POSHAN karyakram rajasthan

POSHAN

Rajasthan POSHAN strategy -Proactive and Optimum zcare of children, through Social- Household Approach for Nutrition" for community based management of children with Severe Acute malnutritionSevere Acute malnutrition is the most dangerous form of malnutrition. Even after a decade of galloping economic growth, child malnutrition rates are worse in India than in many sub-Saharan African countries. India is the home to the largest pool of children with SAM in the world; we have around 80 lakh children which consist of 42 % of Global load of children with SAM. In Rajasthan we have around 638166 children with SAM as of 2012 ( NFHS III- SAM Rajasthan 7.3% ) and as per RSOC it is 2.9%.
Severe acute malnutrition is defined by very low weight-for-height/length (Z- score below -3SD of the median WHO child growth standards), a mid-upper arm circumference <115 mm, or by the presence of nutritional edema. SAM increases significantly the risk of death in children less than five years of age. It can be an indirect cause of child death by increasing the case fatality rate in children suffering from common illnesses such as diarrhea and pneumonia. 
Children with Severe Acute Malnutrition (SAM) have nine times higher risk of dying than well-nourished children. In India, the prevalence of SAM in children remains high despite overall economic growth. The National Family Health Survey-3 revealed that 6.4 percent of all children under-five years of age are severely wasted. With appropriate nutritional and clinical management, many of the deaths due to severe wasting can be prevented.

It is proven by the NFHS data and confirmed by Ministry of Health and Family Welfare, GOI and also after the assessment of the Rajasthan data that the problem of children with SAM is mostly in most deprived populations like scheduled tribes, Primitive Tribes and in Scheduled Caste communities, children youngest- under 2 years and in girl children.

To prevent deaths due to severe acute malnutrition (SAM), specialized treatment and prevention interventions are required with strong food security and feeding drive. Programmatically, it is helpful to categorize children with SAM into ‘complicated and uncomplicated’ cases based on clinical criteria and can be managed through

Facility/hospital-based care for SAM children and medical complications. (MTC)

Home/community-based care for SAM children but without medical complications using Medical Nutrition Therapy ( MNT)

Rajasthan initiative to treat and manage children with SAM –

Department of Health and Family welfare and UNICEF have jointly initiated facility based care for SAM children and complications. A total of 88 MTCs are fully operational and 59 are in the process of operationalisation. We have treated 9143 children with SAM in these facilities in the year 2014-15.
Now state has visualized community based strategy to manage SAM child without complications at Home/ community level. The strategy is discussed and consulted, with proposed frame and key features.