Slide 2 Malnutrition and death Inadequate dietary intake Disease
Inadequate education Formal and nonformal institutions Political
and ideological superstructure Economic structure Potential
resources Inadequate access to food Inadequate care for mothers and
children Insufficient health services and unhealthy environment
Immediate causes Outcomes Underlying Causes Basic Causes Source :
UNICEF (1990) Conceptual Framework of the causes of malnutrition
Slide 3 But regular data gave no indication as it was never
analyzed But regular data gave no indication as it was never
analyzed NFHS -2 revealed that 50% children were malnourished in
Maharashtra Child malnutrition in selected Indian states 56 55 51
46 48 0 25 50 75 M.P. Bihar Maharashtra Gujarat India Source:
NFHS-2, 1998-99 % of underweight children under age 3 Slide 4
INITIATIVES UNDERTAKEN IN AURANGABAD DIVISION Focus on three
issues: survey, weighing, gradation Stress on full coverage (100%
as level for survey efficiency and 95% as acceptable lower limit
for weighing efficiency) Special focus on Grade III/IV reduction
Regular medical examination Fact finding, not fault finding Local
initiative in nutrition/health measures Involvement of community,
especially PRIs, mothers groups Slide 5 Survey Efficiency -
Dec.01-July 02 -Feb06 Fig. in lakhs Sr. No DistrictRural Population
Census 01 Population of 0 to 6 age group Census 01 ICDS Survey
No.of 0 to 6 children- Dec.01 ICDS Survey No.of 0 to 6 children-
July 02 ICDS Survey No.of 0 to 6 children- Feb 06
1Aurangabad18.102.992.102.282.67 2Jalna13.052.131.071.632.04
3Parbhani10.431.760.241.571.68 4Hingoli8.331.420.900.971.34
5Nanded21.873.692.852.573.08 6Beed17.742.782.382.422.76
7Latur15.902.521.881.902.34 8Osmanabad12.531.891.481.501.63
Total117.9519.1812.9014.8417.55 Slide 6 DistrictsDec.
02Dec.04Feb.06 Numbe r % % % Aurangabad1.5852.842.6488.292.5695.62
Jalna0.8539.912.0596.241.9591.55 Parbhani0.179.661.5588.071.6392.61
Hingoli0.535.211.3292.961.3192.25 Nanded2.3563.693.1384.822.9479.67
Beed1.761.152.5892.812.3985.97 Latur1.6264.292.3693.652.2589.29
Osmanabad1.2164.021.7592.591.5682.54
Total9.9852.0317.3890.6216.5886.44 Percentage & Number of
Weighed children against Census 2001 0-6 Children Slide 7 Districts
Dec. 02Dec.04Feb.06 Number% % % Aurangabad 4074516.24 3428013.00
58412.28 Jalna 2915717.92 2862213.97 47372.43 Parbhani 2286817.78
2134613.75 30811.89 Hingoli 2115118.00 2037015.42 46203.54 Nanded
5049518.65 4613714.76 56181.91 Beed 2671810.45 212958.25 61322.56
Latur 2672611.72 201218.52 62112.76 Osmanabad 1740010.73 68483.91
23681.52 Total 23527014.93 19901911.45 386082.33 Percentage of
Gr.II Children against weighed children Slide 8 DistrictDec.01July
02Dec.02Dec.03Dec.0 4 Dec.05Feb.06 Auangaba d
17722278165412104031133 Jalna93013061043659249200142
Parbhani19114449204901404317 Hingoli1365554041501125633
Nanded16291081824365519142 Beed8411448645437141175132
Latur15111324845443155121108 Osmanab ad 9571269679170000
Total786710705701439241251697507 Number of Gr.III+IV children Year
wise trend Slide 9 Slide 10 Slide 11 Slide 12 Malnutrition Removal
Star Competition No. Of StarsCriteria Anganwadi
Centres/PHCs/blocks/districts which do not have any Grade IV child
Anganwadi Centres/PHCs/blocks/districts which do not have any Grade
III or Grade IV child Anganwadi Centres/PHCs/blocks/districts which
do not have any Grade II,III or IV child Anganwadi
Centres/PHCs/blocks/districts which do not have any Grade I,II,III
or IV child Anganwadi Centres/PHCs/blocks/districts which do not
have any Grade I,II,III or IV child & in which jurisdiction
there is no mother below the age of 19 years Slide 13 Outcomes of
the Marathwada Initiative Motivation and enthusiasm in the ICDS
machinery Involvement of many Medical Officers Significant local
involvement in initiatives Problem-solving approach Social audit of
children Substantial reduction in Grade III/IV malnutrition
Replication across the State of Maharashtra Slide 14 Food for
thought With our resources and the money we spend we could easily
accomplish three times what we do, in half the time we normally
take, if we were to operate in mission mode with a vision for the
nation. -- APJ Abdul Kalam in Ignited Minds Slide 15 One of the
States top priorities: malnutrition removal as a MISSION
State-level Steering Committee headed by Chief Minister Monitoring
& Implementation Committee headed by Minister (W&CD)
Advisory Committee under Chief Secretary Establishment of State
Malnutrition Removal Mission Unit Funding of Unit & programmes
through Central/State budget as well as multilateral/bilateral
funding sources Rajmata Jijau Mother-Child Health & Nutrition
Mission Slide 16 Reduction in Grade 3 & 4 malnutrition in 0-6
age group Special focus on health, nutrition and immunisation
aspects in 0-3 age group Reduction in Grade 1 & 2 malnutrition
in 0-6 age group Newborn care initiatives Antenatal, perinatal and
postnatal care for mothers Focus on pre-teen/adolescent girls:
nutrition and health education Transfer of the management function
to the community Objectives of the Mission Slide 17 Functions
Coordination of activities of different departments Monitoring of
key indicators to ensure adherence to Mission targets
Capacity-building in different departments to make the programme
self-sustainable Making the initiative community-driven over time
Composition Secretary level IAS officer ...Director General Addl.
CEO rank officer ..Director (Training) Addl. CEO rank officer .
Director (Monitoring) DHO rank officer . Deputy Director (Health)
CDPO rank officer Assistant Director (Child Development) State
Malnutrition Removal Mission Unit Slide 18 Phases of the Mission
Phase-I Phase-II Phase-III Slide 19 Inputs Processes Outcomes Slide
20 Focus Areas of Mission Antenatal care Feeding practices Complete
immunisation Deworming Micronutrient supplementation
Nutrition/health education Slide 21 Key Activities of Mission
Training & Motivation Sensitization Problem-solving
Coordination Between departments, esp. ICDS/Health Effective budget
utilization Monitoring & Evaluation Ensuring accountability
Informed policy decisions Information, Education, Communication
Behavioural change Community initiatives to evolve local solutions
Slide 22 Slide 23 Some Issues for Thought Still too much focus on
food, too little on improving child-care behaviour, family
nutrition patterns Children in 0-3 age group and from disadvantaged
groups not served adequately by existing ICDS Lack of clear policy
focus on areas with greatest levels of malnutrition Slide 24 The
Bhavishya Alliance Objective Elimination of child malnutrition in
India Slide 25 The Bhavishya Alliance Emphasis on Human change,
relationships & partnerships (personal/interpersonal/systemic)
Shared understanding of malnutrition in a holistic framework
Interaction between actors concerned with malnutrition, especially
the communities to be served Passion, commitment, orientation to
action Slide 26 The Bhavishya Alliance Change Lab One/two
participants from each member organisation (government, corporates,
NGOs/CBOs) Shared understanding of current reality Prototyping
initiatives Implementing pilot projects Slide 27 What partnership
model do we aim for? Sustainable over time Replicable across states
of India Win-win situation for all Built on trust Focused on
outcomes Strong community links Slide 28 THANK YOU
