RESUMO
Malnutrition is a public health problem globally. Gujarat is one of the states facing challenges in dealing with malnutrition and anemia. The NFHS-5 (National Family Health Survey-5) data reveals that the gains made in NFHS-4 (National Family Health Survey-4) were reversed in NFHS-5. Despite numerous schemes and policies in place, Gujarat has yet to reach the full potential of these mandated policies to showcase exponential results in malnutrition and anemia. This study presents an overview of the nutritional status of districts in Gujarat, compared with NFHS-4, by illuminating its potential determinants and inter-district variabilities. An increased prevalence was seen in children under five who are stunted and severely wasted; however, the prevalence of children under five who are wasted improved in Gujarat. The prevalence of anemia increased across all age groups, showing an immediate sign of caution. The study observed decreased prevalence of immediate determinants and increased coverage of nutrition-specific interventions in NFHS-5 compared to NFHS-4 for nutritional indicators in Gujarat. Underlying determinants like households with electricity and improved drinking water have improved drastically in Gujarat. Furthermore, it elaborates on the gaps and improvements observed in inter-district variabilities among determinants in their coverage. This study also consists of actions taken by states that have fared better concerning nutritional indicators instead of improving the nutritional indicators for Gujarat. The study has categorized the districts into top-priority, priority, average, and front-runner districts of Gujarat based on the prevalence of nutritional indicators.
RESUMO
Introduction Severe acute malnutrition (SAM) carries severe implications for a child's development. The survival of a child suffering from severely acute malnourishment is majorly dependent on the management of SAM, and scaling up the framework for addressing malnutrition is one of its main components. A severely malnourished child has a higher risk of mortality as compared to an ideally nourished child. Bal Poshan Yojana under the aegis of Project Tushti, a public-private partnership (PPP) model, aims at strengthening the framework of treatment for SAM children by working towards building a sustainable eco-system through engaging the government body, private practitioners and implementing bodies. Methods Bal Poshan Yojana is a novel approach implemented for the first time in the Devbhumi Dwarka district of Gujarat for the management of SAM under a PPP model. The private practitioners and centres were empanelled and trained on the treatment of SAM. SAM children with medical complications were screened through anthropometric measurements and appetite tests carried out by Rashtriya Bal Swasthya Karyakram (or RBSK, a program for child health) medical team. High-risk cases were referred to the nearest empanelled Bal Poshan Centre in the area. Children were treated for 14 days at the Bal Poshan Centre as per the protocol of the National Rehabilitation Centre and then discharged if the children fulfilled the criteria. The treatment included a 14-day treatment protocol and three follow-ups in an interval of 15 days each. The data was analyzed with appropriate statistical tests. Results Since its inception, a total of 102 severely malnourished children under five years of age have completed their treatment successfully, including three follow-ups. Around 60.79% of SAM children have been found to become normal in their nutritional status. The mean weight gain upon discharge was 0.57 kg and after three follow-ups, it was 1.051 kg. Conclusion Bal Poshan Yojana is a one of its kind initiative to tackle the growing burden of malnutrition among under-five age group children. The initiative has a focused approach. Strong referral and verification mechanisms ensure complete transparency and yielding of desired results.
