Infant and Young Child NutritionGood Practices from Indian States

India: Undernutrition happens very early in life

Source, NFHS-III 2005-06

Antenatal Care - FOGSI IYCF & NBC - IAP/NNF

1000 Day Window of Opportunity (-9/+24) to make a Life long Difference

Essential for Child Growth and Survival

Maternal Nutrition• Antenatal Care • Weight gain• Adequate nutrition• Adequate rest• Postnatal Care• Birth Spacing

Child Nutrition• Early initiation of Breast

feeding within one hour of birth

• Exclusive Breast feeding for the first six months

• Timely, age appropriate and safe complementary foods

• Care during illness

Good Practices – Indian States• Improving Child Survival

– Special Care Newborn Units – Madhya Pradesh, Orissa, Bihar, Assam, WB, Gujarat etc– Call Centres for perintal referral transport – Madhya Pradesh– Nutrition Rehabilitation Centres for SAM children – Madhya

Pradesh, Jharkhand, UP, Orissa, Bihar– Chiranjeevi Yojna - Gujarat

• Targeted Behaviour Change Strategies for improving care and feeding practices– Positive Deviance Approach – Orissa and West Bengal– Dular Strategy – Bihar and Jharkhand– Aanchal se Angan Tak – Rajasthan– Mamta Diwas/VHND- Gujarat– Annaprashan – Gujarat– Mother Support Groups – Uttar Pradesh

• Nutrition Mission– Maharashtra– Madhya Pradesh– Gujarat

Prevalence of underweight and stunting lower in the PD area compared to non PD area

Positive Deviance Approach

Identification of community level POSITIVE

child care practices

Involvement of community in running COUNSELLING

Sessions

Practice of food hygiene

and cleanliness

Hands on child feeding practices

RJMCHN Mission: Making a Difference

• Visibility to the issue• Involving communities –

Community Growth monitoring – Growth faltering

• Tracking of Underweight Children - Creating Accountability

• Strengthening monitoring systems

• Performance Review Institutionalized

RJMCHN Mission-Independent platform with

committed team, enjoys the flexibility and authority to

take decisions

Maharashtra Nutrition Mission Changing the Scenario of the State

NRCs for Child Survival – Madhya Pradesh

7,18011,950

24,620847

100196

241249

34,37054,471

Number of NRCs

Total SAM children managed

2006 2007 2008 2009 2010 Jul'2011

15

On admission

At Follow up – after one month of discharge

On discharge - After 3 weeks

Making a Difference

Khushi (female) -2.5months

• Admitted to a health facility

• Adm date 12.05.09

• Adm wt 1.825kg

• Mother counseled -

Exclusive breast feeding with correct positioning & attachment

• Discharge wt 1.905kg

• Dis date – 23 05 09

Khushi - after two months

• Follow up on feeding practices with counseling by AWW

• Follow up records

• I - 8.6.09- wt2.440kg

• II- 3.7.09- wt3 375kg

Counselling in Hospitals and Clinics

Change is Possible

Way Forward

• Encouraging Mother and Child Friendly Clinic/Hospital Initiative

• Promoting appropriate IYCF practices through trained IYCF Counsellors in Hospitals and Clinics

• Sensitization of Labour Room and Maternity Ward staff on appropriate IYCF practices and counselling

• Early detection of growth faltering and corrective actions – Health care facility

Thank You

There are two ways to live your Life

One is as though Nothing is a Miracle

The other is as though Everything is a MiracleAlbert Einstein (1879-

1955)