Vikalp

NOURISH TO FLOURISH REDUCING MALNUTRITION

Aabhas Singh Thakur Divya Pant K.Rishabh

Arushi Shukla Vineeth Balakrishnan

Team Details

India ranks second worldwide in agricultural farm output and 10th in agricultural and food exports, yet1

• India is home to 23 Crore hungry people.3 • 33% of the world’s malnourished children live in India.4 • About 50% of childhood deaths are attributed to malnutrition. 5 • 48% of children under the age of 5 are stunted 6 • and 43% are underweight.7

The above facts emphasize that MALNUTRITION is attributed to not only food insecurity but various other social and health factors like: • Low intake of nutritional diet. • Adequate purchasing power. • Access to health services. • Availability of safe drinking water. • Sanitation and proper environmental condition. • Literacy and lack of awareness especially in women. • High levels of exposure to infection. • Inappropriate infant and young child feeding and caring practices. INVESTING IN NUTRITION IS INVESTING IN THE FUTURE OF A COUNTRY – IT CREATES STRONGER COMMUNITIES WITH A HEALTHIER, SMARTER AND MORE PRODUCTIVE POPULATION. Some concerning points regarding MALNUTRITION • Six of the eight millennium development goals are dependent on malnutrition • Adults who were malnourished as children earn 20% less on average than those who weren’t.8 • malnourishment hampers the physical and cognitive growth. • Improving nutrition is key to child survival. • malnutrition is costing the Indian economy 2.95% of its GDP annually.9 • The world has enough food for everyone.

43%

37% 33%

25%

46% 41%

undernourished children(0-5 yr)

women suffering fromchronic energy deficiency

total urban rural

OUR POLICY:

ESTABLISHMENT OF NUTRTION-HEALTH CENTERS AND MOBILE UNITS Malnutrition is a widespread problem across INDIA and its eradication is a LONG TERM, CONTINUOUS PROCESS. Government schemes like ICDS, mid-day meal and other schemes like SABLA,NRHM etc. propose good model but the progress has been dramatically slow at an average rate of 0.6 % per year.

POLICY OVERVIEW

Establishment oh NHCs will foster already existing schemes of the government and end the vicious cycle.

• Nutrition-Health Centers(NHCs) will act as both nutritional clinics as well as a monitoring body to curb malnutrition.

• Bridge the gap between problem and treatment by recruitment of skilled workers

• Conduct frequent awareness campaigns regarding all the aspects

of malnutrition.

• Assist and guide anganwadi centers lying in their area.

• Proficient computer aided techniques to maintain nutritional health

• record of all children and women.

• Degree wise treatment of malnutrition will benefit pregnant women and

severely acute malnourished children (19.2 % of children in India suffer from SAM).10

• Introduction of highly nutritious medicinal pants like “spirulina” and “moringa”

-highly cost effective and beneficial.

DISADVANTAGES OF EXISTING POLICY ADVANTAGES OF OUR POLICY

Vicious cycle

Unhealthy underweight

child

Easily prone to infection

Suffer from diseases like

diarrhea, anemia etc.

malnourishment

Malnourished mother

• Mainly focus on universal food supplementation.

• Overload on community workers-pregnant women and children (0-3 years), most vulnerable group gets neglected.

• No proper records maintained.

• Emphasize on other social factors like mother caring behavior breastfeeding, proper sanitation, education and awareness.

• highly nutritional food supplement in mid-day meals and anganwadi - physical and cognitive growth of children enhancing their educational output and reducing school drop out rates.

• increase in skilled workforce special attention to most vulnerable section. • Proper health report card and progress will be monitored.

NUTRITION HEALTH CENTER

CONTROL ROOM+DISTRICT CENTER

ADMINISTRATIVE OFFICERS

MOBILE UNIT

SURVEY AND STATISTICS TEAM

NUTRITIONAL HEALTH WORKER

DATA BASE MANAGEMENT SYSTEM OPERATOR

NUTRITIONAL HEALTH ANALYST

1 District or 25 lacs : 1 MU

5 HEALTH WORKER

5 HEALTH WORKER

3 OFFICIALS

5 MEMBER

2 IT OPERATORS

NHCs can be started up in any district government building or as a subsidiary department in any govt. hospital in a district.

Already existing AWCs can also fall under our workforce per district. It will store Ready stock of highly nutritional food supplements(Spirulina + Moringa) to be

distributed to respective AWCs by MU during their visit.

DATA ENTRY OPERATOR

1 MEMBER

District Nutrition Officer •District head of this project •Preferably IAS officer

Block Nutrition Officer •Block Head of this project. •State PCS officer. •Specialized Services involving professionals of this field.

Nutritional Health Analyst •Contractual Ayurvedic/Homeopathic/ Paramedical staff. •To be employed in District Nutrition Center.

Nutritional Health Worker • Contractual Graduate workers • To be employed in Mobile Units.

Survey and Statistics Workers •Matriculated MNREGA workers.

Database Management Operators •To be provided by contractual company.

Mobile Unit Automobile Staff •Driver, helper etc to be provided by contractual company.

RECRUITMENT & ADMINISTRATIVE SETUP

RECRUITMENT ADMINISTRATIVE SETUP

State Secretary

Ministry Of Women & Child Development: Government of India

Ministry Of Women & Child Development: State Government

District Nutrition Officer

Mobile Unit & Field Workers

Block Nutrition Officer

Anganwadi Workers

District Control Room Staff

WORKING OF NUTRITION HEALTH CENTRE Routine visit of Mobile Unit(MU) to their allotted blocks every four months. Prior announcement of camp locations before arrival.

Functioning of NHCs

Block-wise Mobile

Unit Visit

Medical Examination

Stats Collection & Analysis

Actions Organize

Awareness Campaign

CONTROL ROOM MANAGEMENT

STATISTICS COLLECTION DATA INTERPRETATION

ANALYSIS & CURE

Data collection and online record maintenance(Height-Weight-BMI-Age-Specific Disease) by Survey team(along with the assistance of AWWs).

Creating a Photographic Database double-checked with Child’s Biometric Scan.

Automated receiving of data at the NHC Control room for analysis.

Medical analysis and automated

Report formation using DBMS software.

Classification and highlighting of Targeted Individuals (Level of malnourishment, Married/Pregnant women).

Computing accurate nutritional content intake and diet schedule for each group/individual by Nutritional Health Analyst.

Distribution of High nutritious food supplements(Spirulina, Moringa, etc.)

Treatment of targeted groups.

Organizing campaigns; taking assistance from NGOs

Monitoring the entire policy at district level

Collaboration with various depts. such as Food & Civil supply for efficient working of targeted PDS, quality control by FCI after procurement.

Nutritious Food Supplements: Spirulina and Moringa

SPIRULINA

NUTRITIONAL CONTENT PRODUCTION/HARVESTING PACKAGING AND DISTRIBUTION

Aquatic micro-organisms(micro-algae)

Exceptionally high Protein content (60-70% of its dry weight)

Vitamin(B1) content : 34-50mg/kg (0-3 yrs. child require 0.9mg)

Iron content : 1.8mg/gm. (Most essential for Pregnant Women; deficiency leads to anemia

1 gm. Spirulina=100 gm. Carrot=100 gm. Spinach

Climate Temp. : 35 ⁰C + Sunshine Requires Growth tank(min

depth=20cm) can be made from low costing materials.

1 tank(18 m2 ) produces 144 grams dry Spirulina.(Sufficient to feed 150 infants)

Growth medium can be prepared from any available fertilizers.

Promising small scale production.

Quality check is mandatory after procurement and before processing.

Mass production at certain regional production units(Having optimum conditions for productions).

Distribution through Govt. channels and State PDS.

Distributed in forms of Energy bars, Local made fortified Chikkis, candy.

MORINGA

NUTRITIONAL CONTENT PRODUCTION/HARVESTING PACKAGING AND DISTRIBUTION

Protein content : 27.1gm/100gm dry leaves + High Vitamin A content.

1 gm. =15 times Vit. A in carrot/17 times Calcium in Milk/25x Iron

48 gm. powdered Moringa leaves/day equates daily nutrition intake of breastfeeding mother.

Intake recovers pregnant mother from anemia and to higher birth weights.

Can tolerate extreme high temp and light frost.

Prefers well-drained sandy loom. Leaves are harvested after 1.5-2 m

plant growth (3-6 months).

Fortified seeds for additional micro-nutritional content.

Small scale industry can be developed in the village/Near AWCs.

Quality check is mandatory after procurement and before processing.

Distribution through Govt. channels and State PDS.

Distribution in form of powdered leaves.

Mostly, children of illiterate mothers are malnourished

The most damaging effects of under-nutrition occur during pregnancy and the first two years of a child’s life.

Proper nutritional assistance to pregnant women and not allowing them to work.

Educate mothers on breastfeeding at initial age, prevention of diseases by adopting hygienic practices, and the use of safe drinking water.

MOTHER CARING BEHAVIOUR

PROPER SANITATION

EARLY MARRIAGE AND FAMILY PLANNING

SOCIAL EQUALITY

only 31% of India’s population is able to utilize proper sanitation facilities.11

one in every ten deaths in India is linked to poor sanitation and hygiene

diseases resulting from poor sanitation affects children in their cognitive development.

Fastening the process of government schemes like sulabh shauchalay abhiyan to foster proper public sanitation.

Urging people to use public toilets by teaching them its importance and benefits.

adolescent girls who are malnourished themselves and not yet attained physical and mental maturity

EARLY MARRIAGE pregnancy and birth of undernourished children. young people and their

parents need to DELAY MARRIAGE AND DELAY FIRST PREGNANCY

Family planning to ensure at least 3 years gap between children and not having more than 2 children.

Gender inequality, rural-

urban divide, rich-poor gap, social inequality, demographic and regional inequality – exacerbate situation.

Targeting girls and lower castes (who are at higher risk of under-nutrition).

Educating people that malnutrition can be fought only with an inclusive approach.

Campaigns organized by Mobile Units ; can collaborate with Red cross, NGOs NSS, College students, activists and other volunteers.

Can be made effective by showing DOCUMENTARIES in regional dialects involving celebrities. Panchayat and sarpanch need to be educated adequately regarding the causes, consequences and cures. Beneficiaries and incentives for the village progressing at the fastest rate against malnutrition.

ORGANISATION BUDGET

LOGISTICS BUDGET

FOOD SUPPLEMENTS

COST (spirulina+murin

ga)

TECHNOLOGICAL BUDGET

Transport=55x1000x671x6=22.14 Crores

Maintenance = 15 Crores Survey = 45 Crores Establishment=671x1.25x12=100.65 Crores

Admin officers = Existing Govt. Officers Health workers=10000x12x671x10=80.5 Crores

IT operators=10000x12x671x2=40.26 + Data Entry Operator=44.26Crores

Survey team = 40 Crores

Production = 70 Crores Packaging = 5 Crores Distribution : Via existing PDS

IT hardware = 30 Crores IT software = 50 Crores Biometric = 5 Crores

182.79 Crores

164.76 Crores

75 Crores

85 Crores

FUNDING

GOVERNEMENT FUNDING (STATE AND

CENTRAL)

PRIVATIZATION-BIG CORPORATE HOUSES (CORPORATE SOCIAL

RESPONSIBILITY)

INTERNATIONAL AGENCIES LIKE WORLD

BANK , UNICEF.

Economically Competent Policy Nationwide Budget : 507.55 Crores

CHALLENGES MITIGATIONS

Making Labor intensive society realize intensity of this issue.

Legislative reforms regarding Physical Labor of Pregnant women.

Vast Administrative Setup Whole system being Bureaucratic leads to efficient Administration. Maximum Contractual workers increases competency.

Funds generations from Corporate houses. Luring Corporate houses for CSR by means of Tax rebate and appreciation awards.

Recruitment of skilled personnel. Unemployed Paramedical staffs and inclusion of moderately skilled MNREGA workers.

Inadequate Drinking water and Sanitation. Linking with CSR and subsidies for mass availment.

Negligence of child care in urban working class. Awareness via Media and relaxation of working norms for Mothers with young children.

IMPACT Total children(0-6years) = 158.8 million12 Malnourished children= 41.16%= 65.36million13 Severely malnourished=3.33%= 5.28804 million14 OUR POLICY WILL DIRECTLY EFFECT ALL THE SEVERELY MALNOURISHED CHILDREN. EMPLOYEMENT GENERATION 10 health workers + 2 operators +5 survey team + 10 helpers =27(per district) Total district in India= 671; total direct employment generated= 18117 Indirect generation of employment: production and packaging of spirulina and muringa.

REFERENCES 1. Economic Survey 2012-13 http://en.wikipedia.org/wiki/Agriculture_in_India 2. http://roundtableindia.co.in/index.php?option=com_content&view=article&id=2924:tackling- malnutrition-in-rural-and-urban-areas&catid=123:policy&Itemid=139

3.Deolalikar, A. (2012, July 23). A national shame: Hunger and malnutrition in India. Ideas for India. Retrieved from http://www.ideasforindia.in/article.aspx?article_id=8 4. UNICEF. (n.d.). Nutrition. Retrieved from http://www.unicef.org/india/children_2356.htm 5. Ibid

6.Ministry of Statistics and Programme Implementation. (2012). Children in India 2012 –A Statistical Appraisal. Retrieved from http://mospi.nic.in/mospi_new/upload/Children_in_India_2012.pdf

•

7.Ministry of Statistics and Programme Implementation. (2012). Children in India 2012 –A Statistical Appraisal. Retrieved from http://mospi.nic.in/mospi_new/upload/Children_in_India_2012.pdf 8.S Grantham-McGregor et al (2007) ‘Development potential in the first 5 years for children in developing countries’, The Lancet, 369:60–70

9.Food and Agriculture Organization. (2012). Economic growth, hunger and malnutrition. Retrieved from http://www.fao.org/docrep/016/i3027e/i3027e03.pdf 10. http://everyone.savethechildren.net/sites/everyone.savethechildren.net/files/library/A-Life-Free-From-Hunger-Summary-Africa1.pdf 11.http://en.wikipedia.org/wiki/Socio-economic_issues_in_India 12. http://www.censusindia.gov.in/

13. http://www.google.co.in/search?client=safari&rls=en&q=cag+malnourishment+2011&oe=UTF-8&gws_rd=cr&um=1&ie=UTF-8&hl=en&tbm=isch&source=og&sa=N&tab=wi&ei=esYoUvzaO8q-rgf9mIHYDA&biw=1024&bih=622&sei=fcYoUtCAAcTprQfBn4GoDw#facrc=_&imgrc=MPEREzFJfiNviM%3A%3BIK6I8nJTo3l4dM%3Bhttp%253A%252F%252Fi.imgur.com%252FRFyBxvw.png%3Bhttp%253A%252F%252Fwww.reddit.com%252Fr%252Findia%252Fcomments%252F1jjr33%252Fcag_gujarat_is_the_most_improved_state_with%252F%3B1863%3B2442 14.http://www.google.co.in/search?client=safari&rls=en&q=cag+malnourishment+2011&oe=UTF-8&gws_rd=cr&um=1&ie=UTF-8&hl=en&tbm=isch&source=og&sa=N&tab=wi&ei=esYoUvzaO8q-rgf9mIHYDA&biw=1024&bih=622&sei=fcYoUtCAAcTprQfBn4GoDw#facrc=_&imgrc=MPEREzFJfiNviM%3A%3BIK6I8nJTo3l4dM%3Bhttp%253A%252F%252Fi.imgur.com%252FRFyBxvw.png%3Bhttp%253A%252F%252Fwww.reddit.com%252Fr%252Findia%252Fcomments%252F1jjr33%252Fcag_gujarat_is_the_most_improved_state_with%252F%3B1863%3B244214.