic as per region) , Rs 8/- for Medicines and Rs.8/- for Incentives.

• Done in a camp approach.Apr 21, 2023 47Health & FW

Child Treatment Centre (Maharashtra) Child Treatment Camps CTC• At PHC / CHC / SDH level• Treatment as per protocols• Mother/guardian accompany and stay with the child


• Follow a camp approach for 21 days • Expenditure of Rs. 160 per child per day• Rs. 100 is expended per day on the diet and

medicines of the child and mother/ guardian


Efforts done on IEC/ BCC (Maharashtra)

• IEC Action Plan of Rs. 6.23 crores covering activities from state to village level for campaign.• Rajmata Jijau Malnutrition- Free Village Campaign Each village attaining malnutrition free status are selected for Malnutrition- Free village award scheme which comprises of award Rs.1000/- and Rs 100/child as award for bringing each child in normal category .•Rajmata Jijau Excellence award for first 3 Malnutrition Free Villages in each district i.e.

(a) -1st Prize- Rs 1,00,000 and Certificate. (b) - 2nd Prize- Rs 50,000 and Certificate.

(c ) – 3rd Prize- Rs 50,000 and Certificate. A budget of Rs 10 crores /annum has been provided for this initiative


Year Phase No of Children admitted at VCTC

Children admitted in CTC

Severe Malnutrition Status

2002 Malnutrition Removal Campaign in Aurangabad

7.2%

2005 Maharashtra Nutrition Mission

Mr V. RamaniDirector General

2006-10 Expansion 97813 18115 1.9 %

2011 2nd Phase 132283 12245 Mr Nand KishoreDirector General

Achievements of Rajmata Jijau Mother- Child Nutrition Mission

Way Forward…..• Nodal Departments of Gujarat State Nutrition Mission- HFWD &

WCD• A separate Nutrition Mission structure • Society Structure as suggested • A Full time Mission Director/Director General for Gujarat State

Nutrition Mission• Screening criteria for SAM/MAM Children as per WHO Standard

to be accepted in addition to SUW/MUW• 3-Tier approach of Maharashtra namely VCNC, CMTC and NRC

merits consideration.• Malnutrition- Free Village Campaign.• Strategy need to be separately workout by WCD and Health on

Adolescent and Maternal Nutrition.Apr 21, 2023 51Health & FW

Thanks


gujarat state nutrition mission (gsnm)

Documents