‘Adopt a child’ Maharashtra is one of the most progressive states of India. On the one hand the state has achieved much economic progress, but on the other hand there still remain high levels of child undernutrition. About 20% of children below 6 years are estimated to be malnourished. Some of them are severely wasted, stunted or under-weight. Govt. of Maharashtra has been implementing ICDS for providing supplementary nutrition to children below 6 years of age, pregnant women and lactating mothers. ICDS in Maharashra caters to 86,31,910 children through a huge network of 88,272 Anganwadi Centres in 553 projects in rural, tribal and urban areas. The Government of Maharashtra responded to the high rates of child undernutrition and mortality in the state by setting up the Rajmata Jijau Mother and Child Health and Nutrition Mission (RJMCHN Mission), which is supporting the departments to streamline efforts to tackle the issue of malnutrition. Severe Acute Malnutrition (SAM) is a major public health issue in India. It afflicts an estimated 8.1 million under-five children in India (estimation based on NFHS III 2006 survey). Nearly 0.6 million deaths and 24.6 million DALYs (Disability Adjusted Life Years) are attributed to this condition. Diarrhea and pneumonia account for approximately half the under-five deaths in India, and malnutrition is believed to contribute to 61% of diarrheal deaths and 53% pneumonia deaths. Thus, strong scientific evidence exists on synergism between undernutrition and child mortality due to common childhood morbidities including diarrhea, acute respiratory infections, malaria and measles. Comprehensive Nutrition Survey Maharashtra - 2012 (CNSM) conducted by IIPS, Mumbai in collaboration with UNICEF, gives current levels of malnutrition in the state. It is evident that malnutrition is still high, though there is decline compared to 2006 survey. It shows that 21.8% children under two years of age are underweight and 15.5% are in Acute Malnutrition (wasting). There is wide variation among the regions of the state and also among the rural and urban areas. Urban slums are also a cause for concern since systems in urban areas are not fully established to provide care to severely malnourished children. RJMCHN Mission, ICDS and Public Health Dept. in Maharashtra took an initiative to identify and treat children with Severe Acute Malnutrition using standardized global protocols for their facility based management (treatment in hospitals or PHCs). Maharashtra also took a lead to develop protocols for community based management (treatment in the village itself) of children with SAM, as all children do not need medical treatment. These efforts have resulted in treatment of 600 children with SAM at 6 Nutrition Rehabilitation Centres (NRCs) established in hospitals in 6 tribal districts, 37565 children with SAM at 5038 Child Treatment Centres (CTCs) established across the state, and 52800 Village Child Development Centres (VCDCs) or 30 day camps which were organised in 'anganwadis' in villages, benefitting 353,750 children in the state. National Rural Health Mission (NRHM) has funded this initiative with Rs. 570 million (Rs. 57 crore) for community / village based management and Rs. 273 million (Rs. 27.3 crore) for facility based management. These efforts need further strengthening in terms of both quality of nutrition and care and scaling up of services to reach out to most deprived communities, especially in urban slums for which there is no funding available. It is important that the children showing some improvement through govt. efforts, further sustain the weight gain at home till they are fully recovered to prevent relapse. RJMCHN Mission invites corporates, trusts, institutions, NGOs, donors or individuals to partner with the government for strengthening these efforts by ‘adopting' malnourished children for nutritional support. The partnership will aim at providing support to children with SAM / MAM / SUW in terms of daily additional nutrition including micro- nutrients to achieve desired weight gain. The proposed / expected support is as follows :- Rural and tribal areas: SAM / MAM / SUW (wasted or under-weight) children in rural and tribal areas who have been treated in an anganwadi, PHC, or hospital (NRC) but who have not improved would be further supported for additional sustained nutrition at home. The estimated cost for 'adopting' a child is Rs. 1000 per malnourished child. It would be monitored strictly and linked to sustained weight gain. It is expected that the proposed support will be able to sustain nutritional needs for 2 to 3 months till the child recovers adequately. Urban areas (slums) : Support would be required for community based or home based management (treatment) of SAM / MAM / SUW children in urban slums for at least 30 days or till such time as the child gains adequate weight. The estimated cost for adopting a child is Rs. 2000 per malnourished child. This support will be provided in 'high burden' tribal and urban areas on priority. This support can be provided directly, or by entering into an MOU with the district administration. Interested donors / organizations may contact RJMCHN mission at rjmchnmission@yahoo.com or vkrishna85@gmail.com or rajadighe@yahoo.co.in, for further details.
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